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Li G, Su Q. Exploring the role of personal quantification in alleviating generalized anxiety disorder among Chinese PhD students: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38449. [PMID: 38847731 PMCID: PMC11155607 DOI: 10.1097/md.0000000000038449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024] Open
Abstract
Personal quantification plays a crucial role in preserving individual mental health. However, in previous research, its effectiveness in alleviating generalized anxiety disorder (GAD) has not been conclusively established. This study explores the impact of personal quantification on GAD among PhD students. The research data was obtained through questionnaires distributed to 308 PhD students across universities in China. Among these students, 118 anxiety-free participants were excluded, yielding valuable data from 190 students with GADs. We employed Python programming language and SPSS software for the empirical analysis. The results illustrated that personal quantification significantly and negatively impacted GAD (β = -0.148, P = .002), concurrently producing a significantly positive effect on self-efficacy (β = 0.359, P < .001). Further analysis showed that through 5000 sampling iterations and a 95% confidence level, self-efficacy significantly reduced certain symptoms of GAD (β = -0.1183; P = .026; 95% Cl: -0.2222 to -0.0144). Moreover, when the coefficient of self-efficacy was significantly negative, the impact of personal quantification on GAD remained statistically significant (β = -0.1056; P = .033; 95% Cl: -0.2025 to -0.0087). The findings indicated that personal quantification has a significant role in alleviating GAD among PhD students, which is partly mediated through self-efficacy. This study contributes valuable insights to the nonpharmacological alleviation of GAD in Chinese PhD students.
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Affiliation(s)
- Guilong Li
- Business School, Central University of Finance and Economics, Beijing, China
- School of Business Administration, Xinjiang University of Finance & Economics, Urumqi, Xinjiang, China
| | - Qiulan Su
- Business School, Central University of Finance and Economics, Beijing, China
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Pelcovitz M, Bennett S, Desai P, Schild J, Beaumont R, Walkup J, Shaffer D, Chiu A. High Rates of Anxiety Among Adolescents in a Partial Hospitalization Program. CHILD & YOUTH CARE FORUM 2023; 52:105-122. [PMID: 35228789 PMCID: PMC8866547 DOI: 10.1007/s10566-022-09680-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 01/28/2023]
Abstract
Background Anxiety disorders are garnering increasing attention for their contribution to high-risk issues and functional impairment. Adolescents are typically admitted to partial hospitalization programs (PHPs) due to high-risk presentations. However, the frequency of anxiety disorders in PHPs is not well-established, in part because anxiety can be overlooked in acute settings due to limited lengths of stay and focus on stabilization. Objective This study aims to evaluate the frequency and severity of anxiety disorders among a sample of adolescent PHP patients to assess the need for anxiety-specific assessment and interventions in higher acuity settings. Methods Participants were 158 youths ages 13 to 19 years old (M = 15.49 years, SD = 1.50) who were admitted to an adolescent PHP and their caregivers. Clinician-reported diagnostic information was collected from the youth's electronic medical record, and self- and caregiver-rated severity of anxiety was collected using the Screen for Child Anxiety Related Emotions Disorders (SCARED-C/P). Frequency of anxiety and related disorder diagnoses and self- and caregiver-reported severity were assessed using descriptive statistical methods. Results 75% of participants were diagnosed with an anxiety disorder (n = 118). On average, participants with anxiety disorders had elevated SCARED-C scores. Youths with depressive disorders had elevated SCARED-C scores even when they did not carry anxiety disorder diagnoses. Caregiver ratings of the youth's anxiety symptoms on the SCARED-P were elevated when youths had anxiety disorders. Conclusions These findings suggest that anxiety is common in an adolescent PHP setting and support investing in evidence-based assessment and treatment of anxiety in high-acuity settings.
