1
|
Ki M, Lapierre S, Gim B, Hwang M, Kang M, Dargis L, Jung M, Koh EJ, Mishara B. A systematic review of psychosocial protective factors against suicide and suicidality among older adults. Int Psychogeriatr 2024; 36:346-370. [PMID: 38305360 DOI: 10.1017/s104161022300443x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Research on suicide rarely focuses on protective factors. The goal of this systematic review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults. METHOD First, a scoping review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience, coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis. RESULTS A total of 70 studies were retained for the review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures. CONCLUSION Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.
Collapse
Affiliation(s)
- Myung Ki
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Brain Korea 21 Four Research and Education Center, Korea University, Seoul, South Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Sylvie Lapierre
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
| | - Boeun Gim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Minji Hwang
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Brain Korea 21 Four Research and Education Center, Korea University, Seoul, South Korea
| | - Minku Kang
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Luc Dargis
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
| | - Myoungjee Jung
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Emily Jiali Koh
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
| | - Brian Mishara
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
| |
Collapse
|
2
|
Fabiano N, Gupta A, Wong S, Tran J, Mohammad IY, Bal S, Fiedorowicz JG, Firth J, Stubbs B, Vancampfort D, Schuch FB, Carr LJ, Shorr R, Cortese S, Manchia M, Hartman CA, Høye A, Fusar-Poli P, Koyanagi A, Vieta E, Nielsen RE, Holt RI, Correll CU, Du Rietz E, Taipale H, Lehto K, Larrson H, Nordentoft M, Dragioti E, Skonieczna-Żydecka K, Solmi M. Physical activity, suicidal ideation, suicide attempt and death among individuals with mental or other medical disorders: A systematic review of observational studies. Neurosci Biobehav Rev 2024; 158:105547. [PMID: 38246231 DOI: 10.1016/j.neubiorev.2024.105547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/19/2023] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
A growing body of research has demonstrated the potential role for physical activity as an intervention across mental and other medical disorders. However, the association between physical activity and suicidal ideation, attempts, and deaths has not been systematically appraised in clinical samples. We conducted a PRISMA 2020-compliant systematic review searching MEDLINE, EMBASE, and PsycINFO for observational studies investigating the influence of physical activity on suicidal behavior up to December 6, 2023. Of 116 eligible full-text studies, seven (n = 141691) were included. Depression was the most frequently studied mental condition (43%, k = 3), followed by chronic pain as the most common other medical condition (29%, k = 2). Two case-control studies examined suicide attempts and found an association between physical activity and a reduced frequency of such attempts. However, in studies examining suicidal ideation (k = 3) or suicide deaths (k = 2), no consistent associations with physical activity were observed. Overall, our systematic review found that physical activity may be linked to a lower frequency of suicide attempts in non-prospective studies involving individuals with mental disorders.
Collapse
Affiliation(s)
- Nicholas Fabiano
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Arnav Gupta
- Department of Medicine, University of Calgary, Calgary, AB, Canada; College of Public Health, Kent State University, Kent, OH, United States
| | - Stanley Wong
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jason Tran
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Shan Bal
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jess G Fiedorowicz
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Brendon Stubbs
- EXI, People's Mission Hall, Whitechapel Road, London, UK; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil; Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile; Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucas J Carr
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, United States
| | - Risa Shorr
- Library Services, The Ottawa Hospital, Ottawa, ON, Canada
| | - Samuele Cortese
- Centre for Innovation in Mental Health, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK
| | - Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax NS B3H 4R2, Canada
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulationn (ICPE), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Anne Høye
- Department of Psychiatry, UiT The Arctic University of Norway, Tromsø, Norway; Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; OASIS service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; National Institute for Health Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - René Ernst Nielsen
- Aalborg University Hospital, Department of Psychiatry, Aalborg, Denmark; Aalborg University, Aalborg, Denmark
| | - Richard Ig Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, UK; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Christoph U Correll
- Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany; The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Heidi Taipale
- Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland; Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kelli Lehto
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Henrik Larrson
- Department of Medical Sciences, Örebro Universitet, Örebro, Sweden
| | - Merete Nordentoft
- Core-Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Denmark
| | - Elena Dragioti
- Research Laboratory of Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, 45500 Ioannina, Greece; Pain and Rehabilitation Centre and Department of Medical and Health Sciences, Linköping University, 581 85 Linköping, Sweden
| | | | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Charité - Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany.
| |
Collapse
|
3
|
Kim J, Gwak D, Kim S, Gang M. Identifying the suicidal ideation risk group among older adults in rural areas: Developing a predictive model using machine learning methods. J Adv Nurs 2023; 79:641-651. [PMID: 36534434 DOI: 10.1111/jan.15549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 10/10/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
AIMS The aim of this study was to develop a predictive model that can identify the suicidal ideation risk group among older adults in rural areas using machine learning methods. DESIGN This study applied an exploratory, descriptive and cross-sectional design. METHODS The participants were older adults (N = 650) aged over 65 living in rural areas of South Korea. Self-report questionnaires were used to collect the demographics, suicidal ideation, depression, socioeconomic information and basic health information from September to October 2020. The collected data were analysed using machine learning methods with R statistical software 4.1.0. RESULTS The predictive models indicated that depression, pain, age and loneliness were significant factors of suicidal ideation. Good performance was observed based on the area under the receiver operating characteristic curve in the decision tree, random forest and logistic regression. Finally, the evaluation of model performance indicated moderate to high sensitivity and specificity. CONCLUSION The predictive models using machine learning methods may be useful to predict the risk of suicidal ideation. Furthermore, depression with pain, age and feelings of loneliness should be included in the initial screening to assess suicide risk among older adults in rural areas. IMPACT Identifying suicidal risk among older adults is challenging. Thus, employing predictive models that can assess depression, pain, age and loneliness can enable public healthcare providers to detect suicidal risk groups. Particularly, the presented models from this study can facilitate healthcare providers with initiating early interventions to prevent suicide among older adults in clinical and community nursing care settings. REPORTING METHOD The reporting of this study (Observational, cross-sectional study) conforms to the STROBE statement. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. IMPLICATION FOR THE PROFESSION AND/OR PATIENTS CARE Applying this model may help to prevent geriatric suicide because the nursing staff will have a greater awareness regarding the suicide ideation risk of older adults, thereby reducing the possibility of their suicide.
