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Choi WS, Roh BR, Jon DI, Ryu V, Oh Y, Hong HJ. An exploratory study on spatiotemporal clustering of suicide in Korean adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:54. [PMID: 38730504 PMCID: PMC11088016 DOI: 10.1186/s13034-024-00745-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Adolescent suicides are more likely to form clusters than those of other age groups. However, the definition of a cluster in the space-time dimension has not been established, neither are the factors contributing to it well known. Therefore, this study aimed to identify space-time clusters in adolescent suicides in Korea and to examine the differences between clustered and non-clustered cases using novel statistical methods. METHODS From 2016 to 2020, the dates and locations, including specific addresses from which the latitude and longitude of all student suicides (aged 9-18 years) in Korea were obtained through student suicide reports. Sociodemographic characteristics of the adolescents who died by suicide were collected, and the individual characteristics of each student who died by suicide were reported by teachers using the Strengths and Difficulties Questionnaire (SDQ). Density-Based Spatial Clustering of Applications with Noise (DBSCAN) analysis was used to assess the clustering of suicides. RESULTS We identified 23 clusters through the data analysis of 652 adolescent suicides using DBSCAN. By comparing the size of each cluster, we identified 63 (9.7%) spatiotemporally clustered suicides among adolescents, and the temporal range of these clusters was 7-59 days. The suicide cluster group had a lower economic status than the non-clustered group. There were no significant differences in other characteristics between the two groups. CONCLUSION This study has defined the space-time cluster of suicides using a novel statistical method. Our findings suggest that when an adolescent suicide occurs, close monitoring and intervention for approximately 2 months are needed to prevent subsequent suicides. Future research using DBSCAN needs to involve a larger sample of adolescents from various countries to further corroborate these findings.
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Affiliation(s)
- Won-Seok Choi
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Beop-Rae Roh
- Department of Social Welfare, Pukyong National University, Busan, Republic of Korea
| | - Duk-In Jon
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170Beon-gil, Dongan-gu, Anyang, Gyeonggi-do, Republic of Korea
| | - Vin Ryu
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170Beon-gil, Dongan-gu, Anyang, Gyeonggi-do, Republic of Korea
| | - Yunhye Oh
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170Beon-gil, Dongan-gu, Anyang, Gyeonggi-do, Republic of Korea
| | - Hyun Ju Hong
- Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University, 22, Gwanpyeong-ro 170Beon-gil, Dongan-gu, Anyang, Gyeonggi-do, Republic of Korea.
- Hallym University Suicide and School Mental Health Institute, Anyang, Republic of Korea.
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Awaad R, Durrani Z, Quadri Y, Sifat MS, Hussein A, Kouser T, El-Gabalawy O, Rajeh N, Shareef S. Developing a Suicide Crisis Response Team in America: An Islamic Perspective. JOURNAL OF RELIGION AND HEALTH 2024; 63:985-1001. [PMID: 38245908 DOI: 10.1007/s10943-023-01993-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
Suicide is a critical public health issue in the United States, recognized as the tenth leading cause of death across all age groups (Centers for Disease Control and Prevention, 2020). Despite the Islamic prohibition on suicide, suicidal ideation and suicide mortality persist among Muslim populations. Recent data suggest that U.S. Muslim adults are particularly vulnerable, with a higher attempt history compared to respondents from other faith traditions. While the underlying reasons for this vulnerability are unclear, it is evident that culturally and religiously congruent mental health services can be utilized to steer suicide prevention, intervention, and postvention in Muslim communities across the United States. However, the development of Suicide Response toolkits specific to Muslim populations is currently limited. As a result, Muslim communities lack a detailed framework to appropriately respond in the event of a suicide tragedy. This paper aims to fill this gap in the literature by providing structured guidelines for the formation of a Crisis Response Team (CRT) through an Islamic lens. The CRT comprises of a group of individuals who are strategically positioned to respond to a suicide tragedy. Ideally, the team will include religious leaders, mental health professionals, healthcare providers, social workers, and community leaders. The proposed guidelines are designed to be culturally and religiously congruent and take into account the unique cultural and religious factors that influence Muslim communities' responses to suicide. By equipping key personnel in Muslim communities with the resources to intervene in an emergent situation, provide support to those affected, and mobilize community members to assist in prevention efforts, this model can help save lives and prevent future suicide tragedies in Muslim communities across the United States.
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Affiliation(s)
- Rania Awaad
- Department of Psychiatry and Behavioral Sciences, Muslim Mental Health and Islamic Psychology Lab, Stanford University School of Medicine, 401 Quarry Rd Ste 2114, MC 5723, Stanford, CA, 94305, USA.
- Maristan, 340 Annette Lane, Hayward, CA, 94541, USA.
| | - Zuha Durrani
- Department of Psychiatry, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Yasmeen Quadri
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, 94305-5101, USA
| | - Munjireen S Sifat
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
- Health Promotion Research Center, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Anwar Hussein
- Department of Psychology, The University of Akron, 290 E Buchtel Ave, Akron, OH, 44325, USA
| | - Taimur Kouser
- School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA, 94305-5101, USA
| | - Osama El-Gabalawy
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Neshwa Rajeh
- Department of Professional Studies, Northwestern University, 633 Clark Street, Evanston, IL, 60208, USA
| | - Sana Shareef
- School of Professional Studies, Department of Bioethics, Columbia University, 2970 Broadway, New York, NY, 10027, USA
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Bete T, Ali T, Misgana T, Negash A, Abraham T, Teshome D, Sirtsu A, Nigussie K, Amano A. Suicidal ideation and associated factors among pregnant women attending antenatal care at public hospitals of Harari regional state, eastern Ethiopia: A cross-sectional study. PLoS One 2024; 19:e0300417. [PMID: 38547179 PMCID: PMC10977762 DOI: 10.1371/journal.pone.0300417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Suicide is a global issue. It is the third responsible for death among the reproductive age group. Pregnancy is a complicated event and crucial in the life of a woman with considerable physiological, hormonal changes, social, and mental changes. However, third-world countries like Ethiopia have not been investigated well. Therefore, the study planned to assess the magnitude and factors associated with suicidal ideation. Furthermore, it will identify the role of hyperemesis gravidarum on suicidal ideation. METHOD A Cross-sectional study was employed for 543 pregnant participants attending antenatal care at Hiwot Fana Specialized University Hospital and Jugal General Hospital, Harari regional state, eastern Ethiopia from June 1 to August 1, 2022. The recruited participants were selected by systematic random sampling method. Suicide was assessed using Composite International Diagnostic by interview methods data collection. Epi data and STATA version 14.1 were used for data entry and analysis respectively. Candidate variables were entered into a multivariate logistic regression then those variables that have p-value < 0.05 were considered as significantly associated. RESULTS The magnitude of suicidal ideation in this study was found to be 11.15% at (95% CI: 8.75-14.11). Regarding the associated factor, unwanted pregnancy (AOR = 3.39: at 95% CI = 1.58-7.27), Hyperemesis gravidarum (AOR = 3.65: at 95% CI = 1.81-7.34), having depressive symptoms (AOR = 2.79: at 95% CI = 1.49-5.23), having anxiety symptoms (AOR = 3.37; at 95% CI = 1.69-6.68), experiencing intimate partner violence (AOR = 2.88: at 95% CI = 1.11-7.46), and having stress (AOR = 3.46; at 95% CI = 1.75-6.86) were significantly associated variable with suicidal ideation among pregnant women. CONCLUSION AND RECOMMENDATION This study revealed that suicidal ideation is common among pregnant women. Regarding the associated factors unwanted pregnancy, hyperemesis gravidarum, having depressive and anxiety symptoms, experiencing intimate partner violence, and stress were significantly associated with suicidal ideation. Thus, giving awareness and early screening and interferences for antenatal suicide should be warranted.
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Affiliation(s)
- Tilahun Bete
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Ali
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Misgana
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Teklu Abraham
- Department of Psychiatry, School Medicine, College of Health and Medical Sciences, Arsi University, Assella, Ethiopia
| | - Dekeba Teshome
- Department of Psychiatry, School Medicine, College of Health and Medical Sciences, Arsi University, Assella, Ethiopia
| | - Addisu Sirtsu
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdulkerim Amano
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Trinh E, Ivey-Stephenson AZ, Ballesteros MF, Idaikkadar N, Wang J, Stone DM. CDC Guidance for Community Assessment and Investigation of Suspected Suicide Clusters, United States, 2024. MMWR Suppl 2024; 73:8-16. [PMID: 38412115 PMCID: PMC10899086 DOI: 10.15585/mmwr.su7302a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
This report is the second of three reports in the MMWR supplement updating CDC's guidance for investigating and responding to suicide clusters. The first report, Background and Rationale - CDC Guidance for Assessing, Investigating, and Responding to Suicide Clusters, United States, 2024, describes an overview of suicide clusters, methods used to develop the supplement guidance, and intended use of the supplement reports. The final report, CDC Guidance for Community Response to Suicide Clusters, United States, 2024, describes how local public health and community leaders can develop a response plan for suicide clusters. This report provides updated guidance for the approach to assessing and investigating suspected suicide clusters. Specifically, this approach will guide lead agencies in determining whether a confirmed suicide cluster exists, what concerns are in the community, and what the specific characteristics are of the suspected or confirmed suicide cluster. The guidance in this report is intended to support and assist lead agencies and their community prepare for, assess, and investigate suicide clusters. The steps provided in this report can be adapted to the local context, culture, capacity, circumstances, and needs for each suspected suicide cluster.
