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Heuschen CBBCM, Bolhuis K, Zantvoord JB, Bockting CL, Denys DAJP, Lok A, Arango C, Arrojo M, Bernardo M, Bobes J, Del-Ben CM, Di Forti M, Gayer-Anderson C, Jones PB, Jongsma HE, Kirkbride JB, La Cascia C, Lasalvia A, Tosato S, Llorca PM, Menezes PR, Murray RM, Quattrone D, Rutten BP, Sanjuán J, Selten JP, Szöke A, Tarricone I, Tortelli A, Velthorst E, de Haan L, Schirmbeck F. Self-reported suicidal ideation among individuals with first episode psychosis and healthy controls: Findings from the international multicentre EU-GEI study. Schizophr Res 2024; 270:339-348. [PMID: 38968805 DOI: 10.1016/j.schres.2024.06.041] [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: 03/24/2023] [Revised: 04/24/2024] [Accepted: 06/22/2024] [Indexed: 07/07/2024]
Abstract
INTRODUCTION Suicidal ideation is common among individuals with first episode psychosis (FEP), with prevalence estimates up to 56.5 %. Despite its high prevalence, relatively little is known about how sociodemographic, clinical and/or developmental characteristics contribute to the experience of suicidal ideation in individuals with FEP. METHODS In this cross-sectional study (FEP n = 551 and controls n = 857), univariate logistic regression analyses were performed to study the associations of sociodemographic, clinical, and developmental factors with suicidal ideation in individuals with FEP as well as controls. Suicidal ideation was assessed using the Community Assessment of Psychic Experiences (CAPE). In addition, multivariate logistic regression analyses were conducted based on a stepwise approach. RESULTS In FEP, only depressive symptoms remained significantly associated with suicidal ideation when all correlates were integrated into one model. In the multivariate model in controls, depressive symptoms, positive symptoms, and traumatic childhood experiences were significantly associated with suicidal ideation. CONCLUSIONS This study showed that depressive symptoms are an important factor relating to suicidal ideation in individuals with FEP, over and above other clinical, sociodemographic, and developmental factors. This underscores the relevance of screening for suicidal ideation in individuals with FEP, and highlights the need for a better understanding of the diagnostic uncertainty and course of mood symptoms in early psychosis. LIMITATIONS Cross-sectional study design, self-reported questionnaires.
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Affiliation(s)
- C B B C M Heuschen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands.
| | - K Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - J B Zantvoord
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - C L Bockting
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - D A J P Denys
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - A Lok
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands; Centre for Urban Mental Health, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - C Arango
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañon, Universidad Complutense de Madrid, Spain
| | - M Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Spain; Complejo Hospitalario Universitario de Santiago de Compostela, Servizo de Psiquiatría Santiago de Compostela, Galicia, Spain
| | - M Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Department of Psychiatry and Psychology, Barcelona, Spain; Clinical Institute of Neuroscience, University of Barcelona, CIBERSAM, ISCIII, Barcelona, Spain
| | - J Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - C M Del-Ben
- Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, Campus de Ribeirao Preto, Ribeirao Preto, Brazil
| | - M Di Forti
- Social Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - C Gayer-Anderson
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; ESRC Centre for Society and Mental Health, King's College London, London, United Kingdom
| | - P B Jones
- Department of Psychiatry, University of Cambridge, CAMEO, Cambridge shire & Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - H E Jongsma
- Centre for Transcultural Psychiatry 'Veldzicht', Balkbrug, the Netherlands; Psychosis Group, University Centre for Psychiatry, University Medical Centre Groningen, Groningen, the Netherlands
| | - J B Kirkbride
- Division of Psychiatry, University College London, London, United Kingdom
| | - C La Cascia
- Dept. Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - A Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - S Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - P M Llorca
- University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Clermont-Ferrand, France; Institute Pascal, F-63000 Clermont-Ferrand, France
| | - P R Menezes
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - R M Murray
- Institute of Psychiatry, Psychology and Neuroscience, King's College, De Crespigny Park, London SE5 8AF, United Kingdom
| | - D Quattrone
- Social Genetics and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, United Kingdom
| | - B P Rutten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences Brain and Nerve Centre, Department of Psychiatry & Neuropsychology, Maastricht University, MUMC+, Maastricht, the Netherlands
| | - J Sanjuán
- Faculty of Medicine, Psychiatry, Valencia, Spain
| | - J P Selten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences Brain and Nerve Centre, Department of Psychiatry & Neuropsychology, Maastricht University, MUMC+, Maastricht, the Netherlands; Rivierduinen Psychiatric Institute, Sandifortdreef 19, 2333 ZZ Leiden, the Netherlands
| | - A Szöke
- Paris University Hospital Group for Psychiatry and Neurosciences, University Paris, Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires, DMU IMPACT, Fondation Fondamental, F-94010 Creteil, France
| | - I Tarricone
- University of Bologna, Department of Medical and Surgical Sciences, Psychiatry Unit, Alma Mater Studiorum, Viale Pepoli 5, Bologna, Italy
| | - A Tortelli
- Etablissement Public de Sante Maison Blanche, GHU Psychiatrie Neurosciences Paris, INSERM U-955, Paris, France
| | - E Velthorst
- Community Mental Health Department, GGZ Noord-Holland-Noord, Heerhugowaard, the Netherlands
| | - L de Haan
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands
| | - F Schirmbeck
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Armoon B, Mohammadi R, Griffiths MD. The Global Prevalence of Non-suicidal Self-injury, Suicide Behaviors, and Associated Risk Factors Among Runaway and Homeless Youth: A Meta-analysis. Community Ment Health J 2024; 60:919-944. [PMID: 38451378 DOI: 10.1007/s10597-024-01245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
A meta-analysis was performed to determine pooled prevalence of non-suicidal self-injury (NSSI), suicide behaviors (including ideation, attempts), and associated risk factors among runaway and homeless youth (RHY). The databases PubMed, Scopus, Web of Science, and Cochrane Library were searched for relevant studies published from January 1995 to May 2023. Initially, 8465 papers were screened, resulting in 69 included studies. The results showed that among RHY, lifetime prevalence rates were 42% for NSSI, 38% for suicidal ideation, and 27% for suicide attempts. Lifetime prevalence of NSSI and suicide behaviors was higher among adolescent minors (aged 12-17 years) compared to young adults (aged 18-24 years). Also, NSSI and suicide behaviors were associated with having a childhood history of physical and sexual abuse. Developing an impactful community-based suicide prevention campaign tailored for RHY appears warranted. Peer groups and mentorship programs would provide invaluable support for young individuals, as supportive friendships protect against NSSI.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Huntjens A, van den Bosch LMCW, Sizoo B, Kerkhof A, Smit F, van der Gaag M. The effectiveness and safety of dialectical behavior therapy for suicidal ideation and behavior in autistic adults: a pragmatic randomized controlled trial. Psychol Med 2024:1-12. [PMID: 38606582 DOI: 10.1017/s0033291724000825] [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] [Indexed: 04/13/2024]
Abstract
BACKGROUNDS Many autistic people in mental health are suicidal. This study evaluated the effectiveness of dialectical behavior therapy (DBT) v. treatment as usual (TAU) in reducing suicidal ideation and suicide attempts. METHODS At six Dutch mental health centers, 123 outpatients (18-65 years) with DSM-5 diagnosed autism spectrum disorder (ASD) and suicidal behavior were randomly assigned to the DBT intervention group (n = 63) or TAU control group (n = 60). Assessments were conducted at baseline, post-treatment at 6 months and 12-month follow-up. The primary outcomes were severity of suicidal ideation and frequency of suicide attempts. The severity of depression and social anxiety were secondary outcomes. RESULTS At end-of-treatment, DBT significantly reduced both suicidal ideation (z = -2.24; p = 0.025; b = -4.41; s.e. = 197.0) and suicide attempts (z = -3.15; p = 0.002; IRR = 0.046; s.e. = 0.045) compared to TAU, but lost statistical significance at the 12-month follow-up. Depression severity significantly decreased with DBT (z = -1.99; p = 0.046: b = -2.74; s.e. = 1.37) remaining so at 12 months (z = -2.46; p = 0.014; b = -3.37; s.e. = 1.37). No effects were observed on social anxiety. Severe adverse events included two suicides in the TAU condition. CONCLUSIONS DBT is an acceptable, safe, and short-term effective intervention to reduce suicidal ideation and suicide attempts in autistic adults with suicidal behavior.
