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Jin T, Seo J, Ye S, Lee S, Park EY, Oh JK, Han C, Kim B. Suicide mortality following the implementation of tobacco packaging and pricing policies in Korea: an interrupted time-series analysis. BMC Med 2024; 22:180. [PMID: 38679738 PMCID: PMC11057188 DOI: 10.1186/s12916-024-03372-5] [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: 08/31/2023] [Accepted: 03/26/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND To prevent tobacco use in Korea, the national quitline number was added to tobacco packages in December 2012, tobacco prices were raised by 80% in January 2015, and graphic health warning labels were placed on tobacco packages in December 2016. This study evaluated the association of these tobacco packaging and pricing policies with suicide mortality in Korea. METHODS Monthly mortality from suicide was obtained from Cause-of-Death Statistics in Korea from December 2007 to December 2019. Interrupted time-series analysis was performed using segmented Poisson regression models. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated adjusted for suicide prevention strategies. RESULTS Suicide mortality was 20 per 1,000,000 in December 2007 and showed a downward trend over the study period. After the implementation of tobacco packaging and pricing policies, suicide mortality immediately declined by - 0.09 percent points (95% CI = - 0.19 to 0.01; P > 0.05) for the national quitline number, - 0.22 percent points (95% CI = - 0.35 to - 0.09; P < 0.01) for tobacco prices, and - 0.30 percent points (95% CI = - 0.49 to - 0.11; P < 0.01) for graphic health warning labels. The corresponding RRs for these post-implementation changes compared with the pre-implementation level were 0.91 (95% CI = 0.83 to 1.00), 0.80 (95% CI = 0.70 to 0.91), and 0.74 (95% CI = 0.61 to 0.90), respectively. Significant associations between tobacco control policies and suicide mortality were observed even when stratified by sex and region. CONCLUSIONS The findings of this study provide new evidence for an association between tobacco control policies and deaths by suicide. An array of effective tobacco control policies should be considered for prevention programs targeting suicide.
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Affiliation(s)
- Taiyue Jin
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi, 10408, South Korea
| | - Juhee Seo
- Vital Statistics Division, Statistics Korea, Daejeon, South Korea
| | - Shinhee Ye
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, South Korea
| | - Seulbi Lee
- Department of Big Data Strategy, National Health Insurance Service, Wonju, South Korea
| | - Eun Young Park
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Jin-Kyoung Oh
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi, 10408, South Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Changwoo Han
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Byungmi Kim
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi, 10408, South Korea.
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea.
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Guo J, Wang L, Zhao X, Wang D, Zhang X. Sex difference in association between suicide attempts and lipid profile in first-episode and drug naive patients with major depressive disorder. J Psychiatr Res 2024; 172:24-33. [PMID: 38354544 DOI: 10.1016/j.jpsychires.2024.02.026] [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: 08/08/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND The relationship between suicide attempts and lipid profiles in patients with major depressive disorder (MDD) remains uncertain. The purpose of this study was to investigate sex differences in the relationship between suicide attempts and plasma lipid profiles in a large sample of first-episode and drug naive (FEDN) MDD patients. METHODS We recruited 1718 FEDN MDD patients and gathered demographic, clinical, and blood lipid data. The Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and the Positive and Negative Syndrome Scale were used to assess the symptoms of patients. RESULTS There was no significant difference in the prevalence of suicide attempts between male and female MDD patients. The suicide attempt group had higher levels of depression, anxiety, psychotic symptoms, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C), but lower levels of high-density lipoprotein cholesterol (HDL-C) levels than the non-suicide attempt group. Binary logistic regression showed that TC levels were significantly correlated with suicidal attempts in both male and female patients. Correlation analysis revealed that the levels of TC, HDL-C and LDL-C were significantly associated with the number of suicide attempts in both male and female patients. Further multiple linear regression revealed that TC levels were significantly associated with the number of suicide attempts in male patients only. CONCLUSIONS Lipid biomarkers, particularly high TC levels, are associated with suicide attempts in both male and female MDD patients. However, there is gender difference in association between lipid biomarkers, especially TC levels, and the number of suicide attempts in MDD patients.
