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Guo S, Qing G, Yang G. The relationship between chronic disease variety and quantity and suicidal ideation: A cross-sectional study of NHANES. J Psychosom Res 2024; 184:111854. [PMID: 38943724 DOI: 10.1016/j.jpsychores.2024.111854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND This cross-sectional study examines the link between chronic diseases and suicidal thoughts in U.S. adults using 2013-2018 National Health and Nutrition Examination Survey (NHANES) data, aiming to identify potential risk factors for suicidal ideation. METHODS Using NHANES data, we analyzed the association between various chronic conditions (hypertension, diabetes, asthma, etc.) and suicidal thoughts, employing logistic regression models adjusted for demographics and lifestyle factors. RESULTS The analysis of 8891 participants revealed a significant association between suicidal thoughts and chronic diseases such as liver disease, diabetes, and asthma. The risk of suicidal ideation is higher with the number of chronic conditions. CONCLUSION Our findings suggest a strong link between the presence and number of chronic diseases and the risk of suicidal thoughts, emphasizing the importance of integrated care approaches that address both physical and mental health needs.
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Affiliation(s)
- Shijie Guo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Guangwei Qing
- Department of Psychiatry, Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Guang Yang
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Suzhou, China.
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Tomaszek L, Kurleto P, Turkanik E, Bielec E, Milaniak I, Dąbrowska-Mędrzycka W. Demographic and clinical profile of adolescents suicide attempters admitted to an emergency department during the COVID-19 pandemic - a retrospective cohort study using hospital information system. Front Psychiatry 2024; 15:1422008. [PMID: 38952631 PMCID: PMC11215177 DOI: 10.3389/fpsyt.2024.1422008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024] Open
Abstract
Background The prevalence of suicidal attempts among adolescents during COVID-19 significantly increased compared with pre-pandemic estimates. The aim of the study was to explore the demographic and clinical profile of adolescent suicide attempters admitted to the emergency department during the COVID-19 pandemic. Material and method The retrospective analysis included, on the basis of electronic medical records in the CliniNet system, sociodemographic and clinical data of patients aged 10-18 years with a diagnosis of suicide attempt. Follow-up period: from March 20, 2020 to May 16, 2023. Results During the COVID-19 pandemic, there were 425 emergency department visits among adolescents aged 11-17 due to a suicide attempt, with the largest number in the 15-17 (69%) age range. The percentage of emergency department visits was higher among females (80%) and urban residents (75.3%). Self-poisoning was the most common cause of suicide attempts (52.4%), followed by self-harm (41.4%), hanging (3.2%) and jumping from a height (2.1%). The most common toxic substances in self-poisonings were antidepressants and antipsychotics, followed by paracetamol. About 70% of visits were associated with adolescent mental disorders, of which depressive disorder was the most common. One death per 425 visits was recorded (0.2%). Conclusions Adolescents attempting suicide during COVID-19 were most likely female, aged 15-17, city dwellers, undergoing psychiatric treatment mainly for depressive disorders. The mental health consequences of the pandemic may be more long term, and further monitoring will be needed in the years to come.
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Affiliation(s)
- Lucyna Tomaszek
- Department of Specialist Nursing, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
- Department of Thoracic Surgery, Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój, Poland
| | - Paulina Kurleto
- Department of Specialist Nursing, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
| | - Edyta Turkanik
- Department of Specialist Nursing, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
| | - Ewa Bielec
- Department of Specialist Nursing, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
| | - Irena Milaniak
- Department of Specialist Nursing, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
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Ajluni V, Amarasinghe D. Youth suicide crisis: identifying at-risk individuals and prevention strategies. Child Adolesc Psychiatry Ment Health 2024; 18:58. [PMID: 38783338 PMCID: PMC11119010 DOI: 10.1186/s13034-024-00753-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Affiliation(s)
- Victor Ajluni
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Daniel Amarasinghe
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
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Guo S, Qing G, Chen Q, Yang G. The relationship between weight-adjusted-waist index and suicidal ideation: evidence from NHANES. Eat Weight Disord 2024; 29:37. [PMID: 38743203 PMCID: PMC11093856 DOI: 10.1007/s40519-024-01666-4] [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: 03/21/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Amidst growing evidence of the intricate link between physical and mental health, this study aims to dissect the relationship between the waist-to-weight index (WWI) and suicidal ideation within a representative sample of the US population, proposing WWI as a novel metric for suicide risk assessment. METHODS The study engaged a sample of 9500 participants in a cross-sectional design. It employed multivariate logistic and linear regression analyses to probe the association between WWI and suicidal ideation. It further examined potential nonlinear dynamics using a weighted generalized additive model alongside stratified analyses to test the relationship's consistency across diverse demographic and health variables. RESULTS Our analysis revealed a significant positive correlation between increased WWI and heightened suicidal ideation, characterized by a nonlinear relationship that persisted in the adjusted model. Subgroup analysis sustained the association's uniformity across varied population segments. CONCLUSIONS The study elucidates WWI's effectiveness as a predictive tool for suicidal ideation, underscoring its relevance in mental health evaluations. By highlighting the predictive value of WWI, our findings advocate for the integration of body composition considerations into mental health risk assessments, thereby broadening the scope of suicide prevention strategies.
