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Winters DE, Mikulich SK, Hopfer C, Sakai JT. Adolescents in Treatment for Substance Use Disorders: Callous-Unemotional Traits Moderate Associations Between Transdiagnostic Symptoms and Adolescent Suicidality. Child Psychiatry Hum Dev 2023; 54:397-405. [PMID: 34559328 PMCID: PMC8942863 DOI: 10.1007/s10578-021-01256-w] [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] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
Suicide, a common cause of death in adolescents, is linked to internalizing and externalizing symptoms. These associations are pronounced amongst adolescents who use substances. But these relationships are complex. For example, sex differences are present in association with internalizing/externalizing symptoms as well as differences in suicidality. A rarely explored factor that may account for this complexity as a moderator is callous-unemotional traits. The present study examines associations of internalizing and externalizing in relation to suicidality in the context of callous-unemotional traits amongst adolescents in substance use treatment. Additionally, sex differences were explored. A sample of 317 adolescents (13-18; 16.05 ± 1.22) in treatment for substance use completed measures for internalizing, externalizing, and suicidal symptoms. The main result suggested the presence of callous-unemotional (CU) traits attenuated the positive association between internalizing and a latent suicidality factor. This novel result contextualizes the association between transdiagnostic symptoms and suicidality. Assessing CU traits in the presence of internalizing symptoms may be an important component of understanding suicide risk amongst adolescents in treatment for substance use.
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Affiliation(s)
- Drew E Winters
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
| | - Susan K Mikulich
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Christian Hopfer
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
| | - Joseph T Sakai
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
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2
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Troxel WM, Rodriguez A, Seelam R, Dong L, Perez LG, Tucker JS, Siconolfi D, D'Amico EJ. A latent class approach to understanding longitudinal sleep health and the association with alcohol and cannabis use during late adolescence and emerging adulthood. Addict Behav 2022; 134:107417. [PMID: 35853405 PMCID: PMC10431952 DOI: 10.1016/j.addbeh.2022.107417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 06/14/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Sleep is a multi-dimensional health behavior associated with elevated risk of substance use. This is the first study to utilize a latent class approach to characterize sleep health across multiple dimensions and across time from late adolescence to emerging adulthood, and to examine associations with alcohol and cannabis use trajectories. METHODS The sample included 2995 emerging adults (mean ages = 18 to 24 years across six waves of data collection; 54% female) who provided data on sleep dimensions (quality, duration, and social jetlag) and frequency and consequences of alcohol and cannabis use. Longitudinal latent class analysis (LLCA) models characterized participants according to the three sleep dimensions. Latent growth models examined trajectories of frequency and consequences of alcohol or cannabis use over time among emergent sleep classes, with and without controlling for covariates. RESULTS LLCA models identified four sleep classes: good sleepers (n = 451; 15.2%); untroubled poor sleepers (n = 1024; 34.2%); troubled, moderately good sleepers (n = 1056; 35.3%); and suboptimal sleepers (n = 460; 15.4%). Good sleepers reported significantly lower levels of alcohol or cannabis use and consequences, and less of an increase in alcohol consequences as compared to suboptimal sleepers. CONCLUSIONS Persistent poor sleep health was associated with higher levels of alcohol and cannabis use and consequences, and greater increases in alcohol-related consequences during the transition from late adolescence to emerging adulthood. Findings have important clinical implications, highlighting that addressing multi-dimensional sleep health may be an important, novel target of intervention to reduce substance use frequency and consequences.
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Affiliation(s)
- Wendy M Troxel
- RAND Corporation, Behavioral and Policy Sciences, 4501 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Anthony Rodriguez
- RAND Corporation, Behavioral and Policy Sciences, 20 Park Plaza #920, Boston, MA 02116, USA.
| | - Rachana Seelam
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Lu Dong
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Lilian G Perez
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Joan S Tucker
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
| | - Daniel Siconolfi
- RAND Corporation, Behavioral and Policy Sciences, 4501 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - Elizabeth J D'Amico
- RAND Corporation, Behavioral and Policy Sciences, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
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3
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Do Cigarette Smoking and Amphetamine Use Predict Suicide Behaviors Among Adolescents in Liberia? Findings from a National Cross-sectional Survey. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00867-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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4
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Bista S, Nathan S, Rawstorne P, Palmer K, Ferry M, Williams M, Hayen A. Mortality among young people seeking residential treatment for problematic drug and alcohol use: A data linkage study. Drug Alcohol Depend 2021; 228:109030. [PMID: 34592701 DOI: 10.1016/j.drugalcdep.2021.109030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Young people with problematic alcohol and other drug (AOD) use are often referred to residential treatment. Subsequent mortality rates among this high-risk group is not known. This study estimates mortality rates and determines causes of death amongst young people referred to residential treatment in Sydney, Australia. DESIGN Retrospective data linkage study. Data of young people (13-18 years) referred to a residential treatment service 2001-2015 (n = 3256) linked with Australian death registration data, and followed up to 16 years (2001-2016). METHODS Mortality rates (CMRs) and standardised mortality ratios (SMRs, age-, gender-, calendar-year-adjusted) calculated using population mortality rates. Causes of death were analysed using ICD-10 codes for AOD-induced, AOD as contributory and non-AOD related causes. RESULTS During follow-up of the cohort (28,838 person-years), 63 people died (71.4 % males; 48 % Indigenous; median age at death = 21.9 years; median follow-up = 5.1years), with 76 % dying before aged 25 years. Overall mortality (SMR = 4.91, 95 % CI: 3.8-6.2; CMR = 2.18/1000 person-years, 95 % CI: 1.7-2.8) was significantly higher than age-gender-matched general population, particularly in females (SMR = 9.55; males: SMR = 4.11; RR: 2.3, 95 % CI: 1.3-4.1). SMRs were not significantly different between treatment groups (SMRs>5.5) and non-attend group (SMR = 3.7) (p = 0.359). Two-thirds of deaths involved AOD, with AOD-induced deaths comprising 42 % and AOD as contributory for 22 % deaths. Overdose, mainly opioids (including opiates), suicide, and transport accidents were major causes of deaths. CONCLUSION Very high mortality rates, particularly among females, and the high incidence of overdose and suicide emphasise early screening for those at high-risk, targeted and culturally appropriate interventions, and maximised continuing after-care accessible to young people.
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Affiliation(s)
- Sarita Bista
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Sally Nathan
- School of Population Health, UNSW, Sydney, NSW, Australia
| | | | | | - Mark Ferry
- Ted Noffs Foundation Sydney, NSW, Australia
| | - Megan Williams
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia; National Centre for Cultural Competence, University of Sydney, Sydney, NSW, Australia
| | - Andrew Hayen
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
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5
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Guo L, Wang W, Wang T, Zhao M, Wu R, Lu C. The Longitudinal Association between Sleep Duration and Suicidal Behavior among Chinese Adolescents: The Role of Nonmedical Use of Prescription Drug. Behav Sleep Med 2021; 19:589-601. [PMID: 32967469 DOI: 10.1080/15402002.2020.1822361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE/BACKGROUND Abnormal sleep and nonmedical use of prescription drugs are known to be factors associated with suicidal behavior, but the nature of the association between weekday sleep duration and suicidal behavior has not been elucidated. Nonmedical use of prescription drugs may play a mediator role in the association mentioned above. PARTICIPANTS There were a total of 3,273 high school students interviewed at baseline with a response rate of 96.8% and followed up at one year (retention rate, 96.1%). The mean (SD) age of the students was 13.7 (1.0) years. METHODS Data were drawn from the longitudinal data of the School-based Chinese Adolescents Health Survey. A total of 12 high schools were selected in Guangzhou. Suicidal behavior, weekday sleep duration, and nonmedical use of prescription drugs were measured. RESULTS Sleeping < 7 hours/day at time 0 was positively associated with suicidal ideation (Adjusted odds ratio [AOR] = 1.51, 95% CI = 1.21-1.89) and suicide attempts (AOR = 2.35, 95% CI = 1.02-5.38) at time 1. The mediation analyses showed that baseline opioids misuse or sedatives misuse partially mediated the associations of baseline short weekday sleep duration with suicidal ideation and suicide attempts at one-year follow-up. CONCLUSIONS Baseline short weekday sleep duration was positively associated with subsequent suicidal ideation and suicide attempts, and nonmedical use of opioids or sedatives partially mediated the associations mentioned above. Suicidal behavior can be prevented, short weekday sleep duration and nonmedical use of prescription drugs may be risk factors for suicidal behavior, and the respective roles of these factors are needed to be better understood.