Collapse
Affiliation(s)
- Junglyun Kim
- College of Nursing, Chungnam National University, Daejeon, South Korea.,Department of Biobehavioral Nursing Science, University of Florida, Gainesville, Florida, USA
| | - DongHyeon Gwak
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Seonhee Kim
- Nursing Department, Songwon University, Gwangju, South Korea
| | - Moonhee Gang
- College of Nursing, Chungnam National University, Daejeon, South Korea
| |
Collapse
|
4
|
Kim D, Kim D, Lee K, Choi N, Roh S. Suicidal ideation among the elderly living in the community: Correlation with living arrangement, subjective memory complaints, and depression. J Affect Disord 2022; 298:160-165. [PMID: 34710504 DOI: 10.1016/j.jad.2021.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/01/2021] [Accepted: 10/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study aimed to investigate the correlations of living arrangement, subjective memory complaints, and depression on suicidal ideation in elderly men and women. METHODS There were 1,412 participants (women, 63.5%) from a rural community in South Korea, aged ≥60 years (mean±SD, 73.2 ± 8.0 years). We measured suicidal ideation, subjective memory complaints, and depression using the Columbia-Suicide Severity Rating Scale, Subjective Memory Complaints Questionnaire, and the short form of the Geriatric Depression Scale, respectively. We then estimated correlations of living arrangement, subjective memory complaints, and depression with recent suicidal ideation using multivariate logistic regression analysis. RESULTS With all participants as a group, living alone, subjective memory complaints (SMC+) and high risk of depression (HRD) were found to be significant independent predictors (p = 0.021 for living alone; p = 0.006 for SMC+; p < 0.001 for HRD, respectively) of suicidal ideation (SI+). When men and women were analyzed separately, HRD remained significant both in men and women (OR = 6.01, p < 0.005 for men; OR = 7.23, p < 0.001 for women), while living alone and SMC+ were significant only in men (OR = 3.36, p = 0.013 for living alone; OR = 3.30, p = 0.016 for SMC+). LIMITATIONS The results may not be generalizable to the urban setting as this study included only elderly persons living in the rural community. CONCLUSIONS Living alone and subjective memory complaints were significant predictors of recent suicidal ideation only in men while depression was a significant predictor both in men and women.
Collapse
Affiliation(s)
- Dabin Kim
- Department of Psychiatry, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Psychiatry, Hanyang University Hospital, Seoul, Republic of Korea.
| | - Daeho Kim
- Department of Psychiatry, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Psychiatry, Hanyang University Guri Hospital, Gyeonggi-do, Republic of Korea.
| | - Kounseok Lee
- Department of Psychiatry, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Psychiatry, Hanyang University Hospital, Seoul, Republic of Korea.
| | - Nayeon Choi
- Medical Statistics Support Center at the Medical Research Collaboration Center, Hanyang University Industrial-Academic Cooperation Group, Seoul, Republic of Korea.
| | - Sungwon Roh
- Department of Psychiatry, Hanyang University College of Medicine, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea; Department of Psychiatry, Hanyang University Hospital, Seoul, Republic of Korea.
| |
Collapse
|
5
|
Raschke N, Mohsenpour A, Aschentrup L, Fischer F, Wrona KJ. Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence. BMC Public Health 2022; 22:129. [PMID: 35042490 PMCID: PMC8765829 DOI: 10.1186/s12889-022-12498-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background The economic and human costs of suicide to individuals, families, communities, and society make suicide a major public health problem around the world. Suicide rates in South Korea are among the highest in the world. This paper is the first systematic review investigating socioeconomic risk factors for suicidal behaviors (suicidal ideation, attempted suicides, and completed suicides) in South Korea. Methods We performed a systematic review in Medline and Web of Science. Empirical studies and peer-reviewed articles on the association between individual socioeconomic factors and suicidal behaviors have been included. A total of 53 studies were included in a descriptive synthesis. Results Overall, 35 studies focused on the association between individual socioeconomic factors and suicidal ideation, 16 were related to suicide attempts, while 10 addressed completed suicides. Low income, unemployment, and financial difficulties were identified as risk factors for all suicidal behaviors. Working in precarious conditions, long working hours, self-employment, changes in employment status, shift work/night-time work, and occupational stress were associated with an increased risk for suicidal ideation. Low educational attainment appears to increase the risk for suicide attempts and completed suicide, but the significance of educational attainment on the reporting of suicidal ideation could not be verified. The primary studies were unable to ascertain whether the place of residence impacts on suicidal behaviors. Conclusions The results highlight the relevance of socioeconomic factors for suicidal behaviors in South Korea. Governmental social spending must be increased and redirected more efficiently so that the economically most vulnerable groups are financially protected and income inequality does not widen. Furthermore, comprehensive prevention strategies at the community level are needed. Future research needs to focus on identifying vulnerable groups for whom the effects of low socioeconomic status may have particularly serious consequences with regard to suicidal behaviors. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12498-1.
Collapse
|
6
|
The moderating effects of individual and community social capital on the relationship between depressive symptoms and suicide in the elderly. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01589-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
7
|
Fagerström C, Welmer AK, Elmståhl S, Tuvesson H. Life weariness, suicidal thoughts and mortality: a sixteen-year longitudinal study among men and women older than 60 years. BMC Public Health 2021; 21:1359. [PMID: 34243751 PMCID: PMC8268207 DOI: 10.1186/s12889-021-11329-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 06/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background Suicide in old age is a significant contributor to mortality. However, the extent to which life weariness and suicidal thoughts impact on mortality in a long-term perspective is unknown. The aim of this study was to investigate the effect of life weariness and suicidal thoughts on long-term survival (16 years) in an older Swedish population, controlling for demographic and social network factors and depression. A further aim was to investigate differences in sex and age interactions in relation to mortality among individuals with and without life weariness and suicidal thoughts. Methods A longitudinal cohort study on a national, representative sample of individuals aged 60+ years was conducted within the Swedish National Study of Aging and Care study. The sample included 7213 individuals, who provided information about life weariness and suicidal thoughts through an item derived from the Montgomery-Åsberg Depression Rating Scale. Data were analysed with multivariate Cox proportional hazards models, adjusted for potential confounders. Results At baseline, 12.5% of the participants (14.6% of females and 9.5% of males) reported life weariness and suicidal thoughts. During the 16-year follow-up, a mean survival time was 11.5 years (standard deviation (SD) 5.6), and 3804 individuals died (59.5% females and 40.5% males). Individuals with life weariness and suicidal thoughts had half the survival rate compared with those without such thoughts (24.5% vs. 50.6%), with a mean survival time of 8.4 years (SD 5.7) versus 12.0 years (SD 5.4). The multi-adjusted hazard ratio of mortality for those reporting life weariness and suicidal thoughts was 1.44 (95% confidence interval, 1.30–1.59), with the population attributable risk at 11.1%. In the models, being male or female 80+ years showed the highest multi-adjusted hazard ratio of long-term mortality (ref. female 60–69 years). Conclusions The findings suggested that life weariness and suicidal thoughts were risk factors for long-term mortality, when controlled for sex and age interactions that were found to strongly predict long-term mortality. These findings have practical implications in prevention of mortality, emphasising the importance of screening, identifying, and intercepting older men and women with signs of life weariness and suicidal thoughts. Trial registration Not applicable.