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Affiliation(s)
- Shijie Guo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Guangwei Qing
- Jiangxi Mental Hospital & Affiliated Mental Hospital of Nanchang University, Third Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Qiqi Chen
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Suzhou, Zhejiang, China
| | - Guang Yang
- Department of Neurology, Kunshan Hospital of Traditional Chinese Medicine, Suzhou, Zhejiang, China.
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Wittenhagen L, Hielscher E, Meurk CS, Scott JG, Steele ML, Bosley E, Watson S, Heffernan E. A cohort profile of children and adolescents who had a suicide-related contact with police or paramedics in Queensland (Australia). Emerg Med Australas 2024. [PMID: 38495001 DOI: 10.1111/1742-6723.14392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 08/31/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE Suicide is a leading cause of death in children and adolescents worldwide and a major public health concern. While suicidal behaviours place a significant demand on mental health and emergency services, data regarding suicide-related contacts with police and paramedics are an underutilised resource. The aim of the present study was to identify the demographic profile of young individuals (aged 5-17) and had a suicide-related contact with police or paramedics in Queensland (Australia). METHODS The present study utilised a population-wide linked dataset, including data from police and paramedics and health administrative data, between 1 February 2013 and 31 January 2018. RESULTS The identified cohort of 7929 children had a median age of 15 years and mainly comprised females (63.2%). Over the study period, 64 children died, most by suicide (76.6%). Less than a third of the cohort were responsible for almost two-thirds of the total number of contacts with police or paramedics. CONCLUSION Findings provide a comprehensive profile of children and adolescents in suicidal crisis and highlight the substantial number of interactions that occur with police and paramedics. Due to the way the linked dataset was constructed, it must be assumed that the number of young persons in suicidal crisis is higher. Findings highlight the value of considering pre-hospital alternatives to presenting to emergency departments (EDs) for this cohort, to reduce impost on EDs and improve outcomes. Further examination of re-presentations by young persons is warranted to inform prevention and intervention strategies.
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Affiliation(s)
- Lisa Wittenhagen
- School of Public Health: Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
| | - Emily Hielscher
- Child and Youth Mental Health Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Carla S Meurk
- School of Public Health: Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
- Child and Youth Mental Health Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
- Child and Youth Mental Health Service, Children's Health Queensland, Brisbane, Queensland, Australia
| | - Megan L Steele
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
| | - Emma Bosley
- Information Support, Research & Evaluation, Office of the Medical Director, Queensland Ambulance Service, Brisbane, Queensland, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Shelby Watson
- State Domestic Family Violence and Vulnerable Persons Unit, Domestic Family Violence and Vulnerable Persons Command, Queensland Police Service, Brisbane, Queensland, Australia
| | - Ed Heffernan
- School of Public Health: Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
- Queensland Forensic Mental Health Service, Metro North Mental Health Service, Brisbane, Queensland, Australia
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Wang M, Zhong Y, Chen Y, Li Q, Su X, Wei Z, Sun L. Differentiating the association between age of alcohol use initiation and conditional suicidal behaviors among adolescents. Asia Pac Psychiatry 2024; 16:e12554. [PMID: 38509771 DOI: 10.1111/appy.12554] [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: 09/24/2023] [Revised: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Suicide and early alcohol use initiation are public health concerns. Previous studies have explored the associations between age of alcohol use initiation and suicidal behaviors, which progresses from ideation to action. Distinguishing between the various associations can help gain a deeper understanding of suicidal behaviors and aid in developing social suicide prevention strategies. METHODS The study utilized the Youth Risk Behavior Survey to investigate this association. A total of 17 209 students were finally included in the study. Conditional suicidal behaviors included no suicidal behavior (NS), suicidal ideation without a plan or attempt (SINPA), suicide plan without an attempt (SPNA) and suicide attempt (SA). RESULTS Among 17 209 students, the prevalence of suicidal ideation, suicide plan, and suicide attempt were 21.4%, 17.3%, and 11.1%, respectively. Moreover, 15.2% of the students used alcohol before age 13, whereas 31.7% of students used alcohol at age 13 or older. Compared to NS, students using alcohol showed significant associations with SA (OR = 2.34, p < .001; OR = 1.29, p < .01), SPNA (OR = 1.68, p < .001; OR = 1.19, p < .05) and SINPA (OR = 1.55, p < .001; OR = 1.40, p < .001). Comparing with SINPA and SNPA, students using alcohol before age 13 were associated with SA (OR = 1.61, p < .001; OR = 1.46, p < .001), whereas those using alcohol at or after the age 13 were not associated with SA (OR = 0.98, p > .05; OR = 1.09, p > .05). DISCUSSION This study demonstrated that early alcohol use initiation was significantly associated with suicide attempts among students with suicidal ideations or plans.