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Affiliation(s)
- Anne Huntjens
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
- Parnassia Psychiatric Institute, The Hague, Netherlands
| | | | | | - Ad Kerkhof
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Filip Smit
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
- Parnassia Psychiatric Institute, The Hague, Netherlands
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Lesinskienė S, Karalienė V, Pociūtė K, Šambaras R. Possible Mental Health Interventions for Family Members of a Close Relative Who Has Suicidal Thoughts or Committed Suicide: A Pilot Project at a Mental Health Center. J Clin Med 2024; 13:2032. [PMID: 38610797 PMCID: PMC11012435 DOI: 10.3390/jcm13072032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Suicides are an actual issue, especially in Lithuania, where, despite significant efforts, the number of suicides remains very high. In cases of suicide, society painfully loses its members, and the relatives of the person who committed suicide, engaged in self-harm, or attempted suicide face many negative experiences. Methods: The purpose of this article is to describe the pilot project applied for 2 years in the Mental Health Center (MHC) in the city of Vilnius, Lithuania, in organizing and providing services to people whose relatives committed suicide or attempted suicide or self-harm. This prevention and early intervention program, organized by an interdisciplinary team at an MHC, appeared appropriate, effective, and well-attended. Program clients could participate anonymously and have the opportunity to choose the time and the right services for themselves from the offered program services package. Results: Providing the possibility for family members to receive flexible mental health services at the primary center increased the attractiveness of the program and reduced stigma. Conclusions: The program results demonstrated the applicability of the implementation of such an initiative as a relevant possibility when providing complex help for the relatives of self-harming and/or suicidal people.
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Affiliation(s)
- Sigita Lesinskienė
- Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania; (V.K.); (K.P.); (R.Š.)
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Huntjens A, Landlust A, Wissenburg S, van der Gaag M. The Prevalence of Suicidal Behavior in Autism Spectrum Disorder. CRISIS 2024; 45:144-153. [PMID: 37668055 DOI: 10.1027/0227-5910/a000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Background: Suicidal ideation (SI) and suicide attempts (SA) are common in autistic individuals, but prevalence rates have not yet been estimated with meta-analysis. Aims: This meta-analysis aims to estimate SI and SA prevalence rates in autistic individuals and identify subgroup differences based on sample characteristics and study quality. Methods: A systematic search identified 52 studies with 88,509 autistic participants reporting SI and SA. Pooled prevalence estimates were calculated using a random-effects model. Results: Pooled prevalence estimates of lifetime SI and SA were 37.2% [95% CI 25.3-50.8] and 15.3% [95% CI 9.5-23.6], respectively. For 12-month prevalence, this was 25.4% [95% CI 19.0-33.2] and 14.1% [95% CI 7.4-25.2], respectively. Subgroup analyses revealed significant differences based on age (SI), region (SI), data collection (SI), measurement scales used to define autism and suicidality (SA), and representation of the study sample (SI and SA). Heterogeneity measures were high for all outcomes (I2 = 60.3-99.1%). Limitations: The heterogeneity of the included studies may limit the generalizability of our findings. Conclusion: The high rates of suicidal problems in autistic individuals call for a systematic evaluation of suicidality in clinical practice and adequate therapeutic interventions to improve this condition.
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Affiliation(s)
- Anne Huntjens
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Academy, The Hague, The Netherlands
| | - Annemiek Landlust
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, The Netherlands
- Department of Genetics, University Medical Center Groningen, The Netherlands
| | - Sophie Wissenburg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Academy, The Hague, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Academy, The Hague, The Netherlands
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Scharpf F, Masath FB, Mkinga G, Kyaruzi E, Nkuba M, Machumu M, Hecker T. Prevalence of suicidality and associated factors of suicide risk in a representative community sample of families in three East African refugee camps. Soc Psychiatry Psychiatr Epidemiol 2024; 59:245-259. [PMID: 37277656 PMCID: PMC10838827 DOI: 10.1007/s00127-023-02506-z] [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: 07/12/2022] [Accepted: 05/25/2023] [Indexed: 06/07/2023]
Abstract
PURPOSE To assess the prevalence of suicidality and associated factors of suicide risk in a sample of Burundian refugee families living in three refugee camps in Tanzania. METHODS Children (n = 230) and their parents (n = 460) were randomly selected and interviewed about suicidality (suicidal ideation, plans, and attempts) and a range of sociodemographic, psychological, and environmental factors. Multinomial logistic regression analyses were conducted to examine factors associated with children and parents' lower and moderate or high current suicide risk. RESULTS Past-month prevalence of suicidal ideation, plans, and attempts were 11.3%, 0.9% and 0.9%, respectively, among children; 37.4%, 7.4% and 5.2%, respectively, among mothers; and 29.6%, 4.8% and 1.7%, respectively, among fathers. Older age in years (aORlower = 2.20, 95% CI 1.38-3.51; aORmoderate/high = 3.03, 95% CI 1.15-7.99) and higher levels of posttraumatic stress disorder symptoms (aORlower = 1.64, 95% CI 1.05-2.57; aORmoderate/high = 2.30, 95% CI: 1.02-5.16), internalizing (aORmoderate/high = 2.88, 95% CI 1.33-6.26) and externalizing problems (aORlower = 1.56, 95% CI: 1.06-2.31; aORmoderate/high = 3.03, 95% CI 1.42-6.49) were significantly positively associated with children's current suicide risk. For mothers, higher perceived instrumental social support (aORmoderate/high = 0.05, 95% CI < 0.01-0.58) was significantly negatively related to suicide risk, whereas exposure to community violence (aORlower = 1.97, 95% CI 1.30-2.99; aORmoderate/high = 1.59, 95% CI 1.00-2.52), living in larger households (aORlower = 1.74, 95% CI 1.17-2.57), and higher psychological distress (aORmoderate/high = 1.67, 95% CI 1.05-2.67) were significantly positively associated with suicide risk. For fathers, higher perceived instrumental social support (aORmoderate/high = 0.04, 95% CI < 0.01-0.44) and having more years of formal education (aORmoderate/high = 0.58, 95% CI 0.34-0.98) were significantly negatively and exposure to war-related trauma (aORmoderate/high = 1.81, 95% CI 1.03-3.19) was significantly positively associated with suicide risk. CONCLUSION Prevention programs should target psychopathology, community violence and social support to mitigate children and parents' current suicide risk.
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Affiliation(s)
- Florian Scharpf
- Department of Psychology, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany.
