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Silva AC, Vanzela AS, Pedrollo LFS, Baker J, de Carvalho JCM, Sequeira CADC, Vedana KGG, dos Santos JCP. Characteristics of surveillance systems for suicide and self-harm: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003292. [PMID: 38954687 PMCID: PMC11218961 DOI: 10.1371/journal.pgph.0003292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/07/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Suicide is a complex public health issue. Surveillance systems play a vital role in identifying trends and epidemiologic needs, informing public health strategies, and tailoring effective context-based suicide prevention interventions. AIM To identify and summarise the characteristics of specific surveillance systems and general health behaviour that include data onsuicide and self-harm. METHOD A scoping review following the JBI recommendations and PRISMA-ScR guidelines identified 29 relevant studies on suicide and self-harm surveillance systems. A systematic search was performed on Cinahl, Embase, Lilacs-Latin American and Caribbean Health Sciences Literature, PubMed-US National Library of Medicine, Scopus, and Google Scholar. The eligibility criteria include papers that use qualitative, quantitative or mixed methods with no restrictions on time or language. The following papers were excluded regarding euthanasia and assisted suicide, as well as papers that did not explicitly describe suicide, self-harm, and surveillance systems. Two researchers independently screened the materials for eligibility and extracted data from the included studies. Data analysis was conducted using content analysis. RESULTS Twenty-nine references were included, and 30 surveillance systems were identified and classified into general health behaviour surveillance (n = 15) and specific systems for suicide and self-harm (n = 15). General health behaviour systems often operate at national data collection level, collecting non-fatal data in healthcare settings, mainly emergency departments. The specific systems exhibited greater variability in terms of context, involved actors, data collection level, data collection procedures, and case classification. Limitations found by the studies pointed mostly to case definitions and data quality. Co-production, intersectoral collaboration, clear case definition criteria and data standardisation are essential to improve surveillance systems for suicide and self-harm. CONCLUSIONS This review identified the characteristics of surveillance systems for suicide and self-harm. Monitoring and evaluation are crucial for ongoing relevance and impact on prevention efforts.
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Affiliation(s)
- Aline Conceição Silva
- Health Sciences Research Unit: Nursing–UICISA: E, Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
- University of São Paulo, School of Nursing, Sao Paulo, Sao Paulo, Brazil
| | - Amanda Sarah Vanzela
- University of São Paulo at Ribeirao Preto College of Nursing, Ribeirao Preto, Sao Paulo, Brazil
| | | | - John Baker
- School of Healthcare, University of Leeds, Leeds, United Kingdom
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Minian N, Gayapersad A, Coroiu A, Dragonetti R, Zawertailo L, Zaheer J, O’Neill B, Lange S, Thomson N, Crawford A, Kennedy SH, Selby P. Prototyping the implementation of a suicide prevention protocol in primary care settings using PDSA cycles: a mixed method study. Front Psychiatry 2024; 15:1286078. [PMID: 38333892 PMCID: PMC10850298 DOI: 10.3389/fpsyt.2024.1286078] [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: 08/31/2023] [Accepted: 01/04/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction In Canada, approximately 4,500 individuals die by suicide annually. Approximately 45% of suicide decedents had contact with their primary care provider within the month prior to their death. Current versus never smokers have an 81% increased risk of death by suicide. Those who smoke have additional risks for suicide such as depression, chronic pain, alcohol, and other substance use. They are more likely to experience adverse social determinants of health. Taken together, this suggests that smoking cessation programs in primary care could be facilitators of suicide prevention, but this has not been studied. Study objectives The objectives of the study are to understand barriers/facilitators to implementing a suicide prevention protocol within a smoking cessation program (STOP program), which is deployed by an academic mental health and addiction treatment hospital in primary care clinics and to develop and test implementation strategies to facilitate the uptake of suicide screening and assessment in primary care clinics across Ontario. Methods The study employed a three-phase sequential mixed-method design. Phase 1: Conducted interviews guided by the Consolidated Framework for Implementation Research exploring barriers to implementing a suicide prevention protocol. Phase 2: Performed consensus discussions to map barriers to implementation strategies using the Expert Recommendations for Implementing Change tool and rank barriers by relevance. Phase 3: Evaluated the feasibility and acceptability of implementation strategies using Plan Do Study Act cycles. Results Eleven healthcare providers and four research assistants identified lack of training and the need of better educational materials as implementation barriers. Participants endorsed and tested the top three ranked implementation strategies, namely, a webinar, adding a preamble before depression survey questions, and an infographic. After participating in the webinar and reviewing the educational materials, all participants endorsed the three strategies as acceptable/very acceptable and feasible/very feasible. Conclusion Although there are barriers to implementing a suicide prevention protocol within primary care, it is possible to overcome them with strategies deemed both acceptable and feasible. These results offer promising practice solutions to implement a suicide prevention protocol in smoking cessation programs delivered in primary care settings. Future efforts should track implementation of these strategies and measure outcomes, including provider confidence, self-efficacy, and knowledge, and patient outcomes.
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Affiliation(s)
- Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Allison Gayapersad
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Adina Coroiu
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Laurie Zawertailo
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Juveria Zaheer
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Braden O’Neill
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Shannon Lange
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nicole Thomson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Allison Crawford
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sidney H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Arthur Sommer Rotenberg Program in Suicide Studies, Unity Health Toronto, Toronto, ON, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Schmeckenbecher J, Philipp AC, Emilian CA, Zimmermann C, Kapusta ND. The fearlessness about death scale's efficacy for differentiating suicide attempts from non-suicidal self-injury, a meta-analysis. DEATH STUDIES 2023; 48:801-809. [PMID: 37921500 DOI: 10.1080/07481187.2023.2277818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
We used multivariate meta-analysis modeling variances and covariances of suicidal ideation, suicide attempts, and non-suicidal self-injury to investigate if the Fearlessness About Death scale differentiated between suicide attempts and non-suicidal self-injury. The systematic search yielded 27 studies that fulfilled the inclusion criteria. The association of suicidal ideation with suicide attempts was comparable to the association of suicidal ideation with non-suicidal self-injury. The Fearlessness About Death scale weakened both associations to a comparative degree. These results cast doubt on the clinical utility of the Fearlessness About Death scale, as well as the self-assessment of suicidal ideation, suicide attempts and non-suicidal self-injury.