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Affiliation(s)
- Meiqi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yunxi Zhong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yifan Chen
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Qixiu Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaoying Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Zhen Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Yu Y, Feng Y, Xu S, Wilson A, Chen C, Ling X, Chen R, Wang Y. The influence of childhood trauma and chronotype on suicide attempts in Chinese emerging adults with severe depressive symptoms. BMC Psychol 2024; 12:12. [PMID: 38173011 PMCID: PMC10765889 DOI: 10.1186/s40359-023-01472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Studies have investigated how adults with severe depressive symptoms are more likely to attempt suicide, and these adults often have traumatic experiences and chaotic sleep/wake rhythms. Thus, this study using Latent class analysis aimed to investigate the relationship between childhood trauma class, chronotype, and suicide attempts among emerging adults with severe depressive symptoms. METHODS This study was conducted among emerging adults with severe depressive symptoms covering 63 Universities in Jilin Province, China. A total of 1,225 emerging adults (mean age = 19.6 ± 1.78) constructed the final sample. In addition to measuring socio-demographic characteristics, the Childhood Trauma Questionnaire-Short Form, the Single-Item Chronotyping, and a single item for suicide attempts were used to evaluate childhood trauma, chronotype, and suicide attempts, respectively. Latent class analysis was applied to identify the classes of childhood trauma within emerging adults who had severe depressive symptoms. Hierarchical logistic regression models were run to investigate the effects of socio-demographic characteristics, chronotype, and childhood trauma class on suicide attempts. RESULTS Three latent classes were identified: the Low-risk for childhood trauma class, the Neglect class, and the High-risk for childhood abuse class. Those who suffered sexual, emotional, and physical abuse at the same time were divided into the High-risk for childhood abuse class, and were significantly more likely to experience suicide attempts than those in the Neglect class (OR = 1.97, 95%CI = 1.34-2.89, p < 0.001) and the Low-risk for childhood trauma class (OR = 2.28, 95% CI = 1.50-3.46, p < 0.001). In terms of chronotype, the results showed that the chaotic type was a risk factor for suicide attempts when compared with the evening type (OR = 0.46, 95%CI = 0.27-0.78, p < 0.01), the moderately active type (OR = 0.53, 95%CI = 0.31-0.89, p < 0.05), and the daytime type (OR = 0.42, 95%CI = 0.21-0.86, p < 0.05). Overall, the significant risk factors for suicide attempts included being female, living in an urban area, having experienced sexual, emotional, and physical abuse simultaneously, and having a chaotic chronotype. CONCLUSION Emerging adults suffering sexual, emotional, and physical abuse at the same time and identifying with chaotic chronotype showed a higher risk of attempting suicide. The findings provided a clinical reference to quickly identify those at high risk of suicide attempts among emerging adults with severe depressive symptoms.
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Affiliation(s)
- Yi Yu
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yi Feng
- Mental Health Center, Central University of Finance and Economics, Beijing, China
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, China
- Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun, China
- China Center for Aging Studies and Social-Economic Development, Jilin University, Changchun, China
| | - Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Chang Chen
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xi Ling
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuanyuan Wang
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Lieberman EE. Healing Through Listening. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:605-606. [PMID: 37880550 DOI: 10.1007/s40596-023-01890-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Evan E Lieberman
- Massachusetts General Hospital/McLean Psychiatry Residency Program, Boston, MA, USA.
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Schweitzer J, Bird A, Bowers H, Carr-Lee N, Gibney J, Schellinger K, Holt JR, Adams DP, Hensler DJ, Hollenbach K. Developing an innovative pediatric integrated mental health care program: interdisciplinary team successes and challenges. Front Psychiatry 2023; 14:1252037. [PMID: 38045623 PMCID: PMC10693412 DOI: 10.3389/fpsyt.2023.1252037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/24/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Children and adolescents often do not receive mental healthcare when they need it. By 2021, the complex impact of the COVID-19 pandemic, structural racism, inequality in access to healthcare, and a growing shortage of mental health providers led to a national emergency in child and adolescent mental health in the United States. The need for effective, accessible treatment is more pressing than ever. Interdisciplinary, team-based pediatric integrated mental healthcare has been shown to be efficacious, accessible, and cost-effective. Methods In response to the youth mental health crisis, Rady Children's Hospital-San Diego's Transforming Mental Health Initiative aimed to increase early identification of mental illness and improve access to effective treatment for children and adolescents. A stakeholder engagement process was established with affiliated pediatric clinics, community mental health organizations, and existing pediatric integrated care programs, leading to the development of the Primary Care Mental Health Integration program and drawing from established models of integrated care: Primary Care Behavioral Health and Collaborative Care. Results As of 2023, the Primary Care Mental Health Integration program established integrated care teams in 10 primary care clinics across San Diego and Riverside counties in California. Measurement-based care has been implemented and preliminary results indicate that patient response to therapy has resulted in a 44% reduction in anxiety symptoms and a 62% decrease in depression symptoms. The program works toward fiscal sustainability via fee-for-service reimbursement and more comprehensive payor contracts. The impact on patients, primary care provider satisfaction, measurement-based care, funding strategies, as well as challenges faced and changes made will be discussed using the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. Discussion Preliminary results suggest that the Primary Care Mental Health Integration is a highly collaborative integrated care model that identifies the needs of children and adolescents and delivers brief, evidence informed treatment. The successful integration of this model into 10 primary care clinics over 3 years has laid the groundwork for future program expansion. This model of care can play a role addressing youth mental health and increasing access to care. Challenges, successes, and lessons learned will be reviewed.