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Affiliation(s)
- Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Tian Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Meijun Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ruipeng Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, People's Republic of China
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6
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Kwon H, Hong HJ, Kweon YS. Classification of Adolescent Suicide Based on Student Suicide Reports. Soa Chongsonyon Chongsin Uihak 2020; 31:169-176. [PMID: 33110353 PMCID: PMC7584279 DOI: 10.5765/jkacap.200030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 11/09/2022] Open
Abstract
Exploring the risk factors of adolescent suicide is important for effective suicide prevention. This study explored the clustering of adolescent suicides based on six risk factors: mental disorder, broken family, depression, anxiety, previous suicide attempts, and deviant behaviors. Using 173 student suicide reports obtained from the Ministry of Education, we evaluated the associations between suicide and variables related to mental disorders; dysfunctional family life; depression and anxiety; previous suicide attempts; deviant behaviors such as drinking and smoking; and school life characteristics, including attendance and discipline, problems within the past year, and incidents prior to suicide. In addition, reports of warning signs just before suicide were included in the analysis. The two-stage cluster analysis classified the students into three clusters: the silent type (cluster 1; 48.55%), in which no risk factors were observed; environmental-risk type (cluster 2: 24.28%), which featured a high frequency of broken households, deviant behaviors such as smoking/drinking and running away from home; and depressive type (cluster 3: 27.17%), which featured a high frequency of mental health problems such as depression, anxiety, and suicide attempts. Identifying the sub-types of adolescent suicide may help to inform tailored suicide prevention and intervention strategies in school.
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Affiliation(s)
- Hoin Kwon
- Department of Counseling Psychology, Jeonju University, Jeonju, Korea
| | - Hyun Ju Hong
- Suicide and School Mental Health Institute, Hallym University, Chuncheon, Korea.,Department of Psychiatry, Hallym University Sacred Hospital, Hallym University, Anyang, Korea
| | - Yong-Sil Kweon
- Suicide and School Mental Health Institute, Hallym University, Chuncheon, Korea.,Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, Korea
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Chien LC, Gakh M, Coughenour C, Lin RT. Temporal trend of research related to gun violence from 1981 to 2018 in the United States: a bibliometric analysis. Inj Epidemiol 2020; 7:9. [PMID: 32200761 PMCID: PMC7087386 DOI: 10.1186/s40621-020-0235-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to evaluate the variation in gun violence-related research in the US over time to determine if there are meaningful changes in frequency of research at certain time points. Related publications were searched from the Web of Science. METHODS We searched articles from Web of Science to collect publication data of gun violence research in three disciplines (clinical sciences, life sciences, and social behavior sciences) from 1981 to 2018. The joinpoint regression approach was applied to evaluate the trend of publication ratio. We also adopted the generalized additive mixed model to compare the publication ratio among the three research disciplines. RESULTS During the study period, each research discipline had a significant decrease in publication ratios, especially social behavioral sciences from 2001 to 2011, with an annual percentage change = - 9.77% (95% CI = - 13.45, - 5.93; p-value < .0001). After combining the three research disciplines, the average change of the publication ratio was significantly increased 9.18% (95% CI = 6.42, 12.01; p-value < .0001) per year from 1981 to 2018. Compared to social behavioral sciences, both clinical sciences and life sciences had a significantly smaller publication ratio. CONCLUSIONS Gun violence research exhibited a significant downward trend in publications in the early 2000s, which may be attributed at least in part to limited federal funding, but the publication ratio increased since the 2010s. To enhance the amount of peer-reviewed gun violence research so that research-informed gun violence interventions are more likely to succeed, decision-makers should keep supporting quality research.
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Affiliation(s)
- Lung-Chang Chien
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Pkwy, Suite 335, Las Vegas, Nevada, 89119, USA.
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Pkwy, Suite 335, Las Vegas, Nevada, 89119, USA
| | - Courtney Coughenour
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Pkwy, Suite 335, Las Vegas, Nevada, 89119, USA
| | - Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, No. 91, Xueshi Road, North District, Taichung City, 404, Taiwan
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8
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Blasco MJ, Vilagut G, Almenara J, Roca M, Piqueras JA, Gabilondo A, Lagares C, Soto-Sanz V, Alayo I, Forero CG, Echeburúa E, Gili M, Cebrià AI, Bruffaerts R, Auerbach RP, Nock MK, Kessler RC, Alonso J. Suicidal Thoughts and Behaviors: Prevalence and Association with Distal and Proximal Factors in Spanish University Students. Suicide Life Threat Behav 2019; 49:881-898. [PMID: 30039575 DOI: 10.1111/sltb.12491] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We report on the prevalence of suicidal thoughts and behaviors in Spanish university students and their risk and protective factors (distal/proximal; individual/environmental). METHODS First-year university students completed an online survey including Self-Injurious Thoughts and Behaviors Interview (SITBI) items, the screening version of the Columbia-Suicide Severity Rating Scale (C-SSRS) along with adversities and positive relationships during childhood/adolescence, recent stressful experiences, and lifetime mental disorders. Nested logistic regression models were estimated and areas under the curve (AUC) compared. RESULTS A total of 2,118 students completed the survey (mean age = 18.8 [SD = 1.4] years; 55.4% female). Twelve-month prevalence of suicide ideation (SI) was 9.9%, plans, 5.6%, and attempts, 0.6%. Risk factors of 12-month SI were as follows: parental psychopathology (OR = 1.7, 95% CI 1.2-2.5); sexual assault (OR = 5.6, 95% CI 1.4-22.1); lifetime mood disorder (OR = 5.2, 95% CI 3.5-7.7); and lifetime anxiety disorder (OR = 1.7, 95% CI: 1.1-2.5). Childhood positive relationships protected from SI were as follows: peers/others (OR = 0.6, 95% CI 0.4-0.9 for the second highest tertile) and family (OR = 0.4, 95% CI 0.3-0.7 for the highest tertile). AUC of the final model was 0.82 (SE = 0.015). CONCLUSION Our results indicate a high prevalence of SI among Spanish university students and identify protective and risk factors from a comprehensive conceptual model.
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Affiliation(s)
- Maria Jesús Blasco
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Pompeu Fabra University (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Miquel Roca
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | | | - Andrea Gabilondo
- Outpatient Mental Health Care Network, Osakidetza-Basque Health Service, Basque Country, San Sebastián, Spain
| | | | | | - Itxaso Alayo
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carlos G Forero
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Pompeu Fabra University (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Margalida Gili
- Institut Universitari d'Investigació en Ciències de la Salut (IUNICS-IDISPA), University of Balearic Islands (UIB), Palma de Mallorca, Spain
| | - Ana Isabel Cebrià
- Department of Mental Health, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, KU Leuven (UPC-KUL), Leuven, Belgium
| | - Randy P Auerbach
- Department of Psychiatry, Harvard Medical School, Center for Depression, Anxiety and Stress Research, McLean Hospital, Boston, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Boston, MA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Jordi Alonso
- Health Services Research Group, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Pompeu Fabra University (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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9
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Wilksch SM, O'Shea A, Wade TD. Depressive symptoms, alcohol and other drug use, and suicide risk: Prevention and treatment effects from a two-country online eating disorder risk reduction trial. Int J Eat Disord 2019; 52:132-141. [PMID: 30582194 DOI: 10.1002/eat.23005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Eating disorders are known to have high comorbidity, and the current report outlines the impact of an online eating disorder risk reduction program on brief, self-report measures of depressive symptoms, alcohol and other drug use, and suicidality. METHOD An online pragmatic, randomized-controlled trial was conducted with N = 316 young-women (M age = 20.80 years) across Australia and New Zealand. Media Smart-Targeted (MS-T) was a 9-module program released weekly while control participants received positive body image tips. Prevention effects (asymptomatic at baseline) and treatment effects (symptomatic at baseline) were investigated. RESULTS MS-T participants were 94% and 91% less likely than controls to develop Moderate or higher depressive symptoms at 6-month (MS-T = 3.3%; controls = 35.4%) and 12-month follow-up (MS-T = 3.4%; controls = 29.4%), respectively. MS-T participants did not commence using recreational drugs at any assessment point, compared to 18.2% of controls at a least one assessment point. Regarding treatment effects, MS-T participants were 84% more likely to no longer be using recreational drugs at 12-month follow-up (MS-T = 60%; controls = 21.1%). Mutitvariate logistic regressions revealed group, depressive symptoms and alcohol use to be significant predictors of elevated suicide risk, where being an MS-T participant, without depressive symptoms and not drinking alcohol, significantly lowered likelihood of developing elevated suicide risk. Disordered eating at post-program mediated the relationship between group and depressive symptoms across post-program to 12-mnoth follow-up. DISCUSSION MS-T shows promise as a program with important mental health benefits in addition to previous reports of lowered eating disorder diagnosis, risk and impairment.