- Institute for Interdisciplinary Research on Conflict and Violence, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany.
| | - Faustine Bwire Masath
- Department of Psychology, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany
- Institute for Interdisciplinary Research on Conflict and Violence, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany
- Department of Educational Psychology and Curriculum Studies, Dar es Salaam University College of Education, P. O. Box 2329, Dar es Salaam, Tanzania
| | - Getrude Mkinga
- Department of Psychology, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany
| | - Edna Kyaruzi
- Department of Educational Psychology and Curriculum Studies, Dar es Salaam University College of Education, P. O. Box 2329, Dar es Salaam, Tanzania
| | - Mabula Nkuba
- Department of Educational Psychology and Curriculum Studies, Dar es Salaam University College of Education, P. O. Box 2329, Dar es Salaam, Tanzania
| | - Maregesi Machumu
- Department of Educational Psychology and Curriculum Studies, Dar es Salaam University College of Education, P. O. Box 2329, Dar es Salaam, Tanzania
| | - Tobias Hecker
- Department of Psychology, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany
- Institute for Interdisciplinary Research on Conflict and Violence, Bielefeld University, P. O. Box 100131, 33501, Bielefeld, Germany
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Zwar L, König HH, Hajek A. Wishing for an end? Longitudinal analysis of suicidal ideation among informal caregivers inside and outside their household in different welfare systems of Europe. Int Psychogeriatr 2023; 35:736-750. [PMID: 37587572 DOI: 10.1017/s1041610223000601] [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] [Indexed: 08/18/2023]
Abstract
OBJECTIVE This study examines whether transition to caregiving within or outside the household is associated with changes in suicidal ideation and whether this depends on the type of caregiver relationship, the age or gender of the caregiver, or the welfare system. DESIGN Longitudinal study. SETTING Ten European countries. PARTICIPANTS Data from the Survey of Health, Ageing, and Retirement in Europe were used (waves 1, 2, 4, 5, and 6) including participants aged ≥40 years (pooled Observations = 171,848). MEASUREMENTS Suicidal ideation was measured using the Euro-D scale. Caregiving was measured as care inside and outside the household, and for different recipients. Fixed effects logistic regression analyses, adjusted for health and sociodemographic factors, were used. RESULTS Transitioning into caregiving inside the household was associated with higher odds of suicidal ideation, in particular if they transitioned into care for partners or parents and within Southern and Bismarckian welfare systems. Transitioning into caregiving outside the household was not associated with suicidal ideation, except among those transitioning into caregiving for non-relatives (higher odds of suicidal ideation), and among male and older caregivers (lower odds of suicidal ideation). Suicide ideation was higher among caregivers in Southern compared to Bismarckian or Scandinavian welfare systems. CONCLUSION Informal caregiving is associated with suicidal ideation among caregivers inside but not among all caregivers outside the household. The caregiver's characteristics, the care relationship, and the welfare system play an important role. Preventing suicidal ideation requires interventions that focus on informal caregivers and consider their individual and contextual factors.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Cogley C, Bramham J, Bramham K, Smith A, Holian J, O'Riordan A, Teh JW, Conlon P, Mac Hale S, D'Alton P. High rates of psychological distress, mental health diagnoses and suicide attempts in people with chronic kidney disease in Ireland. Nephrol Dial Transplant 2023; 38:2152-2159. [PMID: 36702532 PMCID: PMC10539206 DOI: 10.1093/ndt/gfad021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND People with chronic kidney disease (CKD) experience high levels of psychological distress, which is associated with higher mortality and adverse health outcomes. Little is known about the rates of a range of mental health difficulties or rates of suicide attempts in people with CKD. METHODS Individuals with CKD (n = 268; age range 18-94 years, mean = 49.96 years) on haemodialysis (n = 79), peritoneal dialysis (n = 46), transplant recipients (n = 84) and who were not on renal replacement therapy (RRT; n = 59) were recruited through the Irish Kidney Association social media pages and three Irish hospitals. Participants completed surveys to gather demographics and mental health histories, the Hospital Anxiety and Depression Scale (HADS) and the 12-item Short Form Health Survey (SF-12) to measure health-related quality of life (HRQoL). RESULTS A total of 23.5% of participants self-reported they had received a mental health diagnosis, with depression (14.5%) and anxiety (14.2%) being the most common, while 26.4% of participants had experienced suicidal ideation and 9.3% had attempted suicide. Using a clinical cut-off ≥8 on the HADS subscales, current levels of clinically significant anxiety and depression were 50.7% and 35.4%, respectively. Depression levels were slightly higher for those on haemodialysis compared with those with a transplant and those not on RRT. Depression, anxiety and having a mental health diagnosis were all associated with lower HRQoL. CONCLUSIONS People with CKD in Ireland experience high levels of psychological distress, mental health difficulties, suicidal ideation and suicide attempts. The identification of and intervention for mental health difficulties in CKD should be prioritised in clinical care.
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Affiliation(s)
- Clodagh Cogley
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | | | | | - John Holian
- Nephrology Department, St Vincent's University Hospital, Dublin, Ireland
| | - Aisling O'Riordan
- Nephrology Department, St Vincent's University Hospital, Dublin, Ireland
| | - Jia Wei Teh
- Nephrology Department, St Vincent's University Hospital, Dublin, Ireland
| | - Peter Conlon
- Nephrology Department, Beaumont Hospital, Dublin, Ireland
| | | | - Paul D'Alton
- School of Psychology, University College Dublin, Dublin, Ireland
- King's College Hospital NHS Trust, London, UK
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Nouri E, Moradi Y, Moradi G. The global prevalence of suicidal ideation and suicide attempts among men who have sex with men: a systematic review and meta-analysis. Eur J Med Res 2023; 28:361. [PMID: 37735701 PMCID: PMC10514985 DOI: 10.1186/s40001-023-01338-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 09/02/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND This study aimed to determine the global prevalence of suicidal ideation and attempts among men who have sex with men (MSM) as a systematic review, and meta-analysis. METHODS For this meta-analysis, a search in four international databases (PubMed, Scopus, Web of Science, and EMBASE) was designed, and performed. In the next step, the information extraction checklist was prepared based on the study authors' opinions, and the quality of the articles was evaluated using the Newcastle-Ottawa scale (NOS) checklist. Data meta-analysis was performed using STATA16 software with a significance level below 0.05. RESULTS The results showed the prevalence of suicidal ideation, and suicide attempts among MSM was 21% (95% CI 17%-26%), and 12% (95% CI 8%-17%), respectively. The results of the subgroup analysis showed that the prevalence of suicidal ideation in the population of MSM living with Human immunodeficiency virus (HIV) was 40% (95% CI 35%-45%), and the prevalence of suicide attempts among MSM with HIV was 10% (95% CI 1%-27%). The prevalence of suicidal ideation in European MSM, and the prevalence of suicide attempts among American MSM were higher than other MSM in other geographical areas. CONCLUSION Considering that the prevalence of suicidal ideation and attempts among these people is many times higher than that among men in the general population, developing programs for the prevention of mental disorders with special attention to suicide is necessary for these people. Screening programs are also recommended for early diagnosis and prevention of suicide among these people.
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Affiliation(s)
- Elham Nouri
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Ghobad Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Ramos-Martín J, Gómez Sánchez-Lafuente C, Martínez-García AI, Castillo-Jiménez P, Guzmán-Parra J, Moreno-Küstner B. Suicidal behavior in persons attended in out-of-hospital emergency services in Spain. Front Psychiatry 2023; 14:1235583. [PMID: 37654995 PMCID: PMC10466888 DOI: 10.3389/fpsyt.2023.1235583] [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: 06/06/2023] [Accepted: 07/27/2023] [Indexed: 09/02/2023] Open
Abstract
Background The aims of this study were to describe the use of health services by patients attended for suicidal behavior by out-of-hospital emergency services and to identify the variables associated with the repetition of this behavior in Spain. Methods An analytical, observational, retrospective study was carried out. A total of 554 patients attended by the mobile teams of the Primary Care Emergency (mt-PCES) of the Malaga Health District (Spain), after being coordinated by the 061 Emergency Coordination Center (ECC) were analyzed. Results Of the total, 61.9% of the patients were women and the mean age was 43.5 years. Ninety-six percent (N = 532) of the patients attended by mt-PCES were transferred to hospital emergency services. Regarding clinical decision, of those transferred 436 persons (82%) were discharged home. Of the total sample 25.5% (N = 141) were referred to primary care, while 69% (N = 382) were referred to outpatient mental health care. Regarding follow up in the 6 months after being seen by emergency services, among those referred to a mental health facility, 64.4% (N = 246) attended the follow-up appointment while out of the total sample only 50.5% (N = 280) attended a follow-up appointment with an outpatient mental health service. Finally, it should be noted that 23.3% presented a relapse of suicidal behavior in the 6 months following index episode. The variables associated with repetition of suicidal behavior were older age, greater number of previous suicide attempts and having any contact with mental health services in the following 6 months. Conclusion We believe that selective suicide prevention initiatives should be designed to target the population at risk of suicide, especially those receiving both out-of-hospital and in-hospital emergency services.
