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Awad MH, Mohamed RS, Abbas MM, Absam MB. Major depressive disorder: point prevalence, suicidal ideation, and risk factors among Sudanese children and adolescents during Sudan army conflict: a cross-sectional study. DISCOVER MENTAL HEALTH 2024; 4:28. [PMID: 39145898 PMCID: PMC11327231 DOI: 10.1007/s44192-024-00084-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 08/12/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Tiredness, poor concentration, disturbed sleep and poor appetite can all be caused by depression, which is a common mental disorder and a leading cause of disability worldwide. This study aimed to assess the prevalence of major depressive disorder, suicidal ideation, and risk factors in Sudanese children and adolescents during the Sudanese army conflict. METHODS A descriptive cross-sectional community-based study was carried out among Sudanese children between 11 and 17 years old who living in Sudan at the start of the conflict by using a self-administered questionnaire under the guidance of parents, if necessary. The questionnaire was adapted from the Patients Health Questionnaire-9 (PHQ-9) checklist for the assessment of major depression disorder symptoms according to the Diagnostic and Statistical Manual Edition 5th Edition (DSM-5). The questionnaire was translated into Arabic by two expert translators, and its validity and reliability were confirmed. Data analysis was performed using Statistical Package for the Social Sciences version 25 software, and descriptive analysis and any appropriate statistical tests were performed. RESULTS Among the 963 participants, the mean age was 15.18 ± 2.1 years, 65.5% were female, and 67.7% had major depressive disorder. There was a significant relationship between MDD score, age, sex, current residency status, and traumatic event exposure, with P values less than 0.001 for all variables. CONCLUSION Major depressive disorder was highly prevalent among Sudanese children and adolescents included in the present study. Additionally, suicidal ideation, which requires immediate intervention, was reported to be very high. The findings will help the government to provide proper mental health interventions for affected people.
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Affiliation(s)
- Mohammed Haydar Awad
- Faculty of Medicine, Karary University, Khartoum, Sudan.
- , Abusead, Block No. 53, House No. 697, Omdurman, Khartoum, Sudan.
| | | | - Maram Mutasim Abbas
- Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan
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Bevione F, Panero M, Abbate-Daga G, Cossu G, Carta MG, Preti A. Risk of suicide and suicidal behavior in refugees. A meta-review of current systematic reviews and meta-analyses. J Psychiatr Res 2024; 177:287-298. [PMID: 39059026 DOI: 10.1016/j.jpsychires.2024.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 07/13/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Despite the exposure to a wide combination of risk factors, evidence concerning risk of suicide among refugees is mixed. AIMS We aimed to establish more precise estimates of suicide and suicidal behavior in refugees and asylum seekers, investigate the role of somatic and psychiatric comorbidities, and the effectiveness of preventative interventions. METHODS We searched PubMed/Medline, EMBASE, CINAHL, and PsycInfo without time limitations from inception until June 5, 2024. Studies were included if systematic reviews or meta-analyses reporting data on suicide or suicidal behavior in refugees or asylum seekers, or detailing the results of preventive interventions. Quality was assessed using the National Institutes of Health Quality Assessment Tool for Systematic Reviews and Meta-Analyses. RESULTS Out of 49 papers, 10 systematic reviews and meta-analyses were included. Refugees showed significantly higher suicide death rates and suicidal ideation, suicide plan and suicide attempt prevalence compared to people living in the host countries. Refugees who arrived in low-income and lower-middle-income countries displayed lower suicidal ideation, but higher suicide death rates and suicide attempt prevalence compared to refugees who arrived in high-income and upper-middle-income countries. However, no review provided data regarding somatic comorbidity, psychiatric comorbidity, or the effectiveness of treatments, and evidence on specific categories of refugees is scarce. CONCLUSION Refugees have been proven to be at risk for suicide and suicidal behavior. More research is required to identify the targets and procedures of intervention.
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Affiliation(s)
| | - Matteo Panero
- Department of Neuroscience, University of Turin, Turin, Italy
| | | | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Preti
- Department of Neuroscience, University of Turin, Turin, Italy.
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3
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Salim S. The burden of trauma in the life of a refugee. Front Public Health 2024; 12:1298544. [PMID: 39086798 PMCID: PMC11288919 DOI: 10.3389/fpubh.2024.1298544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 06/19/2024] [Indexed: 08/02/2024] Open
Affiliation(s)
- Samina Salim
- Department of Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, TX, United States
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4
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Zlotnick C, Jabareen R, Madjar B, Hazoref RH, Gens I, Shachaf S. A country's efforts toward creating an advanced practice nurse in public health. Int Nurs Rev 2024; 71:396-406. [PMID: 38661535 DOI: 10.1111/inr.12971] [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: 12/07/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
AIM The study goal was to inform the creation of a blueprint for an advanced practice nurse (APN) in public health. BACKGROUND No internationally accepted standard for an APN in public health exists. Activities of public health nurses (PHN) traditionally have centered on health promotion and disease prevention, but many have added other population-based activities such as chronic and acute disease treatment. INTRODUCTION An APN in public health is needed to address the global challenges threatening the physical, social, and mental health of populations worldwide. METHODS This qualitative study was comprised of six focus groups, each containing a different group of stakeholders (n = 40). Study results followed the requirements of the consolidated criteria for reporting qualitative research (COREQ). FINDINGS Two major themes emerged: the APN role in public health and core expectations. From the APN role theme, four subthemes emerged on APN domains of public health practice and functions. From the core expectations theme, nine subthemes emerged on the APN's qualifications and behaviors. DISCUSSION Agreement among stakeholders was found in the nine core expectations; however, among the four different visions of an APN in public health, two fit a population-based model rather than the traditional PHN model. CONCLUSIONS A single APN role in public health is insufficient to address the breadth and complexity of today's global challenges as detailed by the sustainable development goals. Due to the interaction between health and the biopsychosocial environments, we need APNs with different areas of expertise. IMPLICATION FOR NURSING POLICY Nurses working at universities, in public health services, and as healthcare policymakers are needed to create a multistage strategy that gradually introduces several different types of APNs in public health.