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Affiliation(s)
- Junru Guo
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China; Department of Psychology, Guizhou Minzu University, Guiyang, 550025, China
| | - Li Wang
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Xiaoqing Zhao
- Student Affairs Office, Guizhou University, Guiyang, 550025, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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Ball J, Crossin R, Boden J, Crengle S, Edwards R. Long-term trends in adolescent alcohol, tobacco and cannabis use and emerging substance use issues in Aotearoa New Zealand. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2060266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jude Ball
- Department of Public Health, University of Otago, Wellington
| | - Rose Crossin
- Department of Population Health, University of Otago, Christchurch
| | - Joseph Boden
- Department of Psychological Medicine, University of Otago, Christchurch
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin
| | - Richard Edwards
- Department of Public Health, University of Otago, Wellington
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Balbuena LD, Baetz M, Sexton JA, Harder D, Feng CX, Boctor K, LaPointe C, Letwiniuk E, Shamloo A, Ishwaran H, John A, Brantsæter AL. Identifying long-term and imminent suicide predictors in a general population and a clinical sample with machine learning. BMC Psychiatry 2022; 22:120. [PMID: 35168594 PMCID: PMC8848909 DOI: 10.1186/s12888-022-03702-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 01/12/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Machine learning (ML) is increasingly used to predict suicide deaths but their value for suicide prevention has not been established. Our first objective was to identify risk and protective factors in a general population. Our second objective was to identify factors indicating imminent suicide risk. METHODS We used survival and ML models to identify lifetime predictors using the Cohort of Norway (n=173,275) and hospital diagnoses in a Saskatoon clinical sample (n=12,614). The mean follow-up times were 17 years and 3 years for the Cohort of Norway and Saskatoon respectively. People in the clinical sample had a longitudinal record of hospital visits grouped in six-month intervals. We developed models in a training set and these models predicted survival probabilities in held-out test data. RESULTS In the general population, we found that a higher proportion of low-income residents in a county, mood symptoms, and daily smoking increased the risk of dying from suicide in both genders. In the clinical sample, the only predictors identified were male gender and older age. CONCLUSION Suicide prevention probably requires individual actions with governmental incentives. The prediction of imminent suicide remains highly challenging, but machine learning can identify early prevention targets.
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Affiliation(s)
- Lloyd D Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada.
| | - Marilyn Baetz
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Douglas Harder
- Mental Health & Addictions Services, Saskatchewan Health Authority, Saskatoon, Canada
| | - Cindy Xin Feng
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Kerstina Boctor
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada
| | - Candace LaPointe
- Mental Health & Addictions Services, Saskatchewan Health Authority, Saskatoon, Canada
| | - Elizabeth Letwiniuk
- Mental Health & Addictions Services, Saskatchewan Health Authority, Saskatoon, Canada
| | - Arash Shamloo
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Canada
| | | | - Ann John
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Anne Lise Brantsæter
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
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Harrison R, Munafò MR, Davey Smith G, Wootton RE. Examining the effect of smoking on suicidal ideation and attempts: triangulation of epidemiological approaches. Br J Psychiatry 2020; 217:701-707. [PMID: 32290872 PMCID: PMC7705667 DOI: 10.1192/bjp.2020.68] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous literature has demonstrated a strong association between cigarette smoking, suicidal ideation and suicide attempts. This association has not previously been examined in a causal inference framework and could have important implications for suicide prevention strategies. AIMS We aimed to examine the evidence for an association between smoking behaviours (initiation, smoking status, heaviness, lifetime smoking) and suicidal thoughts or attempts by triangulating across observational and Mendelian randomisation analyses. METHOD First, in the UK Biobank, we calculated observed associations between smoking behaviours and suicidal thoughts or attempts. Second, we used Mendelian randomisation to explore the relationship between smoking and suicide attempts and ideation, using genetic variants as instruments to reduce bias from residual confounding and reverse causation. RESULTS Our observational analysis showed a relationship between smoking behaviour, suicidal ideation and attempts, particularly between smoking initiation and suicide attempts (odds ratio, 2.07; 95% CI 1.91-2.26; P < 0.001). The Mendelian randomisation analysis and single-nucleotide polymorphism analysis, however, did not support this (odds ratio for lifetime smoking on suicidal ideation, 0.050; 95% CI -0.027 to 0.127; odds ratio on suicide attempts, 0.053; 95% CI, -0.003 to 0.110). Despite past literature showing a positive dose-response relationship, our results showed no clear evidence for a causal effect of smoking on suicidal ideation or attempts. CONCLUSIONS This was the first Mendelian randomisation study to explore the effect of smoking on suicidal ideation and attempts. Our results suggest that, despite observed associations, there is no clear evidence for a causal effect.
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Affiliation(s)
- Ruth Harrison
- Avon & Wiltshire Mental Health Partnership NHS Trust; and Severn Postgraduate Medical Education School of Psychiatry, Health Education England, UK
| | - Marcus R. Munafò
- School of Psychological Science, University of Bristol; MRC Integrative Epidemiology Unit, University of Bristol; NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol; and UK Centre for Tobacco and Alcohol Studies, University of Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol; and Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Robyn E. Wootton
- School of Psychological Science, University of Bristol; MRC Integrative Epidemiology Unit, University of Bristol; and NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, UK,Correspondence: Robyn E. Wootton.
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Characteristics associated with later self-harm hospitalization and/or suicide: A follow-up study of the HUNT-2 cohort, Norway. J Affect Disord 2020; 276:369-379. [PMID: 32871667 DOI: 10.1016/j.jad.2020.03.163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/20/2020] [Accepted: 03/29/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND To improve suicide and self-harm prevention in adults, better knowledge on preexisting characteristics and risk factors is of great importance. METHODS This is a population-based case-control study; baseline measures were collected in the second wave of the North-Trøndelag Health Study (HUNT-2, 1995-1997) in Norway, and outcomes were observed for up to 19 years. Average follow up time was 4.9 years for self-harm and 6.8 years for suicides. Out of 93,898 eligible adult inhabitants aged 20 and above, a total of 65,229 (70%) participated in the study. The data were linked to the National Mortality Registry and hospital patient records in the three hospitals covering the HUNT-2 catchment area. RESULTS Among the participants, 332 patients (68% women) were hospitalized because of self-harm (HSH), and 91 patients (32% women) were died by suicide (SU). A total of 10% of those who died by SU had previously been HSH. People in the HSH and SU groups were younger, reported more depression and anxiety symptoms, sleeping problems, higher use of alcohol and tobacco, poorer social network and more economic problems, compared to the rest of the HUNT-2 population. In addition, the HSH group reported more somatic health problems, higher use of health services, higher sick leave, and lower work participation than the SU group. LIMITATIONS Younger adults (20-40 years) were under-represented in HUNT-2. Younger adults (20-40 years) were constituted 31.7% in HUNT-2, 50% in HSH and 33% in SU. Further, we did not identify less severe self-harm, not requiring hospitalization. Life changes, adverse events, and other possible triggers to self-harming behavior were not recorded. CONCLUSION Psychological problems were long-term predictors of both HSH and SU. Somatic health problems and lower functional performance were more present in HSH-group compared to the SU-group.