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Affiliation(s)
- Javier Ramos-Martín
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
| | - Carlos Gómez Sánchez-Lafuente
- Instituto de Investigación Biomedicina de Málaga (IBIMA), Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Ana I. Martínez-García
- Unidad de Gestión Clínica (UGC) del Servicio de Urgencias de Atención Primaria (SUAP) del Distrito Sanitario Málaga, Málaga, Spain
- Grupo Andaluz de Investigación Psicosocial (GAP) (CTS-945), Málaga, Spain
| | - Pilar Castillo-Jiménez
- Unidad de Gestión Clínica (UGC) del Servicio de Urgencias de Atención Primaria (SUAP) del Distrito Sanitario Málaga, Málaga, Spain
| | - José Guzmán-Parra
- Instituto de Investigación Biomedicina de Málaga (IBIMA), Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Berta Moreno-Küstner
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomedicina de Málaga (IBIMA), Málaga, Spain
- Grupo Andaluz de Investigación Psicosocial (GAP) (CTS-945), Málaga, Spain
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11
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Ramos-Martín J, Pérez-Berlanga JM, Oliver J, Moreno-Küstner B. Non-lethal suicidal behavior in university students of Spain during COVID-19. Front Psychiatry 2023; 14:1155171. [PMID: 37533884 PMCID: PMC10390698 DOI: 10.3389/fpsyt.2023.1155171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/03/2023] [Indexed: 08/04/2023] Open
Abstract
Background Suicide is the fourth external cause of death in the world, in persons between the ages of l5 and 29. The objectives of this study were to measure the prevalence of suicidal behavior in university students and analyze the relationship of suicide risk with psychological distress, resilience, and family and social support. Methods An observational and transversal study wherein the students at the University of Malaga (Spain) completed an online questionnaire which included items from different scales, sociodemographic and academic questions, and the subjective impact of the COVID-19 pandemic. Descriptive analyses and prevalence rates of suicidal behavior were calculated, and bivariate analyses, multiple linear regression, and a mediation and moderation analyses were conducted. Results A total of 2,212 students completed the questionnaire. The prevalence of the last 6 months was 30.4% wishing for death, 14.7% suicidal ideation, 5% self-harm injuries, and 0.5% suicide attempts. Psychological distress, family and social support were linked to the risk of suicide. Lastly, resilience and family support measure and moderate the relation between psychological stress and suicide risk. Conclusion Psychological distress is a risk factor for suicidal behavior, while resilience and family and social support are linked to a lower risk of suicide.
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Affiliation(s)
- Javier Ramos-Martín
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
| | - José Manuel Pérez-Berlanga
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
| | - Jesús Oliver
- Grupo Andaluz de Investigación Psicosocial (GAP) (CTS-945), Málaga, Spain
- Departamento de Psicología, Facultad de Ciencias Humanas y Sociales, Universidad Pontificia Comillas, Madrid, Spain
| | - Berta Moreno-Küstner
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
- Grupo Andaluz de Investigación Psicosocial (GAP) (CTS-945), Málaga, Spain
- Instituto de Biomedicina de Málaga (IBIMA), Málaga, Spain
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12
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Scheunemann J, Kühn S, Biedermann SV, Lipp M, Peth J, Gallinat J, Jelinek L. Implicit cognitions on self-injurious and suicidal behavior in borderline personality disorder. J Behav Ther Exp Psychiatry 2023; 79:101836. [PMID: 36709601 DOI: 10.1016/j.jbtep.2023.101836] [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: 03/27/2022] [Revised: 01/12/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Performance on implicit measures of suicidality has been associated with suicidal and nonsuicidal self-injury. Despite the high prevalence of self-harm in patients with borderline personality disorder (BPD), no previous study has assessed implicit measures in this patient group. METHODS Forty patients with BPD and 25 healthy controls completed three implicit association tests (IATs) (Death words - Me/Others words, Self-Harm pictures - Me/Others, and Self-Harm pictures - Good/Bad words) and a subliminal priming task (effect of the primes "dying"/"growing" on the categorization speed of positive/negative adjectives) as well as measures of psychopathology (suicidal ideation, previous nonsuicidal self-injury, borderline symptomatology, depression, and hopelessness). RESULTS Patients with BPD had higher scores on all three IATs than healthy controls. The subliminal priming procedure did not reveal group differences. Correlations between implicit measures and psychopathology among patients with BPD were mostly weak and nonsignificant with a few exceptions: Positive correlations were observed between IAT Self-Harm - Good/Bad and lifetime frequency of nonsuicidal self-injury, between IAT Self-Harm - Me/Others and depression, and between IAT Death - Me/Others and depression. Correlations between implicit measures were weak to moderate. LIMITATIONS The study was cross-sectional only, and the study had reduced power as the sample size was limited. CONCLUSIONS As expected, patients with BPD had higher scores than healthy controls on the IATs, which indicates higher implicit self-identification with self-harm and death as well as stronger implicit positive attitudes towards self-harm. The mostly weak correlations between implicit and explicit measures speak against the discriminative value of IATs in patients with BPD.
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Affiliation(s)
- Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany.
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany; Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Germany
| | - Sarah V Biedermann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Michael Lipp
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Judith Peth
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
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13
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Newell V, Phillips L, Jones C, Townsend E, Richards C, Cassidy S. A systematic review and meta-analysis of suicidality in autistic and possibly autistic people without co-occurring intellectual disability. Mol Autism 2023; 14:12. [PMID: 36922899 PMCID: PMC10018918 DOI: 10.1186/s13229-023-00544-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Suicidality is highly prevalent in autistic people without co-occurring intellectual disabilities, and high autistic traits are found in adults who have attempted suicide. However, prevalence rates for both autistic and possibly autistic people have not been synthesised meta-analytically. AIMS To (1) calculate pooled prevalence estimates of suicidality in autistic people and possibly autistic people without co-occurring intellectual disability; (2) evaluate the influence of participant and study level characteristics on heterogeneity; and (3) determine the quality of evidence. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. PsycINFO, Embase, MEDLINE and Web of Science were systematically searched from 1992 to January 25, 2022. Empirical quantitative studies reporting prevalence of suicidal ideation, suicide plans, or suicide attempts and behaviours were considered for inclusion. Random effects models were used to estimate pooled prevalence of each suicidality outcome with 95% confidence intervals. Heterogeneity was explored using sensitivity and moderator analyses. RESULTS Data from 48,186 autistic and possibly autistic participants in 36 primary studies were meta-analysed. Pooled prevalence of suicidal ideation was 34.2% (95% CI 27.9-40.5), suicide plans 21.9% (13.4-30.4), and suicidal attempts and behaviours 24.3% (18.9-29.6). High levels of heterogeneity (I2 > 75) were observed in all three analyses. Estimates did not differ between autistic or possibly autistic samples. Geographical location (p = 0.005), transgender or gender non-conforming samples (p < 0.001) and type of report (p < 0.001) significantly moderated suicidal ideation, whereas age group (p = 0.001) and measure of suicidality (p = 0.001) significantly moderated suicide plans. There was a significant association between the proportion of male participants and prevalence of suicide plans, with a decrease in the proportion of males for every unit change of suicide plan prevalence (p = 0.013). No variables were found to moderate estimates of suicide attempts and behaviours. CONCLUSIONS The results confirm suicidality is highly prevalent in both autistic and possibly autistic people without co-occurring intellectual disability and highlights potential moderators. Possibly autistic individuals require more attention in clinical and research considerations going forward to further understand and prevent suicide in both groups.