Collapse
Affiliation(s)
- Cecilia Fagerström
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.,The Research Section, Region Kalmar County, Kalmar, Sweden
| | - Anna-Karin Welmer
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Hanna Tuvesson
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
| |
Collapse
|
8
|
Zhang D, Wang R, Zhao X, Zhang J, Jia J, Su Y, Wang K. Role of resilience and social support in the relationship between loneliness and suicidal ideation among Chinese nursing home residents. Aging Ment Health 2021; 25:1262-1272. [PMID: 32602736 DOI: 10.1080/13607863.2020.1786798] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Loneliness is a risk factor of suicidal ideation, while resilience and social support are protective factors; however, the complex mechanisms behind these factors have not been examined among nursing home residents. This study evaluated the mediating effect of resilience on the association between loneliness and suicidal ideation and whether this mediating effect was moderated by social support. METHODS Residents (N = 538; Aged ≥60years; 321 female, 217 male) from 37 nursing homes in China completed this cross-sectional study. Their loneliness, resilience, social support, and suicidal ideation were measured. Regression analyses using bootstrapping methods were conducted to explore the mediating and moderating effects. RESULTS Some residents (14.9%, 80/538) reported current suicidal ideation. The correlation between loneliness and suicidal ideation was partially mediated by resilience (indirect effect = 0.067, 95% CI = 0.011-0.122). Overall social support moderated the resilience on suicidal ideation, indirectly impacting loneliness on suicidal ideation (moderating effect = 0.086 [95% CI = 0.005-0.167]). Support from family and nursing home staff moderated the direct (path c') and indirect path (path b) of the mediation model, respectively. CONCLUSIONS Our findings underscore the vital role of resilience and social support to buffer against suicidal ideation, which is common among nursing home residents in China.HighlightsWe evaluated suicidal ideation in mainland Chinese nursing home residentsLoneliness and suicidal ideation were partially mediated by resilienceSocial support moderated the effect of loneliness and resilience on suicidal ideationThe results were self-reported and are not generalizable to all of ChinaResilience and social support can buffer against suicidal ideation among residents.
Collapse
Affiliation(s)
- Dan Zhang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Rui Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Xia Zhao
- Department of Health Management, Heze Medical College, Heze, Shandong, China
| | - Jie Zhang
- China Department of Sociology, State University of New York Buffalo State, Buffalo, NY, USA.,School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan, Shandong, China.,School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
| |
Collapse
|
9
|
Proposal for the Inclusion of Tobacco Use in Suicide Risk Scales: Results of a Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116103. [PMID: 34198855 PMCID: PMC8201119 DOI: 10.3390/ijerph18116103] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/21/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022]
Abstract
There is an association between smoking and suicide, even though the direction and nature of this relationship remains controversial. This meta-analysis aimed to evaluate the association between smoking and suicidal behaviours (ideation, planning, suicide attempts, and death by suicide). On 24 August 2020, we searched the PubMed, Cochrane library, Scopus, Web of Science, TRIP, and SCIENCE DIRECT databases for relevant articles on this topic. Twenty prospective cohort studies involving 2,457,864 participants were included in this meta-analysis. Compared with never smokers, former and current smokers had an increased risk of death by suicide (relative risk [RR] = 1.31; 95% CI [1.13, 1.52] and RR = 2.41; 95% CI [2.08, 2.80], respectively), ideation (RR = 1.35; 95% CI [1.31, 1.39] and RR = 1.84; 95% CI [1.21, 2.78]), and attempted suicide (RR = 1.27; 95% CI [0.56, 2.87] and RR = 1.71; 95% CI [0.73, 3.97]). Moreover, compared to never smokers, current smoker women (RR = 2.51; 95% CI [2.06-3.04] had an increased risk of taking their own life (Q = 13,591.53; p < 0.001) than current smoker men (RR = 2.06; 95% CI [1.62-2.62]. Furthermore, smoking exposure (former and current smokers) was associated with a 1.74-fold increased risk (95% CI [1.54, 1.96]) of suicidal behaviour (death by suicide, ideation, planning, or attempts). Thus, because of the prospective relationship between smoking and suicidal behaviours, smoking should be included in suicide risk scales as a useful and easy item to evaluate suicide risk.
Collapse
|
10
|
Liu RT, Steele SJ, Hamilton JL, Do QBP, Furbish K, Burke TA, Martinez AP, Gerlus N. Sleep and suicide: A systematic review and meta-analysis of longitudinal studies. Clin Psychol Rev 2020; 81:101895. [PMID: 32801085 PMCID: PMC7731893 DOI: 10.1016/j.cpr.2020.101895] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 07/06/2020] [Accepted: 08/05/2020] [Indexed: 12/13/2022]
Abstract
The current review provides a quantitative synthesis of the empirical literature on sleep disturbance as a risk factor for suicidal thoughts and behaviors (STBs). A systematic search of PsycINFO, MEDLINE, and the references of prior reviews resulted in 41 eligible studies included in this meta-analysis. Sleep disturbance, including insomnia, prospectively predicted STBs, yielding small-to-medium to medium effect sizes for these associations. Complicating interpretation of these findings however, is that few studies of suicidal ideation and suicide attempts, as well as none of suicide deaths, assessed short-term risk (i.e., employed follow-up assessments of under a month). Such studies are needed to evaluate current conceptualizations of sleep dysregulation as being involved in acute risk for suicidal behavior. This want of short-term risk studies also suggests that current clinical recommendations to monitor sleep as a potential warning sign of suicide risk has a relatively modest empirical basis, being largely driven by cross-sectional or retrospective research. The current review ends with recommendations for generating future research on short-term risk and greater differentiation between acute and chronic aspects of sleep disturbance, and by providing a model of how sleep disturbance may confer risk for STBs through neuroinflammatory and stress processes and associated impairments in executive control.