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Barath D, Chen J. Integrating local health departments to reduce suicide-related emergency department visits among people with substance use disorders - Evidence from the state of Maryland. Prev Med 2019; 129:105825. [PMID: 31473219 PMCID: PMC6864273 DOI: 10.1016/j.ypmed.2019.105825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 11/29/2022]
Abstract
Individuals with a substance use disorder (SUD) are six times as likely than those without a SUD to attempt suicide, however just 18% of the SUD population has received treatment. One of the barriers to treatment is appropriate and timely mental health services. This resulted in a substantial increase in emergency department (ED) visits related to SUD and suicide. This study sought to determine if the number of suicide-related ED visits for patients with SUD is associated with the types of mental health activities provided by their local health department (LHD). Specifically, we examined whether patients with a SUD aged 18-64 experienced reductions in suicide-related ED visits when their LHD directly engaged in mental health activities, such as (1) primary prevention for mental illness or (2) mental health services. Using linked datasets for 2012 from the National Profile of Local Health Departments, U.S. Census data, Area Health Resource File, and Maryland's State Emergency Department Databases (SEDD), we employed multivariable logistic regressions and instrumental variable models to examine this association. After adjusting for the endogeneity of LHDs' activity measures and controlling for individual-, hospital-, LHD-, and county-level characteristics, results demonstrated patients with a SUD experienced a 6% and 5% reduction in suicide-related ED visits when their LHD directly provided primary prevention for mental illness and mental health services, respectively. The results are small but significant, with robust standard errors. This study suggests LHDs may be key players in preventing suicide-related ED visits among the SUD population.
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Affiliation(s)
- Deanna Barath
- University of Maryland, 4200 Valley Drive, Suite 3310, College Park, MD 20742, United States of America.
| | - Jie Chen
- University of Maryland, 4200 Valley Drive, Suite 3310, College Park, MD 20742, United States of America.
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Icick R, Melle I, Etain B, Ringen PA, Aminoff SR, Leboyer M, Aas M, Henry C, Bjella TD, Andreassen OA, Bellivier F, Lagerberg TV. Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder. J Affect Disord 2019; 256:348-357. [PMID: 31202989 DOI: 10.1016/j.jad.2019.05.075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 04/08/2019] [Accepted: 05/30/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Suicide attempts (SA) are more frequent in bipolar disorder (BD) than in most other mental disorders. Prevention strategies would benefit from identifying the risk factors of SA recurrence in BD. Substance use disorders (SUD) (including tobacco-related) are strongly associated with both BD and SA, however, their specific role for the recurrence of SA in BD remains inadequately investigated. Thus, we tested if tobacco smoking - with or without other SUDs - was independently associated with recurrent SA in BD. METHODS 916 patients from France and Norway with ascertained diagnoses of BD and reliable data about SA and SUD were classified as having no, single, or recurrent (≥2) SA. Five SUD groups were built according to the presence/absence/combination of tobacco, alcohol (AUD) and cannabis use disorders. Multinomial logistic regression was used to identify the correlates of SA recurrence. RESULTS 338 (37%) individuals reported at least one SA, half of whom (173, 51%) reported recurrence. SUD comorbidity was: tobacco smoking only, 397 (43%), tobacco smoking with at least another SUD, 179 (20%). Regression analysis showed that tobacco smoking, both alone and comorbid with AUD, depressive polarity of BD onset and female gender were independently associated with recurrent SA. LIMITATIONS Lack of data regarding the relative courses of SA and SUD and cross-national differences in main variables. CONCLUSION Tobacco smoking with- or without additional SUD can be important risk factors of SA recurrence in BD, which is likely to inform both research and prevention strategies.