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Affiliation(s)
- Victoria Newell
- School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
| | - Lucy Phillips
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK
| | - Chris Jones
- School of Psychology, University of Birmingham, 52 Pritchatts Road, Birmingham, B15 2TT, UK
| | - Ellen Townsend
- School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, 52 Pritchatts Road, Birmingham, B15 2TT, UK
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
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14
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Silvestri C, Carpita B, Cassioli E, Lazzeretti M, Rossi E, Messina V, Castellini G, Ricca V, Dell’Osso L, Bolognesi S, Fagiolini A, Voller F. Prevalence study of mental disorders in an Italian region. Preliminary report. BMC Psychiatry 2023; 23:12. [PMID: 36600226 PMCID: PMC9812746 DOI: 10.1186/s12888-022-04401-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/17/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Mental disorders are a major public health problem. However, over the last few years, there have been few studies aimed at evaluating their diffusion. Therefore, this study aimed at evaluating: the prevalence of the most frequent psychiatric disorders in the general population residing in Tuscany using a clinical scale administered by trainee in psychiatry. METHODS The study was carried out on a representative sample of the general population aged > 18 years, randomly extracted from the register of patients in the Tuscany region, adopting a proportional sampling method stratified by gender, age group and Local Health Units (LHU). Each person was contacted by letter followed by a phone call from an operator who makes an appointment with the trainee in psychiatry. The diagnostic interview conducted was the Mini-International Neuropsychiatric Interview (MINI). Point and lifetime prevalence by gender and age group were calculated. Differences and associations were considered statistically significant if their p-values were less than 0.05. RESULTS Of the 408 people involved, 390 people were enrolled (of which 52.6% female). The 28.5% of the sample had been affected by a psychiatric disorder during their lifetime. In their lifetime, the most represented psychiatric disorders were major depressive episode (20.4%), major depressive disorder (17.0%) and panic disorder (10.3%), more frequent in the female than the male group. Current conditions were predominantly major depressive episode (3.1%) and agoraphobia (2.8%). A 5.9% rate of current suicidal ideation was also found. CONCLUSIONS In the general population, 28.5% of people reported a psychiatric disorder during their lifetime. This prevalence is considerably higher than that reported in a previous study carried out in central Italy.
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Affiliation(s)
- Caterina Silvestri
- Regional Health Agency of Tuscany, Epidemiology Observatory, 50100, Florence, Italy.
| | - Barbara Carpita
- grid.5395.a0000 0004 1757 3729Department of Clinical and Experimental Medicine, University of Pisa, 56100 Pisa, Italy
| | - Emanuele Cassioli
- grid.8404.80000 0004 1757 2304Psychiatry Unit, Department of Health Sciences, Florence University, 50100 Florence, Italy
| | - Marco Lazzeretti
- grid.437566.50000 0004 1756 1330Regional Health Agency of Tuscany, Epidemiology Observatory, 50100 Florence, Italy
| | - Eleonora Rossi
- grid.8404.80000 0004 1757 2304Psychiatry Unit, Department of Health Sciences, Florence University, 50100 Florence, Italy
| | - Valentina Messina
- grid.437566.50000 0004 1756 1330Regional Health Agency of Tuscany, Epidemiology Observatory, 50100 Florence, Italy
| | - Giovanni Castellini
- grid.8404.80000 0004 1757 2304Psychiatry Unit, Department of Health Sciences, Florence University, 50100 Florence, Italy
| | - Valdo Ricca
- grid.8404.80000 0004 1757 2304Psychiatry Unit, Department of Health Sciences, Florence University, 50100 Florence, Italy
| | - Liliana Dell’Osso
- grid.5395.a0000 0004 1757 3729Department of Clinical and Experimental Medicine, University of Pisa, 56100 Pisa, Italy
| | - Simone Bolognesi
- grid.9024.f0000 0004 1757 4641Department of Molecular and Development Medicine, University of Siena, 53100 Siena, Italy
| | - Andrea Fagiolini
- grid.9024.f0000 0004 1757 4641Department of Molecular and Development Medicine, University of Siena, 53100 Siena, Italy
| | - Fabio Voller
- grid.437566.50000 0004 1756 1330Regional Health Agency of Tuscany, Epidemiology Observatory, 50100 Florence, Italy
| | - Mental Disorders Study group
- grid.437566.50000 0004 1756 1330Regional Health Agency of Tuscany, Epidemiology Observatory, 50100 Florence, Italy ,grid.5395.a0000 0004 1757 3729Department of Clinical and Experimental Medicine, University of Pisa, 56100 Pisa, Italy ,grid.8404.80000 0004 1757 2304Psychiatry Unit, Department of Health Sciences, Florence University, 50100 Florence, Italy ,grid.9024.f0000 0004 1757 4641Department of Molecular and Development Medicine, University of Siena, 53100 Siena, Italy
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15
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Musetti A, Pingani L, Zagaria A, Uberti D, Meli S, Lenzo V, Gori A, Franceschini C, Galeazzi GM. Insecure adult attachment and reflective functioning as mechanisms of the relationship between traumatic life events and suicidal ideation: A path analysis. Front Psychol 2022; 13:985148. [PMID: 36248502 PMCID: PMC9561888 DOI: 10.3389/fpsyg.2022.985148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
The relationship between traumatic life events and increased suicide risk has been well reported in literature. However, the complex nature of suicidality phenomena still hinders our ability to comprehend the mediation mechanism underlying this association. In this study, we examined the mediating role of adult attachment and reflective functioning in the relationship between traumatic life events and suicidal ideation. Nine hundred and fifty Italian adults completed an online survey evaluating traumatic life events, adult attachment, reflective functioning and suicidal ideation. The path analysis showed that the positive relationship between traumatic life events and suicidal ideation was partially mediated by attachment anxiety and reflective functioning. From a clinical point of view, these results support the relevance of evaluating and improving patients’ ability to mentalize as a part of psychotherapeutic intervention aimed at reducing suicidality in people with a history of traumatic experiences and attachment anxiety.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
- *Correspondence: Alessandro Musetti,
| | - Luca Pingani
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento ad attività integrata Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Roma, Italy
| | - Daniele Uberti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Salvatore Meli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Vittorio Lenzo
- Dipartimento di Scienze della Società e della Formazione d’Area Mediterranea, Università per Stranieri Dante Alighieri, Reggio Calabria, Italy
| | - Alessio Gori
- Department of Health Sciences, School of Psychology, University of Florence, Firenze, Italy
| | | | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Dipartimento ad attività integrata Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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16
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Troya MI, Joyce M, Khashan A, Buckley C, Chakraborti K, Hoevel P, Humphries R, Kearney PM, Kiely E, Murphy M, Perry I, Arensman E. Mental health following an initial period of COVID-19 restrictions: findings from a cross-sectional survey in the Republic of Ireland. HRB Open Res 2022; 4:130. [PMID: 35633845 PMCID: PMC9120930 DOI: 10.12688/hrbopenres.13400.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 11/21/2022] Open
Abstract