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Affiliation(s)
- Jim Schmeckenbecher
- Department of Psychoanalysis and Psychotherapy, Medical University Wien, Wien, Austria
- Center of Mental Health, for Addiction and Addictive Behavior, Hospital Stuttgart, Stuttgart, Germany
| | | | - Christina Alma Emilian
- Department of Psychiatry, Medical Science Division, University of Oxford, Oxford, United Kingdom
| | - Claudia Zimmermann
- Department of Epidemiology, Center for Public Health, Medical University Vienna
| | - Nestor D Kapusta
- Department of Psychoanalysis and Psychotherapy, Medical University Wien, Wien, Austria
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Xing DG, Horan T, Bhuiyan MS, Faisal ASM, Densmore K, Murnane KS, Goeders NE, Bailey SR, Conrad SA, Vanchiere JA, Patterson JC, Kevil CG, Bhuiyan MAN. Social-geographic disparities in suicidal ideations among methamphetamine users in the USA. Psychiatry Res 2023; 329:115524. [PMID: 37852161 PMCID: PMC10841467 DOI: 10.1016/j.psychres.2023.115524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023]
Abstract
IMPORTANCE Methamphetamine use is a growing public health concern nationwide. Suicide is the second leading cause of death in 2019 for US citizens aged 10-14 years and 25-34 years and is also a significant public health concern. Understanding the intersection of methamphetamine use and suicidal ideation (SI) is necessary to develop public health and policy solutions that mitigate these ongoing severe public health issues. OBJECTIVE Our objective was to examine SI in methamphetamine users to allow us to determine prevalence and trends by age, sex, race, and geographical region. DESIGN, SETTINGS, AND PARTICIPANTS Using data collected between 2008 and 2019 from the National Inpatient Sample (NIS) database, we identified hospital admissions (HA) of patients ≥18 years of age with a primary or secondary diagnosis of SI who were also diagnosed as methamphetamine users. Those who used other substances with methamphetamine were excluded from the analysis. MAIN OUTCOME AND MEASURES To determine the trend and prevalence of hospital admissions due to SI and SI among methamphetamine users, we used trend weights to calculate the national estimates and performed design-based analysis to account for complex survey design and sampling weights on data collected between 2008 and 2019 in the US. RESULTS The prevalence ratio (PR) of hospitalizations with concurrent SI and methamphetamine use increased 16-fold from 2008 to 2019. The most significant increase occurred between 2015 and 2016; the PR doubled from 6.07 to 12.14. The PR of hospitalizations with concurrent SI and methamphetamine use was highest in patients aged 26-40 (49.08%) and 41-64 (28.49%). Patients aged 41-64 showed the most significant increase from 2008 to 2019 (15.8-fold). While non-Hispanic White patients comprised most of these hospitalizations (77.02%), non-Hispanic Black patients showed the highest proportional increase (39.1-fold). The Southern and Western regions in the US showed the highest PR for these hospitalizations (34.86% and 34.31%, respectively). CONCLUSION AND RELEVANCE Our findings indicate that SI in methamphetamine users has been increasing for some time and is likely to grow. In addition, our results suggest that these patients are demographically different. Both conditions are associated with a lesser likelihood of seeking and receiving care. Therefore, when addressing increased SI or methamphetamine use, learning more about patients who share both conditions is necessary to ensure proper care.
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Affiliation(s)
- Diensn G Xing
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Teresa Horan
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Md Shenuarin Bhuiyan
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Abu Saleh Mosa Faisal
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Kenneth Densmore
- Office of Research, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Kevin S Murnane
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Nicholas E Goeders
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Steven R Bailey
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Steven A Conrad
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Pediatrics, LSU Health Sciences Center Shreveport, Shreveport, LA, United States
| | - John A Vanchiere
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Pediatrics, LSU Health Sciences Center Shreveport, Shreveport, LA, United States
| | - James C Patterson
- Department of Pharmacology, Toxicology & Neuroscience, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Psychiatry and Behavioral Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States
| | - Christopher G Kevil
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States
| | - Mohammad Alfrad Nobel Bhuiyan
- Department of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, United States; Louisiana Addiction Research Center, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States.
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McTernan N, Griffin E, Cully G, Kelly E, Hume S, Corcoran P. The incidence and profile of self-harm among prisoners: findings from the Self-Harm Assessment and Data Analysis Project 2017-2019. Int J Prison Health 2023; 19:565-577. [PMID: 37125411 DOI: 10.1108/ijph-02-2023-0012] [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] [Indexed: 05/02/2023]
Abstract
PURPOSE Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm. DESIGN/METHODOLOGY/APPROACH Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017-2019 was used. Annual rates per 1,000 were calculated by age and gender. FINDINGS The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18-29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner's environment and relationships. PRACTICAL IMPLICATIONS There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.
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Affiliation(s)
- Niall McTernan
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Eve Griffin
- National Suicide Research Foundation, University College Cork, Cork, Ireland and School of Public Health, University College Cork, Cork, Ireland
| | - Grace Cully
- National Suicide Research Foundation, University College Cork, Cork, Ireland and School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Paul Corcoran
- National Suicide Research Foundation, University College Cork, Cork, Ireland and School of Public Health, University College Cork, Cork, Ireland
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Cusick M, Velupillai S, Downs J, Campion TR, Sholle ET, Dutta R, Pathak J. Portability of natural language processing methods to detect suicidality from clinical text in US and UK electronic health records. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 10:100430. [PMID: 36644339 PMCID: PMC9835770 DOI: 10.1016/j.jadr.2022.100430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background In the global effort to prevent death by suicide, many academic medical institutions are implementing natural language processing (NLP) approaches to detect suicidality from unstructured clinical text in electronic health records (EHRs), with the hope of targeting timely, preventative interventions to individuals most at risk of suicide. Despite the international need, the development of these NLP approaches in EHRs has been largely local and not shared across healthcare systems. Methods In this study, we developed a process to share NLP approaches that were individually developed at King's College London (KCL), UK and Weill Cornell Medicine (WCM), US - two academic medical centers based in different countries with vastly different healthcare systems. We tested and compared the algorithms' performance on manually annotated clinical notes (KCL: n = 4,911 and WCM = 837). Results After a successful technical porting of the NLP approaches, our quantitative evaluation determined that independently developed NLP approaches can detect suicidality at another healthcare organization with a different EHR system, clinical documentation processes, and culture, yet do not achieve the same level of success as at the institution where the NLP algorithm was developed (KCL approach: F1-score 0.85 vs. 0.68, WCM approach: F1-score 0.87 vs. 0.72). Limitations Independent NLP algorithm development and patient cohort selection at the two institutions comprised direct comparability. Conclusions Shared use of these NLP approaches is a critical step forward towards improving data-driven algorithms for early suicide risk identification and timely prevention.
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Affiliation(s)
- Marika Cusick
- WeiCornell Medicine, 402 E. 67th St., New York, NY 10065, USA
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Sumithra Velupillai
- IoPPN, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Johnny Downs
- IoPPN, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Thomas R. Campion
- WeiCornell Medicine, 402 E. 67th St., New York, NY 10065, USA
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Evan T. Sholle
- WeiCornell Medicine, 402 E. 67th St., New York, NY 10065, USA
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Rina Dutta
- IoPPN, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Jyotishman Pathak
- WeiCornell Medicine, 402 E. 67th St., New York, NY 10065, USA
- South London and Maudsley NHS Foundation Trust, London, UK
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Risk and Protective Factors in Adolescent Suicidal Behaviour: A Network Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031784. [PMID: 35162805 PMCID: PMC8834911 DOI: 10.3390/ijerph19031784] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023]
Abstract
Given that death by suicide continues to rank among the top three causes of death during adolescence, new psychological models may contribute critical insight towards understanding the complex interactions between risk and protective factors in suicidal behaviour. The main objective of this study was to analyse the psychological network structure of suicidal behaviour and putative risk and protective factors in school-aged adolescents. Methods: Stratified random cluster sampling was performed. The final sample comprised 1790 students (53.7% female, M = 15.7 years, SD = 1.26). Instruments were administered to assess suicidal behaviour, emotional and behavioural difficulties, prosocial behaviour, subjective well-being, self-esteem, depressive symptomatology, academic performance, socio-economic status, school engagement, bullying, and cyberbullying. Results: In the estimated psychological network, the node with the highest strength was depressive symptomatology, and that with the highest expected influence value was bullying. Suicidal behaviour was positively connected to symptoms of depression and behavioural problems. In addition, suicidal behaviour was negatively connected to self-esteem and personal well-being. The results of the stability analysis indicated that the network was accurately estimated. Conclusions: Suicidal behaviour can be conceptualised as a dynamic, complex system of cognitive, emotional, and affective characteristics. New psychological models allow us to analyse and understand human behaviour from a new perspective, suggesting new forms of conceptualisation, evaluation, intervention, and prevention.