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Affiliation(s)
- Jason Schweitzer
- Child and Adolescent Division, Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
| | - Anne Bird
- Child and Adolescent Division, Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
| | - Hilary Bowers
- Child and Adolescent Division, Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
- Children’s Primary Care Medical Group, San Diego, CA, United States
| | - Nicole Carr-Lee
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
| | - Josh Gibney
- Child and Adolescent Division, Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
| | - Kriston Schellinger
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
| | - Jasmine R. Holt
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
| | - Devin P. Adams
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
| | - Domonique J. Hensler
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
| | - Kathryn Hollenbach
- Transforming Mental Health Initiative, Rady Children’s Hospital-San Diego, San Diego, CA, United States
- Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States
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Kelsall NC, Wang Y, Gameroff MJ, Cha J, Posner J, Talati A, Weissman MM, van Dijk MT. Differences in White Matter Structural Networks in Family Risk of Major Depressive Disorder and Suicidality: A Connectome Analysis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.07.23295211. [PMID: 37732277 PMCID: PMC10508803 DOI: 10.1101/2023.09.07.23295211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Background Depression and suicide are leading global causes of disability and death and are highly familial. Family and individual history of depression are associated with neurobiological differences including decreased white matter connectivity; however, this has only been shown for individual regions. We use graph theory models to account for the network structure of the brain with high levels of specialization and integration and examine whether they differ by family history of depression or of suicidality within a three-generation longitudinal family study with well-characterized clinical histories. Methods Clinician interviews across three generations were used to classify family risk of depression and suicidality. Then, we created weighted network models using 108 cortical and subcortical regions of interest for 96 individuals using diffusion tensor imaging derived fiber tracts. Global and local summary measures (clustering coefficient, characteristic path length, and global and local efficiencies) and network-based statistics were utilized for group comparison of family history of depression and, separately, of suicidality, adjusted for personal psychopathology. Results Clustering coefficient (connectivity between neighboring regions) was lower in individuals at high family risk of depression and was associated with concurrent clinical symptoms. Network-based statistics showed hypoconnected subnetworks in individuals with high family risk of depression and of suicidality, after controlling for personal psychopathology. These subnetworks highlighted cortical-subcortical connections including between the superior frontal cortex, thalamus, precuneus, and putamen. Conclusions Family history of depression and of suicidality are associated with hypoconnectivity between subcortical and cortical regions, suggesting brain-wide impaired information processing, even in those personally unaffected.
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Malhi GS, Jadidi M, Bell E. The diagnosis of bipolar disorder in children and adolescents: Past, present and future. Bipolar Disord 2023; 25:469-477. [PMID: 37433682 DOI: 10.1111/bdi.13367] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
AIMS This article examines the ongoing debate concerning the diagnosis of bipolar disorder in children and adolescents. This contentious issue has generated robust discussion over the past two decades without consensus, and as such the true prevalence of so-called paediatric bipolar disorder (PBD) remains unknown. In this article we offer a solution to break this deadlock. METHODS Recent meta-analyses and additional literature concerning the definition and prevalence of PBD was critically reviewed with a view to understanding the perspectives of those developing the taxonomy of PBD, and those engaged in research and clinical practice. RESULTS A key finding is the lack of iteration and meaningful communication between the various groups interested in PBD that stems from deep-seated problems within our classificatory systems. This undermines our research efforts and complicates clinical practice. These problems make the already difficult diagnosis of bipolar disorder in adults even more challenging to transpose to younger populations, and additional complexities arise when parsing clinical phenomenology from normative developmental changes in youth. Therefore, in those manifesting bipolar symptoms post-puberty, we argue for the use of adolescent bipolar disorder to describe bipolar symptoms whereas in pre-pubertal children, we propose a reconceptualisation that allows symptomatic treatment to be advanced whilst requiring critical review of these symptoms over time. CONCLUSION Significant changes in our current taxonomy are necessary and to be clinically meaningful, these revisions to our diagnoses need to be developmentally-informed.
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Affiliation(s)
- Gin S Malhi
- Academic Department of Psychiatry, Faculty of Medicine and Health, Kolling Institute, Northern Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- CADE Clinic and Mood-T, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Maedeh Jadidi
- Academic Department of Psychiatry, Faculty of Medicine and Health, Kolling Institute, Northern Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- CADE Clinic and Mood-T, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
| | - Erica Bell
- Academic Department of Psychiatry, Faculty of Medicine and Health, Kolling Institute, Northern Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- CADE Clinic and Mood-T, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
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12
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Arisoyin AE, Adeyemi AH, Okobi OE, Alaga AH, Adekunle OJ, Ajayi OO, Aladeniyi F, Oni EO, Okobi E, Okeaya-Inneh M, Young CL. Analyzing Trends in Suicide Attempts Among the Pediatric Population in the United States: A Study Using CDC's Youth Risk Behavior Surveillance System (YRBSS) Database. Cureus 2023; 15:e44099. [PMID: 37753036 PMCID: PMC10518429 DOI: 10.7759/cureus.44099] [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] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Background Suicide is a significant public health concern among the pediatric population in the United States. This study aims to comprehensively analyze suicide attempts among adolescents using data from the Youth Risk Behavior Surveillance System (YRBSS) maintained by the Centers for Disease Control and Prevention (CDC). Methods The pediatric population of grades 9-12 students (13-17 years old) was included in the study population, and data were collected from multiple cycles of the YRBSS survey. Descriptive statistics and time-trend analyses were conducted to examine attempted suicide rates based on location, gender, race/ethnicity, school grade level, and sexual orientation. Results Significant variations in attempted suicide rates were observed among different demographic groups. In 2021, of the subset with suicide attempt, females reported a higher prevalence of attempted suicide (13.3%, n=211), while males exhibited a lower rate (6.6%, n=104). Of the total studied population in 2021, Palau had the highest attempted suicide rate (25.2%, n=3924), followed by the Northern Mariana Islands (17.6%, n=2740). Over 1991-2021, no significant location-based variations were observed. In 2021, American Indian/Alaska Native adolescents had the highest attempted suicide rate at 16% (n=2491), followed by Black adolescents (14.5%, n=2258). Ninth-grade students reported higher rates in 2021 (11.6%, n=1806). Adolescents reporting both opposite-sex (36.7%, n=5715) and same-sex-only sexual contacts or both (32.9%, n=5123) exhibited notably higher rates in 2021. Conclusion This study highlights alarming attempted suicide rates in the US pediatric population, emphasizing the need for tailored prevention efforts and mental health support. It offers essential guidance for policymakers, researchers, and mental health professionals in developing evidence-based strategies to promote youth well-being and combat the impact of suicide attempts.