Background: We assessed the mental health of individuals in the general population, during an initial period of easing of COVID-19 restrictions in the Republic of Ireland (RoI). Methods: Data were collected through a nationally representative cross-sectional telephone survey, during the first period of easing of restrictions during the COVID-19 pandemic between May and July 2020. Mental health was examined using the Patient Health Questionnaire Anxiety Depression Scale. Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic factors and the risk of having depression and anxiety symptoms. Results: Of the 1,983 participants, 27.7% (n = 549; 95% CI: 0.26 - 0.30) reported depression and anxiety symptoms, while 74 (3.8%; 95% CI: 0.03 - 0.05) disclosed self-harm and/or suicidal thoughts. Females (RR: 1.60, 95% CI: 1.37 - 1.87, p < 0.0005), employed individuals who experienced a change in work status (RR: 1.50, 95% CI: 1.24 - 1.82, p < 0.0005), participants cocooning due to a health condition (RR: 1.34, 95% CI: 1.08 - 1.66, p< 0.01), participants who were self-isolating (RR: 1.25, 95% CI: 1.03 - 1.51, p=0.025) and moderate-heavy drinkers (RR: 1.27, 95% CI: 1.09 - 1.47, p<0.01) were at increased risk of depression and anxiety. Young people aged 18-29 years and those in the two lowest income categories were most likely to report self-harm and/or suicidal thoughts. Conclusion: As the COVID-19 pandemic continues, with further waves and associated restrictions, the impact on mental health in the population as a whole and in specific subgroups must be considered. Study protocol registration: doi.org/10.12688/hrbopenres.13103.2
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Affiliation(s)
| | - Mary Joyce
- National Suicide Research Foundation, Cork, Ireland
| | - Ali Khashan
- School of Public Health, University College Cork, Cork, Ireland
| | - Claire Buckley
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Philipp Hoevel
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | - Rory Humphries
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | | | - Elizabeth Kiely
- School of Applied Social Studies, University College Cork, Cork, Ireland
| | - Mike Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Ivan Perry
- School of Public Health, University College Cork, Cork, Ireland
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Australia
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17
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Troya MI, Joyce M, Khashan A, Buckley C, Chakraborti K, Hoevel P, Humphries R, Kearney PM, Kiely E, Murphy M, Perry I, Arensman E. Mental health following an initial period of COVID-19 restrictions: findings from a cross-sectional survey in the Republic of Ireland. HRB Open Res 2022; 4:130. [PMID: 35633845 PMCID: PMC9120930 DOI: 10.12688/hrbopenres.13400.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2022] [Indexed: 03/04/2024] Open
Abstract
Background: We assessed the mental health of individuals in the general population, during an initial period of easing of COVID-19 restrictions in the Republic of Ireland (RoI). Methods: Data were collected through a nationally representative cross-sectional telephone survey, during the first period of easing of restrictions during the COVID-19 pandemic between May and July 2020. Mental health was examined using the Patient Health Questionnaire Anxiety Depression Scale. Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic factors and the risk of having depression and anxiety symptoms. Results: Of the 1,983 participants, 27.7% (n = 549; 95% CI: 0.26 - 0.30) reported depression and anxiety symptoms, while 74 (3.8%; 95% CI: 0.03 - 0.05) disclosed self-harm and/or suicidal thoughts. Females (RR: 1.60, 95% CI: 1.37 - 1.87, p < 0.0005), employed individuals who experienced a change in work status (RR: 1.50, 95% CI: 1.24 - 1.82, p < 0.0005), participants cocooning due to a health condition (RR: 1.34, 95% CI: 1.08 - 1.66, p< 0.01), participants who were self-isolating (RR: 1.25, 95% CI: 1.03 - 1.51, p=0.025) and moderate-heavy drinkers (RR: 1.27, 95% CI: 1.09 - 1.47, p<0.01) were at increased risk of depression and anxiety. Young people aged 18-29 years and those in the two lowest income categories were most likely to report self-harm and/or suicidal thoughts. Conclusion: As the COVID-19 pandemic continues, with further waves and associated restrictions, the impact on mental health in the population as a whole and in specific subgroups must be considered. Study protocol registration: doi.org/10.12688/hrbopenres.13103.2.
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Affiliation(s)
| | - Mary Joyce
- National Suicide Research Foundation, Cork, Ireland
| | - Ali Khashan
- School of Public Health, University College Cork, Cork, Ireland
| | - Claire Buckley
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Philipp Hoevel
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | - Rory Humphries
- School of Mathematical Sciences, University College Cork, Cork, Ireland
| | | | - Elizabeth Kiely
- School of Applied Social Studies, University College Cork, Cork, Ireland
| | - Mike Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Ivan Perry
- School of Public Health, University College Cork, Cork, Ireland
| | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane, Australia
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18
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Favril L, Shaw J, Fazel S. Prevalence and risk factors for suicide attempts in prison. Clin Psychol Rev 2022; 97:102190. [PMID: 36029609 DOI: 10.1016/j.cpr.2022.102190] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/28/2022] [Accepted: 08/03/2022] [Indexed: 11/18/2022]
Abstract
Suicidal behaviour represents a substantial burden of morbidity and mortality in prisons worldwide. We aimed to synthesise the evidence on prevalence and risk factors for suicide attempts during incarceration. In this systematic review and meta-analysis, we searched four bibliographic databases for studies (published up to May 31, 2022) reporting on adults sampled from the general prison population who attempted suicide while incarcerated and an unselected comparison group. A total of 20 studies comprising 19,882 individuals (6.5% women) in 20 countries were eligible for inclusion. The pooled prevalence of suicide attempts during incarceration was 8.6% (95% CI 6.1-11.2) in men and 12.2% (95% CI 7.1-17.2) in women. Across all 36 risk factors studied, the strongest associations were found for suicidal ideation, previous self-harm, and markers of psychiatric morbidity. Prison-related risk factors included solitary confinement, victimisation, and poor social support while incarcerated. Sensitivity analyses indicate that risk factors for near-lethal suicide attempts are similar to those for suicide attempts more generally. In addition to providing a synthesis of previous work, our systematic review highlights several key limitations of the extant literature, which provide directions for future research.
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Affiliation(s)
- Louis Favril
- Faculty of Law and Criminology, Ghent University, Ghent, Belgium.
| | - Jenny Shaw
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
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Carrillo de Albornoz CM, Gutiérrez B, Ibanez-Casas I, Cervilla JA. Paranoia and Suicidality: A Cross-Sectional Study in the General Population. Arch Suicide Res 2022; 26:1587-1599. [PMID: 34286675 DOI: 10.1080/13811118.2021.1950589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Paranoia and suicidality seem to be common traits expressing in the general population to varying degrees. This study aims to explore the association between both and to identify determinants of comorbidity. We interviewed a representative sample of the population in Andalusia (n = 4507) and assessed paranoia and suicidality utilizing the Spanish Green's Paranoid Thoughts Scale (S-GPTS) and the suicidality section of the MINI Neuropsychiatric Interview, respectively. We gathered data on socio-demographics, personality, substance abuse, social support, and environmental distress. We found that paranoia and suicidality were rather common with 6.4% (95% CI: 5.7-7.12) of the sample admitting to some (vs. none) level of suicidality. We also found a robust association between paranoia and suicidality, independent of age and sex (F:298.2; p =.0001; Eta2: .065); 0.5% (95% CI: 0.32-0.76) of the sample (n = 21) presented combinedly high levels of paranoia and some suicidality risk and were considered as having paranoia-suicidality comorbidity (PSC). We identified factors associating with PSC, including poor social support, childhood maltreatment, threatening life-events and increasing personality disorder, and nicotine dependence scores. Paranoia and suicidality are common traits in the general population and their comorbidity seems to associate with low social support, environmental adversity and disordered personality. Suicidality and paranoia are common traits present dimensionally in a representative nonclinical sample. Paranoia strongly and independently associates with suicidality risk in a large population-based study. Paranoia and suicidality comorbidity may be commonly determined by poor social support, disordered personality, previous childhood maltreatment, and exposure to threatening life-events.