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Fusar-Poli L, Aguglia A, Amerio A, Orsolini L, Salvi V, Serafini G, Volpe U, Amore M, Aguglia E. Peripheral BDNF levels in psychiatric patients with and without a history of suicide attempt: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110342. [PMID: 33961965 DOI: 10.1016/j.pnpbp.2021.110342] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Psychiatric patients are at increased risk of attempting suicide. Several potential biomarkers of suicide risk have been proposed with inconsistent findings. The present paper aimed to evaluate differences in peripheral BDNF levels between psychiatric patients with and without a history of suicide attempts. METHODS We conducted a systematic review and meta-analysis following the PRISMA guidelines. Relevant papers published up to January 5, 2021 were identified searching the electronic databases Web of KnowledgeSM and PsycINFO. A random-effect meta-analysis was conducted using Stata 16. RESULTS Thirteen studies met inclusion criteria. Overall, no significant differences in BDNF levels between the two groups were found (13 studies, n = 1340, Hedge's g = -0.21, 95% CI -0.44 to 0.02). Heterogeneity was substantial (I2 = 72.91%). Subgroup analyses revealed that BDNF levels were significantly reduced in plasma with medium effect size (5 studies, n = 363, Hedge's g = -0.44, 95% CI -0.86 to -0.02), but not in serum (8 studies, n = 977, Hedge's g = -0.09, 95% CI -0.33 to 0.15). No significant differences were found according to the type of diagnosis (major depressive disorder vs. other diagnoses) or the period of suicide attempt (lifetime vs. recent). CONCLUSION The utility of BDNF as a biomarker of suicide attempts in psychiatric patients appears limited to its plasma concentration. Although caution interpretation is needed, our findings may represent a starting point for the design of rigorous case-control studies exploring the association between neurotrophins and suicidal behaviors.
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Affiliation(s)
- Laura Fusar-Poli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy.
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Psychiatry, Tufts University, Boston, MA, USA
| | - Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy; Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Virginio Salvi
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
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Piper K, Young CC, V Jones K, Lawson KA, Wesson CL, Barczyk AN. A qualitative content analysis study using electronic medical records to understand youth suicide attempts. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2021; 35:76-82. [PMID: 34523183 DOI: 10.1111/jcap.12350] [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: 06/08/2021] [Revised: 08/02/2021] [Accepted: 09/05/2021] [Indexed: 11/27/2022]
Abstract
PROBLEM Suicide is the second leading cause of death for people aged 10-24 in the United States. The purpose of this study was to examine circumstances youth self-reported when presenting to hospitals due to a suicide attempt. METHODS A qualitative content analysis of clinicians' notes identified major themes of patients' lived experiences and circumstances leading up to suicide attempt. FINDINGS A total of 231 unique patient encounters were included in this study. Mean age of participants was 14.71 (SD = 2.04) the majority being female (75%) and Non-Hispanic White (48%). Four themes characterized contributing factors: (1) trauma, (2) relationship quality, (3) risky behaviors, and (4) personal emotions and symptoms. CONCLUSIONS Findings suggest commonalities among these youths' circumstances and experiences which may have precipitated a suicide attempt. These data will aid nurses and other health-care providers in understanding the complex, and often traumatic, histories of youth who attempt suicide. Improved knowledge in this area has the potential to direct improved screening, treatment, and referral protocols as well as suggest areas to focus prevention efforts.
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Affiliation(s)
- Karen Piper
- Dell Children's Trauma and Injury Research Center, Austin, Texas, USA
| | - Cara C Young
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA
| | - Kristian V Jones
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
| | - Karla A Lawson
- Dell Children's Trauma and Injury Research Center, Austin, Texas, USA
| | | | - Amanda N Barczyk
- Dell Children's Trauma and Injury Research Center, Austin, Texas, USA.,Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
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De Leo D, Goodfellow B, Silverman M, Berman A, Mann J, Arensman E, Hawton K, Phillips MR, Vijayakumar L, Andriessen K, Chavez-Hernandez AM, Heisel M, Kolves K. International study of definitions of English-language terms for suicidal behaviours: a survey exploring preferred terminology. BMJ Open 2021; 11:e043409. [PMID: 33563622 PMCID: PMC7875264 DOI: 10.1136/bmjopen-2020-043409] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Explore international consensus on nomenclatures of suicidal behaviours and analyse differences in terminology between high-income countries (HICs) and low/middle-income countries (LMICs). DESIGN An online survey of members of the International Organisation for Suicide Prevention (IASP) used multiple-choice questions and vignettes to assess the four dimensions of the definition of suicidal behaviour: outcome, intent, knowledge and agency. SETTING International. PARTICIPANTS Respondents included 126 individuals, 37 from 30 LMICs and 89 from 33 HICs. They included 40 IASP national representatives (65% response rate), IASP regular members (20% response rate) and six respondents from six additional countries identified by other organisations. OUTCOME MEASURES Definitions of English-language terms for suicidal behaviours. RESULTS The recommended definition of 'suicide' describes a fatal act initiated and carried out by the actors themselves. The definition of 'suicide attempt' was restricted to non-fatal acts with intent to die, whereas definition of 'self-harm' more broadly referred to acts with varying motives, including the wish to die. Almost all respondents agreed about the definitions of 'suicidal ideation', 'death wishes' and 'suicide plan'. 'Aborted suicide attempt' and 'interrupted suicide attempt' were not considered components of 'preparatory suicidal behaviour'. There were several differences between representatives from HICs and LMICs. CONCLUSION This international opinion survey provided the basis for developing a transcultural nomenclature of suicidal behaviour. Future developments of this nomenclature should be tested in larger samples of professionals, including LMICs may be a challenge.
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Affiliation(s)
- Diego De Leo
- Australian Institute of Suicide Research and Prevention, School of Applied Psychology, Griffith University, Mt Gravatt, Queensland, Australia
| | - Benjamin Goodfellow
- Australian Institute of Suicide Research and Prevention, School of Applied Psychology, Griffith University, Mt Gravatt, Queensland, Australia
- Centre Hospitalier Albert Bousquet, Nouméa, New Caledonia
| | | | - Alan Berman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - John Mann
- Departments of Psychiatry and Radiology, Columbia University, New York City, New York, USA
| | - Ella Arensman
- National Suicide Research Foundation, School of Public Health, University College Cork, Cork, Ireland
| | - Keith Hawton
- Centre for Suicide Research, Oxford University, Oxford, Oxfordshire, UK
| | - M R Phillips
- Suicide Research and Prevention Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Departments of Psychiatry and Epidemiology, Columbia University, New York City, New York, USA
| | - Lakshmi Vijayakumar
- Department of Psychiatry, The Voluntary Health Services Hospital, Chennai, India
| | - Karl Andriessen
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Marnin Heisel
- Department of Psychiatry, University of Western Ontario, London, Ontario, Canada
- Center for the Study and Prevention of Suicide, University of Rochester, Rochester, New York, USA
| | - Kairi Kolves
- Australian Institute of Suicide Research and Prevention, School of Applied Psychology, Griffith University, Mt Gravatt, Queensland, Australia
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11
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Horváth ON, Tóth MD, Àdám S, Purebl G. Factors associated with serious intent to die among suicide attempters in Hungary. Int J Ment Health Nurs 2020; 29:632-638. [PMID: 31994320 DOI: 10.1111/inm.12695] [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] [Accepted: 01/02/2020] [Indexed: 11/28/2022]
Abstract
As suicide attempts pose major risk for future suicide death, understanding the underlying factors of suicide attempts and suicidal behaviour is an important mental health imperative. The aim of this study was to examine suicide attempts with a special focus on the intention. A total of 2540 discharge summaries were collected between 2009 and 2011 in Miskolc, Hungary, and a content analysis was conducted. Data regarding the method, the reason for suicide attempts, the amount, the source, and the type of the medication taken were examined. Deliberate self-poisoning was the most frequent method (73.8%) committed with more than 200 different types of drugs. 40.5% of the patients attempted suicide with an intent to die, whilst 35.6% of the patients wanted to escape from an unbearable situation. Older age groups, greater amount of taken pills, and affective disorders were associated with self-reported serious intention to die. Our findings should be taken into consideration when monitoring drugs for older patients with depressive disorders.