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Affiliation(s)
| | | | | | - Rivka Hazan Hazoref
- Department for Licensing and Nursing Exams, Nursing Division, Ministry of Health, Jerusalem, Israel
| | - Ilana Gens
- Chief Nurse of Public Health Services, Ministry of Health, Jerusalem, Israel
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5
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Anstee L, Richards S, Shah C, Magon R, Zia A. Characteristics and outcomes of people in suicidal crisis at two emergency departments: a service evaluation. Emerg Nurse 2024:e2204. [PMID: 38742289 DOI: 10.7748/en.2024.e2204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 05/16/2024]
Abstract
Emergency departments (EDs) provide critical opportunities for nurses to support suicide prevention. This article details a service evaluation that was undertaken to explore the characteristics and outcomes of people in suicidal crisis at two EDs in the East of England during June 2023. Data routinely collected by the ED mental health liaison team were combined with a retrospective case note review of the local NHS mental health trust's electronic patient records. Attendees had a mean age of 35 years and seven months, and were often diagnosed with depression or emotionally unstable personality disorder. Most had a history of self-harm and were currently known to mental health services. Suicide-specific interventions were rarely recorded by nurses and relapse behaviours were prevalent after presentation. Local and national suicide prevention strategies should encourage nurses to address gaps in support, thereby improving patients' experiences in and beyond the ED.
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Affiliation(s)
- Lottie Anstee
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, England
| | - Sabrina Richards
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, England
| | - Chetan Shah
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, England
| | - Rakesh Magon
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, England
| | - Asif Zia
- Hertfordshire Partnership University NHS Foundation Trust, Hatfield, England
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6
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Sara SS, Rahman MA, Rahman R, Talukder A. Prediction of suicidal ideation with associated risk factors among university students in the southern part of Bangladesh: Machine learning approach. J Affect Disord 2024; 349:502-508. [PMID: 38218257 DOI: 10.1016/j.jad.2024.01.092] [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: 05/27/2023] [Revised: 11/09/2023] [Accepted: 01/07/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The prevalence of suicidal ideation has become an urgent issue, particularly among adolescents. The primary objective of this research is to determine the prevalence of suicidal ideation among students in the southern region of Bangladesh and to predict this phenomenon using machine learning (ML) models. METHODS The data collection process involved using a simple random sampling technique to gather information from university students located in the southern region of Bangladesh during the period spreading from April 2022 to June 2022. Upon accounting for missing values and non-response rates, the ultimate sample size was determined to be 584, with 51.5 % of participants identifying as male and 48.5 % female. RESULTS A significant proportion of students, precisely 19.9 %, reported experiencing suicidal ideation. Most participants were female (77 %) and unmarried (78 %). Within the machine learning (ML) framework, KNN exhibited the highest accuracy score of 91.45 %. In addition, the Random Forest (RF), and Categorical Boosting (CatBoost) algorithms exhibited comparable levels of accuracy, achieving scores of 90.60 and 90.59 respectively. LIMITATIONS Using a cross-sectional design in research limits the ability to establish causal relationships. CONCLUSION Mental health practitioners can employ the KNN model alongside patients' medical histories to detect those who may be at a higher risk of attempting suicide. This approach enables healthcare professionals to take appropriate measures, such as counselling, encouraging regular sleep patterns, and addressing depression and anxiety, to prevent suicide attempts.
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Affiliation(s)
- Sabiha Shirin Sara
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
| | - Md Asikur Rahman
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
| | - Riaz Rahman
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
| | - Ashis Talukder
- Statistics Discipline, Science Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh; National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, 2600, Australia.
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7
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Hoshmand S, Knegtering H, Spoelstra SK. Cultural competence of mental health practitioners in the Netherlands. Int J Soc Psychiatry 2024; 70:282-288. [PMID: 37874035 DOI: 10.1177/00207640231206062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND The importance of providing mental health from a transcultural perspective in establishing a therapeutic alliance is recognized. However, it is currently unknown how many mental health practitioners in the Netherlands feel capable of providing mental healthcare from a transcultural perspective, or if they are familiar with the Cultural Formulation Interview (CFI). The CFI is a tool used in mental health care to gather culturally relevant patient information, enhancing cultural sensitivity in treatment. It is also unknown if there is a difference between psychiatrist and psychiatry residents in terms of their cultural competence. AIMS This study aimed to assess the self-appraised cultural competence of Dutch psychiatrist and psychiatry residents, including their knowledge of the CFI, and the need for further training. METHODS A cross-sectional study was conducted among psychiatrists and psychiatry residents by means of an online questionnaire. RESULTS Ninety-seven mental health practitioners completed the questionnaire. Of the psychiatrists 70% and of the residents 76% reported that treating patients from cultural backgrounds different from their own background is challenging. Only 44% of psychiatrists and 34% of residents considered themselves sufficiently culturally competent, and 56% and 47% respectively, were uninformed about the CFI. The majority of psychiatrists and residents (70 vs 84%) indicated a need for more training in cultural competence. CONCLUSION The majority of psychiatrists and residents in The Netherlands considered treating patients from different cultural backgrounds a challenge, reported feeling insufficiently culturally competent, lacked experience with the cultural formulation interview and reported a need for more training in cultural competence.