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Affiliation(s)
- Eva Trinh
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Asha Z. Ivey-Stephenson
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Michael F. Ballesteros
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Nimi Idaikkadar
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Jing Wang
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
| | - Deborah M. Stone
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia
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Ivey-Stephenson AZ, Ballesteros MF, Trinh E, Stone DM, Crosby AE. CDC Guidance for Community Response to Suicide Clusters, United States, 2024. MMWR Suppl 2024; 73:17-26. [PMID: 38412137 PMCID: PMC10899085 DOI: 10.15585/mmwr.su7302a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
This is the third of three reports in the MMWR supplement that updates and expands CDC's guidance for assessing, investigating, and responding to suicide clusters based on current science and public health practice. The first report, Background and Rationale - CDC Guidance for Communities Assessing, Investigating, and Responding to Suicide Clusters, United States, 2024, describes an overview of suicide clusters, methods used to develop the supplement guidance, and intended use of the supplement reports. The second report, CDC Guidance for Community Assessment and Investigation of Suspected Suicide Clusters, United States, 2024, describes the potential methods, data sources, and analysis that communities can use to identify and confirm suspected suicide clusters and better understand the relevant issues. This report describes how local public health and community leaders can develop a response plan for suicide clusters. Specifically, the steps for responding to a suicide cluster include preparation, direct response, and action for prevention. These steps are not intended to be explicitly adopted but rather adapted into the local context, culture, capacity, circumstances, and needs for each suicide cluster.
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Ballesteros MF, Ivey-Stephenson AZ, Trinh E, Stone DM. Background and Rationale - CDC Guidance for Communities Assessing, Investigating, and Responding to Suicide Clusters, United States, 2024. MMWR Suppl 2024; 73:1-7. [PMID: 38412112 PMCID: PMC10899087 DOI: 10.15585/mmwr.su7302a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
To assist community leaders in public health, mental health, education, and other fields with developing a community response plan for suicide clusters or for situations that might develop into suicide clusters, in 1988, CDC published Recommendations for a Community Plan for the Prevention and Containment of Suicide Clusters (MMWR Suppl 1988;37[No. Suppl 6]:1-12). Since that time, the reporting and investigation of suicide cluster events has increased, and more is known about cluster risk factors, assessment, and identification. This supplement updates and expands CDC guidance for assessing, investigating, and responding to suicide clusters based on current science and public health practice. This report is the first of three in the MMWR supplement that describes an overview of suicide clusters, information about the other reports in this supplement, methods used to develop the supplement guidance, and the intended use of the supplement reports. The second report, CDC Guidance for Community Assessment and Investigation of Suspected Suicide Clusters - United States 2024, describes the potential methods, data sources and analysis that communities can use to identify and confirm suspected suicide clusters, and better understand the relevant issues. The final report, CDC Guidance for Community Response to Suicide Clusters - United States, 2024, describes how local public health and community leaders can develop a response plan for suicide clusters. The guidance in this supplement is intended as a conceptual framework that can be used by public health practitioners and state and local health departments to develop response plans for assessing and investigating suspected clusters that are tailored to the needs, resources, and cultural characteristics of their communities.
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Affiliation(s)
- Michael F Ballesteros
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | | | - Eva Trinh
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Deborah M Stone
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
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Hill NTM, Bouras H, Too LS, Perry Y, Lin A, Weiss D. Association between mental health workforce supply and clusters of high and low rates of youth suicide: An Australian study using suicide mortality data from 2016 to 2020. Aust N Z J Psychiatry 2023; 57:1465-1474. [PMID: 37608497 PMCID: PMC10619187 DOI: 10.1177/00048674231192764] [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] [Indexed: 08/24/2023]
Abstract
OBJECTIVE To examine the association between mental health workforce supply and spatial clusters of high versus low incidence of youth suicide. METHODS A cross-sectional analysis of spatial suicide clusters in young Australians (aged 10-25) from 2016 to 2020 was conducted using the scan statistic and suicide data from the National Coronial Information System. Mental health workforce was extracted from the 2020 National Health Workforce Dataset by local government areas. The Geographic Index of Relative Supply was used to estimate low and moderate-to-high mental health workforce supply for clusters characterised by a high and low incidence of suicide (termed suicide hotspots and coldspots, respectively). Univariate and multivariate logistic regression was used to determine the association between suicide clusters and a range of sociodemographic characteristics including mental health workforce supply. RESULTS Eight suicide hotspots and two suicide coldspots were identified. The multivariate analysis showed low mental health workforce supply was associated with increased odds of being involved in a suicide hotspot (adjusted odds ratio = 8.29; 95% confidence interval = 5.20-13.60), followed by residential remoteness (adjusted odds ratio = 2.85; 95% confidence interval = 1.68-4.89), and illicit drug consumption (adjusted odds ratio = 1.97; 1.24-3.11). Both coldspot clusters occurred in areas with moderate-to-high mental health workforce supply. CONCLUSION Findings highlight the potential risk and protective roles that mental health workforce supply may play in the spatial distributions of youth suicide clusters. These findings have important implications for the provision of postvention and the prevention of suicide clusters.
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Affiliation(s)
- NTM Hill
- Telethon Kids Institute, Nedlands, WA, Australia
- Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - H Bouras
- Telethon Kids Institute, Nedlands, WA, Australia
| | - LS Too
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Y Perry
- Telethon Kids Institute, Nedlands, WA, Australia
- Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia
| | - A Lin
- Telethon Kids Institute, Nedlands, WA, Australia
- Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia
| | - D Weiss
- Telethon Kids Institute, Nedlands, WA, Australia
- Curtin School of Population Health, Curtin University, Bentley, WA, Australia
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Lu FW, Conway E, Liang YL, Chen YY, Gunnell D, Chang SS. Space-time self-harm and suicide clusters in two cities in Taiwan. Epidemiol Psychiatr Sci 2023; 32:e37. [PMID: 37258458 DOI: 10.1017/s2045796023000513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
AIMS Suicidal acts may cluster in time and space and lead to community concerns about further imitative suicidal episodes. Although suicide clusters have been researched in previous studies, less is known about the clustering of non-fatal suicidal behaviour (self-harm). Furthermore, most previous studies used crude temporal and spatial information, e.g., numbers aggregated by month and residence area, for cluster detection analysis. This study aimed to (i) identify space-time clusters of self-harm and suicide using daily incidence data and exact address and (ii) investigate the characteristics of cluster-related suicidal acts. METHODS Data on emergency department presentations for self-harm and suicide deaths in Taipei City and New Taipei City, Taiwan, were used in this study. In all-age and age-specific analyses, self-harm and suicide clusters were identified using space-time permutation scan statistics. A cut-off of 0.10 for the p value was used to identify possible clusters. Logistic regression was used to investigate the characteristics associated with cluster-related episodes. RESULTS A total of 5,291 self-harm episodes and 1,406 suicides in Taipei City (2004-2006) and 20,531 self-harm episodes and 2,329 suicides in New Taipei City (2012-2016) were included in the analysis. In the two cities, two self-harm clusters (n [number of self-harm episodes or suicide deaths in the cluster] = 4 and 8 in Taipei City), four suicide clusters (n = 3 in Taipei City and n = 4, 11 and 4 in New Taipei City) and two self-harm and suicide combined clusters (n = 4 in Taipei City and n = 8 in New Taipei City) were identified. Space-time clusters of self-harm, suicide, and self-harm and suicide combined accounted for 0.05%, 0.59%, and 0.08% of the respective groups of suicidal acts. Cluster-related episodes of self-harm and suicide were more likely to be male (adjusted odds ratio [aOR] = 2.22, 95% confidence interval [CI] 1.26, 3.89) and young people aged 10-29 years (aOR = 2.72, 95% CI 1.43, 5.21) than their cluster-unrelated counterparts. CONCLUSIONS Space-time clusters of self-harm, suicide, and self-harm and suicide combined accounted for a relatively small proportion of suicidal acts and were associated with some sex/age characteristics. Focusing on suicide deaths alone may underestimate the size of some clusters and/or lead to some clusters being overlooked. Future research could consider combining self-harm and suicide data and use social connection information to investigate possible clusters of suicidal acts.
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Affiliation(s)
- Fang-Wen Lu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Erica Conway
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ya-Lun Liang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei, Taiwan
- Institute of Public Health and Department of Public Health, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - David Gunnell
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK
- National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston National Health Service Foundation Trust, Bristol, UK
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Platt JM, Pamplin JR, Gimbrone C, Rutherford C, Kandula S, Olfson M, Gould MS, Martínez-Alés G, Shaman J, Keyes K. Racial Disparities in Spatial and Temporal Youth Suicide Clusters. J Am Acad Child Adolesc Psychiatry 2022; 61:1131-1140.e5. [PMID: 35031449 PMCID: PMC9271532 DOI: 10.1016/j.jaac.2021.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Deaths by suicide correlate both spatially and temporally, leading to suicide clusters. This study aimed to estimate racial patterns in suicide clusters since 2000. METHOD Data from the US National Vital Statistics System included all International Classification of Diseases, Tenth Revision (ICD-10)-coded suicide cases from 2000-2019 among American Indian/Alaska Native (AI/AN), Asian/Pacific Islander (A/PI), Black, or White youth and young adults, aged 5-34 years. We estimated age, period, and cohort (APC) trends and identified spatiotemporal clusters using the SaTScan space-time statistic, which identified lower- and higher-than-expected suicide rates (cold and hot clusters) in a prespecified area (150 km) and time interval (15 months). We also calculated the average proportion of deaths by suicide contained in clusters, to quantify the relative importance of spatiotemporal patterning as a driver of overall suicide rates. RESULTS From 2010-2019, suicide rates increased from between 37% among AI/AN (95% CI = 1.22, 1.55) to 81% among A/PI (95% CI = 1.65, 2.01) groups. Suicide clusters accounted for 0.8%-10.3% of all suicide deaths, across racial groups. Since 2000, the likelihood of detecting cluster increased over time, with considerable differences in the number of clusters in each racial group (4 among AI/AN to 72 among White youth). Among Black youth and young adults, 27 total clusters were identified. Hot clusters were concentrated in southeastern and mid-Atlantic counties. CONCLUSION Suicide rates and clusters in youth and young adults have increased in the past 2 decades, requiring attention from policy makers, clinicians, and caretakers. Racially distinct patterns highlight opportunities to tailor individual- and population-level prevention efforts to prevent suicide deaths in emerging high-risk groups.