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Affiliation(s)
- Orsolya N Horváth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.,Department of Dermatology and Allergy, Ludwig-Maximilians University, Munich, Germany
| | - Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Szilvia Àdám
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
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12
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Barczyk AN, Gillon JT, Piper K, Crocker CL, Christie LM, Lawson KA. Predictors of Traumatic Suicide Attempts in Youth Presenting to Hospitals with Level I Trauma Centers. J Emerg Med 2020; 59:178-185. [PMID: 32451186 DOI: 10.1016/j.jemermed.2020.02.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/24/2020] [Accepted: 02/15/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Limited research exists examining the predictors of suicide attempts by mechanism. OBJECTIVE The purpose of this study was to examine predictors of traumatic suicide attempts in youth. METHODS Data came from patients 5-18 years of age presenting because of a suicide attempt at 2 hospitals in Central Texas with level I trauma centers. Univariate logistic regression examined the association between traumatic suicide attempts and variables describing the patient's demographic, mental health, and social information. We used the Mann-Whitney U test to examine the association between traumatic suicide attempts and the continuous variable of age. RESULTS Of 231 patients included in this study, most were female (75.8%), non-Hispanic white (48.1%), and had a median age of 15.0 years (interquartile range 14-16). Compared with patients presenting because of an intentional overdose, patients presenting because of traumatic suicide attempts were associated with a reported criminal history (odds ratio [OR] 14.50 [95% confidence interval {CI} 3.84-54.82]), reported Child Protective Services history (OR 3.26 [95% CI 0.99-10.77]), being publicly insured or uninsured (OR 1.80 [95% CI 1.02-3.19]), male (OR 2.37 [95% CI 1.28-4.38]), and identifying as Hispanic (OR 2.01 [95% CI 1.10-3.68). CONCLUSIONS Our findings inform targeted preventative resources and education efforts to populations of greatest need.
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Affiliation(s)
- Amanda N Barczyk
- Dell Children's Trauma and Injury Research Center, Austin, Texas
| | - Jason T Gillon
- Dell Children's Medical Center of Central Texas, Austin, Texas
| | - Karen Piper
- Dell Children's Trauma and Injury Research Center, Austin, Texas
| | | | | | - Karla A Lawson
- Dell Children's Trauma and Injury Research Center, Austin, Texas
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13
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Krysinska K, Curtis S, Lamblin M, Stefanac N, Gibson K, Byrne S, Thorn P, Rice SM, McRoberts A, Ferrey A, Perry Y, Lin A, Hetrick S, Hawton K, Robinson J. Parents' Experience and Psychoeducation Needs When Supporting a Young Person Who Self-Harms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3662. [PMID: 32456022 PMCID: PMC7277421 DOI: 10.3390/ijerph17103662] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Self-harm in young people can have a substantial negative impact on the well-being and functioning of parents and other carers. The "Coping with Self-Harm" booklet was originally developed in the UK as a resource for parents and carers of young people who self-harm, and an adaptation study of this resource was conducted in Australia. This paper presents qualitative analysis of interviews with parents about their experiences and psychoeducational needs when supporting a young person who engages in self harm. METHODS The qualitative study drew on semi-structured individual and group interviews with parents (n = 19 participants) of young people who self-harm. Data were analysed using Thematic Analysis. RESULTS The analysis identified six themes: (1) the discovery of self-harm, (2) challenges in the parent-young person relationship, (3) parents' need to understand self-harm, (4) parents' emotional reactions to self-harm, (5) the importance of self-care and help-seeking among parents, and (6) the need for psychoeducational resources. CONCLUSION The study highlights the need for support for parents and carers of young people who engage in self-harm, including development and adaptation of resources, such as the "Coping with Self-Harm" booklet, of which an Australian version has now been developed.
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Affiliation(s)
- Karolina Krysinska
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Sophie Curtis
- North Western Mental Health, Parkville, VIC 3050, Australia
| | - Michelle Lamblin
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nina Stefanac
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Kerry Gibson
- School of Psychology, The University of Auckland, Auckland 1142, New Zealand
| | - Sadhbh Byrne
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Pinar Thorn
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Simon M Rice
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | | | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Sarah Hetrick
- Orygen, Parkville, VIC 3052, Australia
- Department of Psychological Medicine, The University of Auckland, Auckland 1142, New Zealand
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Jo Robinson
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
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14
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Spielmans GI, Spence-Sing T, Parry P. Duty to Warn: Antidepressant Black Box Suicidality Warning Is Empirically Justified. Front Psychiatry 2020; 11:18. [PMID: 32116839 PMCID: PMC7031767 DOI: 10.3389/fpsyt.2020.00018] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/09/2020] [Indexed: 12/23/2022] Open
Abstract
The United States Food and Drug Administration issued a Black Box warning in October 2004 after placebo-controlled trials of antidepressant medications found an increased risk of suicidal thoughts and behaviors among children and adolescents taking antidepressant medications relative to placebo. Subsequently, some researchers have concluded that the Black Box warning caused severe unintended consequences; specifically, they have argued that the warning led to reduced use of antidepressants among youth, which led to more suicides. In this paper, we critically examine research regarding the Black Box warning's alleged deleterious consequences. One study claimed that controlled trials did not actually find an increased risk of suicidality among youth taking fluoxetine relative to those taking placebo, but its measure of suicidality is likely invalid. We found that ecological time series studies claiming that decreasing antidepressant prescriptions are linked to higher rates of suicide attempts or actual suicides among youth were methodologically weak. These studies exhibited shortcomings including: selective use of time points, use of only a short-term time series, lack of performing statistical analysis, not examining level of severity/impairment among participants, inability to control confounding variables, and/or use of questionable measures of suicide attempts. Further, while some time-series studies claim that increased antidepressant prescriptions are related to fewer youth suicides, more recent data suggests that increasing antidepressant prescriptions are related to more youth suicide attempts and more completed suicides among American children and adolescents. We also note that case-control studies show increased risk of suicide attempts and suicide among youth taking antidepressants, even after controlling for some relevant confounds. As clinical trials have the greatest ability to control relevant confounds, it is important to remember such trials demonstrated increased risk of suicidality adverse events among youth taking antidepressants. The Black Box warning is firmly rooted in solid data whereas attempts to claim the warning has caused harm are based on quite weak evidence.
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Affiliation(s)
- Glen I. Spielmans
- Department of Psychology, Metropolitan State University, Saint Paul, MN, United States
| | - Tess Spence-Sing
- Department of Psychology, Metropolitan State University, Saint Paul, MN, United States
| | - Peter Parry
- School of Clinical Medicine – Children’s Health Queensland Unit, University of Queensland, Brisbane, QLD, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
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15
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Affiliation(s)
- Katrina Witt
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, VIC, Australia.,2 Turning Point, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Jo Robinson
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, University of Melbourne, VIC, Australia
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16
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Goodfellow B, Kõlves K, De Leo D. Contemporary Classifications of Suicidal Behaviors. CRISIS 2019; 41:179-186. [PMID: 31512927 DOI: 10.1027/0227-5910/a000622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The absence of agreed-upon terminology, definitions, and operational classifications has hampered research in the field of suicidology for many decades. Aims and Method: We systematically reviewed contemporary classifications of suicidal behavior using the scope of the classification (comprehensive vs. restricted or single behaviors), and the presence or absence of a classification scheme and an operational definition of intent as features to enable analysis and comparison. Results: A chronological perspective shows that classification systems tend to be more and more precise and operational for clinical and research field work. However, on an international level, the development of classifications appears to precede the establishment of agreed-upon definitions and terms to describe suicidal behavior. Limitations: The review was conducted in English only. Conclusion: Universal agreement on definitions and terms for suicidal behavior should precede the development of classifications.