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Affiliation(s)
- Simon M Wilksch
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Anne O'Shea
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Tracey D Wade
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
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10
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Assari S, Mistry R, Caldwell CH, Zimmerman MA. Marijuana Use and Depressive Symptoms; Gender Differences in African American Adolescents. Front Psychol 2018; 9:2135. [PMID: 30505287 PMCID: PMC6250838 DOI: 10.3389/fpsyg.2018.02135] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 10/16/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: This study aimed to examine gender differences in the bidirectional associations between marijuana use and depressive symptoms among African American adolescents. The study also tested gender differences in the effects of socioeconomic status, maternal support, and friends' drug use on adolescents' depressive symptoms and marijuana use. Methods: This is a secondary analysis of the Flint Adolescent Study (FAS). Six hundred and eighty one African American adolescents (335 males and 346 females) were followed for 3 years, from 1995 (mean age 16) to 1997 (mean age 19). Depressive symptoms (Brief Symptom Inventory) and marijuana use were measured annually during the follow up. We used multi-group latent growth curve modeling to explore the reciprocal associations between depressive symptoms and marijuana use over time based on gender. Results: Baseline marijuana use was predictive of an increase in depressive symptoms over time among male but not female African American adolescents. Baseline depressive symptoms were not predictive of an increase in marijuana use among male or female adolescents. Conclusion: Study findings suggest that male African American adolescents who use marijuana are at an increased risk of subsequent depressive symptoms. Interventions that combine screening and treatment for marijuana use and depression may be indicated for African American male adolescents.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, United States
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Cleopatra Howard Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States
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11
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Tseng J, Nuño M, Lewis AV, Srour M, Margulies DR, Alban RF. Firearm legislation, gun violence, and mortality in children and young adults: A retrospective cohort study of 27,566 children in the USA. Int J Surg 2018; 57:30-34. [PMID: 30071359 DOI: 10.1016/j.ijsu.2018.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Firearm violence results in the death of thousands of children in the US annually. The effects of firearm legislation on gun violence are published but widely contested. MATERIALS AND METHODS The Kid's Inpatient Database from 2000 to 2009 were queried to capture hospitalizations of children diagnosed with a firearm-related injury. Cases were categorized into five levels of firearm legislation strictness by Brady State Scorecard. Trends of injuries were explored in terms of legislative strength, age, and race. RESULTS 27,566 children analyzed in the study. Most were adolescents aged 15-19 (87.3%), male (89.7%), and black (53.7%). The proportion of accidental injuries increased relative to state law leniency (R2 = 0.90), with highest percentage in lenient states (33.2%) compared to strict (16.7%). The proportion of suicide attempts were higher in states with lenient laws (4.4%) compared to strict (1.3%). Accidents were inversely related to age (59.3% in ages 0-4 compared to 22.0% in adolescents), while assaults were positively related to age (31.6% in ages 0-4 compared to 66.6% in adolescents). Whites were most likely to present with accidental injuries (44.6%), and Blacks and Hispanics with assaults (68.2% and 75.6%). Race (p = 0.009), age (p < 0.001), and firearm injury type (p = 0.001) were associated with mortality; Hispanics (OR 1.36, 95% CI: 1.03-1.78), children age 5-9 (2.03, 1.30-3.17) and suicide attempts (15.6, 11.6-20.9) had higher odds of in-hospital mortality. CONCLUSIONS Firearm-related injuries types in hospitalized children are associated with age, race, and state level legislation. Accidents are most prevalent in young children, Whites, and states with lenient gun laws, while suicide attempts are more common in adolescents, Whites, and states with lenient gun laws. Suicide attempts are also associated with the greatest odds of in-hospital mortality. To address firearm violence, consideration should be given to legislation that promote safe gun storage behaviors and restrict firearm accessibility to children.
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Affiliation(s)
- Joshua Tseng
- Department of Surgery, Division of Acute Care Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, CA, USA.
| | - Miriam Nuño
- Department of Public Health Sciences, Division of Biostatistics, University of California Davis, Davis, CA, USA.
| | - Azaria V Lewis
- Department of Surgery, Division of Acute Care Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, CA, USA.
| | - Marissa Srour
- Department of Surgery, Division of Acute Care Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, CA, USA.
| | - Daniel R Margulies
- Department of Surgery, Division of Acute Care Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, CA, USA.
| | - Rodrigo F Alban
- Department of Surgery, Division of Acute Care Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, CA, USA.
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Hubers AAM, Moaddine S, Peersmann SHM, Stijnen T, van Duijn E, van der Mast RC, Dekkers OM, Giltay EJ. Suicidal ideation and subsequent completed suicide in both psychiatric and non-psychiatric populations: a meta-analysis. Epidemiol Psychiatr Sci 2018; 27:186-198. [PMID: 27989254 PMCID: PMC6998965 DOI: 10.1017/s2045796016001049] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 11/21/2016] [Indexed: 11/06/2022] Open
Abstract
AIMS Several authors claimed that expression of suicidal ideation is one of the most important predictors of completed suicide. However, the strength of the association between suicidal ideation and subsequent completed suicide has not been firmly established in different populations. Furthermore, the absolute suicide risk after expression of suicidal ideation is unknown. In this meta-analysis, we examined whether the expression of suicidal ideation predicted subsequent completed suicide in various populations, including both psychiatric and non-psychiatric populations. METHODS A meta-analysis of cohort and case-control studies that assessed suicidal ideation as determinant for completed suicide in adults. Two independent reviewers screened 5726 articles for eligibility and extracted data of the 81 included studies. Pooled risk ratios were estimated in a random effects model stratified for different populations. Meta-regression analysis was used to determine suicide risk during the first year of follow-up. RESULTS The risk for completed suicide was clearly higher in people who had expressed suicidal ideation compared with people who had not, with substantial variation between the different populations: risk ratio ranging from 2.35 (95% confidence interval (CI) 1.43-3.87) in affective disorder populations to 8.00 (95% CI 5.46-11.7) in non-psychiatric populations. In contrast, the suicide risk after expression of suicidal ideation in the first year of follow-up was higher in psychiatric patients (risk 1.40%, 95% CI 0.74-2.64) than in non-psychiatric participants (risk 0.23%, 95% CI 0.10-0.54). Past suicide attempt-adjusted risk ratios were not pooled due to large underreporting. CONCLUSIONS Assessment of suicidal ideation is of priority in psychiatric patients. Expression of suicidal ideation in psychiatric patients should prompt secondary prevention strategies to reduce their substantial increased risk of suicide.
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Affiliation(s)
- A. A. M. Hubers
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - S. Moaddine
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - S. H. M. Peersmann
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - T. Stijnen
- Department of Medical Statistics & Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands
| | - E. van Duijn
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Center for Mental Health Care Delfland, Delft, The Netherlands
| | - R. C. van der Mast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Faculty of Medicine, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - O. M. Dekkers
- Department of Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - E. J. Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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Park S, Jang H. Correlations between suicide rates and the prevalence of suicide risk factors among Korean adolescents. Psychiatry Res 2018; 261:143-147. [PMID: 29306174 DOI: 10.1016/j.psychres.2017.12.055] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 11/09/2017] [Accepted: 12/19/2017] [Indexed: 11/26/2022]
Abstract
We examined whether annual changes in the prevalence of suicide risk factors are related to annual changes in suicide rates among male and female adolescents in South Korea. Data from the Korean Youth Risk Behavior Web-based Survey (2005-2015) were used to obtain the annual prevalence of psychological and health-related risk factors among Korean adolescents. Mortality data from the Korean National Statistical Office (NSO) were used to obtain annual suicide rates among Korean adolescents aged 15-19 years. For male adolescents, there were significant positive correlations between suicide rate and the rate of depressive mood, suicidal ideation, suicide attempt, drinking, and smoking and negative correlations between suicide rate and the rate of self-perceived healthiness, obesity, and being physically active. For female adolescents, suicide rates were positively correlated with rate of being sexually active and negatively correlated with rate of obesity. Overall, our study showed that annual rates of suicide are associated with annual prevalence of suicide risk factors in Korean adolescents, particularly in male adolescents.
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Affiliation(s)
- Subin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, Republic of Korea.
| | - Hyesue Jang
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, Republic of Korea
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Ramchand R, Franklin E, Thornton E, Deland SM, Rouse JC. Violence, Guns, and Suicide in New Orleans: Results from a Qualitative Study of Recent Suicide Decedents. J Forensic Sci 2018; 63:1444-1449. [DOI: 10.1111/1556-4029.13742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/21/2017] [Accepted: 12/28/2017] [Indexed: 01/01/2023]
Affiliation(s)
| | - Enchanté Franklin
- RAND Gulf States Policy Institute New Orleans LA
- Orleans Parish Coroner's Office New Orleans LA
| | | | - Sarah M. Deland
- Orleans Parish Coroner's Office New Orleans LA
- Tulane University School of Medicine New Orleans LA
| | - Jeffrey C. Rouse
- Orleans Parish Coroner's Office New Orleans LA
- Tulane University School of Medicine New Orleans LA
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Risk of completed suicide in 89,049 young males assessed by a mental health professional. Eur Neuropsychopharmacol 2016; 26:341-349. [PMID: 26712325 DOI: 10.1016/j.euroneuro.2015.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/11/2015] [Accepted: 12/04/2015] [Indexed: 11/24/2022]
Abstract
In an individual who seeks help or is referred to a mental health professional it is common sense and clinical practice to assume that suicidal thoughts and previous attempts constitute risk factors for imminent suicide. However, this assumption has not been supported by large, population-based longitudinal studies. The current study investigated whether reports of current suicidal ideation and a history of suicide attempts indeed increase risk for later completed suicide in a historical prospective study design. Sequential records on 89,049 young males assessed by mental health professionals were screened for suicidal ideation and a history of suicide attempts. The data were linked with death records from the Israeli Central Bureau of Statistics. Over a follow-up period ranging from 2 months to 9.8 years, 54 individuals died by suicide, constituting an average suicide rate of 6.48 per 100,000 person-years. Overall, neither reporting current suicidal ideation (without a history of suicide attempts; HR=1.29, 95% CI=0.57-2.90) nor reporting a history of suicide attempts (with or without current suicidal ideation; HR=1.67, 95% CI=0.71-3.97) were significantly associated with increased risk for later completed suicide. However, young males with a previously diagnosed psychiatric disorder who reported current suicidal ideation (HR=4.52, 95% CI=1.08-18.91) or a history of suicide attempts (HR=6.43, 95% CI=1.54-26.90) were at increased risk of death by suicide. These findings indicate that in this particular population reports of current suicidal ideation or of a history of suicide attempts are helpful in predicting future suicide only among those with a previous diagnosis of a psychiatric disorder.