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Affiliation(s)
- Michelle Pelcovitz
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
| | - Shannon Bennett
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
| | - Payal Desai
- grid.21729.3f0000000419368729New York State Psychiatric Institute, Columbia University, New York, United States
| | - Jennifer Schild
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
| | - Renae Beaumont
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
| | - John Walkup
- grid.413808.60000 0004 0388 2248Department of Psychiatry, Lurie Children’s Hospital, Chicago, United States
| | - David Shaffer
- grid.239585.00000 0001 2285 2675Department of Psychiatry, Columbia University Medical Center, New York, United States
| | - Angela Chiu
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
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Sanches M, Nguyen LK, Chung TH, Nestadt P, Wilcox HC, Coryell WH, Soares JC, Selvaraj S. Anxiety symptoms and suicidal thoughts and behaviors among patients with mood disorders. J Affect Disord 2022; 307:171-177. [PMID: 35331824 PMCID: PMC9321173 DOI: 10.1016/j.jad.2022.03.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Though the association between anxiety disorders and suicidal behavior is well-described, the impact of anxiety symptoms on suicidal thoughts and behaviors (STB) across different mood disorders is still unclear. METHODS We performed a registry-based retrospective study utilizing outcome measure data collected by the National Network of Depression Centers (NNDC), a nationwide nonprofit consortium of 26 leading clinical and academic member centers in the United States. The sample consisted of 2607 outpatients with mood disorders (major depressive disorder or bipolar disorders). Demographic and clinical variables were compared based on the presence or absence of STB and severity of anxiety symptoms (minimal, mild, moderate, and severe). Univariate and multivariable logistic regressions were conducted to examine the correlations of STB, considering multicollinearity. RESULTS Patients with mild, moderate, and severe anxiety symptoms had higher odds of STB than those with minimal symptoms. Gender, marital status, age, and depressive symptoms were other strong predictors of STB. There was no difference in the odds of STB between patients with major depressive disorder (MDD) and those with bipolar disorders (BD). However, the odds of suicidal ideation were slightly lower among patients with BD than those with MDD. LIMITATIONS Our sample was comprised only of outpatients, limiting the generalization of our findings. Other limitations include the lack of structured interviews for diagnostic characterization of the patients and the utilization of data on anxiety and mood obtained solely through self-report scales. CONCLUSIONS We found a cross-sectional association between the severity of anxiety symptoms and STB among patients with mood disorders. This study demonstrates the need for a suicide risk assessment in patients with mood disorders reporting anxiety symptoms.
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Affiliation(s)
- Marsal Sanches
- UT Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, UT Health McGovern Medical School, Houston, TX, USA.
| | - Linh K Nguyen
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Tong Han Chung
- University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paul Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Holly C Wilcox
- Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - William H Coryell
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Jair C Soares
- UT Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, UT Health McGovern Medical School, Houston, TX, USA
| | - Sudhakar Selvaraj
- UT Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, UT Health McGovern Medical School, Houston, TX, USA
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Moitra M, Santomauro D, Degenhardt L, Collins PY, Whiteford H, Vos T, Ferrari A. Estimating the risk of suicide associated with mental disorders: A systematic review and meta-regression analysis. J Psychiatr Res 2021; 137:242-249. [PMID: 33714076 PMCID: PMC8095367 DOI: 10.1016/j.jpsychires.2021.02.053] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mental disorders (MDs) are known risk factors for suicide. This systematic review updates the evidence base for this association and improves upon analytic approaches by incorporating study-level and methodological variables to account for measurement error in pooled suicide risk estimates. METHODS A systematic review was conducted to review studies on MDs as risk factors for suicide. Relevant studies were searched using PubMed, Embase, PsychINFO, and existing reviews from 2010 to 19. Studies were eligible if they were longitudinal/case-control studies, representative of the general population, used diagnostic instruments, and quantified suicide risk. The outcome assessed was relative risks (RRs) for suicide due to MDs. A multi-level meta-regression approach was used to obtain pooled RRs adjusted for covariates and between-study effects. FINDINGS We identified 20 eligible studies yielding 69 RRs. Disorder type, age, sex, use of psychological autopsy, study design, and adjustment for confounders were tested as predictors of pooled suicide risk. Overall, all disorders were significant predictors of suicide with predicted adjusted RRs ranging from 4·11 [2·09, 8·09] for dysthymia to 7·64 [4·3, 13·58] for major depressive disorder. INTERPRETATION Our results indicate that MDs are important risk factors for suicide. This systematic review provides pooled RRs that have been adjusted for methodological sources of bias. Findings from our paper may inform suicide prevention strategies as part of national health agendas.
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Affiliation(s)
- Modhurima Moitra
- Institute for Health Metrics and Evaluation, University of Washington, United States; Department of Global Health, University of Washington, United States.