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Affiliation(s)
- S Hoshmand
- Lentis Psychiatric institute, Groningen, The Netherlands
| | - H Knegtering
- Lentis Psychiatric institute, Groningen, The Netherlands
- University Medical Center Groningen, University of Groningen, Rob Giel Research Center, Groningen, The Netherlands
| | - S K Spoelstra
- Addiction care North Netherlands, Groningen, The Netherlands
- NHL Stenden Hogeschool, Leeuwarden, The Netherlands
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8
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Kheni N, Lee JJ, Maselka C, Murray S, Sabri B. Addressing Suicide Risk Among Immigrant Women Survivors of Intimate Partner Violence. Issues Ment Health Nurs 2024; 45:311-321. [PMID: 38232224 PMCID: PMC10959683 DOI: 10.1080/01612840.2023.2291685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Intimate partner violence (IPV) is a significant public health problem contributing to multiple morbidities. Immigrant women who experience IPV may be disproportionately vulnerable to poor mental health outcomes, including self-harm and suicidal ideation, due to cultural experiences and contextual factors that prevent them from accessing services. While existing studies identify the risks for suicidal ideation amongst survivors of IPV, there is limited knowledge on how to tailor strategies to support immigrant women survivors of IPV who experience suicidal ideation. This study was conducted as part of the formative phase of a longitudinal research project designed to develop and evaluate a safety planning intervention for immigrant women survivors of IPV. Using qualitative in-depth interviews, we explored the perspectives of immigrant women survivors of IPV (n = 46) from various countries of origin, ages, and educational backgrounds on effective strategies for supporting immigrant women who disclose suicidal ideation. Study participants discussed various strategies for supporting survivors including building trust, providing encouragement, strengthening social support networks, and reminding survivors of parental responsibilities. Participants also pointed to the importance of the following services: domestic violence support, faith-based health resources, supportive immigration programs, mental health support, and emergency and medical treatment. These findings are informative for researchers and practitioners who work with immigrant women survivors of IPV, and they can be used to develop appropriate safety protocols and support strategies for survivors who are experiencing or have previously experienced suicidal ideation to mitigate the risk of self-harm.
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Affiliation(s)
- Nikita Kheni
- Research Administration, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Jennifer J. Lee
- Research Administration, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Chase Maselka
- Research Administration, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Sarah Murray
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bushra Sabri
- Research Administration, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
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9
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Yamashita T, Quy PN, Yamada C, Nogami E, Seto-Suh E, Iwamoto S, Kato K. A cross-sectional survey of material deprivation and suicide-related ideation among Vietnamese technical interns in Japan. Front Psychol 2024; 14:1241837. [PMID: 38250095 PMCID: PMC10797745 DOI: 10.3389/fpsyg.2023.1241837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
Background The economic struggles faced by many technical intern trainees in Japan include the necessity to remit money to their home country, debts owed to intermediaries facilitating their arrival, and reduced working hours due to the COVID-19 pandemic. Furthermore, there is concern that the pandemic may contribute to mental instability resulting from the significant life changes experienced by the trainees. This study examined the experience of material deprivation among Vietnamese intern trainees in Japan and explored the correlation between material deprivation and suicidal ideation. Methods A cross-sectional study was conducted between September and October 2021, involving 310 Vietnamese technical intern trainees. Data from 200 participants were analyzed. The questionnaire included gender, age, duration of residence in Japan, proficiency in the Japanese language, income changes due to the COVID-19 pandemic, material deprivation status, and suicidal ideation. Suicidal ideation was assessed using the ninth item of the Patient Health Questionnaire-9. Logistic regression analysis was performed to investigate the relationship between material deprivation items and suicidal ideation. Results The mean age of the respondents was 26.0 ± 5.1 years, with 62.0% (n = 124) being male. Among the material deprivation items, 74.0% (n = 148) reported food deprivation, 59.0% (n = 118) reported cellphone bill deprivation, and 55.0% (n = 110) reported medical expense deprivation. Suicidal ideation was reported by 23.0% (n = 46) of the respondents. The prevalence of suicidal ideation was associated with age (p = 0.031, odds ratio [OR] = 0.889, 95% confidence interval [CI] = 0.799-0.990), deprivation of food expenses (p = 0.003, OR = 3.897, 95% CI = 1.597-9.511), and deprivation of cellphone usage (p = 0.021, OR = 3.671, 95% CI = 1.217-11.075). Conclusion Vietnamese technical intern trainees in Japan faced various forms of material deprivation, which correlated with a high prevalence of significant psychological issues. Suicidal ideation was influenced by factors such as age, deprivation of food expenses, and inability to pay cellphone bills. The experience of material deprivation could have intensified the mental health challenges faced by Vietnamese trainees, particularly in the demanding circumstances of the COVID-19 pandemic.
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Affiliation(s)
| | - Pham Nguyen Quy
- Department of Medical Oncology, Kyoto Miniren Central Hospital, Kyoto, Japan
| | - Chika Yamada
- Department of Environmental Coexistence, Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan
| | - Emi Nogami
- Department of Social Welfare, School of Psychology and Social Welfare, Mukogawa Women’s University, Nishinomiya, Japan
| | - Erina Seto-Suh
- Human Rights Research Institute, Kindai University, Higashi osaka, Japan
| | - Saori Iwamoto
- Faculty of Nursing, Kobe City College of Nursing, Kobe, Japan
| | - Kenji Kato
- Faculty of Nursing, Kobe Women’s University, Kobe, Japan
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10
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Truong M, Dwyer J, Chan J, Bugeja L. Availability and quality of data related to cultural and linguistic diversity in the Victorian Suicide Register: A pilot study. Aust N Z J Public Health 2023; 47:100078. [PMID: 37586128 DOI: 10.1016/j.anzjph.2023.100078] [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: 07/29/2022] [Revised: 03/29/2023] [Accepted: 07/16/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE While people from culturally and linguistically diverse (CALD) backgrounds have been identified as a priority for suicide prevention in Australia, little is known about suicide in CALD communities. We aim to describe the availability and quality of CALD data in the Victorian Suicide Register (VSR). METHODS A retrospective consecutive case series review of suicides reported to the Coroners Court of Victoria during 2016 was conducted. Using the VSR, we identify suicides showing evidence of CALD identity and relevant variables were extracted and coded according to an adapted Australian Institute of Health and Welfare framework. RESULTS During 2016, 126 of 652 suicides (19.3%, 95% confidence intervals 16.4-22.6) were flagged as showing evidence of CALD. The two most frequent CALD indicators for which information was recorded were country of birth and year of arrival. There was less information pertaining to citizenship, residency/visa status, preferred language, English language proficiency and religious affiliation. CONCLUSIONS This study demonstrates that the VSR, like other databases, has substantial gaps in availability and quality of CALD data. IMPLICATIONS A framework to capture richer data on cultural, religious and linguistic diversity when coding suicides is needed to inform policy on suicide prevention initiatives designed for CALD communities.