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Affiliation(s)
| | - John R Pamplin
- Center for Urban Science and Progress, New York University, New York; Grossman School of Medicine, New York University, New York
| | | | | | | | - Mark Olfson
- Mailman School of Public Health, Columbia University, New York; Columbia University Irving Medical Center and New York State Psychiatric Institute, New York
| | - Madelyn S Gould
- Mailman School of Public Health, Columbia University, New York; Columbia University Irving Medical Center and New York State Psychiatric Institute, New York
| | | | - Jeffrey Shaman
- Mailman School of Public Health, Columbia University, New York
| | - Katherine Keyes
- Mailman School of Public Health, Columbia University, New York
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Benson R, Rigby J, Brunsdon C, Cully G, Too LS, Arensman E. Quantitative Methods to Detect Suicide and Self-Harm Clusters: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095313. [PMID: 35564710 PMCID: PMC9099648 DOI: 10.3390/ijerph19095313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022]
Abstract
Suicide and self-harm clusters exist in various forms, including point, mass, and echo clusters. The early identification of clusters is important to mitigate contagion and allocate timely interventions. A systematic review was conducted to synthesize existing evidence of quantitative analyses of suicide and self-harm clusters. Electronic databases including Medline, Embase, Web of Science, and Scopus were searched from date of inception to December 2020 for studies that statistically analyzed the presence of suicide or self-harm clusters. Extracted data were narratively synthesized due to heterogeneity among the statistical methods applied. Of 7268 identified studies, 79 were eligible for narrative synthesis. Most studies quantitatively verified the presence of suicide and self-harm clusters based on the scale of the data and type of cluster. A Poisson-based scan statistical model was found to be effective in accurately detecting point and echo clusters. Mass clusters are typically detected by a time-series regression model, although limitations exist. Recently, the statistical analysis of suicide and self-harm clusters has progressed due to advances in quantitative methods and geospatial analytical techniques, most notably spatial scanning software. The application of such techniques to real-time surveillance data could effectively detect emerging clusters and provide timely intervention.
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Affiliation(s)
- Ruth Benson
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
- Correspondence:
| | - Jan Rigby
- National Centre for Geocomputation, Maynooth University, W23 F2H6 Maynooth, Ireland; (J.R.); (C.B.)
| | - Christopher Brunsdon
- National Centre for Geocomputation, Maynooth University, W23 F2H6 Maynooth, Ireland; (J.R.); (C.B.)
| | - Grace Cully
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
| | - Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia;
| | - Ella Arensman
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
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Dombrovski AY, Hallquist MN. Search for solutions, learning, simulation, and choice processes in suicidal behavior. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2022; 13:e1561. [PMID: 34008338 PMCID: PMC9285563 DOI: 10.1002/wcs.1561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/06/2021] [Accepted: 04/07/2021] [Indexed: 12/25/2022]
Abstract
Suicide may be viewed as an unfortunate outcome of failures in decision processes. Such failures occur when the demands of a crisis exceed a person's capacity to (i) search for options, (ii) learn and simulate possible futures, and (iii) make advantageous value-based choices. Can individual-level decision deficits and biases drive the progression of the suicidal crisis? Our overview of the evidence on this question is informed by clinical theory and grounded in reinforcement learning and behavioral economics. Cohort and case-control studies provide strong evidence that limited cognitive capacity and particularly impaired cognitive control are associated with suicidal behavior, imposing cognitive constraints on decision-making. We conceptualize suicidal ideation as an element of impoverished consideration sets resulting from a search for solutions under cognitive constraints and mood-congruent Pavlovian influences, a view supported by mostly indirect evidence. More compelling is the evidence of impaired learning in people with a history of suicidal behavior. We speculate that an inability to simulate alternative futures using one's model of the world may undermine alternative solutions in a suicidal crisis. The hypothesis supported by the strongest evidence is that the selection of suicide over alternatives is facilitated by a choice process undermined by randomness. Case-control studies using gambling tasks, armed bandits, and delay discounting support this claim. Future experimental studies will need to uncover real-time dynamics of choice processes in suicidal people. In summary, the decision process framework sheds light on neurocognitive mechanisms that facilitate the progression of the suicidal crisis. This article is categorized under: Economics > Individual Decision-Making Psychology > Emotion and Motivation Psychology > Learning Neuroscience > Behavior.
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Affiliation(s)
| | - Michael N. Hallquist
- Department of Psychology and NeuroscienceUniversity of North CarolinaChapel HillNorth CarolinaUSA
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Astrup H, Myhre MØ, Kildahl AT, Walby FA. Suicide After Contact With Child and Adolescent Mental Health Services-A National Registry Study. Front Psychiatry 2022; 13:886070. [PMID: 35615447 PMCID: PMC9124860 DOI: 10.3389/fpsyt.2022.886070] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research has shown a strong association between suicide and mental disorders, and people in contact with services for mental health and substance use are known to be at high risk of suicide. Still, few studies have previously described suicide among young people in contact with Child and Adolescent Mental Health Services. AIM The aim of this study is to examine the prevalence of contact and suicide rates by gender and age groups, and to describe patient demographics and service utilization in secondary mental health services. METHODS All young people in contact with Child and Adolescent Mental Health Services in the year prior to death in the period 2008-2018 were identified by linking the Norwegian Cause of Death Registry and the Norwegian Patient Registry. We estimated the prevalence of contact and suicide rates among those with and without contact, by gender and age groups. Characteristics of treatment contact were compared between boys and girls. Variables with significant differences were entered into a multivariate logistic regression model using gender as an outcome. RESULTS More girls (39.7%) than boys (11.8%) had contact with Child and Adolescent Mental Health Services in the year prior to death. Among girls, suicide rates per 100,000 patients increased linearly in the age groups 10-13, 14-16, and 17-19 years: 5, 22, and 38 per 100,000 patients, respectively. Among boys, the suicide rate increased sharply from 7 per 100,000 patients in the age group 14-16 years to 40 per 100,000 patients in the 17-19-year-old group. In the age-adjusted multivariate model, boys were 4.07 (1.22-14.44, p = 0.024) times more likely to have terminated contact at the time of death. CONCLUSION This study shows gender differences in both suicide rates and service utilization among young people in contact with Child and Adolescent Mental Health Services before suicide, and future studies should focus on identifying the causes of these gender differences in service contact.
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Affiliation(s)
- Helene Astrup
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Martin Ø Myhre
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anine T Kildahl
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Fredrik A Walby
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Torok M, Konings P, Passioura J, Chen NA, Hewett M, Phillips M, Burnett A, Shand F, Christensen H. Spatial Errors in Automated Geocoding of Incident Locations in Australian Suicide Mortality Data. Epidemiology 2021; 32:896-903. [PMID: 34310446 DOI: 10.1097/ede.0000000000001403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is increasing interest in the spatial analysis of suicide data to identify high-risk (often public) locations likely to benefit from access restriction measures. The identification of such locations, however, relies on accurately geocoded data. This study aims to examine the extent to which common completeness and positional spatial errors are present in suicide data due to the underlying geocoding process. METHODS Using Australian suicide mortality data from the National Coronial Information System for the period of 2008-2017, we compared the custodian automated geocoding process to an alternate multiphase process. Descriptive and kernel density cluster analyses were conducted to ascertain data completeness (address matching rates) and positional accuracy (distance revised) differences between the two datasets. RESULTS The alternate geocoding process initially improved address matching from 67.8% in the custodian dataset to 78.4%. Additional manual identification of nonaddress features (such as cliffs or bridges) improved overall match rates to 94.6%. Nearly half (49.2%) of nonresidential suicide locations were revised more than 1,000 m from data custodian coordinates. Spatial misattribution rates were greatest at the smallest levels of geography. Kernel density maps showed clear misidentification of hotspots relying solely on autogeocoded data. CONCLUSION Suicide incidents that occur at nonresidential addresses are being erroneously geocoded to centralized fall-back locations in autogeocoding processes, which can lead to misidentification of suicide clusters. Our findings provide insights toward defining the nature of the problem and refining geocoding processes, so that suicide data can be used reliably for the detection of suicide hotspots. See video abstract at, http://links.lww.com/EDE/B862.
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Affiliation(s)
- Michelle Torok
- From the Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Paul Konings
- National Centre for Geographic Resources & Analysis in Primary Health Care, Research School of Population Health, Australian National University, Canberra, Australia
| | - Jason Passioura
- National Centre for Geographic Resources & Analysis in Primary Health Care, Research School of Population Health, Australian National University, Canberra, Australia
| | - Nicole A Chen
- Orygen Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Michael Hewett
- National Centre for Geographic Resources & Analysis in Primary Health Care, Research School of Population Health, Australian National University, Canberra, Australia
| | - Matthew Phillips
- From the Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Alexander Burnett
- From the Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Fiona Shand
- From the Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Helen Christensen
- From the Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
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Wasserman D, Carli V, Iosue M, Javed A, Herrman H. Suicide prevention in childhood and adolescence: a narrative review of current knowledge on risk and protective factors and effectiveness of interventions. Asia Pac Psychiatry 2021; 13:e12452. [PMID: 33646646 DOI: 10.1111/appy.12452] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/28/2021] [Accepted: 02/15/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Suicide is a global mental health problem for people of all ages. While rates of suicide in children and adolescents are reported as lower than those in older populations worldwide, they represent the third leading cause of death in 15-19-year-olds. The rates are higher among boys than girls worldwide, though the death rates for girls exceed those for boys in Bangladesh, China, India, and Nepal. There has been a general decrease in adolescent suicide rates over recent decades. However, increases are reported in South East Asia as well as South America over the same time period. METHODS A narrative review method has been used to summarize current knowledge about risk and protective factors for suicide among children and adolescents and to discuss evidence-based strategy for suicide prevention in this age group. RESULTS Identified suicide risk and protective factors for children and adolescents largely overlap with those for adults. Nevertheless, developmental characteristics may strengthen the impact of some factors, such as decision-making style, coping strategies, family and peer relationships, and victimization. The implementation of evidence-based suicide preventive strategies is needed. Restricting access to lethal means, school-based awareness and skill training programs, and interventions delivered in clinical and community settings have been proven effective. The effectiveness of gatekeeper training and screening programs in reducing suicidal ideation and behavior is unproven but widely examined in selected settings. DISCUSSION Since most studies have been conducted in western countries, future research should assess the effectiveness of these promising strategies in different cultural contexts. The use of more rigorous study designs, the use of both short- and long-term follow-up evaluations, the larger inclusion of individuals belonging to vulnerable groups, the evaluation of online intervention, and the analysis of programs' cost-effectiveness are also required.