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Affiliation(s)
- R Icick
- Inserm, U1144, Paris F-75006, France; Paris Diderot University, UMR-S 1144, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Saint-Louis - Lariboisière - F. Widal, Departement of Psychiatry and Addiction Medicine, Paris F-75010, France; FondaMental Foundation, Créteil F-94000, France.
| | - I Melle
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - B Etain
- Inserm, U1144, Paris F-75006, France; Paris Diderot University, UMR-S 1144, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Saint-Louis - Lariboisière - F. Widal, Departement of Psychiatry and Addiction Medicine, Paris F-75010, France; FondaMental Foundation, Créteil F-94000, France
| | - P A Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - S R Aminoff
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - M Leboyer
- FondaMental Foundation, Créteil F-94000, France; Inserm U955, Psychiatric Genetics Team, Créteil F-94000, France; Paris Est University, Faculty of medicine, Créteil F-94000, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Henri Mondor, DHU PePsy, Psychiatry Center, Créteil F-94000, France
| | - M Aas
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C Henry
- FondaMental Foundation, Créteil F-94000, France; Paris Est University, Faculty of medicine, Créteil F-94000, France
| | - T D Bjella
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - O A Andreassen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - F Bellivier
- Inserm, U1144, Paris F-75006, France; Paris Diderot University, UMR-S 1144, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Saint-Louis - Lariboisière - F. Widal, Departement of Psychiatry and Addiction Medicine, Paris F-75010, France; FondaMental Foundation, Créteil F-94000, France
| | - T V Lagerberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Icick R, Vorspan F, Karsinti E, Ksouda K, Lépine JP, Brousse G, Mouly S, Bellivier F, Bloch V. Gender-specific study of recurrent suicide attempts in outpatients with multiple substance use disorders. J Affect Disord 2018; 241:546-553. [PMID: 30153638 DOI: 10.1016/j.jad.2018.08.076] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/06/2018] [Accepted: 08/12/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND people suffering from substance use disorders (SUD) often die by suicide, so that the prevention of suicide attempts (SA) remains a top priority in this population. SA recurrence is common and is associated with suicide death, but this phenotype has been overlooked in SUD populations. Thus, we aimed at identifying the risk factors of SA recurrence in SUD, controlling for both gender and levels of exposure to addictive substances, including tobacco. METHODS we consecutively recruited 433 treatment-seeking outpatients with either opiate or cocaine use disorder and assessed their lifetime history of addictive and suicidal symptoms by standardized questionnaires. They were reliably classified as never, single or recurrent (≥ 2) suicide attempters, whose characteristics were identified by multinomial regression, stratified by gender; and compared to our previous work on serious SA in order to identify common or different risk profiles. RESULTS 86/140 (61%) suicide attempters reported recurrence. The mean number of SA was 3.1. Recurrence was independently associated with psychiatric hospitalization in both genders, with nicotine dependence in men and with sedative use disorders in women. LIMITATIONS psychiatric diagnoses were derived from the current medication regimen. CONCLUSION specific and possibly avoidable/treatable risk factors for the recurrence of SA in SUD have been identified for the first time, opening new avenues for research and prevention in this high-risk population. Apart from nicotine dependence, these risk factors were very similar to those of serious SA. Although this comparison is indirect for now, it suggests a common liability towards suicidal behavior.
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Affiliation(s)
- R Icick
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France.
| | - F Vorspan
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France
| | - E Karsinti
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; ED139, Paris Nanterre University, Nanterre F-92001, France
| | - K Ksouda
- Pharmacology Laboratory, Faculty of Medicine, Sfax, Tunisia
| | - J-P Lépine
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France
| | - G Brousse
- Psychiatry B-Department of Addiction Psychiatry, Faculty of Medicine, EA7280 and CHU Clermont-Ferrand, Clermont 1 University, Clermont-Ferrand F-63003, France
| | - S Mouly
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Internal Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France
| | - F Bellivier
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Psychiatry and Addiction Medicine, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France; INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France
| | - V Bloch
- INSERM U1144, Paris F-75006, France; Inserm UMR-S1144, Paris Descartes University, Paris F-75006, France; Sorbonne Paris Cité, Inserm UMR-S1144, Paris Diderot University, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris (AP-HP), Hospital Pharmacy, Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris F-75010, France
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Oliveira RMD, Santos JLF, Furegato ARF. Tobacco addiction in the psychiatric population and in the general population. Rev Lat Am Enfermagem 2017; 25:e2945. [PMID: 29211192 PMCID: PMC5738870 DOI: 10.1590/1518-8345.2202.2945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/02/2017] [Indexed: 11/21/2022] Open
Abstract
Objective: To estimate the degree of tobacco addiction and identify independently associated
factors by comparing the psychiatric population of secondary and tertiary care
with the general population of the primary healthcare network. Method: This is a cross-sectional epidemiological study, conducted in a municipality of
São Paulo, with 134 smokers of a Mental Health Outpatient Unit (MHOU), a
Psychiatric Hospital (PH), and a Primary Healthcare Unit (PHU). Data were
collected by means of individual interviews, recorded on a mobile device. Data
were statistically processed using Stata/12 Results: Of the 134 participants, 54.5% were women. While 49.1% of the psychiatric
population (MHOU/PH) had medium/high nicotine addiction, 58.3% of smokers of the
general population had very low/low dependency. The Poisson regression model
indicated a higher prevalence of smokers with high dependence among men (PR =
1.41), people aged 49 years or less (15 - 29 years, PR = 4.06, 30 - 39 PR = 2.96
years, 40 - 49 years PR = 1.84), with severe mental disorders (PR = 3.05), with
anxiety disorders/other (PR = 3.98), and with high suicide risk (PR = 1.55). Conclusion: Nicotine dependence was greater in the psychiatric population than in the general
population. The independent factors associated with severe dependence were sex,
age group, diagnosis, and current risk of suicide. These results trigger
reflection among nurses on the need to focus more attention on a neglected subject
in mental health services.