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Affiliation(s)
- Mandy Truong
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia; Menzies School of Health Research, Darwin, Northern Territory, Australia.
| | - Jeremy Dwyer
- Coroners Prevention Unit, Coroners Court of Victoria, Southbank, Victoria, Australia
| | - Jocelyn Chan
- School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
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O'Connor RC, Worthman CM, Abanga M, Athanassopoulou N, Boyce N, Chan LF, Christensen H, Das-Munshi J, Downs J, Koenen KC, Moutier CY, Templeton P, Batterham P, Brakspear K, Frank RG, Gilbody S, Gureje O, Henderson D, John A, Kabagambe W, Khan M, Kessler D, Kirtley OJ, Kline S, Kohrt B, Lincoln AK, Lund C, Mendenhall E, Miranda R, Mondelli V, Niederkrotenthaler T, Osborn D, Pirkis J, Pisani AR, Prawira B, Rachidi H, Seedat S, Siskind D, Vijayakumar L, Yip PSF. Gone Too Soon: priorities for action to prevent premature mortality associated with mental illness and mental distress. Lancet Psychiatry 2023; 10:452-464. [PMID: 37182526 DOI: 10.1016/s2215-0366(23)00058-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 05/16/2023]
Abstract
Globally, too many people die prematurely from suicide and the physical comorbidities associated with mental illness and mental distress. The purpose of this Review is to mobilise the translation of evidence into prioritised actions that reduce this inequity. The mental health research charity, MQ Mental Health Research, convened an international panel that used roadmapping methods and review evidence to identify key factors, mechanisms, and solutions for premature mortality across the social-ecological system. We identified 12 key overarching risk factors and mechanisms, with more commonalities than differences across the suicide and physical comorbidities domains. We also identified 18 actionable solutions across three organising principles: the integration of mental and physical health care; the prioritisation of prevention while strengthening treatment; and the optimisation of intervention synergies across social-ecological levels and the intervention cycle. These solutions included accessible, integrated high-quality primary care; early life, workplace, and community-based interventions co-designed by the people they should serve; decriminalisation of suicide and restriction of access to lethal means; stigma reduction; reduction of income, gender, and racial inequality; and increased investment. The time to act is now, to rebuild health-care systems, leverage changes in funding landscapes, and address the effects of stigma, discrimination, marginalisation, gender violence, and victimisation.
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Affiliation(s)
- Rory C O'Connor
- Suicidal Behaviour Research Laboratory, School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
| | | | - Marie Abanga
- Hope for the Abused and Battered, Douala, Cameroon
| | | | | | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Helen Christensen
- Faculty of Medicine & Health, University of New South Wales, Sydney and the Black Dog Institute, Sydney, NSW, Australia
| | - Jayati Das-Munshi
- Department of Psychological Medicine, King's College London, London, UK; Institute of Psychiatry, Psychology, and Neuroscience, and Centre for Society and Mental Health, King's College London, London, UK; South London and Maudsley NHS Trust, London, UK
| | - James Downs
- Royal College of Psychiatrists, UK and Faculty of Wellbeing, Education, and Language Studies, Open University, Milton Keynes, UK
| | | | | | - Peter Templeton
- The William Templeton Foundation for Young People's Mental Health, Cambridge, UK
| | - Philip Batterham
- Centre for Mental Health Research, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | | | | | - Simon Gilbody
- York Mental Health and Addictions Research Group, University of York, York, UK
| | - Oye Gureje
- WHO Collaborating Centre for Research and Training in Mental Health, Neuroscience, Drug and Alcohol Abuse, University of Ibadan, Ibadan, Nigeria
| | - David Henderson
- Department of Psychiatry, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Murad Khan
- Brain & Mind Institute, Aga Khan University, Karachi, Pakistan
| | - David Kessler
- Bristol Population Health Science Institute, Centre for Academic Mental Health, Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Olivia J Kirtley
- Center for Contextual Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | - Brandon Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Alisa K Lincoln
- Institute for Health Equity and Social Justice Research, Northeastern University, Boston, MA, USA
| | - Crick Lund
- Health Services and Population Research Department, King's College London, London, UK; Centre for Global Mental Health, King's College London, London, UK
| | - Emily Mendenhall
- Edmund A Walsh School of Foreign Service, Georgetown University, Washington, DC, USA
| | - Regina Miranda
- Hunter College, Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA
| | - Valeria Mondelli
- Department of Psychological Medicine, King's College London, London, UK
| | - Thomas Niederkrotenthaler
- Department of Social and Preventive Medicine, Suicide Research & Mental Health Promotion Unit, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - David Osborn
- Division of Psychiatry, University College London and Camden and Islington NHS Foundation Trust, London, UK
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony R Pisani
- University of Rochester Center for the Study and Prevention of Suicide, SafeSide Prevention, Rochester, NY, USA
| | | | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, SAMRC Genomics of Brain Disorders Unit, Stellenbosch University, Cape Town, South Africa
| | - Dan Siskind
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | | | - Paul S F Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Special Administrative Region, China
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12
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Sá FHDL, Waikamp V, Freitas LHM, Baeza FLC. Mental health outcomes in Syrian refugees: A systematic review. Int J Soc Psychiatry 2022; 68:933-953. [PMID: 35657322 DOI: 10.1177/00207640221099404] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Syria is the main country of origin for refugees in the world. The prevalence of mental disorders in this population is high, but there is a lack of more comprehensive data on mental health issues in this population. AIM This study aims to review the literature for mental health outcomes in Syrian refugees. METHODS We performed a systematic quantitative literature review of original observational studies indexed on the MEDLINE via PubMed, Embase, Web of Science, PsycINFO, LILACS, and SciELO databases with quantitative data reporting mental health outcomes in Syrian refugees. A descriptive analysis was conducted, and the quality of the included studies was assessed using an adaptation from The National Institutes of Health (NIH) quality assessment tool for observational studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. RESULTS A total of 64 studies were included. The majority were published between 2019 and 2020, and focused on the prevalence of post-traumatic stress disorder (PTSD), depression, and anxiety, with a wide range of variations. Other outcomes were difficulties in the post-migration period and promotive factors for mental health, such as resilience, positive coping strategies, and psychosocial well-being. CONCLUSIONS High prevalence rates of mental disorders were observed, as well as risk factors for their occurrence. Studies showed a very high variability of prevalence rates and heterogeneity in methodologies. There is a need for research focusing on other determinants and specific necessities for mental health, especially in the post-resettlement period.