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Affiliation(s)
- Benjamin Goodfellow
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia.,Centre Hospitalier Albert Bousquet, Nouméa, New Caledonia
| | - Kairi Kõlves
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia
| | - Diego De Leo
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia
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17
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Goodfellow B, Kõlves K, De Leo D, Silverman M, Berman A, Mann J, Arensman E, Hawton K, Phillips M, Vijayakumar L. International Study of Definitions of English-Language Terms for Suicidal Behaviours: protocol of an opinion survey. BMJ Open 2019; 9:e025770. [PMID: 31296506 PMCID: PMC6624059 DOI: 10.1136/bmjopen-2018-025770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The objective of present paper is to outline the methodology of the International Study of Definitions of English-Language Terms for Suicidal Behaviours (ISDELTSB). The aim of the study is to survey existing English language terms and definitions used around the world for suicidal behaviour. METHODS AND ANALYSIS The ISDELTSB is a worldwide survey based on one 'designated expert' per each WHO-registered country. 'Experts' were contacted through the International Association for Suicide Prevention (IASP), the World Psychiatric Association and the World Organization of Family Doctors. Each individual was sent an invitation to participate and a link to an online questionnaire. A comparison sample was created by inviting all IASP members to respond to the questionnaire. The questionnaire was designed to assess respondents' preferences about a particular set of terms and definitions by using the four major criteria of the definition of suicide identified in the literature (outcome, intent, knowledge and agency). The questionnaire used a multiple-choice question format. Participants were asked to choose one term in the list for each of the proposed definitions. Statements and definitions in the questionnaire were elaborated using the four main features of the definition of suicide, starting by the definitions and terms for which there is already a certain degree of consensus and then progressing to definitions and terms less agreed on. ETHICS AND DISSEMINATION The study protocol obtained approval of Griffith University's Ethics Committee (ethics reference number 2017/601) and in accordance with the Australian National Statement on Ethical Conduct in Human Research. Respondents are asked if they accept to be personally acknowledged in any output originating from this study, and if so to provide their full name, title and affiliations. If respondents do not accept, they are informed that the conduct of this research respects Griffith University's Privacy Plan and that identified personal information is confidential and that anonymity will at all times be safeguarded. As detailed in the questionnaire cover letter, by answering the online or paper version of the questionnaire, respondents express their consent to participate. Dissemination of results will be done through a peer-reviewed journal article publication. This study aims to map the international use of definitions and terms for suicidal behaviour and ideation and favour the future use of an internationally shared set of terms and definitions. This will hopefully avoid undue duplication of efforts and reliably permit meta-analysis of data produced in different countries.
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Affiliation(s)
- Benjamin Goodfellow
- Australian Institute of Suicide Research and Prevention, Griffith University, Brisbane, Queensland, Australia
- Department of Psychiatry, Centre Hospitalier Albert Bousquet, Nouméa, New Caledonia
| | - Kairi Kõlves
- Australian Institute of Suicide Research and Prevention, Griffith University, Brisbane, Queensland, Australia
| | - Diego De Leo
- Australian Institute of Suicide Research and Prevention, Griffith University, Brisbane, Queensland, Australia
| | - Morton Silverman
- Department of Psychiatry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Alan Berman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - John Mann
- Department of Neuroscience, Columbia University, New York, USA
| | - Ella Arensman
- National Suicide Research Foundation, School of Public Health, Cork, Ireland
| | - Keith Hawton
- Psychiatry, Centre for Suicide Research, Oxford University, Oxford, UK
| | - Michael Phillips
- Suicide Research and Prevention Center, Shanghai Mental Health Center, Shanghai, China
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18
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Barczyk AN, Piper K, Duzinski SV, Lawson KA. Suicide Attempt Trends in Central Texas Youth. Community Ment Health J 2019; 55:798-803. [PMID: 30847734 DOI: 10.1007/s10597-019-00386-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/27/2019] [Indexed: 11/24/2022]
Affiliation(s)
- Amanda N Barczyk
- Dell Children's Trauma and Injury Research Center, 4900 Mueller Blvd, Austin, TX, 78723, USA.
| | - Karen Piper
- Dell Children's Trauma and Injury Research Center, 4900 Mueller Blvd, Austin, TX, 78723, USA
| | - Sarah V Duzinski
- Dell Children's Trauma and Injury Research Center, 4900 Mueller Blvd, Austin, TX, 78723, USA
| | - Karla A Lawson
- Dell Children's Trauma and Injury Research Center, 4900 Mueller Blvd, Austin, TX, 78723, USA
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19
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Goodfellow B, Kõlves K, de Leo D. Contemporary Definitions of Suicidal Behavior: A Systematic Literature Review. Suicide Life Threat Behav 2019; 49:488-504. [PMID: 29574910 DOI: 10.1111/sltb.12457] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 11/11/2017] [Indexed: 01/22/2023]
Abstract
To address the lack of comparability around the world, we conducted a systematic review of existing definitions of suicide and suicidal behaviors. In the literature, four key features appear to cover the vast majority of concepts underpinning definitions: agency, knowledge of a potential fatal outcome, intent, and outcome. Intent and outcome appear to be the most consensual features of definitions of suicide, albeit revealing interesting conceptual variations. The four key features could be used to devise a research tool able to explore the meanings of suicide across different countries and different cultures.
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Affiliation(s)
- Benjamin Goodfellow
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia.,Centre Hospitalier Albert Bousquet, Nouméa, New Caledonia
| | - Kairi Kõlves
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia
| | - Diego de Leo
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia
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20
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Cramer RJ, Rasmussen S, Webber WB, Sime VL, Haile C, McFadden C, McManus MC. Preferences in Information Processing and suicide: Results from a young adult health survey in the United Kingdom. Int J Soc Psychiatry 2019; 65:46-55. [PMID: 30488744 DOI: 10.1177/0020764018815206] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Suicide prevention literature currently suffers from inconsistent measurement and incomplete theoretical development. AIMS Using a recommended suicide measurement approach for epidemiological studies (i.e. the Suicidal Behaviors Questionnaire-Revised (SBQ-R)), the present investigation assessed United Kingdom young adult suicide prevalence rates. This study also investigated the utility of a Preferences in Information Processing (PIP) model of suicide in identifying those at increased odds for elevated suicide risk, as well as lifetime ideation and attempt. METHOD A cross-sectional mental health and well-being survey study ( n = 414) was conducted. RESULTS The prevalence rates of elevated risk (49.8%), lifetime ideation only (55.3%) and lifetime attempt (13.5%) were high. Bivariate associations demonstrated that elevated depression, anxiety and Need for Affect (NFA) Avoidance were associated with worsened suicide outcomes, whereas elevated Need for Cognition (NFC) was associated with decreased suicide risk. Logistic regression results identified depression and NFA Avoidance as the strongest predictors of elevated suicide risk. Multinomial logistic regression results established several PIP-based moderation effects for depression and anxiety in which NFA Approach and NFC differentially influenced odds of suicide attempt group membership. CONCLUSION The SBQ-R is an appropriate tool for UK young adult suicide research. NFA and NFC demonstrated potential for inclusion in young adult suicide prevention programming. Further research is needed to fully evaluate the PIP model of suicide and effectiveness of proposed theory-based approaches to suicide prevention.