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Affiliation(s)
| | - Jair Lício Ferreira Santos
- PhD, Full Professor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Antonia Regina Ferreira Furegato
- PhD, Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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11
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Evins AE, Korhonen T, Kinnunen TH, Kaprio J. Prospective association between tobacco smoking and death by suicide: a competing risks hazard analysis in a large twin cohort with 35-year follow-up. Psychol Med 2017; 47:2143-2154. [PMID: 28399944 PMCID: PMC5551385 DOI: 10.1017/s0033291717000587] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/02/2017] [Accepted: 02/14/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND The relationship between smoking and suicide remains controversial. METHOD A total of 16 282 twin pairs born before 1958 in Finland and alive in 1974 were queried with detailed health and smoking questionnaires in 1975 and 1981, with response rates of 89% and 84%. Smoking status and dose, marital, employment, and socio-economic status, and indicators of psychiatric and somatic illness were assessed at both time points. Emergent psychiatric and medical illness and vital status, including suicide determined by forensic autopsy, were evaluated over 35-year follow-up through government registries. The association between smoking and suicide was determined in competing risks hazard models. In twin pairs discordant for smoking and suicide, the prospective association between smoking and suicide was determined using a matched case-control design. RESULTS Smokers had a higher cumulative suicide incidence than former or never smokers. Heavy smokers had significantly higher suicide risk [hazard ratio (HR) 3.47, 95% confidence interval (CI) 2.31-5.22] than light smokers (HR 2.30, 95% CI 1.61-3.23) (p = 0.017). Compared with never smokers, smokers, but not former smokers, had increased suicide risk (HR 2.56, 95% CI 1.43-4.59), adjusting for depressive symptoms, alcohol and sedative-hypnotic use, and excluding those who developed serious somatic or psychiatric illness. In twin pairs discordant for smoking and suicide, suicide was more likely in smokers [odds ratio (OR) 6.0, 95% CI 2.06-23.8]. CONCLUSIONS Adults who smoked tobacco were more likely to die by suicide, with a large, dose-dependent effect. This effect remained after consideration of many known predictors of suicide and shared familial effects, consistent with the hypothesis that exposure to tobacco smoke increases the risk of suicide.
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Affiliation(s)
- A. E. Evins
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - T. Korhonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - T. H. Kinnunen
- Behavioral Science Consulting, Hopkinton, MA, USA
- Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
| | - J. Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland
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12
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Sankaranarayanan A, Castle D. Burden associated with smoking as a suicidal risk factor in an Australian sample of patients with psychosis. Australas Psychiatry 2016; 24:437-40. [PMID: 27130725 DOI: 10.1177/1039856216646232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We aim to describe the burden associated with smoking as a risk factor for suicidal behaviors among patients with psychosis. METHOD We calculated the Population Attributable Risk (PAR) associated with smoking and other known modifiable risk factors for suicidal behaviors for participants (N=1812) who took part in the Australian Survey of High Impact Psychosis (SHIP). A combined PAR for the seven identified modifiable risk factors was calculated. RESULTS Smoking contributed to 21% of the suicidal behaviors in this sample; together, the seven factors contributed to 86% of all attempted suicide in this cohort. CONCLUSIONS Smoking may exert a role either directly or indirectly. Evidence indicates that smoking is associated with psychological, biochemical and neurobiological changes that are in turn implicated in smoking. Suicidal behaviors are nevertheless complex behaviors needing multi-faceted approach.
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Affiliation(s)
| | - David Castle
- Professor, Department of Psychiatry, University of Melbourne, Melbourne, Fitzroy, NSW, Australia
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13
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Sankaranarayanan A, Clark V, Baker A, Palazzi K, Lewin TJ, Richmond R, Kay-Lambkin FJ, Filia S, Castle D, Williams JM. Reducing smoking reduces suicidality among individuals with psychosis: Complementary outcomes from a Healthy Lifestyles intervention study. Psychiatry Res 2016; 243:407-12. [PMID: 27450743 DOI: 10.1016/j.psychres.2016.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 06/02/2016] [Accepted: 07/04/2016] [Indexed: 10/21/2022]
Abstract
This study sought to explore the impact of smoking reduction on suicidality (suicide ideation and behaviour) among people with a psychotic disorder (n=235) who participated in a randomized trial of a healthy lifestyle intervention trial. Suicidality, measured by item -4 of the Brief Psychiatric Rating Scale (BPRS) was the main variable of interest. Measures were collected by research assistants blind to treatment allocation at baseline, at 15 weeks (mid-intervention) and 12 months after baseline. Mediation analysis, adjusted for confounders, was used to determine the relationship between smoking reduction and suicidality and to explore whether this was mediated through depression. At 12 months, smoking reduction was found to be significantly associated with suicidality change; an association was also seen between smoking reduction and depression and depression and suicidality. After adjusting for depression, the association between smoking reduction and suicidality was attenuated but remained statistically significant; the proportion of the total effect that was mediated through depression was 30%. There was no significant association between suicidality and treatment group (vs. controls) over time. Our study suggests that smoking interventions may have benefits over and above those for improved physical health, by reducing suicidal ideation in people with psychosis.