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20
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Liu CH, Chen PC, Chen JH, Yeh CC. Changes in self-harm- and violence-related urgent psychiatric consultation in the emergency department during the different stages of the COVID-19 pandemic. BMC Psychiatry 2022; 22:384. [PMID: 35672738 PMCID: PMC9171742 DOI: 10.1186/s12888-022-04029-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/31/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 pandemic significantly affected emergency department (ED) visits and urgent psychiatric consultation (UPC) seeking behavior in EDs. Our study explored the changes in UPCs during and after the pandemic peak. METHODS This retrospective observational study evaluated UPCs in the ED of a referral medical center in Taiwan, where treated both physical and psychiatric complaints. We defined the COVID-19 pandemic peak period as calendar week 4-18, 2020. The corresponding baseline as calendar week 4-18, 2019, and the slack period as week 4-18, 2021. The total number of UPCs, patient demographic data such as sex and age of the patients seen, the referral system (whether police or emergency medical service [EMS] or other sources), and the chief complaint (self-harm or violence) were recorded. RESULTS Compared with the baseline period, a significant decline in UPCs was observed in the pandemic peak period, and a rebound was observed in the slack period, with the median [IQR] Q1, Q3 values of 22 [18, 26], 12 [10, 17]), and 16 [15, 23], respectively. We observed significantly few men (34.9% vs 45.2%) and less violence (10.2% vs 17.6%) in the peak period compared with in the baseline period, but no significant difference was found compared with the slack period. Throughout the pandemic, younger patients (41.8 ± 17.4 in 2019, 39.2 ± 18.5 [p = 0.121] in 2020, and 35.6 ± 17.2 [p < 0.001] in 2021), higher proportions of police/EMS referral (38.7% in 2019, 41.9% [p = 0.473] in 2020, and 51.9% [p = 0.001] in 2021) and self-harm-related complaints (57% in 2019, 62.4% [p = 0.233] in 2020, and 64.9% [p = 0.049] in 2021) was noted among UPC seekers during the pandemic. However, the proportion of violence-related UPCs (17.6% in 2019, 10.2% [p = 0.023] in 2020, and 12.3% [p = 0.072] in 2021) declined. CONCLUSIONS This study found that UPCs changed throughout the pandemic. This result raises the concern that mental health needs are masked during the pandemic.
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Affiliation(s)
- Chun-Hao Liu
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan city, Taiwan.,College of Medicine, Chang Gung University, Taoyuan city, Taiwan
| | - Po-Cheng Chen
- College of Medicine, Chang Gung University, Taoyuan city, Taiwan.,Department of Rehabilitation Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung city, Taiwan
| | - Jian-Hong Chen
- College of Medicine, Chang Gung University, Taoyuan city, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung city, Taiwan.,National Taiwan Sport University, Taoyuan city, Taiwan
| | - Chung-Cheng Yeh
- Department of Emergency Medicine, Chang Gung Memorial Hospital at Keelung, Keelung city, Taiwan.
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21
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Favril L. Epidemiology, Risk Factors, and Prevention of Suicidal Thoughts and Behaviour in Prisons: A Literature Review. Psychol Belg 2021; 61:341-355. [PMID: 34900324 PMCID: PMC8622377 DOI: 10.5334/pb.1072] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 10/19/2021] [Indexed: 12/21/2022] Open
Abstract
Suicide is a global public health concern that affects all echelons of society, albeit not equally so. Compared with adults in the general population, incarcerated offenders are at increased risk to consider, attempt, and die by suicide, which represents a substantial burden of morbidity and mortality in prisons worldwide. This review synthesises recent literature pertaining to the epidemiology, risk factors, and prevention of suicidal thoughts and behaviour among prisoners, and outlines a framework which emphasises the interplay between individuals (importation) and their surroundings (deprivation). The available evidence suggests that prison-specific stressors may exacerbate risk of suicide in an already vulnerable population characterised by complex health and social care needs. Emerging data point to differential mechanisms through which prisoners come to think about suicide and subsequently progress to suicidal behaviour. As risk of suicide is determined by a complex web of synergistically interacting factors, its management and prevention demands a cross-sectoral policy and service response that includes targeted interventions aimed at high-risk prisoners in combination with population strategies that promote the health and wellbeing of all people in prison.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, BE
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22
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Prevalence of suicidal ideation and planning in patients with major depressive disorder: A meta-analysis of observation studies. J Affect Disord 2021; 293:148-158. [PMID: 34192629 DOI: 10.1016/j.jad.2021.05.115] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Suicidal ideation (SI) and suicide planning (SP) are associated with an increased risk of future suicide. We performed a meta-analysis of observational studies to estimate the prevalence of SI and SP in patients with major depressive disorder (MDD) and its associated factors. METHODS A systematic literature search was conducted in PubMed, EMBASE, PsycINFO and Web of Science from their commencement date until 7 October 2020. Original studies containing data on the prevalence of SI and SP in individuals with MDD were analyzed. RESULTS Forty-six articles covering 53,598 patients were included in the meta-analysis. The overall prevalence of SI was 37.7% (95% confidence interval (CI): 32.3-43.4%) and the pooled prevalence of SP was 15.1% (95% CI: 8.0--26.8%). Subgroup analyses revealed that the timeframe over which SI was assessed, source of patients, study design, and diagnostic criteria were significantly associated with the pooled prevalence of SI. Meta-regression analyses revealed that the Hamilton Depression Rating Scale (HAMD) score and percentage of male participants were positively associated with the pooled prevalence of SI. Study quality and mean age were negatively associated with the pooled prevalence of SI. In contrast, survey year and study quality were negatively associated with pooled prevalence of SP LIMITATION: SI and SP were self-reported and subject to recall bias and impression management. CONCLUSIONS SI and SP are common in patients with MDD, especially among inpatients. Preventive measures and treatments focusing on factors associated with SI and SP may reduce the risk of suicide in patients with MDD.
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Socio-emotional strengths against psychopathology and suicidal ideation in fear of COVID-19. CURRENT PSYCHOLOGY 2021; 42:10344-10354. [PMID: 34602801 PMCID: PMC8478370 DOI: 10.1007/s12144-021-02185-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/02/2022]
Abstract
Coronavirus disease (COVID-19) has caused a global health crisis. It also leads to different types of psychosocial problems in society as a result of preventive health measures and the disease itself. Among others, psychopathological symptoms and suicide behaviors have increased. The PsicorecurSOS COVID-19 online protocol was designed. At baseline, 1020 Spanish adults were assessed, during confinement, for sociodemographics, fear of COVID-19, anxious-depressive symptoms, covitality, and suicidal ideation. Reliability, descriptive, and frequency analyses were carried out, and the computer tool SPSS PROCESS was used to carry out a conditional process analysis (model 59). A total of 595 participants were included (58.30% response rate from baseline; mean age = 37.18 [SD = 13.30]; 72.44% female). Regarding suicidal ideation, 12% responded differently to "never," 19.3% exceeded the cutoff point on the anxiety scale, and 24% on the depression scale. Moderate mediation analysis explained 27% of the variance in suicidal ideation. In addition, the indirect effect of moderate mediation was significant (b = -.004, SE = .002 with the presence of covitality; and b = .01, SE = .003 absence of covitality). Sex and age did not influence the overall outcome of the model. The data from this study can serve as a starting point for generating social and health treatment initiatives based on self-examination of anxiety-depressive symptoms and increasing socio-emotional skills in order to prevent and alleviate the psychosocial effects of the pandemic.