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Affiliation(s)
- Robert J Cramer
- 1 School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA
| | - Susan Rasmussen
- 2 School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Wesley B Webber
- 3 Department of Educational Studies in Psychology, Research Methodology, and Counseling, The University of Alabama, Tuscaloosa, AL, USA
| | - Victoria L Sime
- 2 School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Caitlin Haile
- 2 School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Claire McFadden
- 2 School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Moira C McManus
- 4 College of Health Sciences, Old Dominion University, Norfolk, VA, USA
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21
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Pollock NJ, Healey GK, Jong M, Valcour JE, Mulay S. Tracking progress in suicide prevention in Indigenous communities: a challenge for public health surveillance in Canada. BMC Public Health 2018; 18:1320. [PMID: 30482175 PMCID: PMC6260704 DOI: 10.1186/s12889-018-6224-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/15/2018] [Indexed: 01/07/2023] Open
Abstract
Indigenous peoples in Canada experience disproportionate rates of suicide compared to non-Indigenous populations. Indigenous communities and organizations have designed local and regional approaches to prevention, and the federal government has developed a national suicide prevention framework. However, public health systems continue to face challenges in monitoring the population burden of suicide and suicidal behaviour. National health data systems lack Indigenous identifiers, do not capture data from some regions, and do not routinely engage Indigenous communities in data governance. These challenges hamper efforts to detect changes in population-level outcomes and assess the impact of suicide prevention activities. Consequently, this limits the ability to achieve public health prevention goals and reduce suicide rates and rate inequities. This paper provides a critical analysis of the challenges related to suicide surveillance in Canada and assesses the strengths and limitations of existing data infrastructure for monitoring outcomes in Indigenous communities. To better understand these challenges, we discuss the policy context for suicide surveillance and examine the survey and administrative data sources that are commonly used in public health surveillance. We then review recent data on the epidemiology of suicide and suicidal behaviour among Indigenous populations, and identify challenges related to national surveillance. To enhance capacity for suicide surveillance, we propose strategies to better track progress in Indigenous suicide prevention. Specifically, we recommend establishing an independent community and scientific governing council, integrating Indigenous identifiers into population health datasets, increasing geographic coverage, improving suicide data quality, comprehensiveness, and timeliness, and developing a platform for making suicide data accessible to all stakeholders. Overall, the strategies we propose can build on the strengths of the existing national suicide surveillance system by adopting a collaborative and inclusive governance model that recognizes the stake Indigenous communities have in suicide prevention.
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Affiliation(s)
- Nathaniel J Pollock
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, Prince Philip Drive, St. John's, Newfoundland and Labrador, A1B 3V6, Canada. .,Labrador Institute of Memorial University, P.O. Box 490, Stn. B, 219 Hamilton River Road, Happy Valley-Goose Bay, Newfoundland and Labrador, A0P 1E0, Canada.
| | - Gwen K Healey
- Qaujigiartiit Health Research Centre, PO Box 11372, 764 Fred Coman Dr., Iqaluit, NT, X0A 0H0, Canada.,Northern Ontario School of Medicine, Thunder Bay, ON, Canada
| | - Michael Jong
- Labrador-Grenfell Regional Health Authority, Labrador Health Centre, Happy Valley-Goose Bay, Newfoundland and Labrador, Canada.,Northern Family Medicine Program (NorFam), Discipline of Family Medicine, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - James E Valcour
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, Prince Philip Drive, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
| | - Shree Mulay
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, Prince Philip Drive, St. John's, Newfoundland and Labrador, A1B 3V6, Canada
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22
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The #chatsafe project. Developing guidelines to help young people communicate safely about suicide on social media: A Delphi study. PLoS One 2018. [PMID: 30439958 DOI: 10.1371/journal.pone.0206584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Many countries have developed guidelines advocating for responsible reporting of suicidal behaviour in traditional media. However, the increasing popularity of social media, particularly among young people, means that complementary guidelines designed to facilitate safe peer-peer communication are required. The aim of this study was to develop a set of evidence informed guidelines to assist young people to communicate about suicide via social media with the input of young people as active participants of the study. METHODS Systematic searches of the peer-reviewed and grey literature were conducted resulting in a 284-item questionnaire identifying strategies for safe communication about suicide online. The questionnaire was delivered over two rounds to two panels consisting of Australian youth advocates; and international suicide prevention researchers and media and communications specialists. Items were rerated if they were endorsed by 70-79.5% of both panels, or if 80% or more of one panel rated the item as essential or important. All items that were endorsed as essential or important by at least 80% of both panels were included in the final guidelines. RESULTS A total of 173 items were included in the final guidelines. These items were organised into the following five sections: 1) Before you post anything online about suicide; 2) Sharing your own thoughts, feelings, or experience with suicidal behaviour online; 3) Communicating about someone you know who is affected by suicidal thoughts, feelings or behaviours; 4) Responding to someone who may be suicidal; 5) Memorial websites, pages and closed groups to honour the deceased. DISCUSSION This is the first study to develop a set of evidence-informed guidelines to support young people to talk safely about suicide on social media. It is hoped that they will be a useful resource for young people and those who support them (e.g., parents, teachers, community workers and health professionals).
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Robinson J, Hill NTM, Thorn P, Battersby R, Teh Z, Reavley NJ, Pirkis J, Lamblin M, Rice S, Skehan J. The #chatsafe project. Developing guidelines to help young people communicate safely about suicide on social media: A Delphi study. PLoS One 2018; 13:e0206584. [PMID: 30439958 PMCID: PMC6237326 DOI: 10.1371/journal.pone.0206584] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/16/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Many countries have developed guidelines advocating for responsible reporting of suicidal behaviour in traditional media. However, the increasing popularity of social media, particularly among young people, means that complementary guidelines designed to facilitate safe peer-peer communication are required. The aim of this study was to develop a set of evidence informed guidelines to assist young people to communicate about suicide via social media with the input of young people as active participants of the study. METHODS Systematic searches of the peer-reviewed and grey literature were conducted resulting in a 284-item questionnaire identifying strategies for safe communication about suicide online. The questionnaire was delivered over two rounds to two panels consisting of Australian youth advocates; and international suicide prevention researchers and media and communications specialists. Items were rerated if they were endorsed by 70-79.5% of both panels, or if 80% or more of one panel rated the item as essential or important. All items that were endorsed as essential or important by at least 80% of both panels were included in the final guidelines. RESULTS A total of 173 items were included in the final guidelines. These items were organised into the following five sections: 1) Before you post anything online about suicide; 2) Sharing your own thoughts, feelings, or experience with suicidal behaviour online; 3) Communicating about someone you know who is affected by suicidal thoughts, feelings or behaviours; 4) Responding to someone who may be suicidal; 5) Memorial websites, pages and closed groups to honour the deceased. DISCUSSION This is the first study to develop a set of evidence-informed guidelines to support young people to talk safely about suicide on social media. It is hoped that they will be a useful resource for young people and those who support them (e.g., parents, teachers, community workers and health professionals).