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Affiliation(s)
- Fernando Henrique de Lima Sá
- Post-Graduate Program in Psychiatry and Behavioral Sciences, Federal University at Rio Grande do Sul, Porto Alegre, Brazil
| | - Vitória Waikamp
- Post-Graduate Program in Psychiatry and Behavioral Sciences, Federal University at Rio Grande do Sul, Porto Alegre, Brazil
| | - Lúcia Helena Machado Freitas
- Post-Graduate Program in Psychiatry and Behavioral Sciences, Federal University at Rio Grande do Sul, Porto Alegre, Brazil.,Clinical Hospital of Porto Alegre, Rio Grande do Sul, Brazil
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Suicidal Behaviour, including Ideation and Self-Harm, in Young Migrants: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148329. [PMID: 35886183 PMCID: PMC9318121 DOI: 10.3390/ijerph19148329] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023]
Abstract
Young people experience high rates of suicidal ideation, self-harm, suicide attempt and death due to suicide. As a result of increasing globalisation, young people are increasingly mobile and can migrate from one country to another seeking educational and employment opportunities. With a growing number of young migrants, it is important to understand the prevalence of suicidal behaviour among this population group. We systematically searched Medline, Embase, and PsycINFO from inception until 31 March 2022. Eligible studies were those providing data on suicidal ideation, self-harm, suicide attempt, and death due to suicide. Seventeen studies were included in the review, some of which provided data on multiple outcomes of interest. Twelve studies provided data on suicidal ideation, five provided data on self-harm, eight provided data on suicide attempt, and one study had data on suicide death among young migrants. The quality of the included studies was varied and limited. The studies included in this review commonly reported that young migrants experience higher rates of self-harm and suicide attempt, but no major differences in suicidal ideation and suicide death compared to non-migrant young people. However, the limited number of studies focused on suicidal behaviour among young migrants highlights the need for further high-quality studies to capture accurate information. This will enable the development of policies and interventions that reduce the risk of suicidal behaviour among young migrants.
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Amiri S. Global prevalence of anxiety and PTSD in immigrants: a systematic review and meta-analysis. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2022; 36:69-88. [PMID: 35147917 DOI: 10.1007/s40211-022-00411-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/09/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND A systematic and meta-analysis of the prevalence of anxiety and posttraumatic stress disorder (PTSD) in immigrants was conducted. METHODS Based on the keywords, scientific databases were systematically searched to identify articles. The search included the three databases PubMed, Google Scholar and Research Gate until June 2020. The analysis was performed to assess the prevalence of anxiety and PTSD; subgroups were examined based on anxiety disorders. RESULTS The prevalence of agoraphobia, PTSD, generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), social phobia and specific phobia were 4, 25, 9, 4, 3, 5 and 8%, respectively. CONCLUSIONS Considering the findings of the present study regarding the significant prevalence of anxiety and PTSD in the immigrant population, it is necessary to pay special attention to the mental health of this population.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Troya M, Spittal MJ, Pendrous R, Crowley G, Gorton HC, Russell K, Byrne S, Musgrove R, Hannah-Swain S, Kapur N, Knipe D. Suicide rates amongst individuals from ethnic minority backgrounds: A systematic review and meta-analysis. EClinicalMedicine 2022; 47:101399. [PMID: 35518122 PMCID: PMC9065636 DOI: 10.1016/j.eclinm.2022.101399] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Existing evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally. METHODS Databases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940. FINDINGS A total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4-17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2-139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9-1·7) with again a broad range amongst studies (RR 0·2-18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9-4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7-36·6). There was very substantial heterogeneity (I2 > 98%) between studies for all pooled estimates. INTERPRETATION The homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations. FUNDING No specific funding was provided to conduct this research. DK is funded by Wellcome Trust and Elizabeth Blackwell Institute Bristol. Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. Rebecca Musgrove is funded by the NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC-2016-003).
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Affiliation(s)
- M.Isabela Troya
- School of Public Health, College of Medicine and Health, University College Cork, 4.07 Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Grace Crowley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hayley C Gorton
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Kirsten Russell
- School of Psychological Sciences and Health, Graham Hills Building, 40 George Street, Glasgow, UK
| | - Sadhbh Byrne
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Rebecca Musgrove
- Centre for Mental Health and Safety, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Sciences Centre, University of Manchester, and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Navneet Kapur
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, The University of Manchester, Manchester, UK
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Corresponding author.