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Chasser YM. Profiles of Youth with PTSD and Addiction. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016; 25:448-454. [PMID: 28377669 DOI: 10.1080/1067828x.2015.1081115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hernandez L, Cancilliere MK, Graves H, Chun TH, Lewander W, Spirito A. Substance Use and Depressive Symptoms among Adolescents Treated in a Pediatric Emergency Department. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2015; 25:124-133. [PMID: 27152065 DOI: 10.1080/1067828x.2014.889633] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The current study examined associations between substance use and depressed mood by gender and type of substance used (no use, alcohol, marijuana or both alcohol and marijuana) in a sample of 713 adolescents (Mage = 15.3) recruited from a Pediatric Emergency Department (PED). Adolescents who reported any marijuana use had higher overall depressed mood scores compared to all other adolescents. When examined by gender, females with both alcohol and marijuana use reported the highest overall depressed mood symptoms. These results suggest the usefulness of screening and identification of depressive symptoms among adolescents presenting to a PED for substance use-related problems.
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Affiliation(s)
- Lynn Hernandez
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, The Alpert Medical School of Brown University
| | | | - Hannah Graves
- Center for Alcohol and Addiction Studies, The Alpert Medical School of Brown University
| | - Thomas H Chun
- Departments of Emergency Medicine and Pediatrics, The Alpert Medical School of Brown University
| | - William Lewander
- Departments of Emergency Medicine and Pediatrics, The Alpert Medical School of Brown University
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies, The Alpert Medical School of Brown University
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Kim R, Kwon H, Lee YH, Yook KH, Song J, Song MA, Hong HJ. Risky Behavior Subtypes and Suicide Attempts in Adolescents with Depression. Soa Chongsonyon Chongsin Uihak 2015. [DOI: 10.5765/jkacap.2015.26.3.149] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Dugas EN, Low NC, O'Loughlin EK, O'Loughlin JL. Recurrent suicidal ideation in young adults. Canadian Journal of Public Health 2015; 106:e303-7. [PMID: 26451992 DOI: 10.17269/cjph.106.4774] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 05/01/2015] [Accepted: 04/26/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Recurrent suicidal ideation (SI) may be linked to an increased risk of making suicide plans and suicide attempts. The objectives were to describe the frequency of SI recurrence in a population-based sample of young adults, and to compare mental health diagnoses, substance use, use of health services and medication use among those with and without recurrent SI. METHODS Data were collected from 785 participants at age 20 years and again at age 24. Chi-square tests were used to compare participants with and without recurrent SI. RESULTS Of 56 participants who reported SI at age 20, 32% reported SI four years later. Thirty-nine percent of participants with recurrent SI reported poor mental health compared to 8% of participants who never reported SI; 11% (vs. 4%) had sought professional help, 44% (vs. 8%) had been diagnosed with a mood and/or anxiety disorder, and 22% (vs. 2%) had taken medication for a mental health problem. Past-year substance use was higher among those with recurrent SI than among those with no SI: 67% vs. 42% smoked cigarettes, 56% vs. 39% used other tobacco products, 89% vs. 74% binge drank, 56% vs. 42% used marijuana and 33% vs. 17% reported using illicit drugs. CONCLUSION One third of young adults with a history of SI reported SI four years later. Because SI can recur, clinicians should monitor young adults with a history of SI, assess their substance use and mood/anxiety disorders and if needed, refer them for psychological or psychiatric care.
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McManama O'Brien KH. Rethinking Adolescent Inpatient Psychiatric Care: The Importance of Integrated Interventions for Suicidal Youth With Substance Use Problems. SOCIAL WORK IN MENTAL HEALTH 2015; 11:349-359. [PMID: 26674510 PMCID: PMC4677078 DOI: 10.1080/15332985.2013.774924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Adolescents psychiatrically hospitalized following a suicide attempt are at high risk for a repeat attempt or suicide completion, and substance use is consistently implicated as a risk factor for continued suicidal behavior in adolescents. Despite this knowledge, there have been few studies that have investigated the effectiveness of combined suicidality and substance use interventions within acute psychiatric care settings for suicidal youth with substance use problems. While social workers are well-positioned to deliver such interventions, greater emphasis on teaching integrated therapeutic techniques in social work curriculum and professional training is needed to ensure their implementation.
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Lin IH, Ko CH, Chang YP, Liu TL, Wang PW, Lin HC, Huang MF, Yeh YC, Chou WJ, Yen CF. The association between suicidality and Internet addiction and activities in Taiwanese adolescents. Compr Psychiatry 2014; 55:504-10. [PMID: 24457034 DOI: 10.1016/j.comppsych.2013.11.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aims of this cross-sectional study were to examine the associations of suicidal ideation and attempt with Internet addiction and Internet activities in a large representative Taiwanese adolescent population. METHODS 9510 adolescent students aged 12-18 years were selected using a stratified random sampling strategy in southern Taiwan and completed the questionnaires. The five questions from the Kiddie Schedule for Affective Disorders and Schizophrenia were used to inquire as to the participants' suicidal ideation and attempt in the past one month. The Chen Internet Addiction Scale was used to assess participants' Internet addiction. The kinds of Internet activities that the adolescents participated in were also recorded. The associations of suicidal ideation and attempt with Internet addiction and Internet activities were examined using logistic regression analysis to control for the effects of demographic characteristics, depression, family support and self-esteem. RESULTS After controlling for the effects of demographic characteristics, depression, family support and self-esteem, Internet addiction was significantly associated with suicidal ideation and suicidal attempt. Online gaming, MSN, online searching for information, and online studying were associated with an increased risk of suicidal ideation. While online gaming, chatting, watching movies, shopping, and gambling were associated with an increased risk of suicidal attempt, watching online news was associated with a reduced risk of suicidal attempt. CONCLUSIONS The results of this study indicated that adolescents with Internet addiction have higher risks of suicidal ideation and attempt than those without. Meanwhile, different kinds of Internet activities have various associations with the risks of suicidal ideation and attempt.
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Affiliation(s)
- I-Hsuan Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Master Program and Department of Neurology, School of Medicine, Kaohsiung Medical University, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University, Taiwan
| | - Yu-Ping Chang
- School of Nursing, The State University of New York, University at Buffalo, NY, USA
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Huang-Chi Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Mei-Feng Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Yi-Chun Yeh
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center and College of Medicine, Chang Gung University, Kaohsiung, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
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22
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Association between problematic cellular phone use and suicide: the moderating effect of family function and depression. Compr Psychiatry 2014; 55:342-8. [PMID: 24262117 DOI: 10.1016/j.comppsych.2013.09.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 09/09/2013] [Accepted: 09/18/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Suicidal ideation and attempt among adolescents are risk factors for eventual completed suicide. Cellular phone use (CPU) has markedly changed the everyday lives of adolescents. Issues about how cellular phone use relates to adolescent mental health, such as suicidal ideation and attempts, are important because of the high rate of cellular phone usage among children in that age group. This study explored the association between problematic CPU and suicidal ideation and attempts among adolescents and investigated how family function and depression influence the association between problematic CPU and suicidal ideation and attempts. METHODS A total of 5051 (2872 girls and 2179 boys) adolescents who owned at least one cellular phone completed the research questionnaires. We collected data on participants' CPU and suicidal behavior (ideation and attempts) during the past month as well as information on family function and history of depression. RESULTS Five hundred thirty-two adolescents (10.54%) had problematic CPU. The rates of suicidal ideation were 23.50% and 11.76% in adolescents with problematic CPU and without problematic CPU, respectively. The rates of suicidal attempts in both groups were 13.70% and 5.45%, respectively. Family function, but not depression, had a moderating effect on the association between problematic CPU and suicidal ideation and attempt. CONCLUSION This study highlights the association between problematic CPU and suicidal ideation as well as attempts and indicates that good family function may have a more significant role on reducing the risks of suicidal ideation and attempts in adolescents with problematic CPU than in those without problematic CPU.
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Schulte MT, Hser YI. Substance Use and Associated Health Conditions throughout the Lifespan. Public Health Rev 2014; 35:https://web-beta.archive.org/web/20150206061220/http://www.publichealthreviews.eu/upload/pdf_files/14/00_Schulte_Hser.pdf. [PMID: 28366975 PMCID: PMC5373082 DOI: 10.1007/bf03391702] [Citation(s) in RCA: 238] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
A life stage perspective is necessary for development of age-appropriate strategies to address substance use disorders (SUDs) and related health conditions in order to produce better overall health and well-being. The current review evaluated the literature across three major life stages: adolescence, adulthood, and older adulthood. FINDINGS 1) Substance use is often initiated in adolescence, but it is during adulthood that prevalence rates for SUDs peak; and while substance involvement is less common among older adults, the risk for health complications associated with use increases. 2) Alcohol, tobacco, marijuana, and, increasingly, prescription medications, are the most commonly misused substances across age groups; however, the use pattern of these and other drugs and the salient impact vary depending on life stage. 3) In terms of health outcomes, all ages are at risk for overdose, accidental injury, and attempted suicide. Adolescents are more likely to be in vehicular accidents while older adults are at greater risk for damaging falls. Adulthood has the highest rates of associated medical conditions (e.g., cancer, sexually transmitted disease, heart disease) and mental health conditions (e.g., bipolar disorder, anxiety disorders, antisocial personality disorder). CONCLUSION Prolonged heavy use of drugs and/or alcohol results in an array of serious health conditions. Addressing SUDs from a life stage perspective with assessment and treatment approaches incorporating co-occurring disorders are necessary to successfully impact overall health.