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Affiliation(s)
- Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Nicole T. M. Hill
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Pinar Thorn
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Rikki Battersby
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
| | - Zoe Teh
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
| | - Nicola J. Reavley
- Centre for Mental Health, The Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Jane Pirkis
- Centre for Mental Health, The Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Michelle Lamblin
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Simon Rice
- Orygen, The National Centre of Excellence in Youth Mental Health, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Victoria, Australia
| | - Jaelea Skehan
- Everymind, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
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Barczyk AN, Piper K, Duzinski SV, Klingensmith M, Lawson KA. Youth Suicide Attempt Nomenclature Used in Two Central Texas Hospitals. CRISIS 2018; 39:461-468. [DOI: 10.1027/0227-5910/a000521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Surveillance systems capturing instances of self-directed violence (SDV) continue to lack uniform nomenclature and classification methodology. Aims: To apply and compare two retrospective surveillance approaches to youth experiencing SDV presenting to two urban hospitals with Level I Trauma Centers. Method: Two suicide attempt surveillance methods where retrospectively applied to our SDV cohort: (a) a rigorous method facilitated by medical record review and application of standardized classification; and (b) a common surveillance method conducted by systematic queries of suicide attempt key terms and diagnosis codes among hospital databases. Results: Rigorous surveillance identified 249 patients attempting suicide. The common method's querying suicide attempt in the chief complaint field had a high positive predictive value and specificity; however, sensitivity was low. Limitations: Authors were unable to determine whether all SDV encounters during the study timeframe were identified for initial screening owing to the hospital's lack of a uniform nomenclature or classification system. Conclusion: Results showed underreporting of suicide attempt cases, inadequate sensitivity and specificity in common surveillance methods, and skewed demographic representation compared with the rigorous surveillance method. This study elucidates the negative impact of inconsistent SDV nomenclature including impeding effective patient identification, treatment, surveillance, and generalizable research.
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Affiliation(s)
| | - Karen Piper
- Dell Children's Trauma and Injury Research Center, Austin, TX, USA
| | | | | | - Karla A. Lawson
- Dell Children's Trauma and Injury Research Center, Austin, TX, USA
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James K, Stewart D. Blurred Boundaries – A Qualitative Study of How Acts of Self-Harm and Attempted Suicide Are Defined by Mental Health Practitioners. CRISIS 2018; 39:247-254. [DOI: 10.1027/0227-5910/a000491] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: There is no commonly accepted definition of the term self-harm, and there is an ongoing debate about whether or not it should include acts of attempted suicide. The use of this language in clinical practice has not previously been explored. Aims: To investigate if, and how, practitioners distinguish between acts of self-harm and attempted suicide, and present any implications for practice. Method: We conducted semistructured interviews with a random sample of 18 frontline practitioners from 10 mental health wards and completed a thematic analysis of interview data. Results: Most participants described self-harm and attempted suicide as distinct behaviors. Characteristics of the act, disclosures of intent, and the level of distress observed were commonly used to differentiate between self-harm and attempted suicide. Very few participants believed that people who self-harm may also feel suicidal. Practitioners confidently described two different behaviors, yet self-harm and attempted suicide were often conflated, revealing the challenges and complexities associated with the separation of these acts in clinical practice. Limitations: Clinicians working in other settings or disciplines may have different views. Participants' accounts may not be an accurate representation of what happens in practice. Conclusion: This study adds to a body of evidence which argues against the dichotomous separation of these behaviors into acts of suicidal and nonsuicidal self-harm.Our findings suggest there is no common understanding of the boundaries between self-harm and attempted suicide among frontline clinicians. The language currently used, and consequent practice, particularly with regard to risk assessment, is problematic. Efforts should be made to operationalize terms around suicidal behavior and to incorporate these into training for clinical staff.
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Affiliation(s)
- Karen James
- Kingston University and St. George’s University of London, Joint Faculty of Health, Social Care and Education, London, UK
| | - Duncan Stewart
- Kingston University and St. George’s University of London, Joint Faculty of Health, Social Care and Education, London, UK
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Aladağ AE, Muderrisoglu S, Akbas NB, Zahmacioglu O, Bingol HO. Detecting Suicidal Ideation on Forums: Proof-of-Concept Study. J Med Internet Res 2018; 20:e215. [PMID: 29929945 PMCID: PMC6035349 DOI: 10.2196/jmir.9840] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 04/22/2018] [Accepted: 05/08/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In 2016, 44,965 people in the United States died by suicide. It is common to see people with suicidal ideation seek help or leave suicide notes on social media before attempting suicide. Many prefer to express their feelings with longer passages on forums such as Reddit and blogs. Because these expressive posts follow regular language patterns, potential suicide attempts can be prevented by detecting suicidal posts as they are written. OBJECTIVE This study aims to build a classifier that differentiates suicidal and nonsuicidal forum posts via text mining methods applied on post titles and bodies. METHODS A total of 508,398 Reddit posts longer than 100 characters and posted between 2008 and 2016 on SuicideWatch, Depression, Anxiety, and ShowerThoughts subreddits were downloaded from the publicly available Reddit dataset. Of these, 10,785 posts were randomly selected and 785 were manually annotated as suicidal or nonsuicidal. Features were extracted using term frequency-inverse document frequency, linguistic inquiry and word count, and sentiment analysis on post titles and bodies. Logistic regression, random forest, and support vector machine (SVM) classification algorithms were applied on resulting corpus and prediction performance is evaluated. RESULTS The logistic regression and SVM classifiers correctly identified suicidality of posts with 80% to 92% accuracy and F1 score, respectively, depending on different data compositions closely followed by random forest, compared to baseline ZeroR algorithm achieving 50% accuracy and 66% F1 score. CONCLUSIONS This study demonstrated that it is possible to detect people with suicidal ideation on online forums with high accuracy. The logistic regression classifier in this study can potentially be embedded on blogs and forums to make the decision to offer real-time online counseling in case a suicidal post is being written.
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Affiliation(s)
- Ahmet Emre Aladağ
- Department of Computer Engineering, Bogazici University, Istanbul, Turkey.,Amazon Research, Madrid, Spain
| | | | - Naz Berfu Akbas
- Medical School, Department of Psychiatry, Yeditepe University, Istanbul, Turkey
| | - Oguzhan Zahmacioglu
- Medical School, Department of Child and Adolescent Psychiatry, Yeditepe University, Istanbul, Turkey
| | - Haluk O Bingol
- Department of Computer Engineering, Bogazici University, Istanbul, Turkey
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Goodfellow B, Kõlves K, de Leo D. Contemporary Nomenclatures of Suicidal Behaviors: A Systematic Literature Review. Suicide Life Threat Behav 2018; 48:353-366. [PMID: 28485508 DOI: 10.1111/sltb.12354] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/02/2017] [Indexed: 11/29/2022]
Abstract
Addressing the lack of comparability of research results around the world, a systematic literature review of existing nomenclatures was conducted. After distinguishing the concepts of nomenclature and classification, 13 contributions to nomenclature of suicidal behavior are described and summarized using outcome and intent as guiding concepts for analysis. The issue of what is being defined in nomenclatures is fundamental and impacts the way intent and outcome are used. The existing confusion between classification and nomenclature stems from conflicting purposes of the nature of definition; that is, to communicate concepts versus to be descriptive of reality.