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Prevalence of suicidal ideation and suicide attempts among refugees: a meta-analysis. BMC Public Health 2022; 22:635. [PMID: 35365108 PMCID: PMC8976302 DOI: 10.1186/s12889-022-13029-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background Suicidal ideation and attempts are one of the most serious mental health problems affecting refugees. Risk factors such as mental disorders, low socio-economic status, and stressful life events all contribute to making refugees a high-risk group. For this reason, this meta-analysis aims to investigate the prevalence of suicidal ideation and attempts among refugees in non-clinical populations. Method We searched PubMed, Web of Science, PubPsych, and PsycInfo for articles reporting (period) prevalence rates of suicidal ideation and attempts. Inclusion criteria were the population of refugees or asylum seekers (aged 16 years and older), assessment of the prevalence of suicidal ideation and attempts in empirical studies in cross-sectional or longitudinal settings, written in English, and published by August 2020. Exclusion criteria were defined as a population of immigrants who have lived in the host country for a long time, studies that examined children and adolescents younger than 16 years, and research in clinical samples. Overall prevalence rates were calculated using Rstudio. Results Of 294 matches, 11 publications met the inclusion criteria. The overall period prevalence of suicidal ideation was 20.5% (CI: 0.11–0.32, I2 = 98%, n = 8), 22.3% (CI: 0.10–0.38, I2 = 97%, n = 5) for women, and 27.7% for men (CI: 0.14–0.45, I2 = 93%, n = 3). Suicide attempts had an overall prevalence of 0.57% (CI: 0.00–0.02, I2 = 81%, n = 4). Conclusion There is a great lack of epidemiological studies on suicidal ideation and attempts among refugees. The high prevalence of suicidal ideation indicates the existence of heavy psychological burden among this population. The prevalence of suicide attempts is similar to that in non-refugee populations. Because of the large heterogeneity between studies, the pooled prevalence estimates must be interpreted with caution. The results underline the need for systematic and standardized assessment and treatment of suicidal ideation and attempts. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13029-8.
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Magwood O, Kassam A, Mavedatnia D, Mendonca O, Saad A, Hasan H, Madana M, Ranger D, Tan Y, Pottie K. Mental Health Screening Approaches for Resettling Refugees and Asylum Seekers: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063549. [PMID: 35329237 PMCID: PMC8953108 DOI: 10.3390/ijerph19063549] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/24/2022]
Abstract
Refugees and asylum seekers often face delayed mental health diagnoses, treatment, and care. COVID-19 has exacerbated these issues. Delays in diagnosis and care can reduce the impact of resettlement services and may lead to poor long-term outcomes. This scoping review aims to characterize studies that report on mental health screening for resettling refugees and asylum seekers pre-departure and post-arrival to a resettlement state. We systematically searched six bibliographic databases for articles published between 1995 and 2020 and conducted a grey literature search. We included publications that evaluated early mental health screening approaches for refugees of all ages. Our search identified 25,862 citations and 70 met the full eligibility criteria. We included 45 publications that described mental health screening programs, 25 screening tool validation studies, and we characterized 85 mental health screening tools. Two grey literature reports described pre-departure mental health screening. Among the included publications, three reported on two programs for women, 11 reported on programs for children and adolescents, and four reported on approaches for survivors of torture. Programs most frequently screened for overall mental health, PTSD, and depression. Important considerations that emerged from the literature include cultural and psychological safety to prevent re-traumatization and digital tools to offer more private and accessible self-assessments.
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Affiliation(s)
- Olivia Magwood
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON K1N 7K4, Canada
| | - Azaad Kassam
- Department of Psychiatry, University of Ottawa, 75 Laurier Ave E, Ottawa, ON K1N 6N5, Canada;
- Pinecrest-Queensway Community Health Centre, 1365 Richmond Rd #2, Ottawa, ON K2B 6R7, Canada
- Ottawa Newcomer Health Centre, 291 Argyle, Ottawa, ON K2P 1B8, Canada
| | - Dorsa Mavedatnia
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada; (D.M.); (M.M.)
| | - Oreen Mendonca
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
| | - Ammar Saad
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 5B2, Canada
| | - Hafsa Hasan
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON M5T 3M6, Canada
| | - Maria Madana
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada; (D.M.); (M.M.)
| | - Dominique Ranger
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
| | - Yvonne Tan
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- Faculty of Arts and Sciences, Queen’s University, 99 University Ave, Kingston, ON K7L 3N6, Canada
| | - Kevin Pottie
- C.T. Lamont Primary Care Research Center, Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 7G5, Canada; (O.M.); (O.M.); (A.S.); (H.H.); (D.R.); (Y.T.)
- Department of Family Medicine, Western University, London, ON N6A 3K7, Canada
- Correspondence:
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López-Cuadrado T, Hernández-Calle D, Martínez-Alés G. Trends in suicide mortality in Spain, 2000-2019: Moderation by foreign-born status. J Affect Disord 2022; 300:532-539. [PMID: 34998806 DOI: 10.1016/j.jad.2022.01.031] [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: 09/23/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Suicide rates in Spain remained stable during the early 21st century. Suicide rates among specific socially vulnerable groups, however, remain unknown, and there are no data on suicide mortality rates and trends among migrants living in Spain. METHODS We analyzed Spain's 2000-2019 suicide mortality data by migration status (native- vs. foreign-born), examining crude and age-standardized rates and trends overall and by sex, age-group, suicide method, Spanish citizenship status, and country of origin, using joinpoint regression models. RESULTS Annual crude suicide mortality rates were higher among native- than foreign-born individuals (9.2 versus 6.2 por 100.000 inhabitants, respectively). While suicide rates decreased among native-born men and remained roughly stable among native-born women - with slight decreases among older native-born women, they increased after 2010 among foreign-born men aged 15-44 and ≥65 years and foreign-born women aged ≥65 years. Increases in suicide trends among foreign-born residents in Spain were largely driven by increases specific to individuals without Spanish citizenship. LIMITATIONS Suicide mortality data are subject to potential errors due to underreporting of suicide in death certificates CONCLUSIONS: Between 2010-2019, suicide in Spain increased only among foreign-born residents. These findings should enhance our understanding of the dynamics and potential actionable causes of suicide among migrants living in Spain.