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Affiliation(s)
- Anoop Sankaranarayanan
- Hunter New England Mental Health Service, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.
| | - Vanessa Clark
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Amanda Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Kerrin Palazzi
- Public Health Program, Hunter Medical Research Institute (HMRI), Newcastle, NSW, Australia
| | - Terry J Lewin
- Hunter New England Mental Health Service, Australia; School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Centre for Translational Neuroscience and Mental Health, University of Newcastle, Australia
| | - Robyn Richmond
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Frances J Kay-Lambkin
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Australia; NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, Australia
| | - Sacha Filia
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, Victoria, Australia; Alfred Hospital, 55 Commercial Road, Prahran, Melbourne, Victoria, Australia
| | - David Castle
- St. Vincent's Hospital, PO Box 2900, Fitzroy, Victoria, Australia; The University of Melbourne, Parkville, Melbourne, Victoria, Australia; Faculty of Health Sciences, Australian Catholic University, 1100 Nudgee Road, Banyo, Queensland, Australia
| | - Jill M Williams
- Division of Addiction Psychiatry, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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14
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Penberthy JK, Penberthy JM, Harris MR, Nanda S, Ahn J, Martinez CP, Osika AO, Slepian ZA, Forsyth JC, Starr JA, Farrell JE, Hook JN. Are Smoking Cessation Treatments Associated with Suicidality Risk? An Overview. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 10:19-30. [PMID: 27081311 PMCID: PMC4830638 DOI: 10.4137/sart.s33389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/25/2016] [Accepted: 01/27/2016] [Indexed: 12/29/2022]
Abstract
Risk of suicidality during smoking cessation treatment is an important, but often overlooked, aspect of nicotine addiction research and treatment. We explore the relationship between smoking cessation interventions and suicidality and explore common treatments, their associated risks, and effectiveness in promoting smoking reduction and abstinence. Although active smokers have been reported to have twofold to threefold increased risk of suicidality when compared to nonsmokers,1–4 research regarding the safest way to stop smoking does not always provide clear guidelines for practitioners wishing to advise their patients regarding smoking cessation strategies. In this article, we review pharmacological and cognitive behavioral therapy (CBT) options that are available for people seeking to quit smoking, focusing on the relationship between the ability of these therapies to reduce smoking behavior and promote abstinence and suicidality risks as assessed by reported suicidality on validated measures, reports of suicidal ideation, behaviors, actual attempts, or completed suicides. Pharmacotherapies such as varenicline, bupropion, and nicotine replacement, and CBTs, including contextual CBT interventions, have been found to help reduce smoking rates and promote and maintain abstinence. Suicidality risks, while present when trying to quit smoking, do not appear to demonstrate a consistent or significant rise associated with use of any particular smoking cessation pharmacotherapy or CBT/contextual CBT intervention reviewed.
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Affiliation(s)
- J Kim Penberthy
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - J Morgan Penberthy
- Department of Psychology, Wake Forest University, Winston-Salem, NC, USA
| | - Marcus R Harris
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Sonali Nanda
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Jennifer Ahn
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Caridad Ponce Martinez
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Apule O Osika
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Zoe A Slepian
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | - J Andrew Starr
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | - Joshua N Hook
- Department of Psychology, University of North Texas, Denton, TX, USA
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15
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Wu S, Ding Y, Wu F, Xie G, Hou J, Mao P. Serum lipid levels and suicidality: a meta-analysis of 65 epidemiological studies. J Psychiatry Neurosci 2016; 41:56-69. [PMID: 26505144 PMCID: PMC4688029 DOI: 10.1503/jpn.150079] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We conducted a systematic review and meta-analysis to determine the association between serum lipid levels and suicidality, as evidence from previous studies has been inconsistent. METHODS We identified relevant studies by searching Medline, Web of Science, EMBASE, and the Cochrane Database of Systematic Reviews (1980 to Dec. 5, 2014). Studies assessing the association between serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and/or triglycerides (TG) levels and suicidality were included. We used a random-effects model to take into account heterogeneity among studies. RESULTS We included 65 studies with a total of 510 392 participants in our analysis. Compared with the nonsuicidal patients, suicidal patients had significantly lower serum TC (weighted mean difference [WMD] -22.35, 95% confidence interval [CI] -27.95 to -16.75), LDL-C (WMD -19.56, 95% CI -26.13 to -12.99) and TG (WMD -23.40, 95% CI -32.38 to -14.42) levels, while compared with the healthy controls, suicidal patients had significantly lower TC (WMD -24.75, 95% CI -27.71 to -21.78), HDL-C (WMD -1.75, 95% CI -3.01 to -0.48) and LDL-C (WMD -3.85, 95% CI -7.45 to -0.26) levels. Furthermore, compared with the highest serum TC level category, a lower serum TC level was associated with a 112% (95% CI 40%-220%) higher risk of suicidality, including a 123% (95% CI 24%-302%) higher risk of suicide attempt and an 85% (95 CI 7%-221%) higher risk of suicide completion. The cut-off values for low and high serum TC level were in compliance with the categories reported in the original studies. LIMITATIONS A major limitation of our study is the potential heterogeneity in most of the analyses. In addition, the suicidal behaviour was examined using different scales or methods across studies, which may further explain heterogeneity among the studies. CONCLUSION We identified an inverse association between serum lipid levels and suicidality. More mechanistic studies are needed to further explain this association.