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Affiliation(s)
- Marya T. Schulte
- UCLA Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
| | - Yih-Ing Hser
- UCLA Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA
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Mumie ohne Geheimnisse – Identifizierung, Eingrenzung der Liegezeit und Nachweis von Morphin. Rechtsmedizin (Berl) 2013. [DOI: 10.1007/s00194-013-0921-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Relatively little is known about legal entanglements and suicide risk. This matched case-control study estimated the risk of suicide associated with legal strains using online court archives, a novel source of exposure data. Court records linked to suicide deaths (N = 315), controls (N = 630), and unintentional injury and poisoning deaths (N = 630) for an urban county from 2000 to 2005 revealed that nearly a third of suicide victims had recent court involvement, twice the proportion among controls. Misdemeanors, car accidents, and foreclosures were each associated with a threefold risk of suicide. Implications for suicide prevention and research are discussed.
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Affiliation(s)
- Thomas Bradley Cook
- Epidemiology & Biostatistics, Case Western Reserve University, Cleveland, OH, USA.
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Pompili M, Serafini G, Innamorati M, Biondi M, Siracusano A, Di Giannantonio M, Giupponi G, Amore M, Lester D, Girardi P, Möller-Leimkühler AM. Substance abuse and suicide risk among adolescents. Eur Arch Psychiatry Clin Neurosci 2012; 262:469-485. [PMID: 22290639 DOI: 10.1007/s00406-012-0292-0] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 01/10/2012] [Indexed: 01/17/2023]
Abstract
The aim of this paper was to review the literature concerning the relationship between suicide and substance abuse behaviours among adolescents, focusing on epidemiology, comorbidity and preventive programmes. We performed a Pubmed/Medline, Scopus, PsycLit and PsycInfo search to identify all papers and book chapters during the period between 1980 and 2011. Adolescents with substance abuse disorder who attempt or complete suicide can be characterized as having mood disorders, stressful life events, interpersonal problems, poor social support, lonely lives and feelings of hopelessness. The research supports the existence of a strong relationship between suicide and substance abuse. Preventive programmes should be based on the detection of risk factors associated with both suicide and substance abuse disorder. Management programmes should combine different therapeutic strategies such as peer-to-peer education, school-based programmes, psychotherapy and pharmacological treatment. Evidence suggests that targeted suicide prevention programmes can be delivered which reduce the burden associated with substance abuse and suicide in youths.
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Affiliation(s)
- Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Functions, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy,
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Sheidow AJ, Jayawardhana J, Bradford WD, Henggeler SW, Shapiro SB. Money Matters: Cost Effectiveness of Juvenile Drug Court with and without Evidence-Based Treatments. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2012; 21:69-90. [PMID: 22389577 PMCID: PMC3290130 DOI: 10.1080/1067828x.2012.636701] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The 12-month cost effectiveness of juvenile drug court and evidence-based treatments within Court were compared with traditional Family Court for 128 substance abusing/dependent juvenile offenders participating in a four-condition randomized trial. Intervention conditions included Family Court with community services (FC), Drug Court with community services (DC), Drug Court with Multisystemic Therapy (DC/MST), and Drug Court with MST enhanced with a contingency management program (DC/MST/CM). Average cost effectiveness ratios for substance use and criminal behavior outcomes revealed that economic efficiency in achieving outcomes generally improved from FC to DC, with the addition of evidence-based treatments improving efficiency in obtaining substance use outcomes.
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Affiliation(s)
- Ashli J. Sheidow
- Family Services Research Center, Medical University of South Carolina, Charleston, SC
| | - Jayani Jayawardhana
- Center for Health Economic and Policy Studies, Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC
| | - W. David Bradford
- Department of Public Administration and Policy, University of Georgia, Athens, GA
| | - Scott W. Henggeler
- Family Services Research Center, Medical University of South Carolina, Charleston, SC
| | - Steven B. Shapiro
- Family Services Research Center, Medical University of South Carolina, Charleston, SC
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Britton PC, Bohnert ASB, Wines JD, Conner KR. A procedure that differentiates unintentional from intentional overdose in opioid abusers. Addict Behav 2012; 37:127-30. [PMID: 21955872 DOI: 10.1016/j.addbeh.2011.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Revised: 06/10/2011] [Accepted: 08/19/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study is to develop a procedure for assessing unintentional overdose (OD) in opiate abusers that differentiates it from intentional OD, and provides reliable information about the incident. METHODS A sample of 121 patients in a methadone maintenance program at an urban university hospital completed a baseline assessment. A total of 70 participants completed an identical assessment at least 14 days later. The ability of an OD item to differentiate unintentional OD from intentional OD was tested, as was the test-retest reliability of questions assessing symptoms and treatment of OD. RESULTS The procedure is reliable and differentiated unintentional OD from intentional OD. Questions assessing symptoms of OD were endorsed in almost every unintentional OD incident, although reliability was affected by loss of consciousness. The reliability of questions assessing emergency treatment and Narcan administration was outstanding. CONCLUSIONS Our procedure for assessing OD differentiates unintentional OD from intentional OD. The use of follow-up questions assessing acute treatment for OD is recommended. Items concerning symptoms of OD are not needed to confirm the presence of an OD, but may be used to clarify whether an event was an OD.
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Affiliation(s)
- Peter C Britton
- Center of Excellence, Department of Veteran Affairs Medical Center, Canandaigua, USA.
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Javdani S, Sadeh N, Verona E. Suicidality as a function of impulsivity, callous-unemotional traits, and depressive symptoms in youth. JOURNAL OF ABNORMAL PSYCHOLOGY 2011; 120:400-13. [PMID: 21280931 DOI: 10.1037/a0021805] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Suicidality represents one of the most important areas of risk for adolescents, with both internalizing (e.g., depression, anxiety) and externalizing-antisocial (e.g., substance use, conduct) disorders conferring risk for suicidal ideation and attempts (e.g., Bridge, Goldstein, & Brent, 2006). However, no study has attended to gender differences in relationships between suicidality and different facets of psychopathic tendencies in youth. Further, very little research has focused on disentangling the multiple manifestations of suicide risk in the same study, including behaviors (suicide attempts with intent to die, self-injurious behavior) and general suicide risk marked by suicidal ideation and plans. To better understand these relationships, we recruited 184 adolescents from the community and in treatment. As predicted, psychopathic traits and depressive symptoms in youth showed differential associations with components of suicidality. Specifically, impulsive traits uniquely contributed to suicide attempts and self-injurious behaviors, above the influence of depression. Indeed, once psychopathic tendencies were entered in the model, depressive symptoms only explained general suicide risk marked by ideation or plans but not behaviors. Further, callous-unemotional traits conferred protection from suicide attempts selectively in girls. These findings have important implications for developing integrative models that incorporate differential relationships between (a) depressed mood and (b) personality risk factors (i.e., impulsivity and callous-unemotional traits) for suicidality in youth.
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Affiliation(s)
- Shabnam Javdani
- University of Illinois at Urbana-Champaign, Department of Psychology, 603 East Daniel Street, Champaign, IL 61820, USA.
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Betz ME, Barber C, Miller M. Suicidal behavior and firearm access: results from the second injury control and risk survey. Suicide Life Threat Behav 2011; 41:384-91. [PMID: 21535097 DOI: 10.1111/j.1943-278x.2011.00036.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The association between home firearms and the likelihood and nature of suicidal thoughts and plans was examined using the Second Injury Control and Risk Survey, a 2001-2003 representative telephone survey of U.S. households. Of 9,483 respondents, 7.4% reported past-year suicidal thoughts, 21.3% with a plan. Similar proportions of those with and without a home firearm reported suicidal thoughts, plans, and attempts. Among respondents with suicidal plans, the odds of reporting a plan involving a firearm were over seven times greater among those with firearms at home, compared with those without firearms at home. The results suggest people with home firearms may not be more likely to be suicidal, but when suicidal they may be more likely to plan suicide by firearm.
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Affiliation(s)
- Marian E Betz
- University of Colorado Denver, Aurora, CO 80045, USA.