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Affiliation(s)
- Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.,Section on Suicidology, World Psychiatric Association (WPA), Geneva, Switzerland
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.,Section on Suicidology, World Psychiatric Association (WPA), Geneva, Switzerland
| | - Miriam Iosue
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.,Section on Suicidology, World Psychiatric Association (WPA), Geneva, Switzerland
| | - Afzal Javed
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Helen Herrman
- Orygen and Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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Reen GK, Bailey J, McGuigan L, Bloodworth N, Nawaz RF, Vincent C. Environmental changes to reduce self-harm on an adolescent inpatient psychiatric ward: an interrupted time series analysis. Eur Child Adolesc Psychiatry 2021; 30:1173-1186. [PMID: 32719945 PMCID: PMC8310847 DOI: 10.1007/s00787-020-01607-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/20/2020] [Indexed: 12/17/2022]
Abstract
Existing interventions to reduce self-harm in adolescents admitted to psychiatric wards are usually focused on individual psychological treatments. However, the immediate ward environment in which treatment takes place is an important factor in the success of the treatment and can also influence the likelihood of self-harming behaviours. The aim of the current study was to evaluate changes made to a psychiatric ward environment on incidence of self-harm in adolescents. A quasi-experimental interrupted time series study was conducted on one child and adolescent psychiatric ward. An intervention was developed alongside staff and patients to address the high incidence of self-harm on weekday evenings on the ward. The intervention components involved adding a regular twilight shift (3-11 pm) for nursing staff and introducing a structured evening activity programme on the ward. A segmented regression analysis of an interrupted time series found that the rate of self-harm per 100 bed days was already declining at baseline and continued to decline post-intervention, but the rate of decline was not significant (p = 0.415). However, the proportion of patients self-harming was increasing at baseline and significantly reduced post-intervention (p = 0.001), and this reduction was significantly larger in the evenings (p = 0.004) compared to other times of day (p = 0.09). A tailored intervention targeting the psychiatric ward environment helped to reduce the proportion of adolescents self-harming on the ward. An interrupted time series analysis should be considered for future interventions making changes to health systems over time.
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Affiliation(s)
- Gurpreet K Reen
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK.
- Oxford Healthcare Improvement Centre, Oxford Health NHS Foundation Trust, Oxford, OX3 7JX, UK.
| | - Jill Bailey
- Oxford Healthcare Improvement Centre, Oxford Health NHS Foundation Trust, Oxford, OX3 7JX, UK
| | - Lorna McGuigan
- Oxford Healthcare Improvement Centre, Oxford Health NHS Foundation Trust, Oxford, OX3 7JX, UK
| | - Natasha Bloodworth
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
- Oxford Healthcare Improvement Centre, Oxford Health NHS Foundation Trust, Oxford, OX3 7JX, UK
| | - Rasanat Fatima Nawaz
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
- Patient Safety Collaborative, Oxford Academic Health Science Network, Oxford, OX4 4GA, UK
| | - Charles Vincent
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
- Oxford Healthcare Improvement Centre, Oxford Health NHS Foundation Trust, Oxford, OX3 7JX, UK
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Sa J, Cho BY, Chaput JP, Chung J, Choe S, Gazmararian JA, Shin JC, Lee CG, Navarrette G, Han T. Sex and racial/ethnic differences in the prevalence of overweight and obesity among U.S. college students, 2011-2015. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:413-421. [PMID: 31689167 DOI: 10.1080/07448481.2019.1679814] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 08/08/2019] [Accepted: 10/06/2019] [Indexed: 06/10/2023]
Abstract
To investigate sex and racial/ethnic differences in overweight and obesity in college students. Participants: A nationally representative sample of 319,342 U.S. college students (mean age = 20.4 years; 67.7% female) from Fall 2011 to Spring 2015. Methods: A secondary data analysis of multi-year cross-sectional data was performed. Multiple logistic regression was used to examine factors (e.g. cumulative grade average, year in school, and living place) associated with overweight and obesity determined from BMI calculated by self-reported height and weight. Results: The prevalence of overweight and obesity was significantly higher for both sexes in Spring 2015 than in Fall 2011. Significant differences were found in overweight and obesity by sex and race/ethnicity. Higher adjusted odds ratios for overweight and obesity were observed for men, blacks, and Hispanics (compared to whites). Asians had the lowest adjusted odds of overweight and obesity. Conclusions: Intervention strategies for the prevention and management of overweight and obesity in U.S. college students should consider sex and racial/ethnic inequalities.
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Affiliation(s)
- Jaesin Sa
- College of Education and Health Sciences, Touro University, Vallejo, CA, USA
| | - Beom-Young Cho
- Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jean-Philippe Chaput
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Joon Chung
- Division of Sleep and Circadian Disorders, Harvard Medical School, Boston, MA, USA
- Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Siyoung Choe
- Department of Kinesiology and Health, Miami University, Oxford, OH, USA
| | | | - Jong Cheol Shin
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Chung Gun Lee
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea
| | - Gabriel Navarrette
- College of Education and Health Sciences, Touro University, Vallejo, CA, USA
| | - Tiffany Han
- College of Education and Health Sciences, Touro University, Vallejo, CA, USA
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Mueller AS, Abrutyn S, Pescosolido B, Diefendorf S. The Social Roots of Suicide: Theorizing How the External Social World Matters to Suicide and Suicide Prevention. Front Psychol 2021; 12:621569. [PMID: 33868089 PMCID: PMC8044307 DOI: 10.3389/fpsyg.2021.621569] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/22/2021] [Indexed: 01/03/2023] Open
Abstract
The past 20 years have seen dramatic rises in suicide rates in the United States and other countries around the world. These trends have been identified as a public health crisis in urgent need of new solutions and have spurred significant research efforts to improve our understanding of suicide and strategies to prevent it. Unfortunately, despite making significant contributions to the founding of suicidology - through Emile Durkheim's classic Suicide (1897/1951) - sociology's role has been less prominent in contemporary efforts to address these tragic trends, though as we will show, sociological theories offer great promise for advancing our understanding of suicide and improving the efficacy of suicide prevention. Here, we review sociological theory and empirical research on suicide. We begin where all sociologists must: with Durkheim. However, we offer a more comprehensive understanding of Durkheim's insights into suicide than the prior reviews provided by those in other disciplines. In so doing, we reveal the nuance and richness of Durkheim's insights that have been largely lost in modern suicidology, despite being foundational to all sociological theories of suicide - even those that have moved beyond his model. We proceed to discuss broadly acknowledged limitations to Durkheim's theory of suicide and review how more recent theoretical efforts have not only addressed those concerns, but have done so by bringing a larger swatch of sociology's theoretical and empirical toolkit to bare on suicide. Specifically, we review how recent sociological theories of suicide have incorporated insights from social network theories, cultural sociology, sociology of emotions, and sociological social psychology to better theorize how the external social world matters to individual psychological pain and suffering. We conclude by making explicit bridges between sociological and psychological theories of suicide; by noting important limitations in knowledge about suicide - particularly regarding the roles of organizations, inequality, and intersectionality in suicide - that sociology is well situated to help address.
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Affiliation(s)
- Anna S. Mueller
- Department of Sociology, Indiana University Bloomington, Bloomington, IN, United States
| | - Seth Abrutyn
- Department of Sociology, The University of British Columbia, Vancouver, BC, Canada
| | - Bernice Pescosolido
- Department of Sociology, Indiana University Bloomington, Bloomington, IN, United States
| | - Sarah Diefendorf
- Department of Political Science, The University of Utah, Salt Lake City, UT, United States
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Hill NT, Spittal MJ, Pirkis J, Torok M, Robinson J. Risk factors associated with suicide clusters in Australian youth: Identifying who is at risk and the mechanisms associated with cluster membership. EClinicalMedicine 2020; 29-30:100631. [PMID: 33294825 PMCID: PMC7691728 DOI: 10.1016/j.eclinm.2020.100631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/18/2020] [Accepted: 10/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND It is unclear who is at risk of being involved in a suicide cluster and whether suicide clusters are influenced by the social transmission of suicidal behaviour, assortative relating, or a combination of both. METHODS Suicide clusters involving two or more young people were identified from the free text of electronic police and coroners reports in Australia's National Coronial Information System in a nationwide cross-sectional study. The duration of survival among exposed cases were estimated using time-to-event methods. The casewise concordance of demographic, social and clinical characteristics and circumstances of death were examined among index and exposed cases. FINDINGS We identified links between 117 young people (51 suicide clusters). 50% of young people died within 90 days of the index suicide. Individuals exposed to railway suicide had an 80% probability of dying by the same method. Those exposed to the suicide of a person aged 10-18 years had an 86% probability of being from the same age group. Young people had a 67% and 60% probability of sharing the same characteristics as the index suicide when the index suicide resided in a remote community or was of Aboriginal and Torres Strait Islander descent. INTERPRETATION Suicide clusters may be associated with both the social transmission of suicidal behaviour and assortative relating. Individuals who were close to the deceased should be provided with access to postvention support, particularly within the first 90 days of exposure to an index suicide. FUNDING Australian Rotary Health, National Health and Medical Research Council.