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Affiliation(s)
| | | | | | | | - Jun Hou
- Correspondence to: P. Mao or J. Hou, Research Center for Clinical Medicine, the 302nd Hospital of PLA, No. 100 of West Fourth Ring Middle Road, Beijing, China, 100039; or
| | - Panyong Mao
- Correspondence to: P. Mao or J. Hou, Research Center for Clinical Medicine, the 302nd Hospital of PLA, No. 100 of West Fourth Ring Middle Road, Beijing, China, 100039; or
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16
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Agrawal A, Bogdan R. Risky Business: Pathways to Progress in Biologically Informed Studies of Psychopathology. PSYCHOLOGICAL INQUIRY 2015; 26:231-238. [PMID: 27114696 DOI: 10.1080/1047840x.2015.1039930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Arpana Agrawal
- Washington University School of Medicine, Department of Psychiatry, 660 S. Euclid, CB 8134, Saint Louis, MO 63110
| | - Ryan Bogdan
- Washington University in St. Louis, Department of Psychology, CB 1125, One Brookings Drive, Saint Louis, MO 63130
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17
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Grucza RA, Hur M, Agrawal A, Krauss MJ, Plunk AD, Cavazos-Rehg PA, Chaloupka FJ, Bierut LJ. Medical Marijuana Laws and Suicide. Am J Public Health 2015; 105:e3. [PMID: 26066919 PMCID: PMC4504326 DOI: 10.2105/ajph.2015.302745] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2015] [Indexed: 11/04/2022]
Affiliation(s)
- Richard A Grucza
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Michael Hur
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Arpana Agrawal
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Melissa J Krauss
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Andrew D Plunk
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Patricia A Cavazos-Rehg
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Frank J Chaloupka
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
| | - Laura J Bierut
- Richard A. Grucza, Michael Hur, Arpana Agrawal, Melissa J. Krauss, and Patricia A. Cavazos-Rehg are with the Department of Psychiatry, Washington University School of Medicine, St. Louis, MO. Laura J. Bierut is with the Department of Psychiatry and the Siteman Cancer Center, Washington University School of Medicine. Andrew D. Plunk is with the Department of Pediatrics, Eastern Virginia Medical School, Norfolk. Frank J. Chaloupka is with the Department of Economics and Health Policy Center, University of Illinois at Chicago
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18
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Grucza RA, Hur M, Agrawal A, Krauss MJ, Plunk AD, Cavazos-Rehg PA, Chaloupka FJ, Bierut LJ. A reexamination of medical marijuana policies in relation to suicide risk. Drug Alcohol Depend 2015; 152:68-72. [PMID: 25979644 PMCID: PMC4459507 DOI: 10.1016/j.drugalcdep.2015.04.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Previous research has suggested that medical marijuana policies lead to reductions in suicide rates. In this study, we further investigate the association between these policies and within-state changes in suicide risk. METHODS Data on suicide deaths (n=662,993) from the National Vital Statistics System Multiple Cause of Death files were combined with living population data. Fixed-effects regression methods were employed to control for state differences in suicide rates and national and state secular trends. Analyses extended prior research that suggested a protective effect of medical marijuana policies by incorporating newer data and additional covariates. RESULTS After adjustment for race/ethnicity, tobacco control policies, and other covariates, we found no association between medical marijuana policy and suicide risk in the population ages 15 and older (OR=1.000; 95% CI: 0.956, 1.045; p=0.98), among men overall (OR=0.996; 95% CI: 0.951, 1.043; p=0.87) or for any other age-by-sex groups. CONCLUSION We find no statistically significant association between medical marijuana policy and suicide risk. These results contradict prior analyses which did not control for race/ethnicity and certain state characteristics such as tobacco control policies. Failure to control for these factors in future analyses would likely bias estimates of the associations between medical marijuana policy and health outcomes.
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Affiliation(s)
- Richard A Grucza
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Michael Hur
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Melissa J Krauss
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Andrew D Plunk
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
| | | | - Frank J Chaloupka
- Department of Economics and Health Policy Center, University of Illinois at Chicago, Chicago, IL, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
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19
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Liang Y, Zheng X, Zeng DD, Zhou X, Leischow SJ, Chung W. Characterizing Social Interaction in Tobacco-Oriented Social Networks: An Empirical Analysis. Sci Rep 2015; 5:10060. [PMID: 26091553 PMCID: PMC4473607 DOI: 10.1038/srep10060] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 03/23/2015] [Indexed: 11/18/2022] Open
Abstract
Social media is becoming a new battlefield for tobacco "wars". Evaluating the current situation is very crucial for the advocacy of tobacco control in the age of social media. To reveal the impact of tobacco-related user-generated content, this paper characterizes user interaction and social influence utilizing social network analysis and information theoretic approaches. Our empirical studies demonstrate that the exploding pro-tobacco content has long-lasting effects with more active users and broader influence, and reveal the shortage of social media resources in global tobacco control. It is found that the user interaction in the pro-tobacco group is more active, and user-generated content for tobacco promotion is more successful in obtaining user attention. Furthermore, we construct three tobacco-related social networks and investigate the topological patterns of these tobacco-related social networks. We find that the size of the pro-tobacco network overwhelms the others, which suggests a huge number of users are exposed to the pro-tobacco content. These results indicate that the gap between tobacco promotion and tobacco control is widening and tobacco control may be losing ground to tobacco promotion in social media.