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24
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Abstract
COVID-19, and efforts to mitigate its spread, are creating extensive mental health problems. Experts have speculated the mental, economic, behavioral, and psychosocial problems linked to the COVID-19 pandemic may lead to a rise in suicide behavior. However, a quantitative synthesis is needed to reach an overall conclusion regarding the pandemic-suicide link. In the most comprehensive test of the COVID-19-suicidality link to date, we meta-analyzed data from 308,596 participants across 54 studies. Our results suggested increased event rates for suicide ideation (10.81%), suicide attempts (4.68%), and self-harm (9.63%) during the COVID-19 pandemic when considered against event rates from pre-pandemic studies. Moderation analysis indicated younger people, women, and individuals from democratic countries are most susceptible to suicide ideation during the COVID-19 pandemic. Policymakers and helping professionals are advised that suicide behaviors are alarmingly common during the COVID-19 pandemic and vary based upon age, gender, and geopolitics. Strong protections from governments (e.g., implementing best practices in suicide prevention) are urgently needed to reduce suicide behaviors during the COVID-19 pandemic.
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25
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Bifftu BB, Tiruneh BT, Dachew BA, Guracho YD. Prevalence of suicidal ideation and attempted suicide in the general population of Ethiopia: a systematic review and meta-analysis. Int J Ment Health Syst 2021; 15:27. [PMID: 33761982 PMCID: PMC7992356 DOI: 10.1186/s13033-021-00449-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/06/2021] [Indexed: 02/08/2023] Open
Abstract
Background In Ethiopia, in spite of the high burden of suicide related-adverse effect, substantial variability in the reported prevalence of individual studies about suicidal ideation and attempted suicide; there is no national level epidemiological evidence. Thus, the present study aimed to determine the pooled prevalence of suicide ideation and suicidal attempt in the general population. Methods We followed the PRISMA Guidelines to report the results of the finding. Databases including: PubMed/Medline, SCOPUS, CINAHL (EBSCOhost), African Journal Online (AJOL) and African Indexed Medicus (AIM) were searched. Heterogeneity was assessed by Cochrane chi-square (χ2) and quantified by I2 statistics test. Sensitivity test and subgroup analysis performed. Publication bias was tested by funnel plots and Egger’s test. Effect size was calculated by random effects model. Results A total of 12 studies for suicidal ideation and 10 studies for attempted suicide were included in the study. The prevalence of suicidal ideation and attempted suicide were ranged from 1 to 55% and 0.6% to 14% respectively. The 12-month pooled prevalence of suicidal ideation and suicidal attempt were 9% (5–16%), I2 = 99.64%, p < 0.001 and 4% (1–8%), I2 = 98.11%, p < 0.001] respectively. The lifetime pooled prevalence of attempted suicide was found to be 4% (3–6%). We found evidence of significant heterogeneity for suicidal ideation [I2 = 99.64%, p < 0.001] and attempted suicide [I2 = 98.11%, p < 0.001]. The subgroup analysis could not identified source of heterogeneity. The sensitivity analysis showed that none of the point estimates was outside of the overall 95%CI for suicidal ideation and attempted suicide. No evidence of publication bias from the visual inspection of the funnel plot for suicidal ideation and [Egger’s test (P = 0.174)] and attempted suicide [Egger’s test (P = 0.318)]. Conclusion High prevalence of suicidal ideation and attempted suicide were observed in the general population of Ethiopia. These suggest the need of strengthening the awareness of suicidal behaviours and evaluate the effectiveness of the national health strategy in addressing the issues of suicidal behaviours.
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Affiliation(s)
- Berhanu Boru Bifftu
- School of Nursing, University of Gondar College of Medicine and Health Science, Gondar, Ethiopia.
| | - Bewket Tadesse Tiruneh
- School of Nursing, University of Gondar College of Medicine and Health Science, Gondar, Ethiopia
| | - Berihun Assefa Dachew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Institute for Social Science Research, The University of Queensland, Brisbane, QLD. 4068, Australia
| | - Yonas Deressa Guracho
- Department of Psychiatry, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Abstract
AIMS There is evidence that patients with schizophrenia spectrum disorders present higher mortality in comparison with the general population. The aim of this study was to analyse the causes of mortality and sociodemographic factors associated with mortality, standardised mortality ratios (SMRs), life expectancy and potential years of life lost (YLL) in patients with schizophrenia spectrum disorders in Spain. METHODS The study included a cohort of patients from the Malaga Schizophrenia Case Register (1418 patients; 907 males; average age 42.31 years) who were followed up for a minimum of 10 years (median = 13.43). The factors associated with mortality were analysed with a survival analysis using Cox's proportional hazards regression model. RESULTS The main causes of mortality in the cohort were circulatory disease (21.45%), cancer (17.09%) and suicide (13.09%). The SMR of the cohort was more than threefold that of the population of Malaga (3.19). The life expectancy at birth was 67.11 years old, which is more than 13 years shorter than that of the population of Malaga. The YLL was 20.74. The variables associated with a higher risk of mortality were age [adjusted hazard ratio (AHR) = 1.069, p < 0.001], male gender (AHR = 1.751, p < 0.001) and type of area of residence (p = 0.028; deprived urban zone v. non-deprived urban area, AHR = 1.460, p = 0.028). In addition, receiving welfare benefit status in comparison with employed status (AHR = 1.940, p = 0.008) was associated with increased mortality. CONCLUSIONS There is excess mortality in patients with schizophrenia spectrum disorders and also an association with age, gender, socioeconomic inequalities and receiving welfare benefits. Efforts directed towards improved living conditions could have a positive effect on reducing mortality.
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Huertas P, Moreno-Küstner B, Gutiérrez B, Cervilla JA. Prevalence and correlates of suicidality in Andalusia (Spain): Results of the epidemiological study PISMA-ep. J Affect Disord 2020; 266:503-511. [PMID: 32056919 DOI: 10.1016/j.jad.2020.01.115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/06/2019] [Accepted: 01/20/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Suicidality is an important public health problem. Hence, the aims of this study are to report prevalence rates and correlates of suicidality in Andalusia (Southern Spain). METHODS This is a cross-sectional household survey conducted on a representative sample of adults living in Andalusia. 4507 subjects were interviewed using the Mini International Neuropsychiatric Interview (MINI) to assess suicidality and standardized instruments were employed to evaluate associated variables. A multivariate logistic regression analysis was used to explore independent associations with suicidality. RESULTS Current prevalence of suicidality was 6.4%, 4.4% showed death wish, 1.4% had ideas of self-harm, 2.4% had suicidal thoughts, 1.1% had a suicidal plan, 0.6% had attempted suicide during the month prior to the interview, and, lastly, 2.6% reported to have had any sort of suicide attempt during his/her previous life. Independent factors associated with suicidality were being female, older age, not having a stable couple, lower levels of social support, having had physical childhood abuse experience, having experienced an increasing number of stressful life events, higher neuroticism scores, having a family history of mental disorder and nicotine or drugs dependence. LIMITATIONS The instrument employed to measure suicidality is a screening tool rather than a more in-depth diagnostic measure. We have not included all potential correlates of suicidality. This is a cross-sectional study which cannot establish causal relationships between exposures and outcomes. CONCLUSIONS This is the first epidemiological study in Andalusia on suicidality offering important results of clinical interest for suicide prevention.
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Affiliation(s)
- Paloma Huertas
- Departament of Personality, Assessment and Psychological Treatment, University of Málaga, Group GAP, Málaga, Spain
| | - Berta Moreno-Küstner
- Departament of Personality, Assessment and Psychological Treatment, University of Málaga, IBIMA, Group GAP, Málaga, Spain.
| | | | - Jorge A Cervilla
- Department of Psychiatry, University of Granada, Granada, Spain; San Cecilio University Hospital, Granada, Spain
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