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Affiliation(s)
- Nicole T.M. Hill
- Telethon Kids Institute, 15 Hospital Ave, Nedlands, Perth, WA 6008, Australia
- Orygen, Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Jo Robinson
- Orygen, Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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Understanding the characteristics and mechanisms underlying suicide clusters in Australian youth: a comparison of cluster detection methods. Epidemiol Psychiatr Sci 2020; 29:e151. [PMID: 32758330 PMCID: PMC7443820 DOI: 10.1017/s2045796020000645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIMS There is currently no gold-standard definition or method for identifying suicide clusters, resulting in considerable heterogeneity in the types of suicide clusters that are detected. This study sought to identify the characteristics, mechanisms and parameters of suicide clusters using three cluster detection methods. Specifically, the study aimed to: (1) determine the overlap in suicide clusters among each method, (2) compare the spatial and temporal parameters associated with different suicide clusters and (3) identify the demographic characteristics and rates of exposure to suicide among cluster and non-cluster members. METHODS Suicide data were obtained from the National Coronial Information System. N = 3027 Australians, aged 10-24 who died by suicide in 2006-2015 were included. Suicide clusters were determined using: (1) poisson scan statistics, (2) a systematic search of coronial inquests and (3) descriptive network analysis. These methods were chosen to operationalise three different definitions of suicide clusters, namely clusters that are: (1) statistically significant, (2) perceived to be significant and (3) characterised by social links among three or more suicide descendants. For each method, the demographic characteristics and rates of exposure to suicide were identified, in addition to the maximum duration of suicide clusters, the geospatial overlap between suicide clusters, and the overlap of individual cluster members. RESULTS Eight suicide clusters (69 suicides) were identified from the scan statistic, seven (40 suicides) from coronial inquests; and 11 (37 suicides) from the descriptive network analysis. Of the eight clusters detected using the scan statistic, two overlapped with clusters detected using the descriptive network analysis and one with clusters identified from coronial inquests. Of the seven clusters from coronial inquests, four overlapped with clusters from the descriptive network analysis and one with clusters from the scan statistic. Overall, 9.2% (12 suicides) of individuals were identified by more than one method. Prior exposure to suicide was 10.1% (N = 7) in clusters from the scan statistic, 32.5% (N = 13) in clusters from coronial inquest and 56.8% (N = 21) in clusters from the descriptive network analysis. CONCLUSION Each method identified markedly different suicide clusters. Evidence of social links between cluster members typically involved clusters detected using the descriptive network analysis. However, these data were limited to the availability information collected as part of the police and coroner investigation. Communities tasked with detecting and responding to suicide clusters may benefit from using the spatial and temporal parameters revealed in descriptive studies to inform analyses of suicide clusters using inferential methods.
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Chesin M, Cascardi M, Rosselli M, Tsang W, Jeglic EL. Knowledge of Suicide Risk Factors, But Not Suicide Ideation Severity, Is Greater Among College Students Who Viewed 13 Reasons Why. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:644-649. [PMID: 30939105 DOI: 10.1080/07448481.2019.1586713] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 12/05/2018] [Accepted: 02/08/2019] [Indexed: 06/09/2023]
Abstract
Objective: To test associations between viewing 13 Reasons Why, Season 1 and past week suicide ideation severity, behavior risk, stigma, and knowledge in college students. To explore whether personal exposure to suicide and depressive symptom severity moderated these associations. Participants: Eight-hundred and eighteen college students, 64% (n = 522) of whom watched 13 Reasons Why. Methods: Students completed surveys online. Multivariate negative binomial regressions were used to test associations between watching 13 Reasons Why and suicide-related variables, and interaction terms. Results: Suicide ideation severity and suicide behavior risk were not significantly associated with viewing 13 Reasons Why; however, there was limited statistical power to detect associations. The association between watching 13 Reasons Why and greater suicide knowledge was stronger among those who did not have personal exposure to suicide. Conclusions: 13 Reasons Why may be a platform for psychoeducation on suicide, particularly among those who do not have personal exposure.
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Affiliation(s)
- Megan Chesin
- Department of Psychology, William Paterson University, Wayne, NJ, USA
| | - Michele Cascardi
- Department of Psychology, William Paterson University, Wayne, NJ, USA
| | - Michelle Rosselli
- Department of Psychology, William Paterson University, Wayne, NJ, USA
| | - William Tsang
- Department of Psychology, William Paterson University, Wayne, NJ, USA
| | - Elizabeth L Jeglic
- Department of Psychology, City University of New York-John Jay College, New York, USA
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Regional Variation of Suicide Mortality in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155433. [PMID: 32731583 PMCID: PMC7432038 DOI: 10.3390/ijerph17155433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 01/22/2023]
Abstract
South Korea’s suicide rate is the highest among the members of the Organization for Economic Cooperation and Development. This study seeks to verify regional variation in suicide rates in South Korea and to identify correlating factors. We used age-adjusted suicide rates for 252 administrative districts, and a Community Health Survey, national representative data, and other national representative data such as censuses were used to obtain information on socioeconomic, health related and social integration variables according to each administrative district. Regional variation in suicide rates was analyzed by using Extremal Quotient (EQ), and multiple linear regression analyses were used to investigate associations between variation in suicide rates and regional socioeconomic, public service factors and health related factors. The average suicide rate from 252 regions was 142.7 per 100,000 people. The highest region was Hongchun-gun (217.8) and the lowest was Gwachen-si (75.5). The EQ was 2.89, meaning that there is significant regional variation in suicide rates. Financial independence (β = −0.662, p < 0.001), social welfare budget (β = −0.754, p < 0.001) and divorce rates (β = 17.743, p < 0.001) were significant, along with other adjusted variables. This study suggests considering these factors in order to reduce suicide rates in South Korea.
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Anomie or imitation? The Werther effect of celebrity suicides on suicide rates in 34 OECD countries, 1960–2014. Soc Sci Med 2020; 246:112755. [DOI: 10.1016/j.socscimed.2019.112755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 12/13/2019] [Accepted: 12/17/2019] [Indexed: 11/22/2022]
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Sy KTL, Shaman J, Kandula S, Pei S, Gould M, Keyes KM. Spatiotemporal clustering of suicides in the US from 1999 to 2016: a spatial epidemiological approach. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1471-1482. [PMID: 31177308 PMCID: PMC6858930 DOI: 10.1007/s00127-019-01736-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 06/03/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aims to describe and characterize the spatial and temporal clustering patterns of suicide in the ten states with the greatest suicide burden in the United States from 1999 to 2016. METHODS All suicide deaths from January 1, 1999 to December 31, 2016 in the United States were identified using data from the Wide-ranging Online Data for Epidemiologic Research (WONDER) dataset. The ten states with the highest age-adjusted suicide rates were Montana, Alaska, Wyoming, New Mexico, Nevada, Utah, Idaho, Colorado, Arizona, and Oklahoma. A spatiotemporal scan statistic using a discrete Poisson model was employed to retrospectively detect spatiotemporal suicide clusters. RESULTS From 1999 to 2016, a total of 649,843 suicides were recorded in the United States. Nineteen statistically significant spatiotemporal suicide mortality clusters were identified in the states with the greatest suicide rates, and 13.53% of the suicide cases within these states clustered spatiotemporally. The risk ratio of the clusters ranged from 1.45 to 3.64 (p < 0.001). All states had at least one cluster, with three clusters spanning multiple states, and four clusters were found in Arizona. While there was no clear secular trend in the average size of suicide clusters, the number of clusters increased from 1999 to 2016. CONCLUSIONS Hot spots for suicidal behavior in the United States warrant public health intervention and continued surveillance. As suicide rates in the US continue to increase annually, public health efforts could be maximized by focusing on regions with substantial clustering.
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Affiliation(s)
- Karla Therese L Sy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sasikiran Kandula
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sen Pei
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Madelyn Gould
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Yi H, Hwang J, Bae HJ, Kim N. Age and sex subgroups vulnerable to copycat suicide: evaluation of nationwide data in South Korea. Sci Rep 2019; 9:17253. [PMID: 31754190 PMCID: PMC6872728 DOI: 10.1038/s41598-019-53833-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 11/06/2019] [Indexed: 12/30/2022] Open
Abstract
Media reports of a celebrity's suicide may be followed by copycat suicides, and the impact may vary in different age and sex subgroups. We proposed a quantitative framework to assess the vulnerability of age and sex subgroups to copycat suicide and used this method to investigate copycat suicides in relation to the suicides of 10 celebrities in South Korea from 1993 to 2013. By applying a detrending model to control for annual and seasonal fluctuations, we estimated the expected number of suicides within a copycat suicide period. The copycat effect was assessed in two ways: the magnitude of copycat suicide by dividing the observed by the expected number of suicides, and the mortality rate by subtracting the expected from the observed number of suicides. Females aged 20-29 years were the most vulnerable subgroup according to both the magnitude of the copycat effect (2.31-fold increase over baseline) and the mortality rate from copycat suicide (22.7-increase). Males aged 50-59 years were the second most vulnerable subgroup according to the copycat suicide mortality rate (20.5- increase). We hope that the proposed quantitative framework will be used to identify vulnerable subgroups to copycat effect, thereby helping devise strategies for prevention.
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Affiliation(s)
- Hahn Yi
- Asan Institute for Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Jeongeun Hwang
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun-Jin Bae
- Department of Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Namkug Kim
- Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
- Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
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Abstract
Although recent years have seen large decreases in the overall global rate of suicide fatalities, this trend is not reflected everywhere. Suicide and suicidal behaviour continue to present key challenges for public policy and health services, with increasing suicide deaths in some countries such as the USA. The development of suicide risk is complex, involving contributions from biological (including genetics), psychological (such as certain personality traits), clinical (such as comorbid psychiatric illness), social and environmental factors. The involvement of multiple risk factors in conveying risk of suicide means that determining an individual's risk of suicide is challenging. Improving risk assessment, for example, by using computer testing and genetic screening, is an area of ongoing research. Prevention is key to reduce the number of suicide deaths and prevention efforts include universal, selective and indicated interventions, although these interventions are often delivered in combination. These interventions, combined with psychological (such as cognitive behavioural therapy, caring contacts and safety planning) and pharmacological treatments (for example, clozapine and ketamine) along with coordinated social and public health initiatives, should continue to improve the management of individuals who are suicidal and decrease suicide-associated morbidity.
