USA Suicides Compared to Other Western Countries in the 21st Century: Is there a Relationship with Gun Ownership?

Regional differences in mortality risk and in attenuating or aggravating factors in schizophrenia: A systematic review and meta-analysis

People with schizophrenia die prematurely, yet regional differences are unclear. PRISMA 2020-compliant systematic review/random-effects meta-analysis of cohort studies assessing mortality relative risk (RR) versus any control group, and moderators, in people with ICD/DSM-defined schizophrenia, comparing countries and continents. We conducted subgroup, meta-regression analyses, and quality assessment. The primary outcome was all-cause mortality. Secondary outcomes were suicide-, /natural-cause- and other-cause-related mortality. We included 135 studies from Europe (n = 70), North-America (n = 29), Asia (n = 33), Oceania (n = 2), Africa (n = 1). In incident plus prevalent schizophrenia, differences across continents emerged for all-cause mortality (highest in Africa, RR=5.98, 95 %C.I.=4.09-8.74, k = 1, lowest in North-America, RR=2.14, 95 %C.I.=1.92-2.38, k = 16), suicide (highest in Oceania, RR=13.5, 95 %C.I.=10.08-18.07, k = 1, lowest in North-America, RR=4.4, 95 %C.I.=4.07-4.76, k = 6), but not for natural-cause mortality. Europe had the largest association between antipsychotics and lower all-cause mortality/suicide (Asia had the smallest or no significant association, respectively), without differences for natural-cause mortality. Higher country socio-demographic index significantly moderated larger suicide-related and smaller natural-cause-related mortality risk in incident schizophrenia, with reversed associations in prevalent schizophrenia. Antipsychotics had a larger/smaller protective association in incident/prevalent schizophrenia regarding all-cause mortality, and smaller protective association for suicide-related mortality in prevalent schizophrenia. Additional regional differences emerged in incident schizophrenia, across countries, and secondary outcomes. Significant regional differences emerged for all-cause, cause-specific and suicide-related mortality. Natural-cause death was homogeneously increased globally. Moderators differed across countries. Global initiatives are needed to improve physical health in people with schizophrenia, local studies to identify actionable moderators.

Women's health inequalities in 15 Muslim-populated countries: Evidence from population and mortality statistics

In this study, we examined health inequalities and the status of women as evidenced in the patterns of population and mortality statistics in fifteen Muslim-populated countries. Based on WHO data, female-to-male ratios were calculated to determine differential gender ratios of population and mortality, using Western gender patterns as a baseline. The socioeconomic contexts of the analysis were the percentage of women in parliaments data by OECD and the Gross National Income Per Capita PPP by the World Bank. The study results indicate that former USSR countries had fewer girls, suggesting gender selection, whilst fewer adult women in the Gulf States population indicate health inequalities. Female children's mortality was under-reported, inferring under-valuing girls. Higher female adult deaths in Egypt, Iran, and the Gulf States show greater discrimination. Women in the richest Muslim countries face more inequalities and less representation in Parliament. The implications of the study are discussed.

Misuse of Prescription Opioids and Suicidal Behaviors Among Black Adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey

PURPOSE

Although some studies have examined the association between prescription opioid misuse and mental health outcomes, few have investigated the effects of prescription opioid misuse on suicidal behaviors among Black adolescents. The objective of this study was to investigate the cross-sectional association between prescription opioid misuse and suicidal ideation, suicide plan, and suicide attempt among Black adolescents.

METHODS

Data for this study came from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 4798 Black adolescents aged 14-18 years (51.2% female) was analyzed using binary logistic regression. The outcome variables investigated were suicidal ideation, suicide plan, and suicide attempt, and the main explanatory variable was prescription opioid misuse.

RESULTS

Of the 4798 Black adolescents, 15% reported ever misusing prescription opioids; 16.2% experienced suicidal ideation; 14% made a suicide plan; and 11.3% attempted suicide during the past 12 months. In the multivariate logistic regression models, Black adolescents who misused prescription opioids had 1.39 times higher odds of making a suicide plan and 1.65 times higher odds of making a suicide attempt during the past 12 months when compared to their counterparts who did not misuse prescription opioids. Other significant factors associated with suicidal behaviors include female sex, school bullying, cyberbullying, depressive symptoms, and illicit drug use. In addition, physical activity had a protective effect on suicide attempt.

CONCLUSION

The findings of the present study demonstrate the effects of prescription opioid misuse and its association with suicidal behaviors among Black adolescents.