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Affiliation(s)
| | | | - Gonzalo Martínez-Alés
- La Paz University Hospital, Madrid, Spain; Columbia University Mailman School of Public Health, New York, NY, USA; Network Center for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
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Bürgin D, Anagnostopoulos D, Vitiello B, Sukale T, Schmid M, Fegert JM. Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches. Eur Child Adolesc Psychiatry 2022; 31:845-853. [PMID: 35286450 PMCID: PMC9209349 DOI: 10.1007/s00787-022-01974-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The infliction of war and military aggression upon children must be considered a violation of their basic human rights and can have a persistent impact on their physical and mental health and well-being, with long-term consequences for their development. Given the recent events in Ukraine with millions on the flight, this scoping policy editorial aims to help guide mental health support for young victims of war through an overview of the direct and indirect burden of war on child mental health. We highlight multilevel, need-oriented, and trauma-informed approaches to regaining and sustaining outer and inner security after exposure to the trauma of war. The impact of war on children is tremendous and pervasive, with multiple implications, including immediate stress-responses, increased risk for specific mental disorders, distress from forced separation from parents, and fear for personal and family's safety. Thus, the experiences that children have to endure during and as consequence of war are in harsh contrast to their developmental needs and their right to grow up in a physically and emotionally safe and predictable environment. Mental health and psychosocial interventions for war-affected children should be multileveled, specifically targeted towards the child's needs, trauma-informed, and strength- and resilience-oriented. Immediate supportive interventions should focus on providing basic physical and emotional resources and care to children to help them regain both external safety and inner security. Screening and assessment of the child's mental health burden and resources are indicated to inform targeted interventions. A growing body of research demonstrates the efficacy and effectiveness of evidence-based interventions, from lower-threshold and short-term group-based interventions to individualized evidence-based psychotherapy. Obviously, supporting children also entails enabling and supporting parents in the care for their children, as well as providing post-migration infrastructures and social environments that foster mental health. Health systems in Europe should undertake a concerted effort to meet the increased mental health needs of refugee children directly exposed and traumatized by the recent war in Ukraine as well as to those indirectly affected by these events. The current crisis necessitates political action and collective engagement, together with guidelines by mental health professionals on how to reduce harm in children either directly or indirectly exposed to war and its consequences.
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Affiliation(s)
- David Bürgin
- grid.410712.10000 0004 0473 882XDepartment of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073 Ulm, Germany ,grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | | | | | - Benedetto Vitiello
- grid.7605.40000 0001 2336 6580Division of Child Neurology and Psychiatry, Department of Public Health and Pediatric Sciences, Regina Margherita Pediatric Hospital, University of Turin, Turin, Italy
| | - Thorsten Sukale
- grid.410712.10000 0004 0473 882XDepartment of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073 Ulm, Germany
| | - Marc Schmid
- grid.6612.30000 0004 1937 0642Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Jörg M. Fegert
- grid.410712.10000 0004 0473 882XDepartment of Child and Adolescent Psychiatry/Psychotherapy, University Hospital Ulm, University of Ulm, Steinhövelstrasse 5, 89073 Ulm, Germany
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Khan Amiri D, Madsen T, Norredam M, Brande SE, Mittendorfer-Rutz E, Nordentoft M, Erlangsen A. Suicide and Suicide Attempts Among Asylum-Seekers in Denmark. Arch Suicide Res 2021; 27:415-425. [PMID: 34877921 DOI: 10.1080/13811118.2021.2011809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE There are concerns that asylum-seekers are at increased risk of suicide attempt and suicide mortality. Yet, largescale nationwide studies are limited. Our aim was to examine whether asylum-seekers in Denmark had higher rates of suicide attempt and suicide when compared to the general population. METHODS A retrospective cohort design was used. Data on asylum-seekers and the general population living in Denmark during 2009-2019 were obtained from the Immigration services and national registers. Indirect standardization was applied to adjust for differences with respect to age group and sex and Incidence Rate Ratios (IRR) with 95% confidence intervals were calculated. RESULTS In a population of 78,666 asylum-seekers, a total of 601 suicide attempts and 9 suicides were recorded. The rate of suicide attempt was 842.0 per 100,000 person-years for asylum-seekers and 92.3 per 100,000 person-years for the general population. When adjusting for differences related to age group and sex, an IRR of 8.5 (95% CI: 7.6-9.5) was found for suicide attempt between 2014-2019. The IRR for suicide attempt unaccompanied minors between 2015 and 2019 was 5.8 (95% CI: 4.3-7.5) when adjusting for age group. We did not find an elevated rate of suicide among asylum-seekers (IRR: 1.6, 95% CI: 0.6-3.5). CONCLUSIONS Asylum-seekers were found to have higher rates of suicide attempt than the general population in Denmark. This also applied to unaccompanied minors. Our study emphasizes the need for awareness and preventive measures targeting mental health and suicidal behavior among asylum-seekers.HIGHLIGHTSAsylum-seekers had an 8-fold higher rate of suicide attempt than the general population.The suicide attempt rate for asylum-seekers reached its lowest levels during recent years.Unaccompanied minors had a 5-fold higher frequency of suicide attempt when compared to peers in the general population.We did not find elevated rates of death by suicide among asylum-seekers. No suicide deaths were recorded among unaccompanied minors.