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Hawton K, Hill NTM, Gould M, John A, Lascelles K, Robinson J. Clustering of suicides in children and adolescents. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 4:58-67. [PMID: 31606323 DOI: 10.1016/s2352-4642(19)30335-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/28/2019] [Accepted: 09/09/2019] [Indexed: 02/05/2023]
Abstract
Suicide is one of the major causes of death in young people, in whom suicide can occur in clusters. In this Review, we have investigated definitions and epidemiology of such clusters, the factors associated with them, mechanisms by which they occur, and means of intervening and preventing them. Clustering of suicidal behaviour is more common in young people (<25 years) than adults. Suicide clusters can occur as a greater number of episodes than expected at a specific location, including in institutions (eg, schools, universities, psychiatric units, and youth offender units). They might also involve linked episodes spread out geographically. Locations exposed to clusters can be at risk for future clusters. Mechanisms involved in clusters include social transmission (particularly via person-to-person transmission and the media), perception that suicidal behaviour is widespread, susceptible young people being likely to socialise with others at risk of suicidal behaviour, and social cohesion contributing to the diffusion of ideas and attitudes. The internet and social media might have particularly important roles in spreading suicidal behaviour. The effect of suicide clusters on communities and institutions is usually profound. Experience of intervening in clusters has resulted in best practice guidance. This guidance includes preparation for occurrence of clusters in both community and institutional settings. Identification of clusters in the community requires real-time monitoring of suicidal behaviour. Effective intervention is more likely if a cluster response group is established than if no such group exists. The response should include bereavement support, provision of help for susceptible individuals, proactive engagement with media interest, and population-based approaches to support and prevention. Social media can provide a powerful means for disseminating information and reaching young people at risk.
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Affiliation(s)
- Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
| | - Nicole T M Hill
- Orygen, The National Centre of Excellence for Youth Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Madelyn Gould
- Division of Child & Adolescent Psychiatry, and Department of Epidemiology, Columbia University Medical Center, New York, NY 10032, USA
| | - Ann John
- Division of Applied Population Data Science, Population Psychiatry, Suicide and Informatics, Swansea University Medical School, Swansea University, Swansea, UK
| | - Karen Lascelles
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Jo Robinson
- Orygen, The National Centre of Excellence for Youth Mental Health, University of Melbourne, Melbourne, VIC 3052, Australia
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Robinson J, Clarke A. Commentary: Adolescent self-harm prevention and intervention in secondary schools: a survey of staff in England and Wales - a reflection on Evans et al. (2019). Child Adolesc Ment Health 2019; 24:239-241. [PMID: 32677212 DOI: 10.1111/camh.12335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2019] [Indexed: 11/27/2022]
Abstract
Self-harm (SH) continues to be a worldwide concern among adolescents and there is a great need for programming aimed at reducing SH in adolescents. Evans and colleagues discuss the opinions of school staff from a representative sample of secondary schools across England and Wales regarding their school's current prevention and intervention practices in responding to self-harm and how this should be addressed in future practice. The most salient points include the high prevalence of SH internationally, the existing barriers to SH prevention and intervention and possible solutions to these barriers. There is clearly an urgent need for high quality, evidence-based interventions that can be embedded in school settings, and have the capacity to overcome both the individual and structural barriers to supporting these vulnerable young people.
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Affiliation(s)
- Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic., Australia
| | - Alison Clarke
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic., Australia.,Centre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic., Australia
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29
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Edwards AC, Ohlsson H, Mościcki EK, Sundquist J, Sundquist K, Kendler KS. Geographic proximity is associated with transmission of suicidal behaviour among siblings. Acta Psychiatr Scand 2019; 140:30-38. [PMID: 31102549 PMCID: PMC6667185 DOI: 10.1111/acps.13040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to clarify the role of 'contagion', or social transmission, in risk of suicidal behaviour (SB) among siblings. METHODS We followed Swedish sibling pairs until one of them (S1; N = 111,848) was registered for a suicide attempt or completion. We tested the effect of geographic proximity between siblings on risk of a first SB registration of S1's sibling (S2). To control for familial confounding, we conducted complementary analyses of sibling trios (N = 701), comparing risk in different siblings as a function of their respective proximity to S1. RESULTS The best-fitting model across sibling pairs included an effect of distance between siblings (HR = 0.96, 95% CI = 0.93-0.99). Hazard ratios declined quickly up to 25 km and largely stabilized beyond 150 km. Across all pairs, a larger age difference between siblings was associated with reduced SB risk (HR = 0.96 95% CI = 0.93-0.98). Findings were consistent within the sibling trios. CONCLUSIONS Consistent with the concept of suicide contagion, risk of suicidal behaviour subsequent to a sibling's suicide completion or attempt is higher as a function of sibling closeness. These findings are robust to potentially confounding familial factors.
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Affiliation(s)
- Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Eve K. Mościcki
- Department of Epidemiology and Biostatistics, Temple University, Philadelphia, PA, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Functional Pathology, School of Medicine, Center for Community-based Healthcare Research and Education (CoHRE), Shimane University, Matsue, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Functional Pathology, School of Medicine, Center for Community-based Healthcare Research and Education (CoHRE), Shimane University, Matsue, Japan
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
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30
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Too LS, Pirkis J, Milner A, Robinson J, Spittal MJ. Clusters of Suicidal Events Among Young People: Do Clusters from One Time Period Predict Later Clusters? Suicide Life Threat Behav 2019; 49:561-571. [PMID: 29578243 DOI: 10.1111/sltb.12460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/11/2018] [Indexed: 11/28/2022]
Abstract
We sought to compare clusters of suicidal events between two different time periods and examine the extent to which earlier clusters predict later clusters. We included data on suicides and suicide attempts from New South Wales between July 2001 and June 2012 and Western Australia between January 2000 and December 2011. Suicide attempts included admissions to hospital for deliberate self-harm and suicides were deaths due to deliberate self-harm. We combined data on suicides and suicide attempts and grouped them into two equal time periods. We detected clusters in each period using Poisson discrete scan statistics adjusted for socio-economic status. We estimated the predictive values of earlier clusters on later clusters. The results showed that clusters from earlier time period had a moderate power (36%) in predicting later clusters. During the later time period, some additional cluster areas (14%) were found and some earlier cluster areas subsided (64%). Historical clusters predict 36% of the subsequent clusters, which is probably not sufficient for targeting interventions. Our study highlights the need for other strategies to detect emerging clusters, for example, up-to-date data.
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Affiliation(s)
- Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Vic, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Vic, Australia
| | - Allison Milner
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Vic, Australia
| | - Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Vic, Australia
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Vic, Australia
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Mishara BL, Dargis L. Systematic comparison of recommendations for safe messaging about suicide in public communications. J Affect Disord 2019; 244:124-154. [PMID: 30340101 DOI: 10.1016/j.jad.2018.09.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/14/2018] [Accepted: 09/15/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The diversity of guidelines for safe public messaging about suicide and the heterogeneous scientific research on the topic warrants comparisons of guidelines and analysis of the relevance of research findings to determine best practices. METHODS We searched databases and websites for organizations' guidelines concerning safe public messaging on suicide, and relevant research articles. RESULTS We identified 24 public messaging guidelines, 11 terminology guidelines and 44 research papers. No recommendations were in all guidelines, with more agreement on what not to do than on what to do. Recommendations in over half of guidelines are: avoid glorifying suicide, do not describe suicide methods, don't say suicide in inexplicable or explain simplistically, do not state that suicide is frequent in specific circumstances, encourage help seeking. There were disagreements on including personal details about people who died by suicide, and agreement to avoid: "committed suicide," "completed suicide," "successful suicide," "failed suicide/attempt" "unsuccessful suicide/attempt". Only "died by suicide" was recommended by a majority. Some recommended and some said to avoid: "Suicide attempt," "attempt to end his life," "attempted suicide," "non-fatal attempt at suicide," "unintentional (death)," "intentional self-harm," "suicidal ideation," "completed suicide," "survivor," "suicide loss survivor." Research papers had a wide range of objectives, methodologies, media studied and target populations. None provided empirical data that could help support or refute any recommendations. LIMITATIONS Lack of justifications for guidelines and scarce relevant research makes validation of recommendations challenging. CONCLUSIONS Research is needed to validate recommendations and terminology and develop consensus on guidelines for public messages, and determine if media guidelines for reporting on suicide are relevant for public messaging who's goal is to inform and educate rather than report news.
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Affiliation(s)
- Brian L Mishara
- Psychology Department and Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, C.P.8888, Succ. Centre-ville, Montreal, QC H3C 3P8 Canada.
| | - Luc Dargis
- Psychology Department and Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, C.P.8888, Succ. Centre-ville, Montreal, QC H3C 3P8 Canada.
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Wainberg ML, Helpman L, Duarte CS, Vermund SH, Mootz JJ, Gouveia L, Oquendo MA, McKinnon K, Cournos F. Curtailing the communicability of psychiatric disorders. Lancet Psychiatry 2018; 5:940-944. [PMID: 30316807 PMCID: PMC6433373 DOI: 10.1016/s2215-0366(18)30342-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 08/12/2018] [Accepted: 08/24/2018] [Indexed: 12/14/2022]
Abstract
Although psychiatric disorders are classified as non-communicable diseases, we believe this classification is too rigid and limiting. We present evidence of the communicability of psychiatric disorders through three major pathways: infectious and ecological, familial, and sociocultural communicability. Successful strategies developed to control the spread of communicable infectious diseases are relevant to curtailing the communicability of psychiatric disorders, thereby reducing their burden. Current interventions and policies that conceptualise psychiatric illnesses as non-communicable mostly focus on the individual. By applying strategies from infectious disease and chronic illness prevention models within a socioecological framework, we posit a broad communicable chronic disease psychiatric illness control plan for effectively treating the patient with the psychiatric disorder (host) as early as possible, providing benefits to their family and the community, and preventing transmission to others.