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Affiliation(s)
- Yunji Liang
- School of Computer Science, Northwestern Polytechnical University, Xi’an, Shaanxi, China
- Department of Management Information Systems, University of Arizona, Tucson, Arizona, USA
| | - Xiaolong Zheng
- State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Daniel Dajun Zeng
- Department of Management Information Systems, University of Arizona, Tucson, Arizona, USA
- State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Xingshe Zhou
- School of Computer Science, Northwestern Polytechnical University, Xi’an, Shaanxi, China
| | | | - Wingyan Chung
- Department of Decision and Information Sciences, School of Business Administration, Stetson University, DeLand, FL, USA
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20
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Christofferson DE, Hamlett-Berry K, Augustson E. Suicide Prevention Referrals in a Mobile Health Smoking Cessation Intervention. Am J Public Health 2015; 105:e7-9. [PMID: 26066949 DOI: 10.2105/ajph.2015.302690] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Automated mobile health (mHealth) programs deliver effective smoking cessation interventions through text message platforms. Smoking is an independent risk factor for suicide, so the Department of Veterans Affairs incorporated information about the Veterans Crisis Line into its SmokefreeVET smoking cessation text messaging program. Almost 7% of all SmokefreeVET enrollees have accessed this information. Because of the reach and automated nature of this and similar programs, we recommend including a referral to a suicide prevention hotline for all smoking cessation mHealth interventions.
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Affiliation(s)
- Dana E Christofferson
- Dana E. Christofferson and Kim Hamlett-Berry are with the Office of Public Health, Veterans Health Administration, Department of Veterans Affairs, Washington, DC. Erik Augustson is with the Tobacco Control Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Kim Hamlett-Berry
- Dana E. Christofferson and Kim Hamlett-Berry are with the Office of Public Health, Veterans Health Administration, Department of Veterans Affairs, Washington, DC. Erik Augustson is with the Tobacco Control Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Erik Augustson
- Dana E. Christofferson and Kim Hamlett-Berry are with the Office of Public Health, Veterans Health Administration, Department of Veterans Affairs, Washington, DC. Erik Augustson is with the Tobacco Control Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
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21
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Berlin I, Hakes JK, Hu MC, Covey LS. Tobacco use and suicide attempt: longitudinal analysis with retrospective reports. PLoS One 2015; 10:e0122607. [PMID: 25849514 PMCID: PMC4388646 DOI: 10.1371/journal.pone.0122607] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/11/2015] [Indexed: 11/18/2022] Open
Abstract
Background Suicide has been associated with smoking/tobacco use but its association of and change in smoking/tobacco use status with suicide attempt (SA) is not well established. Methods We investigated whether persistent, former tobacco use, initiation, quitting tobacco use, relapse to tobacco use, and DSM-IV nicotine dependence predict independently SA using Wave 1 and 2 data of the National Epidemiologic Survey of Alcohol and Related Conditions. Data from 34,653 US adults interviewed at Wave 1 (2001-02) and Wave 2 (2004-05) were analyzed. The main outcome measure was SA between Wave 1 and Wave 2 as reported at Wave 2. Results Among the 1,673 respondents reporting lifetime SA at Wave 2, 328 individuals reported SA between Wave 1 and Wave 2. Current and former tobacco use at Wave 1 predicted Wave 2 SA independently of socio-demographic characteristics, psychiatric history, and prior SA (Adjusted Odds Ratio (AOR): 1.49; 95% CI: 1.13-1.95, AOR: 1.31; 95% CI:1.01-1.69, respectively versus never tobacco users). The strongest association with SA was observed among former tobacco users who relapsed after Wave 1 (AOR: 4.66; 95% CI: 3.49-6.24) and among tobacco use initiators after Wave 1 (AOR: 3.16; 95% CI: 2.23-4.49). Persistent tobacco use (current tobacco use at both Wave 1 and Wave 2) also had an increased risk of SA (AOR: 1.89; 95% CI: 1.47-2.42). However, former tobacco users in both Waves 1 and 2 did not show a significantly elevated risk for SA in Wave 2 (AOR:1.09, 95% CI: 0.78-1.52) suggesting that the risk resided mainly in Wave 1 former tobacco users who relapsed to tobacco use by Wave 2. DSM-IV nicotine dependence did not predict SA at Wave 2. Conclusion In a representative sample of US adults, relapse, tobacco use initiation, and persistent tobacco use, which are amenable to intervention, were associated with risk of SA.
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Affiliation(s)
- Ivan Berlin
- Département de Pharmacologie, Hôpital Pitié-Salpêtrière-Assistance publique-Hôpitaux de Paris-Faculté de médicine, Université P.& M. Curie—INSERM U1178, Paris, France
- * E-mail:
| | - Jahn K. Hakes
- Center for Administrative Records Research and Applications, U.S. Census Bureau, Suitland, MD, United States of America
| | - Mei-Chen Hu
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America
| | - Lirio S. Covey
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America
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