Collapse
Affiliation(s)
- Richard T Liu
- Massachusetts General Hospital, Boston, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America.
| | - Stephanie J Steele
- Department of Psychology, Williams College, Williamstown, MA, United States of America
| | - Jessica L Hamilton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America
| | - Quyen B P Do
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Kayla Furbish
- Department of Psychology, Boston University, Boston, MA, United States of America
| | - Taylor A Burke
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Ashley P Martinez
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Nimesha Gerlus
- Duke University School of Medicine, Durham, NC, United States of America
| |
Collapse
|
11
|
Howarth EJ, O'Connor DB, Panagioti M, Hodkinson A, Wilding S, Johnson J. Are stressful life events prospectively associated with increased suicidal ideation and behaviour? A systematic review and meta-analysis. J Affect Disord 2020; 266:731-742. [PMID: 32217256 DOI: 10.1016/j.jad.2020.01.171] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/11/2019] [Accepted: 01/28/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Stressful life events are a risk factor for suicidal ideation and behaviour, but the strength and nature of this association is unclear. This review examined the prospective relationship between stressful life events and subsequent suicidal ideation and behaviours. METHODS Five databases were searched from inception to April 2019. Eligible studies included observational, quantitative longitudinal cohort studies with adult or adolescent samples. A random-effects meta-analysis model was used to examine the prospective relationship between stressful life events and subsequent suicidal ideation and behaviours. Sub-group analyses examined moderating factors. RESULTS Eight studies were identified in the systematic review, and seven studies comprising 2,639 participants were included in the meta-analysis. Six studies investigated suicidal ideation and one investigated suicidal behaviours. Stressful life events were associated with a 37% higher odds of subsequently reported suicidal ideation and behaviours combined (Odds Ratio (OR): 1.37, 95% CI: 1.10 to 1.70), and a 45% increased risk for suicidal ideation (OR: 1.45, 95% CI: 1.20 to 1.75). This association was stronger in males, young adults, and studies with shorter term follow-up. LIMITATIONS The analyses indicated statistical heterogeneity was high (I2 = 76. 48, 95% CI: 55.0 to 87.7%) and there was evidence of publication bias. CONCLUSIONS Stressful life events were shown to increase the risk of subsequently reported suicidal ideation and behaviours. These findings suggest that the experience of stressful life events should be incorporated into clinical suicide risk assessments and suicide interventions could include a component on developing resilience and adaptive coping to stressful life events.
Collapse
Affiliation(s)
- Emma J Howarth
- Clinical Psychology Training Programme, University of Leeds, Leeds, United Kingdom.
| | - Daryl B O'Connor
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, NIHR School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Alexander Hodkinson
- NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Sarah Wilding
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Judith Johnson
- School of Psychology, University of Leeds, Leeds, United Kingdom; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom; School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| |
Collapse
|
12
|
Abstract
Objectives: Alcohol use has several consequences and is one of the variables that increase risk of suicide. This meta-analysis was performed using cohort studies to clarify the association of alcohol use and suicide.Method: Scientific sources were reviewed regarding the keywords. After screening, thirty cohort studies were identified for the meta-analysis. The analysis was performed based on the random effects and subsequent analysis of the subgroups, based on various variables.Result: Analysis of the results showed that there is a relationship between alcohol use and suicide. Risk Ratio (RR) between alcohol use and suicide was 1.65. In men, pooled RR was 1.56 with 95% CI = 1.20-2.03, and in women, the pooled RR was equal to 1.40 with 95% CI = 1.11-1.77.Conclusion: Overall, the findings indicate that alcohol use is a risk factor for suicide. Therefore, it seems that prevention and control of alcohol use can be effective in promoting mental health.
Collapse
Affiliation(s)
- Sohrab Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
13
|
Santos J, Martins S, Azevedo LF, Fernandes L. Pain as a risk factor for suicidal behavior in older adults: A systematic review. Arch Gerontol Geriatr 2020; 87:104000. [DOI: 10.1016/j.archger.2019.104000] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 11/30/2019] [Accepted: 12/15/2019] [Indexed: 02/06/2023]
|
14
|
Costanza A, Amerio A, Radomska M, Ambrosetti J, Di Marco S, Prelati M, Aguglia A, Serafini G, Amore M, Bondolfi G, Michaud L, Pompili M. Suicidality Assessment of the Elderly With Physical Illness in the Emergency Department. Front Psychiatry 2020; 11:558974. [PMID: 33024437 PMCID: PMC7516267 DOI: 10.3389/fpsyt.2020.558974] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/21/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Andrea Amerio
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Mood Disorders Program, Tufts Medical Center, Boston, MA, United States
| | - Michalina Radomska
- Faculty of Psychology, University of Geneva (UNIGE), Geneva, Switzerland
| | - Julia Ambrosetti
- Emergency Psychiatric Unit, Department of Psychiatry and Emergency Department, Geneva University Hospitals, Geneva, Switzerland
| | - Sarah Di Marco
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Massimo Prelati
- Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Andrea Aguglia
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.,Department of Psychiatry, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland.,Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Geneva, Switzerland
| | - Laurent Michaud
- Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.,McGill Group for Suicide Studies, McGill University, Montreal, QC, Canada
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
15
|
Park CHK, Lee JW, Lee SY, Shim SH, Kim SG, Lee J, Kim MH, Paik JW, Cho SJ, Moon JJ, Jeon DW, Kim S, Park JH, You S, Jeon HJ, Ahn YM. Characteristics of the "young-old" and "old-old" community-dwelling suicidal Ideators: A longitudinal 6-month follow-up study. Compr Psychiatry 2019; 89:67-77. [PMID: 30597426 DOI: 10.1016/j.comppsych.2018.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 11/20/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Despite heterogeneity of older people in suicidal behavior, research identifying characteristics by age groups is scarce. We examined baseline features of older community-dwelling suicidal ideators by dichotomized age groups and the 6-month trajectory of their suicidal ideation along with its related psychopathology. Predictors of suicidal ideation within each group were investigated. METHODS Older community-dwelling suicidal ideators enrolled in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were subdivided into the "young-old (65-74 years)" and "old-old (≥75 years)" group. Baseline, 1-, and 6-month assessments were compared. Within each group, multiple regression analysis using rating scales (Patient Health Questionnaire-9, Beck Anxiety Inventory, Alcohol Use Disorders Identification Test, Stress Questionnaire for Korean National Health and Nutrition Examination Survey-Short Form, and Social Relationships Scale) was conducted to identify predictors of suicidal ideation measured with the intensity subscale of the Columbia-Suicide Severity Rating Scale. Two-way repeated-measures analysis of variance (RM-ANOVA) was used to compare changes in suicidal ideation, depression, anxiety between age groups over time, and one-way RM-ANOVA to examine changes within each age group. RESULTS Among 29 "young-old" and 53 "old-old" ideators, the latter were less likely to be receiving psychiatric treatment (odds ratio [OR] = 4.065) and make suicide attempts (OR = 2.874), whereas the former revealed greater levels of anxiety and stress. Baseline depression and stress in the "young-old" group and the "old-old" group, respectively, predicted the intensity of suicidal ideation at both baseline and 1-month assessments. No significant age group x time interactions on suicidal ideation and depression were found. However, within each age group, both suicidal ideation and depression significantly decreased only during the first month with no further improvement. CONCLUSION We speculate cautiously that more attention may need to be paid to the "old-old" ideators in the evaluation of psychiatric issues and for referral to psychiatrists. To decrease suicidal ideation, tailored approaches involving proactive, timely management of depression in the "young-old" and interventions focusing on stress reduction in the "old-old," would be helpful.