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Affiliation(s)
- Milton L Wainberg
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA.
| | - Liat Helpman
- Psychiatric Research Unit, Tel Aviv Sourasky Medical Center, Tel Aviv-Yafo, Israel
| | - Cristiane S Duarte
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | | | - Jennifer J Mootz
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Lidia Gouveia
- Department of Mental Health, Mozambique Ministry of Health, Avenida Eduardo Mondlane, Maputo, Mozambique
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Karen McKinnon
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Francine Cournos
- Mailman School of Public Health, Columbia University, New York, NY, USA
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33
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Pisinger VS, Hawton K, Tolstrup JS. School- and class-level variation in self-harm, suicide ideation and suicide attempts in Danish high schools. Scand J Public Health 2018; 47:146-156. [DOI: 10.1177/1403494818799873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: Strong associations have been found between being exposed to self-harm in family and friends and own self-harm in adolescence. Therefore, self-harm and suicide behaviour might tend to cluster within school and school classes. The aim of this study was to describe the prevalence, frequency and type of self-harm, suicide ideation and suicide attempts within Danish high schools and to test whether self-harm and suicide behaviour cluster in schools and school classes. Methods: Data came from the Danish National Youth Study 2014, a national survey. The respective study included 66,284 high-school students nested in 117 schools and 3146 school classes. The prevalence and clustering of self-harm behaviour, ever and within the last year, type of self-harm (e.g. cutting, burning, scratching and hitting) and suicide ideation and suicide attempts were investigated. Multi-level logistic regression was applied to quantify clustering among participants within the same class and school. Results: In total, 12,960 (20%) reported self-harm ever and 5706 (8.6%) within the last year. Prevalence was higher among girls than boys. Among girls, cutting (15%) and scratching (13%) was the most common type of self-harm, whereas among boys, hitting (6.7%) was most prevalent. The degree of clustering of self-harm and suicide behaviour was low, with school-level intra-class correlation coefficients (ICC) ranging from 0.8–1.8% and school class level ICC’s from 4.3–6.8%. Conclusions: This study shows that self-harm was common, especially in girls. The degree of clustering of self-harm and suicide behaviour in school and school classes was low.
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Affiliation(s)
- Veronica S.C. Pisinger
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, Oxford University and Oxford Health NHS Foundation Trust, Oxford, UK
| | - Janne S. Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Chan S, Denny S, Fleming T, Fortune S, Peiris-John R, Dyson B. Exposure to suicide behaviour and individual risk of self-harm: Findings from a nationally representative New Zealand high school survey. Aust N Z J Psychiatry 2018; 52:349-356. [PMID: 28565940 DOI: 10.1177/0004867417710728] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To examine whether there is an association between students self-reported suicide attempts and non-suicidal self-injury and exposure to suicidal behaviour among friends, family members or within school communities. METHODS A cross-sectional analysis of a nationally representative health and well-being survey of 8500 New Zealand high school students conducted from March through November 2012. Students' self-reported suicide attempts and repeated non-suicidal self-injury was examined in relation to student reports of self-harming behaviour among friends and family as well as data from school administrators of completed suicides within the school community. RESULTS Almost 1 in 20 (4.5%) students reported a suicide attempt in the last 12 months and 7.9% reported repeated non-suicidal self-injury in the last 12 months. The risk of both suicide attempts and repeated non-suicidal self-injury was highest among females, students from homes with economic deprivation and among students reporting an episode of low mood in the previous 12 months. Students exposed to suicide attempts or completed suicide among friends and/or family members were at increased risk of reporting attempted suicide and repeated non-suicidal self-injury in the last year. There was no association between completed suicide in school community and students self-reported suicide attempts or repeated non-suicidal self-injury. CONCLUSIONS Low mood and exposure to suicide attempts of friends and family members are associated with suicide attempts and repeated non-suicidal self-injury in New Zealand high school students. This research highlights importance of supporting adolescents with low mood and exposed to suicide of friends and family.
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Affiliation(s)
- Song Chan
- 1 School of Population Health, University of Auckland, Auckland, New Zealand.,2 Mental Health Services, Counties Manukau Health, Auckland, New Zealand
| | - Simon Denny
- 1 School of Population Health, University of Auckland, Auckland, New Zealand.,3 Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Theresa Fleming
- 1 School of Population Health, University of Auckland, Auckland, New Zealand.,3 Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.,4 Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Sarah Fortune
- 5 Department of Psychological Medicine, Counties Manukau Health, Auckland, New Zealand
| | - Roshini Peiris-John
- 6 Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Ben Dyson
- 7 School of Curriculum and Pedagogy, Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
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Fontanella CA, Saman DM, Campo JV, Hiance-Steelesmith DL, Bridge JA, Sweeney HA, Root ED. Mapping suicide mortality in Ohio: A spatial epidemiological analysis of suicide clusters and area level correlates. Prev Med 2018; 106:177-184. [PMID: 29133266 DOI: 10.1016/j.ypmed.2017.10.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 10/24/2017] [Accepted: 10/30/2017] [Indexed: 11/15/2022]
Abstract
Previous studies have investigated spatial patterning and associations of area characteristics with suicide rates in Western and Asian countries, but few have been conducted in the United States. This ecological study aims to identify high-risk clusters of suicide in Ohio and assess area level correlates of these clusters. We estimated spatially smoothed standardized mortality ratios (SMR) using Bayesian conditional autoregressive models (CAR) for the period 2004 to 2013. Spatial and spatio-temporal scan statistics were used to detect high-risk clusters of suicide at the census tract level (N=2952). Logistic regression models were used to examine the association between area level correlates and suicide clusters. Nine statistically significant (p<0.05) high-risk spatial clusters and two space-time clusters were identified. We also identified several significant spatial clusters by method of suicide. The risk of suicide was up to 2.1 times higher in high-risk clusters than in areas outside of the clusters (relative risks ranged from 1.22 to 2.14 (p<0.01)). In the multivariate model, factors strongly associated with area suicide rates were socio-economic deprivation and lower provider densities. Efforts to reduce poverty and improve access to health and mental health medical services on the community level represent potentially important suicide prevention strategies.
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Affiliation(s)
- Cynthia A Fontanella
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, 1670 Upham Drive, Columbus, OH 43210, United States.
| | - Daniel M Saman
- Essentia Institute of Rural Health, 502 East Second St, Duluth, MN 55805, United States.
| | - John V Campo
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, 1670 Upham Drive, Columbus, OH 43210, United States.
| | | | - Jeffrey A Bridge
- The Research Institute at Nationwide Children's Hospital, 700 Children's Dr, Columbus, OH 43205, United States.
| | - Helen Anne Sweeney
- Ohio Department of Mental Health and Addition Services, 30 East Broad Street, 8th Floor, Columbus, OH 43215, United States.
| | - Elisabeth D Root
- Department of Geography, Ohio State University, 1036 Derby Hall, 154 N. Oval Mall, Columbus, OH 43210, United States.
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36
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Torok M, Konings P, Batterham PJ, Christensen H. Spatial clustering of fatal, and non-fatal, suicide in new South Wales, Australia: implications for evidence-based prevention. BMC Psychiatry 2017; 17:339. [PMID: 28985736 PMCID: PMC5639600 DOI: 10.1186/s12888-017-1504-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 10/02/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rates of suicide appear to be increasing, indicating a critical need for more effective prevention initiatives. To increase the efficacy of future prevention initiatives, we examined the spatial distribution of suicide deaths and suicide attempts in New South Wales (NSW), Australia, to identify where high incidence 'suicide clusters' were occurring. Such clusters represent candidate regions where intervention is critically needed, and likely to have the greatest impact, thus providing an evidence-base for the targeted prioritisation of resources. METHODS Analysis is based on official suicide mortality statistics for NSW, provided by the Australian Bureau of Statistics, and hospital separations for non-fatal intentional self-harm, provided through the NSW Health Admitted Patient Data Collection at a Statistical Area 2 (SA2) geography. Geographical Information System (GIS) techniques were applied to detect suicide clusters occurring between 2005 and 2013 (aggregated), for persons aged over 5 years. The final dataset contained 5466 mortality and 86,017 non-fatal intentional self-harm cases. RESULTS In total, 25 Local Government Areas were identified as primary or secondary likely candidate regions for intervention. Together, these regions contained approximately 200 SA2 level suicide clusters, which represented 46% (n = 39,869) of hospital separations and 43% (n = 2330) of suicide deaths between 2005 and 2013. These clusters primarily converged on the Eastern coastal fringe of NSW. CONCLUSIONS Crude rates of suicide deaths and intentional self-harm differed at the Local Government Areas (LGA) level in NSW. There was a tendency for primary suicide clusters to occur within metropolitan and coastal regions, rather than rural areas. The findings demonstrate the importance of taking geographical variation of suicidal behaviour into account, prior to development and implementation of prevention initiatives, so that such initiatives can target key problem areas where they are likely to have maximal impact.