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Affiliation(s)
| | | | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | | | | | - Olamide O Ajayi
- Internal Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu, NGA
| | - Funmi Aladeniyi
- Department of Medicine, American University of Antigua, Antigua, ATG
| | - Esther O Oni
- General Practice, Ladoke Akintola University of Technology, Ogbomoso, NGA
| | - Emeka Okobi
- Dentistry, Ahmadu Bello University Teaching Hospital, Abuja, NGA
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13
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Auger N, Low N, Ayoub A, Chang J, Luu TM. Connection between maternal suicide attempt and chronic morbidity in children. Psychol Med 2023; 53:5091-5098. [PMID: 35837688 PMCID: PMC10476049 DOI: 10.1017/s0033291722002094] [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: 02/28/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Maternal suicide attempts are associated with adverse psychosocial outcomes in children, but the association with chronic morbidity is poorly understood. We examined the relationship between maternal suicide attempt and risk of hospitalization for potentially preventable conditions in offspring. METHODS We analyzed a longitudinal cohort of 1 032 210 children born in Quebec, Canada between 2006 and 2019. The main exposure measure was maternal suicide attempt before or during pregnancy. Outcomes included child hospitalizations for potentially preventable conditions, including infectious diseases, dental caries, atopy, and injury up to 14 years after birth. We used adjusted Cox proportional hazards regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association of maternal suicide attempt with risk of hospitalization for these outcomes. RESULTS Compared with no suicide attempt, children whose mothers attempted suicide had an increased risk of hospitalization for infectious diseases (HR 1.11, 95% CI 1.06-1.16), dental caries (HR 1.31, 95% CI 1.15-1.48), and injury (HR 1.16, 95% CI 1.03-1.31). Risk of hospitalization for any of these outcomes was greater if mothers attempted suicide by hanging (HR 1.46, 95% CI 1.22-1.75), had their first attempt between the age of 25 and 34 years (HR 1.27, 95% CI 1.13-1.42), and had 3 or more attempts (HR 1.56, 95% CI 1.27-1.91). Maternal suicide attempts were more strongly associated with child hospitalization before 10 years of age. CONCLUSIONS Children whose mothers have a history of suicide attempt have an elevated risk of hospitalization for potentially preventable conditions.
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Affiliation(s)
- Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Nancy Low
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Aimina Ayoub
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Jungmin Chang
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
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14
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Schick MR, Hostetler KL, Kirk-Provencher KT, Spillane NS. Depressive symptoms, alcohol use, and alcohol-related consequences: the moderating role of gender among American Indian adolescents. J Ethn Subst Abuse 2023:1-17. [PMID: 37222686 PMCID: PMC10667562 DOI: 10.1080/15332640.2023.2216162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Depression, alcohol use, and alcohol-related consequences are experienced disproportionately by American Indian (AI) adolescents. The co-occurrence of depression and alcohol use is clinically relevant, as it is associated with increased risk for suicide, among other negative consequences. Understanding how the association between depressive symptoms and alcohol use and related consequences is influenced by gender is important to understand for whom intervention efforts might be particularly relevant. Thus, the present study seeks to evaluate gender differences in these associations among AI adolescents. METHODS Participants were a representative sample of AI adolescents (N = 3,498, Mage=14.76, 47.8% female) residing on or near reservations who completed self-report questionnaires in school classrooms. Study activities were approved by IRB, school boards, and tribal authorities. RESULTS The interaction of depressive symptoms and gender was significant in predicting past-year alcohol use frequency (b=.02, p=.02) and, among youth reporting lifetime alcohol use, alcohol-related consequences (b=.03, p=.001). Analysis of simple slopes revealed that, for females, depressive symptoms were significantly associated with past-year alcohol use frequency (b=.02, p<.001) and alcohol-related consequences (b=.05, p<.001). For males, depressive symptoms were only significantly associated with alcohol-related consequences (b=.02, p=.04), and this effect was weaker than for females. CONCLUSIONS Results of the present study may inform the development of gender-sensitive recommendations for the assessment and treatment of alcohol use and alcohol-related consequences among AI adolescents. For instance, results suggest that treatments focusing on depressive symptoms may subsequently reduce alcohol use and related consequences for female AI adolescents.