| | - Damian Santomauro
- Institute for Health Metrics and Evaluation, University of Washington, United States; The University of Queensland, School of Public Health, Queensland, Australia; Queensland Centre for Mental Health Research, Queensland, Australia
| | - Louisa Degenhardt
- Institute for Health Metrics and Evaluation, University of Washington, United States; National Drug and Alcohol Research Center, University of New South Wales, Australia
| | - Pamela Y Collins
- Department of Global Health, University of Washington, United States; Department of Psychiatry and Behavioral Sciences, University of Washington, United States
| | - Harvey Whiteford
- Institute for Health Metrics and Evaluation, University of Washington, United States; The University of Queensland, School of Public Health, Queensland, Australia; Queensland Centre for Mental Health Research, Queensland, Australia
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, United States
| | - Alize Ferrari
- Institute for Health Metrics and Evaluation, University of Washington, United States; The University of Queensland, School of Public Health, Queensland, Australia; Queensland Centre for Mental Health Research, Queensland, Australia
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Suicidal ideation among nurses: Unique and cumulative effects of different subtypes of sleep problems. J Affect Disord 2020; 276:600-607. [PMID: 32871691 DOI: 10.1016/j.jad.2020.07.095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 06/10/2020] [Accepted: 07/05/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Nurses have high rates of sleep problems, and higher risk of suicide than the general population. However, there is no empirical evidence showing the extent to which sleep problems among nurses are related to suicidal ideation. METHODS Multistage stratified cluster sampling was performed to recruit nurses from tertiary hospitals in Shandong, China. Item 9 of the Patient Health Questionnaire-9 was used to assess suicidal ideation. The Pittsburgh Sleep Quality Index was used to assess different subtypes of sleep problems. RESULTS Overall prevalence of suicidal ideation among the sample was 10.8%. Nurses with sleep problems were at high risk for suicidal ideation (bOR = 1.79, 95% CI = 1.20-2.65). Among different sleep problem subtypes, only "cannot breathe comfortably" was independently related to suicidal ideation. Different subtypes of sleep problems had cumulative effects on suicidal ideation: the more subtypes of sleep problems nurses experienced, the higher the likelihood of suicidal ideation. LIMITATIONS The cross-sectional study design prevents inferring causation, and the use of self-report measures may lead to recall bias. Other physical/mental conditions, besides depression, were not assessed. Statistical power may have been insufficient due to the small sub-sample who reported suicidal ideation. Also, the generalizability of the results is limited, as the sample only comprised nurses in tertiary hospitals. CONCLUSIONS Nurses experiencing sleep problems were associated with increased likelihood of suicidal ideation. It may be beneficial to incorporate sleep problems into routine screening and intervention for suicide prevention in clinical practice.
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Zhou L, Zhang H, Luo Z, Liu X, Yang L, Hu H, Wang Y, Wang C, Wang F. Abnormal night sleep duration and inappropriate sleep initiation time are associated with elevated anxiety symptoms in Chinese rural adults: the Henan Rural Cohort. Psychiatry Res 2020; 291:113232. [PMID: 32574900 DOI: 10.1016/j.psychres.2020.113232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 12/20/2022]
Abstract
Sleep problems have been demonstrated to cause mental symptoms, such as anxiety. However, research on the association of the night sleep duration and sleep initiation time on anxiety symptoms in rural China is still lacking. The current study, therefore, explored the independent and combined association of the night sleep duration and sleep initiation time on anxiety symptoms. This study included 28, 054 participants from the Henan Rural Cohort. Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI). Anxiety was assessed by the two-item Generalized Anxiety Disorder scale (GAD-2). Multivariable logistic regression models and restricted cubic spline with anxiety symptoms as a dependent variable were fitted. Among the participants in this study, 11, 209 (39.96%) were males, and 16,845 (60.04%) were females, 1574 (5.61%) had anxiety symptoms. Both shorter and longer night sleep duration were significantly related to elevated prevalence of anxiety symptoms. Extreme sleep initiation time was also significantly associated with elevated anxiety symptoms. Additionally, night sleep duration and sleep initiation time had a combined effect on the prevalent anxiety symptoms. In conclusion, there was a dose-response association of night sleep duration and sleep initiation time with anxiety among Chinese rural population. Moreover, they might jointly increase the odds of prevalent anxiety.
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Affiliation(s)
- Li Zhou
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, PR. China
| | - Haiqing Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhicheng Luo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Liuye Yang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, PR. China
| | - Haiyuan Hu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, PR. China
| | - Yan Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
| | - Fang Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, PR. China.
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Tae H, Jeong BR, Chae JH. Sleep problems as a risk factor for suicide: Are certain specific sleep domains associated with increased suicide risk? J Affect Disord 2019; 252:182-189. [PMID: 30986733 DOI: 10.1016/j.jad.2019.04.053] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The purpose of this study was to examine the relationship between sleep problems and suicidal ideation in depressive patients. BACKGROUND AND AIMS Evidence from diverse settings and populations indicates that sleep problems are associated with suicidal ideation. However, relationships between them are not well defined. This study was conducted in order to explore whether poor sleep was associated with suicidal ideation above and beyond depression and whether specific domains of sleep were related to suicidal ideation. We also determined whether the association between sleep problems and suicidal ideation was mediated by depression. MATERIALS AND METHODS Patients aged 18-65 years from an outpatient clinic at Seoul St. Mary's Hospital were recruited for this study. From September 2010 to November 2017, a total of 909 participants were included in the final sample. The Beck Depression Inventory (BDI) and Pittsburgh Sleep Quality Index (PSQI) were used to assess psychiatric symptoms. Independent samples t-test, chi-square test, Pearson correlation analyses, hierarchical multiple regression analyses, and mediation analyses were performed using SPSS PROCESS macro. RESULTS The majority of participants with suicidal ideation also had sleep problems (94.9%). After controlling for age, marital status, and depressive symptoms, total sleep problems estimated by the PSQI global score were also significant associated with suicidal ideation. Among seven sleep components derived from the PSQI, several components including cough or snore loudly, have bad dreams, and use sleep medication were associated with increased suicide risk. Also, the relationship between sleep problems and suicidal ideation was mediated by depressive symptoms indirectly. There was no convincing direct relationship between sleep problems and suicidal ideation. CONCLUSIONS Investigating the pathways which connect sleep problems and suicidality is fundamental to the development of suicide prevention. While it might be premature to suggest specific interventions, it would be important for clinicians to consider evaluating and managing sleep problems in the context of suicidality.