Collapse
Affiliation(s)
- C Hyung Keun Park
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Jae Won Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Sang Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, 895 Muwang-ro, Iksan, Jeollabuk-do 54538, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soon Chun Hyang University Cheonan Hospital, Soon Chun Hyang University, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Republic of Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14854, Republic of Korea.
| | - Jeewon Lee
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14854, Republic of Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Wonju Severance Christian Hospital, 20 Ilsan-ro, Wonju, Gangwon-do 26426, Republic of Korea.
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, 21 Namdongdae-ro 774 gil, Namdong-gu, Incheon 21565, Republic of Korea.
| | - Jung-Joon Moon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Dong-Wook Jeon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Seokho Kim
- Department of Sociology, College of Social Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University College of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do 16419, Republic of Korea
| | - Sungeun You
- Department of Psychology, College of Social Sciences, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungcheongbuk-do 28644, Republic of Korea.
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| |
Collapse
|
16
|
Schepis TS, Simoni-Wastila L, McCabe SE. Prescription opioid and benzodiazepine misuse is associated with suicidal ideation in older adults. Int J Geriatr Psychiatry 2019; 34:122-129. [PMID: 30328160 PMCID: PMC6445380 DOI: 10.1002/gps.4999] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/02/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Suicide in older adults is a major public health issue. Past research across the US adult population has linked prescription medication misuse with suicidal ideation. No work has evaluated associations between prescription opioid or benzodiazepine misuse and suicidal ideation in older adults, and this work aimed to address that gap. METHODS/DESIGN Data were from adults 50 years and older participating in the 2015 to 2016 National Survey on Drug Use and Health (n = 17 608). Design-based logistic regression evaluated links between any past-year prescription opioid or benzodiazepine use without misuse or prescription misuse and past-year suicidal ideation, after controlling for sociodemographic, physical health, mental health, and substance use correlates associated with suicidal ideation. RESULTS After controlling for all correlates, past-year use without misuse of prescription opioids or benzodiazepines was not associated with past-year suicidal ideation in older adults. In contrast, past-year opioid misuse (AOR = 1.84, 95% CI = 1.07-3.19) and benzodiazepine misuse (AOR = 2.00, 95% CI = 1.01-3.94) were significantly associated with past-year suicidal ideation, even after controlling for all covariates. While 2.2% of US older adults not engaged in either opioid or benzodiazepine misuse reported past-year suicidal ideation, 25.4% of those who misused both medication classes endorsed such suicidality (AOR = 4.73, 95% CI = 2.07-10.79). CONCLUSIONS Both past-year prescription opioid and benzodiazepine misuse are associated with past-year suicidal ideation in US older adults. Clinicians encountering older adult patients at-risk for or engaged in prescription medication misuse also should screen for suicidality.
Collapse
Affiliation(s)
- Ty S. Schepis
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Linda Simoni-Wastila
- Peter Lamy Center on Drug Therapy and Aging, and Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
17
|
Zhu J, Xu L, Sun L, Li J, Qin W, Ding G, Wang Q, Zhang J, Xie S, Yu Z. Chronic Disease, Disability, Psychological Distress and Suicide Ideation among Rural Elderly: Results from a Population Survey in Shandong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1604. [PMID: 30060593 PMCID: PMC6121389 DOI: 10.3390/ijerph15081604] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/23/2018] [Accepted: 07/25/2018] [Indexed: 12/12/2022]
Abstract
Objective: Suicide is a major public health and social problem in contemporary societies. Previous studies showed that the older the seniors were, the more likely it was that they would experience disability, chronic disease, or both. The objective of this study was to examine the joint effects of chronic disease and physical disability on suicide ideation while controlling for psychological distress among the rural elderly living in Shandong Province, China. Method: A total of 5514 rural elderly individuals (60+) living in Shandong Province, China were included in this study. Suicidal ideation was assessed by using questions from the National Comorbidity Survey (NCS). Multiple logistic analyses were performed to examine the factors associated with suicide ideation. A path analysis was conducted to test the direct and indirect effects of chronic disease and of activity of daily living (ADL) limitation on suicide ideation while controlling for psychological distress. Results: The prevalence of suicide ideation among the rural elderly in Shandong, China was 11.0%. Psychological distress had the strongest direct (β = 0.392) and total effect (β = 0.392), chronic disease (β = -0.034; β = -0.063) had both direct and indirect impacts, and ADL (β = 0.091) had indirect impacts on suicide ideation. Psychological distress was a mediator between chronic disease, ADL limitation, and suicide ideation. Conclusions: Psychological distress was the greatest influencing factor of suicide ideation among the rural elderly, followed by chronic disease and disability. Effective intervention measures should be taken to facilitate the early detection of psychological distress in clinical practice among the rural elderly.