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Affiliation(s)
- Melissa R. Schick
- Divisision of Prevention and Community Research, Yale School of Medicine Department of Psychiatry, New Haven CT 06511
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston RI 02881
| | | | - Katelyn T. Kirk-Provencher
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston RI 02881
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO 80045
| | - Nichea S. Spillane
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston RI 02881
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15
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Abaatyo J, Favina A, Bulega SE, Kaggwa MM. Suicidal behavior among inpatients with severe mental conditions in a public mental health hospital in Uganda. BMC Psychiatry 2023; 23:346. [PMID: 37208631 DOI: 10.1186/s12888-023-04858-x] [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: 02/15/2023] [Accepted: 05/10/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Suicidal behaviors are prevalent among inpatients with severe mental conditions and may result in many dying by suicide. Few studies have focused on the burden of suicidal behaviors among these inpatients in low-income settings, despite suicide being consistently higher in lower-income countries such as Uganda. This study, therefore, provides the prevalence and associated factors of suicidal behaviors and suicide attempts among inpatients with severe mental conditions in Uganda. METHOD This was a retrospective chart review of all individuals admitted with severe mental conditions to a large psychiatry inpatient unit in Uganda for four years (2018-2021). Two separate logistic regressions were conducted to determine the factors associated with suicidal behaviors or suicidal attempts among the admitted individuals. RESULTS The prevalence of suicidal behavior and suicidal attempts among 3104 (mean age = 33, Standard deviation [SD] = 14.0; 56% were males) were 6.12% and 3.45%, respectively. Having a diagnosis of depression increased the likelihood of both suicidal behaviors (adjusted odds ratio [aOR]: 5.36; 95% confidence interval [CI]: 2.14-13.37; p =0.001) and attempts (aOR: 10.73; 95% CI: 3.44-33.50; p < 0.001). However, a diagnosis of substance-related disorder increased the likelihood of having attempted suicide (aOR: 4.14; 95% CI: 1.21-14.15; p = 0.023). The likelihood of having suicidal behavior decreased as one increased in age (aOR: 0.97; 95% CI: 0.94-0.99; p = 0.006) and increased among individuals reporting stress from financial constraints (aOR: 2.26; 95% CI: 1.05-4.86; p = 0.036). CONCLUSION Suicidal behaviors are common among inpatients managed for severe mental health conditions in Uganda, especially those with substance use and depressive disorders. In addition, financial stressors are a main predictor in this low-income country. Therefore, regular screening for suicide behaviors is warranted, especially among individuals with depression, and substance use, among those who are young, and among those reporting financial constraints/stress.
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Affiliation(s)
- Joan Abaatyo
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Alain Favina
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Steven Elijah Bulega
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Mohan Kaggwa
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, McMaster, Canada.
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16
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Amate-Fortes I, Guarnido-Rueda A, Martínez-Navarro D, Oliver-Márquez FJ. Social Isolation, Healthy Habits, Inequality and Mental Health in the United States. APPLIED RESEARCH IN QUALITY OF LIFE 2023; 18:1-27. [PMID: 37359221 PMCID: PMC9999329 DOI: 10.1007/s11482-023-10155-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/15/2023] [Indexed: 06/28/2023]
Abstract
The objective of this work is to deepen the analysis of the socioeconomic determinants of mental health, paying special attention to the impact of inequality, not only in income distribution but also in gender, racial, health and education inequality, social isolation, including new variables to measure loneliness, and healthy habits, on the mental health status. For this purpose, a cross-sectional model for a sample of 2735 counties in the United States is estimated using Ordinary Least Squares in its robust version to solve the detected heteroscedasticity problems. The results obtained show that inequality, social isolation and certain lifestyles, such as smoking or insomnia, are detrimental to mental health, while sexual activity prevents mental distress. On the other hand, poor counties suffer more cases of suicide, with food insecurity being the main problem for mental health. Finally, we found detrimental effects of pollution on mental health.
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Affiliation(s)
- Ignacio Amate-Fortes
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| | - Almudena Guarnido-Rueda
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| | - Diego Martínez-Navarro
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
| | - Francisco J. Oliver-Márquez
- Department of Economics and Business, University of Almeria, Carretera de Sacramento, s/n, 04120 Almeria, Spain
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17
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Grzejszczak J, Strzelecki D, Gabryelska A, Kotlicka-Antczak M. Affiliation to a Social Group as a Preventive Factor in Suicidal Behaviors in Children and Adolescents during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020333. [PMID: 36832461 PMCID: PMC9955561 DOI: 10.3390/children10020333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
Suicide is one of the most common causes of death in the population of children and adolescents. Available data show the continuous growth of this phenomenon and the ineffectiveness of prevention programs. Additionally, the COVID-19 pandemic significantly affected young people's mental health, including an increased risk of suicidal behaviors due to limited direct contact with the school and peer groups in favor of the home environment. Therefore, the aim of this narrative review was to consider the risk factors and protective factors for suicidal behavior in the under-18 population, with a particular focus on the importance of belonging to a social group and building identification with it as a phenomenon protecting against suicidal behavior. Additionally, in this review, we evaluate how the COVID-19 pandemic affected these relationships. The PubMed database was used in the search with the following keywords: suicide, suicide behaviors, child and adolescent suicide behaviors, group affiliation, family affiliation, ethnicity, religious affiliation, and the COVID-19 pandemic, with articles published between 2002 and 2022 analyzed. Research conducted to date indicates that both sustained and stable family and peer relationships, as well as a sense of identification and belonging, noticeably reduce the risk of suicidal behavior. Ethnic or cultural affiliation seems to have been particularly important during the isolation in the home environment caused by the COVID-19 pandemic. Additionally, it has been shown that while in lockdown, contact through social media with individuals' identification groups was associated with a reduced chance of emotional crises. Furthermore, regardless of cultural background, attachment to a particular group correlates with enhanced psychiatric state of children and adolescents. Thus, available data highlight the need for building and maintaining affiliations with suitable groups as a protective factor against suicidal behaviors.
