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Oh TK, Park HY, Song IA. Suicidal Thinking Among Patients With Spinal Conditions in South Korea: A Population-Based Cross-Sectional Study. Psychiatry Investig 2023; 20:834-842. [PMID: 37794665 PMCID: PMC10555517 DOI: 10.30773/pi.2023.0072] [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: 03/02/2023] [Revised: 04/15/2023] [Accepted: 06/28/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE Chronic pain increases the risk of suicide because it is often accompanied by depressive symptoms. However, the existing information regarding suicidal thinking in patients with chronic pain such as spinal conditions is insufficient. We aimed to examine the prevalence of suicidal thinking and the factors associated with it among patients with spinal conditions. METHODS Data from the National Health Insurance Service database in South Korea were used in this population-based, cross-sectional study, and 2.5% of adult patients diagnosed with spinal conditions (low back pain and/or neck pain) between 2018 and 2019 were selected using a stratified random sampling technique. Patient Health Questionnaire-9 was used to determine the presence of suicidal thoughts and depressive symptoms. RESULTS 33,171 patients with spinal conditions were included in this study. Among them, 5.9% had suicidal thinking and 20.7% had depressive symptoms. In the multivariable logistic regression model, old age, male sex, and employment were associated with a decreased prevalence of suicidal thinking. Current smokers, previous smokers, medical aid program recipients, and patients with mild-to-moderate or severe disability showed increased suicidal thinking. Underlying depression, bipolar disorder, insomnia disorder, and substance abuse were also associated with increased suicidal thinking. CONCLUSION In South Korea, 5.9% and 20.7% of patients with spinal conditions had suicidal thoughts and depressive symptoms, respectively. Some factors were associated with an increased prevalence of suicidal thoughts among patients with spinal conditions. Our results suggest that screening for these factors can help prevent suicide in patients with spinal conditions.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Hye Yoon Park
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
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Peprah P, Asare BYA, Okwei R, Agyemang-Duah W, Osafo J, Kretchy IA, Gyasi RM. A moderated mediation analysis of the association between smoking and suicide attempts among adolescents in 28 countries. Sci Rep 2023; 13:5755. [PMID: 37031212 PMCID: PMC10082789 DOI: 10.1038/s41598-023-32610-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 03/30/2023] [Indexed: 04/10/2023] Open
Abstract
Globally, evidence has shown that many adolescents are victims of substance use, mainly cigarette smoking, and it has been associated with suicidal ideation. However, the mechanisms underlying this association are poorly understood. This study examines whether truancy mediates and gender moderates the association of cigarette smoking with suicide attempts among adolescents in 28 countries. Data from the Global School-Based Student Health Survey were used. Hierarchical multiple logistic regression analyses were used to estimate the effect-modification of gender on cigarette smoking and suicide attempt. The mediating effect of truancy on the association between cigarette smoking and suicidal attempt was assessed using the generalized decomposition method. Cigarette smoking was associated with suicide attempts after adjusting for several confounding variables (aOR = 1.21; 95% CI = 1.09-1.33). The bootstrap results from the generalized decomposition analysis indicated that truancy partially mediated the association of cigarette smoking with a suicide attempt, contributing 21% of the total effect among in-school adolescents. Hierarchical regression analyses suggested that gender moderated the effect of cigarette smoking on suicidal attempts: female adolescents who smoked had 36% higher odds of suicidal attempts compared to male adolescents. The findings suggest possible pathways for designing and implementing interventions to address adolescents' cigarette smoking and truancy to prevent suicidal attempts.
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Affiliation(s)
- Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, Australia.
- Centre for Primary Health Care and Equity, University New South Wales, Sydney, Australia.
| | - Bernard Yeboah-Asiamah Asare
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Reforce Okwei
- Department of Geography, Miami University, Oxford, USA
| | | | - Joseph Osafo
- Department of Psychology, University of Ghana, Legon, Ghana
- Centre for Suicide and Violence Research - CSVR, Accra, Ghana
| | - Irene A Kretchy
- Centre for Suicide and Violence Research - CSVR, Accra, Ghana
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Razak M Gyasi
- African Population and Health Research Center, Manga Close, Off-Kirawa Road, P.O. Box 10787, Nairobi, 00100, Kenya
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Wang T, Yao Z, Liu Q, Zhao J, Wang X, Wong JPH, Vahabi M, Jia C. The Mediating Effect of Stress between Extracurricular Activities and Suicidal Ideation in Chinese College Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3105. [PMID: 36833799 PMCID: PMC9963993 DOI: 10.3390/ijerph20043105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The objective of this study was to explore the relationship between extracurricular activities, stress, and suicidal ideation and to examine the mediating effect of stress between extracurricular activities and suicidal ideation in Chinese college students. METHOD A total of 6446 college students were surveyed with a web-based online data collection system using the self-made demographic questionnaire, Suicidal Behaviors Questionnaire-Revised (SBQ-R), and the 21-Item Depression Anxiety Stress Scales (DASS-21). SPSS 24.0 was used for descriptive statistics and correlation analysis, and the bootstrap method in the process procedure for SPSS Version 3.4.1 was used to construct the mediating effect model. RESULTS Gender, school grades, living area, and family income status were influencing factors for suicidal ideation, stress, and extracurricular activities. Extracurricular activities were negatively correlated with stress (r = -0.083, p < 0.001) and suicidal ideation (r = -0.039, p < 0.01). Extracurricular activities had no direct predictive effect on college students' suicidal ideation (c = -0.198, CI: -0.418, 0.023), while stress had a mediating effect between extracurricular activities and suicidal ideation; the indirect mediating effect was 0.159. CONCLUSIONS Extracurricular activities indirectly predict college students' suicidal ideation through stress. A variety of extracurricular activities can decrease the stress and suicidal ideation of college students and benefit their mental health.