Collapse
Affiliation(s)
- Jing Zhu
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Lingzhong Xu
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
- Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Long Sun
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Jiajia Li
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Wenzhe Qin
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Gan Ding
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Qian Wang
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Jiao Zhang
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Su Xie
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| | - Zihang Yu
- Key Lab of Health Economics and Policy Research, School of Public Health, Shandong University, 44 Wen-hua-xi Road, Jinan 250012, China.
| |
Collapse
|
18
|
Suicidal Ideation among the Chinese Elderly and Its Correlates: A Comparison between the Rural and Urban Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030422. [PMID: 29495615 PMCID: PMC5876967 DOI: 10.3390/ijerph15030422] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/08/2018] [Accepted: 02/25/2018] [Indexed: 11/30/2022]
Abstract
Background: As China is going through a profound aging process, the mental health of the elderly is becoming an issue. As in many other societies, the elderly in China is a population at high risk of suicide; Methods: Data for the study were taken from the Sample Survey of the Aged Population in Urban/Rural China (SSAPUR) accomplished in 2010 by the China Ministry of Civil Affairs. The valid sample for this study was composed of 18,683 individuals, including 9416 urban residents and 9267 rural residents both aged 60 or more years; Results: Logistic regression analyses showed that household income and expenditure, the number of children, chronic diseases, disability of daily living, depression, the frequency of visiting neighbors and having friends or relatives who can help or not had remarkable effects on the suicidal ideation among urban and rural old people. Gender, education, political affiliation, marital status and self-rated health status did not work on the dependent variable. However, some risk factors for suicidal ideation among the Chinese elderly were different between rural and urban regions; Conclusions: We should take different measures when facing the different groups of the elderly.
Collapse
|
19
|
Lai DWL, Li L, Daoust GD. Factors Influencing Suicide Behaviours in Immigrant and Ethno-Cultural Minority Groups: A Systematic Review. J Immigr Minor Health 2018; 19:755-768. [PMID: 27640011 DOI: 10.1007/s10903-016-0490-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This paper reviews recent literature on factors influencing suicide behaviours, including thoughts, plans, and attempts, in immigrant and ethno-cultural minority groups, to inform a more comprehensive understanding of suicide behaviours in increasingly culturally diverse populations. Thirty-three studies published between 2002 and 2013 were identified through digital databases searches and included in this review. Analysis of study findings focused on impacts of ethno-cultural identity and acculturation, other cultural and immigration influences, and family and community supports on suicide behaviours. Policy, practice, and research recommendations are identified, to inform relevant suicide prevention efforts and enhance mental health supports for immigrant and ethno-cultural minority populations.
Collapse
Affiliation(s)
- Daniel W L Lai
- Department of Applied Social Sciences, Institute of Active Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada.
| | - Lun Li
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Gabrielle D Daoust
- Department of International Relations, University of Sussex, Brighton, UK
| |
Collapse
|
20
|
Lutz J, Fiske A. Functional disability and suicidal behavior in middle-aged and older adults: A systematic critical review. J Affect Disord 2018; 227:260-271. [PMID: 29107819 DOI: 10.1016/j.jad.2017.10.043] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 10/23/2017] [Accepted: 10/27/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Middle-aged and older adults have elevated rates of suicide around the globe, but there is a paucity of knowledge about risk factors for suicide in these age groups. One possible risk factor may be functional disability, which is more common at later ages. METHODS The current systematic critical review examined findings regarding the associations between functional disability and suicidal behavior (suicidal ideation, suicide attempts, and death by suicide) in middle-aged and older adults (i.e. age 50 and older). RESULTS Forty-five studies were found that examined these associations. The majority of studies supported a significant association between functional disability and suicidal ideation. In addition, findings to date strongly suggest that depression serves as a mediator of the association between functional disability and suicidal ideation, though most studies did not directly test for mediation. LIMITATIONS Firm conclusions regarding suicide attempts and death by suicide, as well as mediation, cannot be drawn due to a relative lack of research in these areas. CONCLUSIONS The association between functional disability and suicidal behavior suggests an important area for prevention and intervention among middle-aged and older adults, but additional research is necessary to clarify the specifics of these associations and examine appropriate intervention strategies. Important future directions for research in this area include the direct comparison of associations of risk factors with different types of suicidal behavior, greater use of longitudinal data with multiple time points, and further examination of potential mediators and moderators of the association between functional disability and suicidal behavior.
Collapse
Affiliation(s)
- Julie Lutz
- West Virginia University, Department of Psychology, Morgantown, WV, United States.
| | - Amy Fiske
- West Virginia University, Department of Psychology, Morgantown, WV, United States; West Virginia University Injury Control Research Center, Morgantown, WV, United States
| |
Collapse
|
21
|
Vancampfort D, Hallgren M, Firth J, Rosenbaum S, Schuch FB, Mugisha J, Probst M, Van Damme T, Carvalho AF, Stubbs B. Physical activity and suicidal ideation: A systematic review and meta-analysis. J Affect Disord 2018; 225:438-448. [PMID: 28858658 DOI: 10.1016/j.jad.2017.08.070] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/07/2017] [Accepted: 08/20/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND A potential approach to suicide prevention that has not been closely examined, but which holds promise in terms of widespread dissemination without major side-effects, is physical activity (PA). This systematic review and meta-analysis set out to: (a) explore associations between PA and suicidal ideation (SI) levels, and (b) investigate the effect of PA interventions on SI. METHODS Major electronic databases were searched from inception up to 05/2017 to identify quantitative studies reporting an association between PA and SI. A quantitative correlates synthesis and random effects meta-analysis were conducted. RESULTS Fourteen of 21 studies in adults (67%) (n = 130,737), 7/14 (50%) in adolescents (n = 539,170) and 2/3 (67%) in older adults (n = 50,745) found a significant negative association between PA- and SI-levels. Pooled adjusted meta-analysis of 14 effect sizes over eight studies and 80,856 people found that those who were "active" versus those who were "inactive" were less likely to have SI (OR = 0.87, 95%CI = 0.76-0.98). Additionally, meeting PA guidelines conferred a significant protective effect against SI (OR = 0.91, 95%CI = 0.51-0.99, P = 0.03; N studies = 3, n people = 122,395), while not meeting guidelines was associated with increased SI (OR = 1.16, 95%CI = 1.09-1.24, P < 0.001; N = 4, n = 78,860). Data from the intervention studies (N = 3, n = 121) was mixed and limited. LIMITATIONS Our findings are based mainly on cross-sectional studies, while the majority of studies did not include a rigorous physical activity assessment. CONCLUSIONS The current study suggests that higher PA levels are associated with lower SI. However, the associations observed need to be confirmed in prospective observational studies and controlled trials.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre, Leuven-Kortenberg, Belgium.