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Haw CM, Hawton K. Problem drug use, drug misuse and deliberate self-harm: trends and patient characteristics, with a focus on young people, Oxford, 1993-2006. Soc Psychiatry Psychiatr Epidemiol 2011; 46:85-93. [PMID: 19936579 DOI: 10.1007/s00127-009-0170-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2008] [Accepted: 11/03/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND Drug misuse is related to self-harm and suicide. However, relatively little is known about deliberate self-harm (DSH) in patients with drug problems and whether drug misuse by DSH patients is increasing. METHODS We used data collected by the Oxford Monitoring System for Attempted Suicide to study the characteristics of DSH patients with drug problems who presented to the general hospital in Oxford between 1993 and 2006, and who underwent psychosocial assessment at their first presentation in the study period. We also studied trends in problem drug use and drugs misused over this period. RESULTS During the 14-year study period, 11,426 patients presented of whom 9,248 underwent psychosocial assessment and it was known whether or not they had a drug problem. Problem drug use was present in 805/9,248 (8.7%) patients. Problem drug use was more common in males (13.6%) than in females (5.3%). Problem drug users were younger, more likely to be socially disadvantaged, to have a personality disorder and comorbid alcohol problems and to have a further episode of DSH within a year. Problem drug use in young females was associated with higher suicidal intent scale (SIS) scores. During the study period, problem drug use and drug misuse increased in females, but not in males. Cannabis and cocaine misuse increased with time. CONCLUSIONS Provision of help for DSH patients with problem drug use is particularly challenging due to their complex social and clinical characteristics and increased risk of further self-harm, suicide and accidental death. It may require extensive liaison between different services. The increasing misuse of drugs by female DSH patients and the higher SIS scores of young females are of concern.
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Affiliation(s)
- Camilla M Haw
- St Andrew's Hospital, Billing Road, Northampton, NN1 5DG, UK.
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Miller M, Borges G, Orozco R, Mukamal K, Rimm EB, Benjet C, Medina-Mora ME. Exposure to alcohol, drugs and tobacco and the risk of subsequent suicidality: findings from the Mexican Adolescent Mental Health Survey. Drug Alcohol Depend 2011; 113:110-7. [PMID: 20801585 DOI: 10.1016/j.drugalcdep.2010.07.016] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Revised: 03/16/2010] [Accepted: 07/03/2010] [Indexed: 10/19/2022]
Abstract
AIMS To examine whether the association between prevalence measures of suicidality and substance abuse/dependence among adolescents (1) is attenuated when temporal priority of exposure and outcome are taken into account, (2) extends to substance use (i.e. without disorder), (3) applies to tobacco use and dependence independent of illicit drugs and alcohol use/disorder, and (4) is confounded by comorbid mental illness. DESIGN Discrete-time survival models were applied to retrospectively reported age of onset of first suicidal ideation, plan and attempt and age of onset of first substance use and disorder. PARTICIPANTS 3005 adolescents aged 12-17 residing in the Mexico City Metropolitan Area in 2005. MEASUREMENTS The World Mental Health computer-assisted adolescent version of the Composite International Diagnostic Interview was used to assess suicidal outcomes and psychiatric disorders including substance dependence/abuse. FINDINGS Use of and dependence on tobacco is as strong a predictor of subsequent suicidality as is use of and dependence with abuse of alcohol and drugs. The association between substance use and subsequent suicidality is not fully accounted for by comorbid mental illness. CONCLUSION Efforts to reduce the use as well as the abuse of alcohol, drugs and tobacco may help reduce the risk of subsequent suicidal behaviors among adolescents in Mexico.
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Affiliation(s)
- M Miller
- Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Avenue, Room 305, Kresge Building, Boston, MA 02115, United States.
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Backmund M, Meyer K, Schütz C, Reimer J. Factors associated with suicide attempts among injection drug users. Subst Use Misuse 2011; 46:1553-9. [PMID: 21463204 DOI: 10.3109/10826084.2011.564443] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Injection drug users (IDUs) entering an urban low-threshold opiate detoxification unit in Munich, Germany, between 1991 and 1997 were asked for lifetime suicide attempts and administered a questionnaire, including sociodemographic, IDU-related, and drug user treatment related variables. Among 1,049 participants, 20% had ever tried to commit suicide. In the logistic regression, female gender, older age, drug user treatment experience, lack of drug user counseling, and emergency treatment were associated with attempted suicide. Regular screening for suicidal behavior in IDUs should be undertaken with a special focus to mention risk factors. The study's limitations are noted. This study was partially sponsored by the German Ministry of Health.
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Affiliation(s)
- Markus Backmund
- 1Department of Addiction Medicine, General Hospital Munich Schwabing, Munich, Germany
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Hegerl U, Wittenburg L, Arensman E, Van Audenhove C, Coyne JC, McDaid D, Feltz-Cornelis CMVD, Gusmão R, Kopp M, Maxwell M, Meise U, Roskar S, Sarchiapone M, Schmidtke A, Värnik A, Bramesfeld A. Optimizing suicide prevention programs and their implementation in Europe (OSPI Europe): an evidence-based multi-level approach. BMC Public Health 2009; 9:428. [PMID: 19930638 PMCID: PMC2787518 DOI: 10.1186/1471-2458-9-428] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Accepted: 11/23/2009] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Suicide and non-fatal suicidal behaviour are significant public health issues in Europe requiring effective preventive interventions. However, the evidence for effective preventive strategies is scarce. The protocol of a European research project to develop an optimized evidence based program for suicide prevention is presented. METHOD The groundwork for this research has been established by a regional community based intervention for suicide prevention that focuses on improving awareness and care for depression performed within the European Alliance Against Depression (EAAD). The EAAD intervention consists of (1) training sessions and practice support for primary care physicians,(2) public relations activities and mass media campaigns, (3) training sessions for community facilitators who serve as gatekeepers for depressed and suicidal persons in the community and treatment and (4) outreach and support for high risk and self-help groups (e.g. helplines). The intervention has been shown to be effective in reducing suicidal behaviour in an earlier study, the Nuremberg Alliance Against Depression. In the context of the current research project described in this paper (OSPI-Europe) the EAAD model is enhanced by other evidence based interventions and implemented simultaneously and in standardised way in four regions in Ireland, Portugal, Hungary and Germany. The enhanced intervention will be evaluated using a prospective controlled design with the primary outcomes being composite suicidal acts (fatal and non-fatal), and with intermediate outcomes being the effect of training programs, changes in public attitudes, guideline-consistent media reporting. In addition an analysis of the economic costs and consequences will be undertaken, while a process evaluation will monitor implementation of the interventions within the different regions with varying organisational and healthcare contexts. DISCUSSION This multi-centre research seeks to overcome major challenges of field research in suicide prevention. It pools data from four European regions, considerably increasing the study sample, which will be close to one million. In addition, the study will gather important information concerning the potential to transfer this multilevel program to other health care systems. The results of this research will provide a basis for developing an evidence-based, efficient concept for suicide prevention for EU-member states.
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Affiliation(s)
- Ulrich Hegerl
- University of Leipzig, Department of Psychiatry, Germany
| | | | | | | | - James C Coyne
- University of Pennsylvania, School of Medicine, Pennsylvania, USA
| | - David McDaid
- London School of Economics, Personal Social Services Research Unit, LSE Health and Social Care, UK
| | - Christina M van der Feltz-Cornelis
- Trimbos-Instituut/Netherlands Institute of Mental Health and Addiction, The Netherlands
- VU University Medical Centre Institute of Extramural Research, Dept. of Psychiatry, Amsterdam, the Netherlands
| | - Ricardo Gusmão
- CEDOC, Departamento de Saúde Mental, Faculdade de Ciências, Médicas da Universidade Nova de Lisboa, Portugal
| | - Mária Kopp
- Semmelweis University Budapest, Institute of Behavioural Sciences, Hungary
| | | | - Ullrich Meise
- Gesellschaft für Psychische Gesundheit - pro mente tirol, Austria
| | | | - Marco Sarchiapone
- University of Primorska, PINT, Slovenia
- Current address: University of Molise, Health Science Department, Italy
| | - Armin Schmidtke
- Bayerische Julius-Maximilians-Universität Würzburg, Department of Clinical Psychology, Clinic for Psychiatry and Psychotherapy, Germany
| | - Airi Värnik
- Estonian-Swedish Mental Health and Suicidology Institute, Estonia
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King CA, O'Mara RM, Hayward CN, Cunningham RM. Adolescent suicide risk screening in the emergency department. Acad Emerg Med 2009; 16:1234-41. [PMID: 19845554 DOI: 10.1111/j.1553-2712.2009.00500.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Many adolescents who die by suicide have never obtained mental health services. In response to this, the National Strategy for Suicide Prevention recommends screening for elevated suicide risk in emergency departments (EDs). This cross-sectional study was designed to examine 1) the concurrent validity and utility of an adolescent suicide risk screen for use in general medical EDs and 2) the prevalence of positive screens for adolescent males and females using two different sets of screening criteria. METHODS Participants were 298 adolescents seeking pediatric or psychiatric emergency services (50% male; 83% white, 16% black or African American, 5.4% Hispanic). The inclusion criterion was age 13 to 17 years. Exclusion criteria were severe cognitive impairment, no parent or legal guardian present to provide consent, or abnormal vital signs. Parent or guardian consent and adolescent assent were obtained for 61% of consecutively eligible adolescents. Elevated risk was defined as 1) Suicidal Ideation Questionnaire-Junior [SIQ-JR] score of > or =31 or suicide attempt in the past 3 months or 2) alcohol abuse plus depression (Alcohol Use Disorders Identification Test-3 [AUDIT-3] score of > or =3, Reynolds Adolescent Depression Scale-2 [RADS-2] score of > or =76). The Beck Hopelessness Scale (BHS) and Problem Oriented Screening Instrument for Teenagers (POSIT) were used to ascertain concurrent validity. RESULTS Sixteen percent (n = 48) of adolescents screened positive for elevated suicide risk. Within this group, 98% reported severe suicide ideation or a recent suicide attempt (46% attempt and ideation, 10% attempt only, 42% ideation only) and 27% reported alcohol abuse and depression. Nineteen percent of adolescents who screened positive presented for nonpsychiatric reasons. One-third of adolescents with positive screens were not receiving any mental health or substance use treatment. Demonstrating concurrent validity, the BHS scores of adolescents with positive screens and the POSIT scores of those with positive screens due to alcohol abuse and depression indicated substantial impairment. The addition of alcohol abuse with co-occurring depression as a positive screen criterion did not result in improved case identification. Among the subgroup screening positive due to depression plus alcohol abuse, all but one (>90%) also reported severe suicide ideation and/or a recent suicide attempt. This subgroup (approximately 17% of adolescents who screened positive) also reported significantly more impulsivity than other adolescents who screened positive. CONCLUSIONS The suicide risk screen showed evidence of concurrent validity. It also demonstrated utility in identifying 1) adolescents at elevated risk for suicide who presented to the ED with unrelated medical concerns and 2) a subgroup of adolescents who may be at highly elevated risk for suicide due to the combination of depression, alcohol abuse, suicidality, and impulsivity.