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Affiliation(s)
- Hyejin Tae
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bo Ram Jeong
- Catholic Biomedical Industrial Institute, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
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Wang TX, Wu YE, Xu W, Gong WK, Ni J, Qu WM, Huang ZL. The anxiolytic effects of Bai Le Mian capsule, a traditional Chinese hypnotic in mice. Sleep Biol Rhythms 2019. [DOI: 10.1007/s41105-018-00199-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Holmstrand C, Bogren M, Mattisson C, Brådvik L. First and Subsequent Lifetime Alcoholism and Mental Disorders in Suicide Victims With Reference to a Community Sample-the Lundby Study 1947-1997. Front Psychiatry 2018; 9:173. [PMID: 29773997 PMCID: PMC5943570 DOI: 10.3389/fpsyt.2018.00173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/16/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Suicide victims have been found to frequently suffer from mental disorders, often more than one, and comorbidity has also been found to be a risk factor for suicide. The aim of the present study was to determine the first disorder and possible subsequent disorders in suicide victims during their lifetimes and to compare their development with the development of mental and alcohol use disorders (AUDs) in a community sample. Methods: The Lundby Study is a prospective longitudinal study of mental health in a general population comprising 3,563 subjects, including 68 suicide victims, followed by four field investigations from 1947 to 1997; mortality was monitored up to 2011. Results: AUD was most common as a first diagnosis (26/68, 38.2%) among suicide victims, followed by "depression" (20/68, 29.4%) and "anxiety" (7/68, 10.3%). A predominance of AUD as a first diagnosis was found in the male group, whereas "depression" was the most common first diagnosis in the female group. However, there were very few females with AUD in the Lundby Study. In the whole population, it was more common for someone who started with an AUD to develop a subsequent mental disorder than the other way around. The same was true for AUD in relation to depression. Conclusions: AUD was the most common first mental disorder among male suicide victims and could thus be considered a starting point in the suicidal process. We propose that in addition to detecting and treating depression, it is important to detect and treat AUD vigorously and to be alert for subsequent symptoms of depressive and other mental disorders in suicide prevention efforts.
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Affiliation(s)
| | | | | | - Louise Brådvik
- Division of Psychiatry, Department of Clinical Sciences, Skåne University Hospital, University of Lund, Lund, Sweden
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Holmstrand C, Bogren M, Mattisson C, Brådvik L. Long-term suicide risk in no, one or more mental disorders: the Lundby Study 1947-1997. Acta Psychiatr Scand 2015; 132:459-69. [PMID: 26402416 PMCID: PMC5054879 DOI: 10.1111/acps.12506] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate long-term suicide risk in individuals with no, one or more mental disorders. METHOD In the Lundby Study, involving a total population of 3563 subjects, mental health and suicide risk were monitored over 54-64 years. RESULTS The long-term suicide risk in subjects with no, one, or more mental disorders was 0.3%, 3.4% and 6.2% respectively. For individuals with only depression, the risk was 6.0%, only alcohol use disorder 4.7%, and only psychosis 3.1%. However, when individuals had additional disorders, the suicide risks were 6.6%, 9.4% and 10.4% respectively. Each diagnosis per se was significantly related to increased risk of suicide. Men had a higher suicide risk in depression than women. Men who had alcohol use disorder in addition to depression showed a very high risk of suicide, 16.2%. CONCLUSION Long-term suicide risk was increased for depression, alcohol use disorder, and psychosis per se. For the latter two the diagnosis alone there may be a lower risk than previously estimated when there is no additional diagnosis. In men, depression in addition to alcohol use disorder should be treated vigorously in the work to prevent suicide.
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Affiliation(s)
- C. Holmstrand
- Department of Clinical SciencesPsychiatryLund UniversityLundSweden
| | - M. Bogren
- Department of Clinical SciencesPsychiatryLund UniversityLundSweden
| | - C. Mattisson
- Department of Clinical SciencesPsychiatryLund UniversityLundSweden
| | - L. Brådvik
- Department of Clinical SciencesPsychiatryLund UniversityLundSweden
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