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Affiliation(s)
- Jagoda Grzejszczak
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 92-216 Lodz, Poland
| | - Dominik Strzelecki
- Department of Affective and Psychotic Disorders, Medical University of Lodz, 92-216 Lodz, Poland
| | - Agata Gabryelska
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, 92-215 Lodz, Poland
- Correspondence:
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18
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Argabright ST, Visoki E, Moore TM, Ryan DT, DiDomenico GE, Njoroge WFM, Taylor JH, Guloksuz S, Gur RC, Gur RE, Benton TD, Barzilay R. Association Between Discrimination Stress and Suicidality in Preadolescent Children. J Am Acad Child Adolesc Psychiatry 2022; 61:686-697. [PMID: 34425231 PMCID: PMC8917360 DOI: 10.1016/j.jaac.2021.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/17/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality). METHOD We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non-US-born individuals, sexual orientation-based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality. RESULTS Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2-3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7-1.2). CONCLUSION Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.
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Affiliation(s)
- Stirling T Argabright
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Elina Visoki
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Tyler M Moore
- Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Dallas T Ryan
- Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Grace E DiDomenico
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania
| | - Wanjikũ F M Njoroge
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jerome H Taylor
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Sinan Guloksuz
- School for Mental Health and Neuroscience, Maastricht University Medical Centre, the Netherlands; Yale University School of Medicine, New Haven, Connecticut
| | - Ruben C Gur
- Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Raquel E Gur
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Tami D Benton
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ran Barzilay
- Children's Hospital of Philadelphia, Pennsylvania; Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia.
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19
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Factors Related to Immigrant/Nonimmigrant Children's Experience of Being Bullied: An Analysis Using the Multiple Disadvantage Model. Community Ment Health J 2022; 58:689-700. [PMID: 34259968 DOI: 10.1007/s10597-021-00873-y] [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: 01/30/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
Applying the multiple disadvantage model, a study of children in the United States examined experiences of being bullied in terms of 5 factors: social disorganization, social structural factors, social relationships, mental health and access to care, and acculturation. The study was a secondary data analysis of 19,882 immigrant and non-immigrant children, using data from the 2018 National Survey of Children's Health. Logistic regression results show children's likelihood of being bullied to be associated positively with racial discrimination; child mental health problem (either attention deficit/hyperactivity disorder, depression, anxiety, behavioral/conduct problem, or Tourette Syndrome); family substance use; being female; being age 6-10; being age 11-13; and parent education level. Likelihood of being bullied was associated negatively with safe neighborhood; being Black; being Asian; family cohesiveness; neighbor support; parent mental health; being a first- or second-generation immigrant; and parent age. The results imply the usefulness of interventions promoting racial harmony and family support.
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20
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Argabright ST, Visoki E, Moore TM, Ryan DT, DiDomenico GE, Njoroge WFM, Taylor JH, Guloksuz S, Gur RC, Gur RE, Benton TD, Barzilay R. Association Between Discrimination Stress and Suicidality in Preadolescent Children. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2022; 20:252-262. [PMID: 37153135 PMCID: PMC10153507 DOI: 10.1176/appi.focus.22020005] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 05/09/2023]
Abstract
Objective Youth suicide rates in the United States have been increasing in recent years, especially in Black Americans, the reasons for which are unclear. Environmental adversity is key in youth suicidality; hence there is a need to study stressors that have a disproportionate impact on Black youths. We aimed to disentangle the unique contribution of racial/ethnic discrimination from other adversities associated with childhood suicidal ideation and attempts (suicidality). Method We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, which included a large, diverse sample of US children (N = 11,235, mean age 10.9 years, 20.2% Black), assessed for multiple environmental adversities including discrimination. Multivariate regression models tested the association of self-reported racial/ethnic discrimination with suicidality, covarying for multiple confounders including other discrimination types (toward non-US-born individuals, sexual orientation-based, and weight-based). Matched analyses contrasted effects of racial/ethnic discrimination and racial identity on suicidality. Results Black youths reported more discrimination and higher suicidality rates than non-Black youths. High racial/ethnic discrimination was positively and significantly associated with suicidality, adjusting for other discrimination types (odds ratio = 2.6, 95% CI = 2.1-3.2). Findings remained significant after adjusting for multiple suicidality risk factors. Once experienced, racial/ethnic discrimination was similarly associated with suicidality in White, Black, and Hispanic youths. Matched analyses revealed that racial/ethnic discrimination was associated with suicidality (relative risk = 2.7, 95% CI = 2-3.5), whereas Black race was not (relative risk = 0.9, 95% CI = 0.7-1.2). Conclusion Racial/ethnic discrimination is disproportionately experienced by Black children, and is associated with preadolescent suicidality, over and above other adversities. Findings highlight the need to address discrimination as part of suicide prevention strategies. Cross-sectional design hampers causal inferences.Reprinted from J Am Acad Child Adolesc Psychiatry, Argabright et al., Association Between Discrimination Stress and Suicidality in Preadolescent Children, S0890-8567(21)01355-1, copyright 2021, with permission from Elsevier.