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Affiliation(s)
- Cheryl A King
- Department of Psychiatry, University of Michigan, and the University of Michigan Depression Center, Ann Arbor, MI, USA.
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Webb L. Counting girls out: A review of suicide among young substance misusers and gender difference implications in the evaluation of risk. DRUGS-EDUCATION PREVENTION AND POLICY 2009. [DOI: 10.1080/09687630701801404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tang TC, Ko CH, Yen JY, Lin HC, Liu SC, Huang CF, Yen CF. Suicide and its association with individual, family, peer, and school factors in an adolescent population in southern Taiwan. Suicide Life Threat Behav 2009; 39:91-102. [PMID: 19298154 DOI: 10.1521/suli.2009.39.1.91] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A representative sample of 10,233 adolescent students was recruited to examine the rate of suicidal attempt and its correlates in the adolescents living in southern Taiwan. Five questions from the Kiddie Schedule for Affective Disorders and Schizophrenia (Kiddie-SADS-E) were used to inquire about the participants' suicidality. The associations between suicidal attempt and multidimensional factors were examined by using logistic regression analysis: 9.1% of the participants reported a suicidal attempt in the preceding year. Female gender, low self-esteem, weekly alcohol use, illicit drugs use, depression, high family conflict, low maternal education level, poor family function, low connectedness to school, low rank, poor feeling in peer group, and drop out from school were associated with adolescent suicidal attempt. The rate of suicidal attempt was found to be high in Taiwanese adolescents, and multidimensional factors were correlated to adolescent suicidal attempt.
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Affiliation(s)
- Tze-Chun Tang
- Department of Psychiatry, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Arria AM, O'Grady KE, Caldeira KM, Vincent KB, Wilcox HC, Wish ED. Suicide ideation among college students: a multivariate analysis. Arch Suicide Res 2009; 13:230-46. [PMID: 19590997 PMCID: PMC2709750 DOI: 10.1080/13811110903044351] [Citation(s) in RCA: 194] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The goal of this study was to develop a multi-dimensional model that might explain suicide ideation among college students. Face-to-face interviews were conducted with 1,249 first-year college students. An estimated 6%(wt) of first-year students at this university had current suicide ideation. Depressive symptoms, low social support, affective dysregulation, and father-child conflict were each independently associated with suicide ideation. Only 40%(wt) of individuals with suicide ideation were classified as depressed according to standard criteria. In the group who reported low levels of depressive symptoms, low social support and affective dysregulation were important predictors of suicide ideation. Alcohol use disorder was also independently associated with suicide ideation, while parental conflict was not. Results highlight potential targets for early intervention among college students.
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Affiliation(s)
- Amelia M Arria
- Center for Substance Abuse Research, University of Maryland, College Park, 4321 Hartwick Rd., College Park, MD 20740, USA .
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Abstract
Substance use disorders are among the most frequent psychiatric disorders found in suicides. In psychological autopsy studies between 19% and 63% of all suicides suffered from substance use disorders, mostly from alcohol use disorders. Suicide risk is highly increased in substance use disorders, particularly in alcohol use disorders, and in co-morbid alcoholism and depression. So far, some risk factors for suicide have been identified in alcoholism. Nevertheless, various questions about the relationship between substance use disorders and suicide remain open, which indicate directions for future research.
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Affiliation(s)
- Barbara Schneider
- Center of Psychiatry, Department for Psychiatry, Psychosomatics, and Psychotherapy, Goethe-University, Frankfurt/Main, Gernany.
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Goldstein BI, Strober MA, Birmaher B, Axelson DA, Esposito-Smythers C, Leonard H, Hunt J, Gill MK, Iyengar S, Grimm C, Yang M, Ryan ND, Keller MB, Keller MB. Substance use disorders among adolescents with bipolar spectrum disorders. Bipolar Disord 2008; 10:469-78. [PMID: 18452443 PMCID: PMC2768482 DOI: 10.1111/j.1399-5618.2008.00584.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We set out to examine the prevalence and correlates of substance use disorders (SUD) in a large sample of adolescents with bipolar disorder (BP). METHODS Subjects were 249 adolescents ages 12 to 17 years old who fulfilled DSM-IV criteria for bipolar I disorder [(BPI), n = 154], or bipolar II disorder [(BPII), n = 25], or operationalized criteria for BP not otherwise specified [(BP NOS), n = 70], via the Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS). As part of the multi-site Course and Outcome of Bipolar Youth study, demographic, clinical, and family history variables were measured via intake clinical interview with the subject and a parent/guardian. RESULTS The lifetime prevalence of SUD among adolescents with BP was 16% (40/249). Results from univariate analyses indicated that subjects with, as compared to without, SUD were significantly less likely to be living with both biological parents, and that there was significantly greater lifetime prevalence of physical abuse, sexual abuse, suicide attempts, conduct disorder, and posttraumatic stress disorder among subjects with SUD. Subjects with SUD reported significantly greater 12-month prevalence of trouble with police, and females with SUD reported significantly greater 12-month prevalence of pregnancy and abortion. Significant predictors of SUD in a logistic regression model included living with both biological parents (lower prevalence), conduct disorder and suicide attempts (increased prevalence). In logistic regression analyses controlling for demographic differences and conduct disorder, SUD remained significantly associated with trouble with police, whereas the association of SUD with pregnancy and abortion was reduced to a statistical trend. The prevalence of SUD was not significantly different among child- versus adolescent-onset BP subjects. CONCLUSIONS SUD among adolescents with BP is associated with profound hazards including suicide attempts, trouble with police, and teenage pregnancy and abortion.
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Affiliation(s)
- Benjamin I. Goldstein
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Michael A. Strober
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA
| | - Boris Birmaher
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - David A. Axelson
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Henrietta Leonard
- Department of Psychiatry and Butler Hospital, Brown University School of Medicine, Providence, RI
| | - Jeffrey Hunt
- Department of Psychiatry and Butler Hospital, Brown University School of Medicine, Providence, RI
| | - Mary Kay Gill
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, PA
| | - Colleen Grimm
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Mei Yang
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Neal D. Ryan
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Martin B. Keller
- Department of Psychiatry and Butler Hospital, Brown University School of Medicine, Providence, RI
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Zouk H, McGirr A, Lebel V, Benkelfat C, Rouleau G, Turecki G. The effect of genetic variation of the serotonin 1B receptor gene on impulsive aggressive behavior and suicide. Am J Med Genet B Neuropsychiatr Genet 2007; 144B:996-1002. [PMID: 17510950 DOI: 10.1002/ajmg.b.30521] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Impulsive-aggressive behaviors (IABs) are regarded as possible suicide intermediate phenotypes, mediating the relationship between genes and suicide outcome. In this study, we aimed to investigate the putative relationship between genetic variation at the 5-HT1B receptor gene, which in animal models is involved in impulse-aggression control, IABs, and suicide risk. We investigated the relationship of variation at five 5-HT1B loci and IAB measures in a sample of 696 subjects, including 338 individuals who died by suicide and 358 normal epidemiological controls. We found that variation at the 5-HT1B promoter A-161T locus had a significant effect on levels of IABs, as measured by the Buss-Durkee Hostility Inventory (BDHI). Suicides also differed from controls in distribution of variants at this locus. The A-161T locus, which seems to impact 5-HT1B transcription, could play a role in suicide predisposition by means of mediating impulsive-aggressive behaviors.