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Affiliation(s)
- Benjamin Goodfellow
- Centre Hospitalier Albert Bousquet, Nouméa, New Caledonia.,Australian Institute of Suicide Research and Prevention, Mt Gravatt, Qld, Australia
| | - Kairi Kõlves
- Australian Institute of Suicide Research and Prevention, Mt Gravatt, Qld, Australia
| | - Diego de Leo
- Australian Institute of Suicide Research and Prevention and Griffith University, Mt Gravatt, Qld, Australia
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The Impact of COMT and Childhood Maltreatment on Suicidal Behaviour in Affective Disorders. Sci Rep 2018; 8:692. [PMID: 29330410 PMCID: PMC5766555 DOI: 10.1038/s41598-017-19040-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 12/14/2017] [Indexed: 12/02/2022] Open
Abstract
The inconsistent findings on the association between COMT (catecholamine-O-methyl-transferase) and suicidal behaviour gave reason to choose a clear phenotype description of suicidal behaviour and take childhood maltreatment as environmental factor into account. The aim of this candidate-gene-association study was to eliminate heterogeneity within the sample by only recruiting affective disorder patients and find associations between COMT polymorphisms and defined suicidal phenotypes. In a sample of 258 affective disorder patients a detailed clinical assessment (e.g. CTQ, SCAN, HAMD, SBQ-R, VI-SURIAS, LPC) was performed. DNA of peripheral blood samples was genotyped using TaqMan® SNP Genotyping Assays. We observed that the haplotype GAT of rs737865, rs6269, rs4633 is significantly associated with suicide attempt (p = 0.003 [pcorr = 0.021]), and that there is a tendency towards self-harming behaviour (p = 0.02 [pcorr = 0.08]) and also NSSI (p = 0.03 [pcorr = 0.08]), though the p values did not resist multiple testing correction. The same effect we observed with the 4-marker slide window haplotype, GATA of rs737865, rs6269, rs4633, rs4680 (p = 0.009 [pcorr = 0.045]). The findings support an association between the COMT gene and suicidal behaviour phenotypes with and without childhood maltreatment as environmental factor.
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High Rates of Suicide and Violence in the Lives of Girls and Young Women in Bangladesh: Issues for Feminist Intervention. SOCIAL SCIENCES 2017. [DOI: 10.3390/socsci6040140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Favril L, Vander Laenen F, Vandeviver C, Audenaert K. Suicidal ideation while incarcerated: Prevalence and correlates in a large sample of male prisoners in Flanders, Belgium. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2017; 55:19-28. [PMID: 29157508 DOI: 10.1016/j.ijlp.2017.10.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 09/05/2017] [Accepted: 10/03/2017] [Indexed: 05/22/2023]
Abstract
Prisoners constitute a high-risk group for suicide. As an early stage in the pathway leading to suicide, suicidal ideation represents an important target for prevention, yet research on this topic is scarce in general prison populations. Using a cross-sectional survey design, correlates of suicidal ideation while incarcerated were examined in a sample of 1203 male prisoners, randomly selected from 15 Flemish prisons. Overall, a lifetime history of suicidal ideation and attempts was endorsed by 43.1% and 20.3% of respondents, respectively. Approximately a quarter of all prisoners (23.7%) reported past-year suicidal ideation during their current incarceration, which was significantly associated with both imported vulnerabilities (psychiatric diagnoses and a history of attempted suicide) and variables unique to the prison experience (lack of working activity, exposure to suicidal behaviour by peers, and low levels of perceived autonomy, safety and social support) in the multivariate regression analysis. A first-ever period of imprisonment and a shorter length of incarceration (≤12months) were also associated with increased odds of recent suicidal ideation. Collectively, the current findings underscore the importance of both vulnerability factors and prison-specific stressors for suicidal ideation in prisoners, and hence the need for a multi-faceted approach to suicide prevention in custodial settings. In addition to the provision of appropriate mental health care, environmental interventions that target modifiable aspects of the prison regime could provide a substantial buffer for the onset and persistence of suicidal ideation in this at-risk population.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy (IRCP), Faculty of Law and Criminology, Ghent University, Belgium.
| | - Freya Vander Laenen
- Institute for International Research on Criminal Policy (IRCP), Faculty of Law and Criminology, Ghent University, Belgium
| | - Christophe Vandeviver
- Institute for International Research on Criminal Policy (IRCP), Faculty of Law and Criminology, Ghent University, Belgium
| | - Kurt Audenaert
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences, Ghent University, Belgium
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Cramer RJ, Kapusta ND. A Social-Ecological Framework of Theory, Assessment, and Prevention of Suicide. Front Psychol 2017; 8:1756. [PMID: 29062296 PMCID: PMC5640776 DOI: 10.3389/fpsyg.2017.01756] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 09/22/2017] [Indexed: 12/11/2022] Open
Abstract
The juxtaposition of increasing suicide rates with continued calls for suicide prevention efforts begs for new approaches. Grounded in the Centers for Disease Control and Prevention (CDC) framework for tackling health issues, this personal views work integrates relevant suicide risk/protective factor, assessment, and intervention/prevention literatures. Based on these components of suicide risk, we articulate a Social-Ecological Suicide Prevention Model (SESPM) which provides an integration of general and population-specific risk and protective factors. We also use this multi-level perspective to provide a structured approach to understanding current theories and intervention/prevention efforts concerning suicide. Following similar multi-level prevention efforts in interpersonal violence and Human Immunodeficiency Virus (HIV) domains, we offer recommendations for social-ecologically informed suicide prevention theory, training, research, assessment, and intervention programming. Although the SESPM calls for further empirical testing, it provides a suitable backdrop for tailoring of current prevention and intervention programs to population-specific needs. Moreover, the multi-level model shows promise to move suicide risk assessment forward (e.g., development of multi-level suicide risk algorithms or structured professional judgments instruments) to overcome current limitations in the field. Finally, we articulate a set of characteristics of social-ecologically based suicide prevention programs. These include the need to address risk and protective factors with the strongest degree of empirical support at each multi-level layer, incorporate a comprehensive program evaluation strategy, and use a variety of prevention techniques across levels of prevention.
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Affiliation(s)
- Robert J Cramer
- School of Community and Environmental Health Sciences, Old Dominion University, Norfolk, VA, United States
| | - Nestor D Kapusta
- Suicide Research Group, Department for Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Berman AL, Silverman MM. How to Ask About Suicide? A Question in Need of an Empirical Answer. CRISIS 2017; 38:213-216. [DOI: 10.1027/0227-5910/a000501] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Alan L. Berman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Andriessen K, Castelli Dransart DA, Cerel J, Maple M. Current Postvention Research and Priorities for the Future. CRISIS 2017; 38:202-206. [DOI: 10.1027/0227-5910/a000459] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Abstract. Background: Suicide can have a lasting impact on the social life as well as the physical and mental health of the bereaved. Targeted research is needed to better understand the nature of suicide bereavement and the effectiveness of support. Aims: To take stock of ongoing studies, and to inquire about future research priorities regarding suicide bereavement and postvention. Method: In March 2015, an online survey was widely disseminated in the suicidology community. Results: The questionnaire was accessed 77 times, and 22 records were included in the analysis. The respondents provided valuable information regarding current research projects and recommendations for the future. Limitations: Bearing in mind the modest number of replies, all from respondents in Westernized countries, it is not known how representative the findings are. Conclusion: The survey generated three strategies for future postvention research: increase intercultural collaboration, increase theory-driven research, and build bonds between research and practice. Future surveys should include experiences with obtaining research grants and ethical approval for postvention studies.
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Affiliation(s)
- Karl Andriessen
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Taskforce on Suicide Bereavement and Postvention Research of the IASP Special Interest Group on Suicide Bereavement
| | - Dolores Angela Castelli Dransart
- School of Social Work Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
- Taskforce on Suicide Bereavement and Postvention Research of the IASP Special Interest Group on Suicide Bereavement
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, KY, USA
- Taskforce on Suicide Bereavement and Postvention Research of the IASP Special Interest Group on Suicide Bereavement
| | - Myfanwy Maple
- School of Health, University of New England, Armidale, NSW, Australia
- Taskforce on Suicide Bereavement and Postvention Research of the IASP Special Interest Group on Suicide Bereavement
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