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Joseph Firth
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK; NICM, School of Science and Health, University of Western Sydney, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, Australia; Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Felipe B Schuch
- Unilasalle, Canoas, Brazil; Escola de Educação Física, Fisioterapia e Dança, Porto Alegre, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - James Mugisha
- Kyambogo University, Kampala, Uganda; Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Michel Probst
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Tine Van Damme
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
| |
Collapse
|
22
|
Chang Q, Chan CH, Yip PS. A meta-analytic review on social relationships and suicidal ideation among older adults. Soc Sci Med 2017; 191:65-76. [DOI: 10.1016/j.socscimed.2017.09.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/29/2017] [Accepted: 09/03/2017] [Indexed: 12/30/2022]
|
23
|
Federici S, Bracalenti M, Meloni F, Luciano JV. World Health Organization disability assessment schedule 2.0: An international systematic review. Disabil Rehabil 2016; 39:2347-2380. [PMID: 27820966 DOI: 10.1080/09638288.2016.1223177] [Citation(s) in RCA: 221] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument. METHOD Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on "whodas" using the ProQuest, PubMed, and Google Scholar electronic databases. RESULTS We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry). CONCLUSIONS The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single "minimal clinically important .difference" score for the WHODAS 2.0 has not yet been established.
Collapse
Affiliation(s)
- Stefano Federici
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Marco Bracalenti
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Fabio Meloni
- a Department of Philosophy, Social & Human Sciences and Education , University of Perugia , Perugia , Italy
| | - Juan V Luciano
- b Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan De Déu , St. Boi De Llobregat , Spain.,c Primary Care Prevention and Health Promotion Research Network (RedIAPP) , Madrid , Spain
| |
Collapse
|
24
|
Lee YS. Is giving or receiving psychologically beneficial to older mothers in South Korea? Importance of marital status. J Women Aging 2016; 29:137-149. [PMID: 27455120 DOI: 10.1080/08952841.2015.1080551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In order to understand intergenerational financial transfers and subjective well-being for older mothers, this study argues that marital status is an important factor to be considered. Using the first wave of the Korean Longitudinal Study of Aging (KLoSA), this study finds that married older mothers report higher levels of life satisfaction when they provide economic support but widowed older mothers feel higher levels of life satisfaction when they receive economic support. Also, regular or irregular financial support appears to also matter in the associations between financial support and life satisfaction. These findings suggest that married and widowed older mothers have different viewpoints about the parent-children relationship.
Collapse
Affiliation(s)
- Yun-Suk Lee
- a Department of Urban Sociology , University of Seoul , Seoul , South Korea
| |
Collapse
|
25
|
Song HB, Lee SA. Socioeconomic and lifestyle factors as risks for suicidal behavior among Korean adults. J Affect Disord 2016; 197:21-8. [PMID: 26967916 DOI: 10.1016/j.jad.2016.02.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 01/17/2016] [Accepted: 02/06/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Preventing suicide has become a major public health priority in Korea. The aim of this study was to evaluate the associated factors of suicidal ideation (SI(1)) and attempt (SA(2)) among Korean adults. METHODS The data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES), a nationally representative sample recruited using a multi-stage clustered probability design. The association of putative risk factors focused on nutrition and health behaviors which were evaluated using multiple logistic regression analyses after adjusting for confounding factors. Survey sample weights were used for all analysis. RESULTS The 12-month prevalence of SI and SA in Korea was 15.0% and 0.85%, respectively. Female, previously married status, lower education and lower household income were associated with SI and SA. In particular, the effect of age on SI presented a reverse pattern based on gender; there was a positive association for men and a negative association for women. Additionally, drinking, smoking, physical activity above moderate intensity and eating fewer meals were associated with SA in women, whereas regular exercise was protective against SI in men. LIMITATIONS The data were collected using a cross-sectional survey, embedding possible bias. CONCLUSIONS Higher prevalence of SI and SA among women was associated with smoking, drinking, avoiding regular exercise and insufficiency of food. Lower prevalence of SI was observed in men who engaged in physical activity while men with insufficient food showed a higher prevalence of SI and SA.
Collapse
Affiliation(s)
- Han-Byol Song
- Department of Preventive Medicine, Kangwon National University, Kangwon-do, Republic of Korea
| | - Sang-Ah Lee
- Department of Preventive Medicine, Kangwon National University, Kangwon-do, Republic of Korea.
| |
Collapse
|
26
|
Fässberg MM, Cheung G, Canetto SS, Erlangsen A, Lapierre S, Lindner R, Draper B, Gallo JJ, Wong C, Wu J, Duberstein P, Wærn M. A systematic review of physical illness, functional disability, and suicidal behaviour among older adults. Aging Ment Health 2016; 20:166-94. [PMID: 26381843 PMCID: PMC4720055 DOI: 10.1080/13607863.2015.1083945] [Citation(s) in RCA: 218] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To conduct a systematic review of studies that examined associations between physical illness/functional disability and suicidal behaviour (including ideation, nonfatal and fatal suicidal behaviour) among individuals aged 65 and older. METHOD Articles published through November 2014 were identified through electronic searches using the ERIC, Google Scholar, PsycINFO, PubMed, and Scopus databases. Search terms used were suicid* or death wishes or deliberate self-harm. Studies about suicidal behaviour in individuals aged 65 and older with physical illness/functional disabilities were included in the review. RESULTS Sixty-five articles (across 61 independent samples) met inclusion criteria. Results from 59 quantitative studies conducted in four continents suggest that suicidal behaviour is associated with functional disability and numerous specific conditions including malignant diseases, neurological disorders, pain, COPD, liver disease, male genital disorders, and arthritis/arthrosis. Six qualitative studies from three continents contextualized these findings, providing insights into the subjective experiences of suicidal individuals. Implications for interventions and future research are discussed. CONCLUSION Functional disability, as well as a number of specific physical illnesses, was shown to be associated with suicidal behaviour in older adults. We need to learn more about what at-risk, physically ill patients want, and need, to inform prevention efforts for older adults.
Collapse
Affiliation(s)
| | - Gary Cheung
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | | | - Annette Erlangsen
- Research Unit, Mental Health Centre Copenhagen, Denmark,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Sylvie Lapierre
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Reinhard Lindner
- Geriatric Psychosomatics and Psychotherapy, Medical Geriatric Clinic Albertinen-Haus, University of Hamburg, Hamburg, Germany
| | - Brian Draper
- School of Psychiatry, University of NSW, Sydney, Australia
| | - Joseph J. Gallo
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Jing Wu
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - Paul Duberstein
- Department of Psychiatry and Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Margda Wærn
- Section of Psychiatry and Neurochemistry, University of Gothenburg/Sahlgrenska University Hospital, Gothenburg, Sweden,Corresponding author.