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Paraschakis A, Efstathiou V, Karageorgiou V, Boyokas I, Michopoulos I. An age-period-cohort study of completed suicides in Greece: Patterns and implications for suicide prevention. Psychiatry Res 2021; 306:114260. [PMID: 34785425 DOI: 10.1016/j.psychres.2021.114260] [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: 05/12/2021] [Revised: 10/23/2021] [Accepted: 10/30/2021] [Indexed: 10/19/2022]
Abstract
Suicide is a dynamic phenomenon. Psychiatric medication intake, illicit drug and alcohol use or the preference for particular suicide methods shift continuously over time. To capture such variations -and their potential implications for suicide prevention-, we researched the forensic records of suicide cases for the period 1992-2016 at a large department of forensic medicine and conducted age-period-cohort (APC) analyses of our sample (1162 suicides, 77.45% males, 22.25% females). We primarily investigated socio-demographic and toxicological parameters. Benzodiazepine, alcohol and illicit drug use increased considerably towards the younger cohorts. The segment of individuals of foreign nationality raised significantly too; likewise, the proportion of prison suicides. Hanging appears increasingly preferred by the younger APCs (the opposite is true for jumping). Hanging seems more popular among males, prisoners, and those under the influence of illicit drugs; jumping by females and those less likely to have consumed alcohol or illicit drugs. Given that the method of a prior attempt, if a highly lethal one, usually gets repeated in the completed suicide, a history of an attempt by hanging should never be underestimated. The mental health needs of immigrants and prisoners look inadequately addressed. Young-middle aged immigrant prisoners appear a group at high suicide risk.
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Affiliation(s)
| | - Vasiliki Efstathiou
- 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, "Attikon" General Hospital, Athens, Greece
| | - Vasilios Karageorgiou
- 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, "Attikon" General Hospital, Athens, Greece
| | - Ilias Boyokas
- Piraeus Department of Forensic Medicine, Piraeus, Greece
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, "Attikon" General Hospital, Athens, Greece
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Kira IA, Rihan Ibrahim ES, Shuwiekh HAM, Ashby JS. Does Intersected Discrimination Underlie the Disproportionate Impact of COVID-19 Infection and Its Severity on Minorities? An Example from Jordan. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2021.1992224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | | | | | - Jeffrey S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
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Zhang X, Sun S, Peng P, Ma F, Tang F. Prediction of risk of suicide death among lung cancer patients after the cancer diagnosis. J Affect Disord 2021; 292:448-453. [PMID: 34144370 DOI: 10.1016/j.jad.2021.05.123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patients diagnosed with lung cancer have a higher suicide rate than the general population and other cancer patients. The aim of this study was to develop and validate a prediction model for the individual risk for suicide after the diagnosis of lung cancer. METHODS Patients diagnosed with lung cancer between 2007 and 2016 were selected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training and validation cohorts. Cox proportional hazard models were used to identify relevant predictors and construct prediction models. Additionally, graphic visualization methods were used to predict the risk for suicide within 5 years after the diagnosis of lung cancer. We used bootstrapping for the internal validation, Harrell's C-index for the discrimination, and a calibration plot for the calibration of the proposed model. RESULTS We obtained complete information on 112372 patients diagnosed with lung cancer from the SEER cohort. Multivariate Cox regression identified sex, race, marital status, tumour grade, surgery, radiation, and chemotherapy as significant predictors for suicide. A nomogram and a risk matrix were developed to visualize the risk for suicide within 5 years after lung cancer diagnosis. The bootstrapped and validated C-indices of the nomogram were 0.77 and 0.78, respectively. The calibration plot indicated good agreement between the prediction and actual observation. CONCLUSIONS The proposed model demonstrated good discrimination and calibration performance for predicting the risk for suicide within 5 years after lung cancer diagnosis. Reliable and feasible risk assessment tools can be promising for preventing unnecessary suicides among lung cancer patients.
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Affiliation(s)
- Xiaoshuai Zhang
- Department of Data Science, School of Statistics, Shandong University of Finance and Economics, Jinan, China
| | - Shihua Sun
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peng Peng
- School of Public Health, Weifang Medical University, Weifang, China
| | - Feifei Ma
- School of Public Health, Weifang Medical University, Weifang, China
| | - Fang Tang
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China; Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
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Amiri S, Behnezhad S. The global prevalence of postpartum suicidal ideation, suicide attempts, and suicide mortality: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1959814] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Moran JK, Bretz J, Winkler J, Gutwinski S, Brandl EJ, Schouler-Ocak M. The Differential Impact of Lockdown Measures Upon Migrant and Female Psychiatric Patients - A Cross-Sectional Survey in a Psychiatric Hospital in Berlin, Germany. Front Psychiatry 2021; 12:642784. [PMID: 34122174 PMCID: PMC8192805 DOI: 10.3389/fpsyt.2021.642784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/28/2021] [Indexed: 01/07/2023] Open
Abstract
The COVID-19 pandemic could have major effects on already vulnerable individuals with psychiatric disorders. It is important to assess how different patient groups respond to stress related to the pandemic, and what additional factors influence it, including family-related stress, migration background, and sex. We conducted a survey in a sample of 294 psychiatric patients in a large outpatient clinic in Berlin, measuring level of distress in relation to COVID-19 lockdown as well as family-related distress. We also measured potential influencing factors such as media consumption and medical support. In the migration background group, we found that women had more lockdown related psychological distress than men. This was not apparent in those patients with a German background. We found that females were more strongly affected by family-related distress, particularly those with a migration background. People with PTSD were most strongly affected by family-related distress, whereas people with psychotic disorders and addiction reported the least distress. There were no effects of media consumption. There were no differences in ability to abide by the lockdown related restrictions across diagnoses. Our results support earlier findings on differential vulnerability of diagnostic groups to these stressors. Thus, clinicians can optimize treatment by taking family-related stressors into account particularly for females and people with a migrant background.
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Affiliation(s)
- James K Moran
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Joachim Bretz
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Johanna Winkler
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Gutwinski
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eva J Brandl
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Meryam Schouler-Ocak
- Department of Psychiatry and Psychotherapy, St. Hedwig Hospital, Charité-Universitätsmedizin Berlin, Berlin, Germany
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