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Affiliation(s)
- Hana Zouk
- McGill Group for Suicide Studies, Douglas Hospital Research Center, McGill University, Montreal, Canada
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Kalyoncu A, Mırsal H, Pektaş Ö, Tan D, Beyazyürek M. Heroin-dependent patients attempting and not attempting suicide: a comparison. Acta Neuropsychiatr 2007; 19:297-303. [PMID: 26952942 DOI: 10.1111/j.1601-5215.2007.00192.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Heroin dependence is a serious illness associated with an increased risk of suicidal behaviour. There are many risk factors associated with heroin dependence. The current study examined the sociodemographic and clinical characteristics of a number of young adult heroin-dependent patients who had attempted suicide. METHODS We studied a group of 108 young adult heroin-dependent patients in our in-patient clinics. All diagnoses were made according to DSM-IV diagnostic criteria using the Structured Clinical Interview for DSM-IV Axis I-II Disorders (SCID-I, II). The age range of patients was 18-24 years. Their substance abuse histories were assessed by semistructured interview. The Addiction Severity Index (ASI) was administered to all the patients. Serum total cholesterol and high-density lipoprotein cholesterol (HDL-C) levels were routinely measured. In the statistical analyses, Student's t test, and chi-squared tests were applied. RESULTS Of the 108 heroin-dependent patients, 40 (37.0%) had histories of attempted suicide. There was a statistically significant difference in the age at which heroin use had commenced between female attempters [mean = 16.82, standard deviation (SD) = 3.06] and nonattempters (mean = 18.32, SD = 2.68, t= 2.25, P < 0.05). Both the male (mean = 33.35, SD = 4.05) and the female (mean = 28.00, SD = 5.36) attempters had significantly higher ASI scores than did the male (mean = 20.16, SD = 3.80) and the female (mean = 18.88, SD = 4.14) nonattempters (t= 14.34, P < 0.001; t= 5.25, P < 0.001, respectively). A significant difference in total cholesterol (mean = 131.8, SD = 19.3; mean = 172.2, SD = 21.3, t= 3.9, P < 0.05) and HDL-C (mean = 30.9, SD = 1.0 and mean = 54.8, SD = 13.7; t= 5.1, P < 0.05) levels between the group of violent and nonviolent suicide attempters was revealed. CONCLUSIONS These results suggest that suicide attempts in young adult heroin-dependent patients are associated with more profound biopsychosocial pathology and decreased serum cholesterol levels. In particular, low levels of total cholesterol and HDL-C might indeed be associated with violent suicide attempts in young heroin-dependent patients.
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Affiliation(s)
- Ayhan Kalyoncu
- 1Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Hasan Mırsal
- 1Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Özkan Pektaş
- 1Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Devran Tan
- 1Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Mansur Beyazyürek
- 1Department of Psychiatry, Faculty of Medicine, Maltepe University, Istanbul, Turkey
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Kerr DCR, Washburn JJ, Feingold A, Kramer AC, Ivey AZ, King CA. Sequelae of Aggression in Acutely Suicidal Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2007; 35:817-30. [PMID: 17534711 DOI: 10.1007/s10802-007-9132-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2006] [Accepted: 03/28/2007] [Indexed: 11/29/2022]
Abstract
The consequences of aggression on problem course and suicide risk were examined in 270 acutely suicidal adolescents (ages 12-17 years; 184 girls). Participants were assessed during psychiatric hospitalization (T1), 6-months post-hospitalization (T2), and 15 or more months post-hospitalization (T3). Study variables included self- and parent-reported aggression; self-reported internalizing symptoms, suicidal ideation, suicide attempt, and adverse events; and clinician-rated suicidal behavior. Aggression was not directly related to suicide attempt concurrently or prospectively. However, among more aggressive youth, internalizing symptoms were more predictive of T3 suicide attempt than among less aggressive youth. T1 aggression predicted aggressive incidents and the likelihood of incarceration prior to T3. Two-level hierarchical linear modeling indicated that self-reported aggression and internalizing problems were linked in terms of severity and rates of decline over time. Overall, parent-reported aggression was negatively associated with suicidal ideation. Findings highlight (a) the continuity and consequences of aggression, (b) a possible role of aggression in worsening suicide risk factors and potentiating suicide attempt, and (c) the importance of ongoing research on subtypes of suicidal adolescents.
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Miller M, Lippmann SJ, Azrael D, Hemenway D. Household Firearm Ownership and Rates of Suicide Across the 50 United States. ACTA ACUST UNITED AC 2007; 62:1029-34; discussion 1034-5. [PMID: 17426563 DOI: 10.1097/01.ta.0000198214.24056.40] [Citation(s) in RCA: 145] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The current investigation explores the association between rates of household firearm ownership and suicide across the 50 states. Prior ecologic research on the relationship between firearm prevalence and suicide has been criticized for using problematic proxy-based, rather than survey-based, estimates of firearm prevalence and for failing to control for potential psychological risk factors for suicide. We address these two criticisms by using recently available state-level survey-based estimates of household firearm ownership, serious mental illness, and alcohol/illicit substance use and dependence. METHODS Negative binomial regression was used to assess the relationship between household firearm ownership rates and rates of firearm, nonfirearm, and overall suicide for both sexes and for four age groups. Analyses controlled for rates of poverty, urbanization, unemployment, mental illness, and drug and alcohol dependence and abuse. RESULTS US residents of all ages and both sexes are more likely to die from suicide when they live in areas where more households contain firearms. A positive and significant association exists between levels of household firearm ownership and rates of firearm and overall suicide; rates of nonfirearm suicide were not associated with levels of household firearm ownership. CONCLUSION Household firearm ownership levels are strongly associated with higher rates of suicide, consistent with the hypothesis that the availability of lethal means increases the rate of completed suicide.
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Miller M, Azrael D, Hepburn L, Hemenway D, Lippmann SJ. The association between changes in household firearm ownership and rates of suicide in the United States, 1981-2002. Inj Prev 2007; 12:178-82. [PMID: 16751449 PMCID: PMC2563517 DOI: 10.1136/ip.2005.010850] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To explore whether recent declines in household firearm prevalence in the United States were associated with changes in rates of suicide for men, women, and children. METHODS This time series study compares changes in suicide rates to changes in household firearm prevalence, 1981-2002. Multivariate analyses adjust for age, unemployment, per capita alcohol consumption, and poverty. Regional fixed effects controlled for cross sectional, time invariant differences among the four census regions. Standard errors of parameter estimates are adjusted to account for serial autocorrelation of observations over time. RESULTS Over the 22 year study period household firearm ownership rates declined across all four regions. In multivariate analyses, each 10% decline in household firearm ownership was associated with significant declines in rates of firearm suicide, 4.2% (95% CI 2.3% to 6.1%) and overall suicide, 2.5% (95% CI 1.4% to 3.6%). Changes in non-firearm suicide were not associated with changes in firearm ownership. The magnitude of the association between changes in household firearm ownership and changes in rates of firearm and overall suicide was greatest for children: for each 10% decline in the percentage of households with firearms and children, the rate of firearm suicide among children 0-19 years of age dropped 8.3% (95% CI 6.1% to 10.5%) and the rate of overall suicide dropped 4.1% (2.3% to 5.9%). CONCLUSION Changes in household firearm ownership over time are associated with significant changes in rates of suicide for men, women, and children. These findings suggest that reducing availability to firearms in the home may save lives, especially among youth.
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Affiliation(s)
- M Miller
- Harvard School of Public Health, Boston, MA, USA.
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Maremmani I, Pani PP, Canoniero S, Pacini M, Perugi G, Rihmer Z, Akiskal HS. Is the bipolar spectrum the psychopathological substrate of suicidality in heroin addicts? Psychopathology 2007; 40:269-77. [PMID: 17622705 DOI: 10.1159/000104742] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2005] [Accepted: 06/02/2006] [Indexed: 11/19/2022]
Abstract
BACKGROUND To describe the prevalence and the risk factors of suicidal ideation in a cohort of Italian opioid addicts presenting for treatment. METHOD Systematic cross-sectional clinical data on suicidal ideation, socio-demographic variables, psychiatric status, social adjustment, status and history of addiction in 616 patients were gathered. RESULTS Suicidal thoughts during the past week were reported by 29.1%. Suicidal thoughts were more frequent in patients with bipolar spectrum diagnoses (OR = 1.42) and in patients with depressive and aggressive symptoms (multiple R = 0.47). The odds of having suicidal thoughts were also higher for subjects receiving public welfare benefits (OR = 1.69), unemployed patients (OR = 1.37), those with early onset of heroin dependence (OR = 1.36), living alone (OR = 1.33), and experiencing problems in organizing social contacts and leisure time (OR = 1.28). CONCLUSION Current suicidal ideation was a common feature of patients with opioid addiction. Depression and hostility as part of the bipolar spectrum - in the context of early-onset drug dependence, work and social/leisure problems - appear independently associated with suicidal ideation. Given the elevated rates of completed suicide in heroin addiction, these data have implications for preventing suicide in patients with this type of addiction. Prospective data are needed to further address this important clinical and public health agenda.
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Affiliation(s)
- Icro Maremmani
- Santa Chiara University Hospital, Department of Psychiatry, University of Pisa, Pisa, Italy.
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Dougherty PA. Research Synthesis: Adolescent Suicide and Substance Abuse in the United States, 1990–2002. J Addict Nurs 2007. [DOI: 10.1080/10884600701334853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schwartz BS, Parker C, Glass TA, Hu H. Global environmental change: what can health care providers and the environmental health community do about it now? ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:1807-12. [PMID: 17185267 PMCID: PMC1764173 DOI: 10.1289/ehp.9313] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available "planetary health" metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations.
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Affiliation(s)
- Brian S Schwartz
- Department of Environmental Health Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA.
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