| |
Collapse
|
27
|
Oh DJ, Park JY, Oh M, Kim K, Hong J, Kim T, Han JW, Kim TH, Kim KW. Suicidality-based prediction of suicide attempts in a community-dwelling elderly population: Results from the Osan Mental Health Survey. J Affect Disord 2015; 184:286-92. [PMID: 26120807 DOI: 10.1016/j.jad.2015.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 06/09/2015] [Accepted: 06/09/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Data on outcomes of suicidality in the community-dwelling elderly are scarce. We investigated the association of suicidality with the suicide attempts in a community-dwelling elderly cohort. METHODS In the Osan Mental Health Survey, 848 randomly sampled elderly Koreans participated in the baseline evaluation, 623 completed 2-year follow-up evaluation and 32 died during the follow-up period. The survey was conducted between February 2010 and January 2013. We evaluated suicidality using the Mini-International Neuropsychiatric Interview suicidality module that includes both suicidal ideation and attempts. RESULTS The incidences of suicidality and suicide attempts were 70.7 and 13.1 per 1000 persons per year, respectively. Suicidality was associated with increased risk of suicide attempts (odds ratio (OR) = 3.84, 95% CI = 1.06-13.87). Two men with suicidality committed suicide by self-poisoning. Moderate to high intensity daily exercise decreased the risk of suicidality to become persistent or recurrent (OR = 0.32, 95% CI = 0.12-0.81). Low education level (OR = 2.41, 95% CI = 1.21-4.77) and depression (OR = 3.02, 95% CI = 1.65-5.53) were associated with risk of incident suicidality. LIMITATIONS Study sample was enrolled from a single city of Korea, and the size of the study sample was small. CONCLUSIONS We may reduce suicide attempts by screening for suicidality and implementing exercise programs in community-dwelling elderly people.
Collapse
Affiliation(s)
- Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jae Young Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Miyoung Oh
- Osan Mental Health Center, Osan, Republic of Korea
| | - Kayoung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jongwoo Hong
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Taehyun Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Won Han
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
| |
Collapse
|
28
|
Cox KHM, Pipingas A, Scholey AB. Investigation of the effects of solid lipid curcumin on cognition and mood in a healthy older population. J Psychopharmacol 2015; 29:642-51. [PMID: 25277322 DOI: 10.1177/0269881114552744] [Citation(s) in RCA: 212] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Curcumin possesses many properties which may prevent or ameliorate pathological processes underlying age-related cognitive decline, dementia or mood disorders. These benefits in preclinical studies have not been established in humans. This randomized, double-blind, placebo-controlled trial examined the acute (1 and 3 h after a single dose), chronic (4 weeks) and acute-on-chronic (1 and 3 h after single dose following chronic treatment) effects of solid lipid curcumin formulation (400 mg as Longvida®) on cognitive function, mood and blood biomarkers in 60 healthy adults aged 60-85. One hour after administration curcumin significantly improved performance on sustained attention and working memory tasks, compared with placebo. Working memory and mood (general fatigue and change in state calmness, contentedness and fatigue induced by psychological stress) were significantly better following chronic treatment. A significant acute-on-chronic treatment effect on alertness and contentedness was also observed. Curcumin was associated with significantly reduced total and LDL cholesterol and had no effect on hematological safety measures. To our knowledge this is the first study to examine the effects of curcumin on cognition and mood in a healthy older population or to examine any acute behavioral effects in humans. Results highlight the need for further investigation of the potential psychological and cognitive benefits of curcumin in an older population.
Collapse
Affiliation(s)
- Katherine H M Cox
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrew B Scholey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| |
Collapse
|
29
|
Abstract
Suicide in older adults is a significant clinical concern. In this review of recent findings, we concentrate on the role of emotions and cognition in suicide risk and behavior in older adults. We discuss the epidemiology of suicide in older adults, integrate recent findings on non-psychotic major depression, schizophrenia and suicidal ideation, explore the relationship of emotion regulation with suicide, present recent advances on suicide in demented patients, and describe the latest developments on cognition and decision processes in suicide.
Collapse
Affiliation(s)
- Dimitris N. Kiosses
- Associate Professor of Psychology in Clinical Psychiatry, Weill Cornell Medical College, Weill Cornell Institute of Geriatric Psychiatry, 21 Blomingdale Rd, White Plains, NY 10605, Phone: 914-997-4381,
| | - Katalin Szanto
- Associate Professor of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA 15213, Phone: 412-586-9601,
| | - George S. Alexopoulos
- Professor of Psychiatry, Weill Cornell Medical College, Weill Cornell Institute of Geriatric Psychiatry, 21 Bloomingdale Rd, White Plains, NY 10605, Phone: 914-997-5767,
| |
Collapse
|
30
|
Dong Y, Huang F, Hu G, Liu Y, Zheng R, Zhang Q, Mao X. The prevalence of suicidal ideation among the elderly in China: a meta-analysis of 11 cross-sectional studies. Compr Psychiatry 2014; 55:1100-5. [PMID: 24673954 DOI: 10.1016/j.comppsych.2014.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 02/18/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study aimed to estimate the pooled prevalence of suicidal ideation among Chinese elderly aged ≥ 60 years. METHODS Two reviewers independently searched the potentially relevant studies through electronic database (PubMed-Medline, Embase, Wanfang Data, Chinese National Knowledge Infrastructure and Chongqing VIP) using key terms 'suicid', 'suicidal ideation' combined with 'aged', 'elderly' and 'old people'. All selected studies should meet the eligibility criteria in this study. Chi-square based Q test and I(2) statistic assessed the heterogeneity. Forest plots were used to display results graphically. Potential publication bias was assessed by the funnel plot and Begg's test. Prevalence rate was meta-analysed. RESULTS In total, 11 studies were included with 11,526 subjects. The prevalence of suicidal ideation among Chinese elderly ranged from 2.2% to 21.5%. The pooled prevalence of all 11 studies was 11.5% (95% CI: 8.3%-14.8%). Subgroup analyses showed the prevalence for males was 11.0%, and for the females was 15.6%. In three subgroups for age, 60-69, 70-79 and ≥ 80, the prevalence was 9.1%, 12.1% and 18.9% respectively. A slightly higher prevalence in rural areas was calculated than in urban (14.7% vs. 11.8%). In mainland China, the prevalence was 12.6%. And in Taiwan and Hongkong, the pooled prevalence was 9.2%. CONCLUSIONS The prevalence of suicidal ideation was relatively high among elderly in China, and it should attract enough attention.
Collapse
Affiliation(s)
- Yonghai Dong
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China
| | - Fen Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Guoliang Hu
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China
| | - Yun Liu
- Cadre Wards of Neurology Medicine, Jiangxi Provincial People's Hospital, Nanchang, China
| | - Ruizhi Zheng
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, China
| | - Qinghe Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Xiangqun Mao
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China.
| |
Collapse
|