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21
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Liu C, Pan W, Zhu D, Meng F, Tian T, Li L, Li X. Factors of suicidal behavior among inpatients with major depressive disorder: A retrospective case series. Front Psychiatry 2022; 13:996402. [PMID: 36213915 PMCID: PMC9537680 DOI: 10.3389/fpsyt.2022.996402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Previous studies indicate that more than half of those who died by suicide had a depressive disorder. When discussing the factors associated to suicidal behavior (SB) among patients with major depressive disorder (MDD), sociocultural contexts should also be carefully considered. This case series study explored the factors correlated to SB among MDD patients in Beijing, China. METHODS The patient information sheets were retrieved from an electronic database that comprised patient medical information. Three forms of binary logistic regression equations were conducted to explore the factors associated to SB among patients with MDD. For the inconsistent variables produced by the three regression models, the propensity score matching (PSM) analysis was done for further verification. RESULTS In this retrospective study, 1,091 depressed cases were enrolled. The difference between the SB group and non-SB group in gender, impulsivity, the severity of depression, history of major mental trauma, and family history of suicide were statistically significant in univariate comparisons (P < 0.05); the binary logistic regression analysis and the PSM analysis showed that female gender, history of major mental trauma, impulsivity, family history of suicide and severity of depression were factors correlated to SB among patients with MDD (odds ratios >1). CONCLUSIONS Female gender, the history of major mental trauma, impulsivity, the severity of depression, and family history of suicide were independently associated with the appearance of SB among MDD patients in Beijing, China. Inevitably, these findings should be viewed with particular caution due to the inherent drawbacks of a retrospective nature. More prospective longitudinal research should be conducted to examine those dynamic alterations in the corresponding confounders.
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Affiliation(s)
- Chaomeng Liu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Weigang Pan
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Dandi Zhu
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fanqiang Meng
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tengfei Tian
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Li Li
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiaohong Li
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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22
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Liu C, Pan W, Zhu D, Mao P, Ma X. Risk factors for suicidal behavior in late-life depression: A retrospective preliminary clinical study. Geriatr Gerontol Int 2021; 21:849-854. [PMID: 34291556 DOI: 10.1111/ggi.14244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/21/2021] [Accepted: 06/30/2021] [Indexed: 12/24/2022]
Abstract
AIM To explore the risk factors associated with suicidal behavior (SB) using logistic regression analysis and the propensity score matching (PSM) method among Chinese patients suffering from late-life depression (LLD). METHOD Patient information sheets were retrieved with the International Classification of Diseases, Tenth Revision (ICD-10) code from an electronic database that comprised patient medical information. Herein, we set SB as a dependent variable, and gender, marital status, monthly income, quality of interpersonal relationships, hobbies, impulsivity, severity of depression, psychiatric symptoms or not, and having histories of smoking, drinking, major mental trauma as independent variables according to clinical experience and previous findings. For uncertain independent risk factors associated with SB generated by logistic regression analysis, PSM was performed for further verification. RESULTS The differences between the SB group and non-SB group for marital status, severity of depression, a history of drinking, and a history of major mental trauma were found to be statistically significant in univariate comparisons (P < 0.05); binary logistic regression analysis and PSM analysis showed that the severity of depression, a history of drinking, and a history of major mental trauma were independent risk factors associated with SB of patients with LLD with an odds ratio greater than one. CONCLUSION The severity of depression, a history of drinking, and a history of major mental trauma were independently associated with the occurrence of SB of patients with LLD in China. Further longitudinal and prospective studies are warranted to examine the dynamic changes of confounding risk factors. Geriatr Gerontol Int 2021; 21: 849-854.
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Affiliation(s)
- Chaomeng Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Weigang Pan
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Dandi Zhu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Peixian Mao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xin Ma
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Risk factors for pre-adolescent onset suicidal behavior in a high-risk sample of youth. J Affect Disord 2021; 290:292-299. [PMID: 34015624 PMCID: PMC8223608 DOI: 10.1016/j.jad.2021.04.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/20/2021] [Accepted: 04/25/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To identify risk factors for preadolescent onset suicidal behavior compared with adolescent/young adult onset suicidal behavior in a longitudinal sample of youth with parental history of mood disorders. METHODS The sample includes 545 youth who were age 21 years or less at the time of their baseline assessment. Participants underwent baseline and yearly study assessments. Observations were censored at the time point closest to the first episode of suicidal behavior for youth with suicidal behavior and at the time of last observation for youth without suicidal behavior. Youth were categorized into 3 groups: first onset of suicidal behavior before the age of 13 (n = 32), first onset of suicidal behavior between the ages of 13-21 (n = 51) and those without suicide related behaviors (n = 462). ANOVA, Chi-square, Fisher's exact test and multinomial regression were used to test the hypotheses. RESULTS Significant predictors of preadolescent onset suicidal behavior were diagnosis of depressive disorder (RRR = 11.41, p<.001) and diagnosis of ADHD (RRR = 2.86, p = .02). Adolescent onset was predicted by diagnosis of depressive disorder (RRR = 4.12, p = .008), female sex (RRR = 2.68, p = .02) and self-reported suicidal ideation (RRR = 1.48, p = .004). LIMITATIONS These results are most applicable to offspring of parents with significant mood disorders. CONCLUSIONS The strongest predictor of suicidal behavior in both groups was a diagnosis of depressive disorder, and the risk was nearly 3 times higher in preadolescents. ADHD was a significant predictor only for preadolescents, while female sex and self-reported suicidal ideation predicted suicidal behavior in adolescents.
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