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Affiliation(s)
- Tao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University Center for Suicide Prevention Research, Shandong University, Jinan 250012, China
| | - Zhiying Yao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University Center for Suicide Prevention Research, Shandong University, Jinan 250012, China
| | - Qianqian Liu
- Student Counseling Center, Shandong University, Jinan 250012, China
| | - Jingjing Zhao
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Xinting Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University Center for Suicide Prevention Research, Shandong University, Jinan 250012, China
| | - Josephine Pui-Hing Wong
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 1Z5, Canada
| | - Mandana Vahabi
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON M5B 1Z5, Canada
| | - Cunxian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University Center for Suicide Prevention Research, Shandong University, Jinan 250012, China
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Li C, Wei Z, Wang Y, Sun L. Associations between Suicidal Ideation and Relatives' Physical and Mental Health among Community Residents: Differences between Family Members and Lineal Consanguinity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15997. [PMID: 36498070 PMCID: PMC9737015 DOI: 10.3390/ijerph192315997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/27/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Despite the verified relationship between relatives’ characteristics and individual suicidal ideation, few studies have discussed the role of family members and lineal consanguinity independently according to whether they live together with the individuals or not. (2) Methods: The data in this study were collected in November 2019 and identified rural adults over 18 years old in Shandong as the survey objects, with a total of 879 valid cases included in this survey. Logistic regression analysis was employed to examine the risk factors affecting adults’ suicidal ideation and differentiate the effects of a family member and lineal consanguinity’s physical and mental health. Relatives’ physical and mental health were estimated by three aspects: whether they were suffering from chronic diseases, mental illness, or alcoholism. (3) Results: The study showed that a family member’s physical (OR = 2.303, p < 0.01) and mental health (OR = 5.877, p < 0.05) was related to suicidal ideation, but the association between lineal consanguinities’ physical and mental health and suicidal ideation were not supported. People over 40 years old (OR = 6.528, p < 0.05), from only-child families (OR = 4.335, p < 0.01), with household indebtedness (OR = 2.992, p < 0.001), or difficulty falling asleep (OR = 3.165, p < 0.001) had risk factors of suicidal ideation. (4) Conclusions: The physical and mental health of individuals’ family members are related to their suicidal ideation, and their lineal consanguinities’ physical and mental health are not related to suicidal ideation. These findings imply the different associations between family environment, genetic factors, and suicidal ideation. Family members’ health should be considered as a factor to prevent and control suicidal behaviors, including suicidal ideation.
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Affiliation(s)
- Caifeng Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Zhen Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Yifan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
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Mills J. Varenicline (Chantix): The Smoking Cessation Medication Prescribers May Be Avoiding. Issues Ment Health Nurs 2022; 43:489-494. [PMID: 35412411 DOI: 10.1080/01612840.2022.2061806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jeremy Mills
- Peninsula, A Division of Parkwest Medical Center, Knoxville, Tennessee, USA
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Swann AC, Graham DP, Wilkinson AV, Kosten TR. Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms. Am J Addict 2021; 30:316-329. [PMID: 34109688 DOI: 10.1111/ajad.13171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/26/2021] [Accepted: 03/06/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Extensive evidence links smoking and suicide independently of psychiatric diagnoses, but there are questions about the pathophysiology and specificity of this relationship. We examined characteristics of this linkage to identify potential transdiagnostic mechanisms in suicide and its prevention. METHODS We reviewed literature that associated suicide with smoking and e-cigarettes, including the temporal sequence of smoking and suicide risk and their shared behavioral risk factors of sensitization and impulsivity. RESULTS Smoking is associated with increased suicide across psychiatric diagnoses and in the general population, proportionately to the number of cigarettes smoked per day. Rapid nicotine uptake into the brain through inhalation of conventional cigarettes, electronic cigarettes (e-cigarette), or even second-hand smoke can facilitate long-term sensitization and short-term impulsivity. Both impair action regulation and predispose to negative affect, continued smoking, and suicidal behavior. Intermittent hypoxia, induced by cigarettes or e-cigarettes, synergistically promotes impulsivity and sensitization, exacerbating suicidality. Two other shared behavioral risks also develop negative urgency (combined impulsivity and negative affect) and cross-sensitization to stressors or to other addictive stimuli. Finally, early smoking onset, promoted by e-cigarettes in never-smokers, increases subsequent suicide risk. CONCLUSION AND SCIENTIFIC SIGNIFICANCE Prevention or cessation of nicotine inhalation can strategically prevent suicidality and other potentially lethal behavior regardless of psychiatric diagnoses. Medications for reducing smoking and suicidality, especially in younger smokers, should consider the neurobehavioral mechanisms for acute impulsivity and longer-term sensitization, potentially modulated more effectively through glutamate antagonism rather than nicotine substitution. (Am J Addict 2021;30:316-329).
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Affiliation(s)
- Alan C Swann
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - David P Graham
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | | | - Thomas R Kosten
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
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