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Affiliation(s)
- Michelle Torok
- Black Dog Institute, University of NSW, Sydney, Australia.
| | - Paul Konings
- 0000 0001 2180 7477grid.1001.0National Centre for Geographic Resources & Analysis in Primary Health Care, Australian National University, Canberra, Australia
| | - Philip J. Batterham
- 0000 0001 2180 7477grid.1001.0Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Helen Christensen
- 0000 0004 4902 0432grid.1005.4Black Dog Institute, University of NSW, Sydney, Australia
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Too LS, Pirkis J, Milner A, Spittal MJ. Clusters of suicides and suicide attempts: detection, proximity and correlates. Epidemiol Psychiatr Sci 2017; 26:491-500. [PMID: 27278418 PMCID: PMC6998993 DOI: 10.1017/s2045796016000391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/12/2016] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND A suicide cluster is defined as a higher number of observed cases occurring in space and/or time than would typically be expected. Previous research has largely focused on identifying clusters of suicides, while there has been comparatively limited research on clusters of suicide attempts. We sought to identify clusters of both types of behaviour, and having done that, identify the factors that distinguish suicide attempts inside a cluster from those that were outside a cluster. METHODS We used data from Western Australia from 2000 to 2011. We defined suicide attempts as admissions to hospital for deliberate self-harm and suicides as deaths due to deliberate self-harm. Using an analytic strategy that accounted for the repetition of attempted suicide within a cluster, we performed spatial-temporal analysis using Poisson discrete scan statistics to detect clusters of suicide attempts and clusters of suicides. Logistic regression was then used to compare clustered attempts with non-clustered attempts to identify risk factors for an attempt being in a cluster. RESULTS We detected 350 (1%) suicide attempts occurring within seven spatial-temporal clusters and 12 (0.6%) suicides occurring within two spatial-temporal clusters. Both of the suicide clusters were located within a larger but later suicide attempt cluster. In multivariate analysis, suicide attempts by individuals who lived in areas of low socioeconomic status had higher odds of being in a cluster than those living in areas of high socioeconomic status [odds ratio (OR) = 29.1, 95% confidence interval (CI) = 6.3-135.5]. A one percentage-point increase in the proportion of people who had changed address in the last year was associated with a 60% increase in the odds of the attempt being within a cluster (OR = 1.60, 95% CI = 1.29-1.98) and a one percentage-point increase in the proportion of Indigenous people in the area was associated with a 7% increase in the suicide being within a cluster (OR = 1.07, 95% CI = 1.00-1.13). Age, sex, marital status, employment status, method of harm, remoteness, percentage of people in rented accommodation and percentage of unmarried people were not associated with the odds of being in a suicide attempt cluster. CONCLUSIONS Early identification of and responding to suicide clusters may reduce the likelihood of subsequent clusters forming. The mechanisms, however, that underlie clusters forming is poorly understood.
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Affiliation(s)
- L. S. Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - J. Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - A. Milner
- Deakin Population Health SRC, School of Health and Social Development, Deakin University, Victoria, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - M. J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
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Briggs S, Slater T, Bowley J. Practitioners' experiences of adolescent suicidal behaviour in peer groups. J Psychiatr Ment Health Nurs 2017; 24:293-301. [PMID: 28321968 DOI: 10.1111/jpm.12388] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2017] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Group suicidal behaviour can be devastating for all concerned. There is an absence of research on adolescent suicidal group behaviour. The perspectives of practitioners' experiences of these groups are largely lacking from research literature. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Practitioners work regularly with suicidal behaviour in adolescent peer groups. Practitioners identify peer relationships in groups as complex, including elements that are both suicide encouraging and preventing. Practitioners identify a range of ways in which young people become involved in suicidal behaviour in groups, including indirectly through risk taking and care-seeking as well as directly suicidal or self-harming. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Assessments of young people should routinely include a focus on the qualities of peer relations, including those in the online/digital realm. Assessments and interventions need to consider the complexity of group relationships and roles, and the multiplicity of factors that can contribute to suicidal behaviour in groups. Interventions that sustain therapeutic connectedness are helpful for taking dynamic/fluctuating risks into account. ABSTRACT Introduction Group suicidal behaviour by young people can have harmful effects; it may be increasing, influenced by online media and reported increasing self-harm rates; new knowledge and understanding to inform interventions is required. Aim To explore how practitioners experience group suicidal behaviour amongst adolescents, how they assess risks/needs, and how these insights inform understanding about these groups. Method Ten practitioners, including Mental Health Nurses, were interviewed in one multidisciplinary CAMHS, in England. Data analysis was by Thematic Analysis (Braun & Clarke 2006). Results Participants described frequently working with suicidal groups. Roles in groups include suicide encouraging and preventing. Practitioners identify risky and protective connections between young people, online and offline. Clinical tensions include living with suicidal risks, emotional and positional challenges, and getting to grips with digital media. Discussion Peer groups appear to have a larger role in adolescent suicide than recognized to date. Practitioners need to assess young people's roles in groups, their diverse motivations and to understand constantly changing digital media. Implications for practice Assessments of suicide risk for young people should routinely include focus on peer relations including the online/digital realm. Maintaining relationships with vulnerable young people facilitates managing fluctuating risks and understanding different group dynamics.
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Affiliation(s)
- S Briggs
- Department of Social Work, University of East London, London, UK
| | - T Slater
- Department of Social Work, University of Cardiff, Cardiff, UK
| | - J Bowley
- Barnet Enfield and Haringey Mental Health NHS Trust, London, UK
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Mueller AS. Does the media matter to suicide?: Examining the social dynamics surrounding media reporting on suicide in a suicide-prone community. Soc Sci Med 2017; 180:152-159. [DOI: 10.1016/j.socscimed.2017.03.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 03/08/2017] [Accepted: 03/09/2017] [Indexed: 11/25/2022]
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Strauss MJ, Klimek P, Sonneck G, Niederkrotenthaler T. Suicides on the Austrian railway network: hotspot analysis and effect of proximity to psychiatric institutions. ROYAL SOCIETY OPEN SCIENCE 2017; 4:160711. [PMID: 28405359 PMCID: PMC5383816 DOI: 10.1098/rsos.160711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 02/06/2017] [Indexed: 06/07/2023]
Abstract
Railway suicide is a significant public health problem. In addition to the loss of lives, these suicides occur in public space, causing traumatization among train drivers and passengers, and significant public transport delays. Prevention efforts depend upon accurate knowledge of clustering phenomena across the railway network, and spatial risk factors. Factors such as proximity to psychiatric institutions have been discussed to impact on railway suicides, but analytic evaluations are scarce and limited. We identify 15 hotspots on the Austrian railway system while taking case location uncertainties into account. These hotspots represent 0.9% of the total track length (5916 km/3676 miles) that account for up to 17% of all railway suicides (N=1130). We model suicide locations on the network using a smoothed inhomogeneous Poisson process and validate it using randomization tests. We find that the density of psychiatric beds is a significant predictor of railway suicide. Further predictors are population density, multitrack structure and-less consistently-spatial socio-economic factors including total suicide rates. We evaluate the model for the identified hotspots and show that the actual influence of these variables differs across individual hotspots. This analysis provides important information for suicide prevention research and practice. We recommend structural separation of railway tracks from nearby psychiatric institutions to prevent railway suicide.
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Affiliation(s)
- Markus J. Strauss
- Suicide Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
| | - Peter Klimek
- Section for Science of Complex Systems, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria
| | - Gernot Sonneck
- Crisis Intervention Centre, Lazarettgasse 14A, 1090 Vienna, Austria
| | - Thomas Niederkrotenthaler
- Suicide Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria
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John A, Hawton K, Gunnell D, Lloyd K, Scourfield J, Jones PA, Luce A, Marchant A, Platt S, Price S, Dennis MS. Newspaper Reporting on a Cluster of Suicides in the UK. CRISIS 2017; 38:17-25. [DOI: 10.1027/0227-5910/a000410] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract. Background: Media reporting may influence suicide clusters through imitation or contagion. In 2008 there was extensive national and international newspaper coverage of a cluster of suicides in young people in the Bridgend area of South Wales, UK. Aims: To explore the quantity and quality of newspaper reporting during the identified cluster. Method: Searches were conducted for articles on suicide in Bridgend for 6 months before and after the defined cluster (June 26, 2007, to September 16, 2008). Frequency, quality (using the PRINTQUAL instrument), and sensationalism were examined. Results: In all, 577 newspaper articles were identified. One in seven articles included the suicide method in the headline, 47.3% referred to earlier suicides, and 44% used phrases that guidelines suggest should be avoided. Only 13% included sources of information or advice. Conclusion: A high level of poor-quality and sensationalist reporting was found during an ongoing suicide cluster at the very time when good-quality reporting could be considered important. A broad awareness of media guidelines and expansion and adherence to press codes of practice are required by journalists to ensure ethical reporting.
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Affiliation(s)
- Ann John
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, UK
- Public Health Wales National Health Service Trust, Cardiff, Wales, UK
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, Warnford Hospital, Oxford, UK
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Keith Lloyd
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, UK
| | | | - Phillip A. Jones
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, UK
| | - Ann Luce
- Institute for Media and Communication Research, Bournemouth University, UK
| | - Amanda Marchant
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, UK
| | - Steve Platt
- Centre for Population Health Sciences, University of Edinburgh Medical School, UK
| | - Sian Price
- Public Health Wales National Health Service Trust, Cardiff, Wales, UK
| | - Michael S. Dennis
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, UK
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Robinson J, Too LS, Pirkis J, Spittal MJ. Spatial suicide clusters in Australia between 2010 and 2012: a comparison of cluster and non-cluster among young people and adults. BMC Psychiatry 2016; 16:417. [PMID: 27876026 PMCID: PMC5120558 DOI: 10.1186/s12888-016-1127-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A suicide cluster has been defined as a group of suicides that occur closer together in time and space than would normally be expected. We aimed to examine the extent to which suicide clusters exist among young people and adults in Australia and to determine whether differences exist between cluster and non-cluster suicides. METHODS Suicide data were obtained from the National Coronial Information System for the period 2010 and 2012. Data on date of death, postcode, age at the time of death, sex, suicide method, ICD-10 code for cause of death, marital status, employment status, and aboriginality were retrieved. We examined the presence of spatial clusters separately for youth suicides and adult suicides using the Scan statistic. Pearson's chi-square was used to compare the characteristics of cluster suicides with non-cluster suicides. RESULTS We identified 12 spatial clusters between 2010 and 2012. Five occurred among young people (n = 53, representing 5.6% [53/940] of youth suicides) and seven occurred among adults (n = 137, representing 2.3% [137/5939] of adult suicides). Clusters ranged in size from three to 21 for youth and from three to 31 for adults. When compared to adults, suicides by young people were significantly more likely to occur as part of a cluster (difference = 3.3%, 95% confidence interval [CI] = 1.8 to 4.8, p < 0.0001). Suicides by people with an Indigenous background were also significantly more likely to occur in a cluster than suicide by non-Indigenous people and this was the case among both young people and adults. CONCLUSIONS Suicide clusters have a significant negative impact on the communities in which they occur. As a result it is important to find effective ways of managing and containing suicide clusters. To date there is limited evidence for the effectiveness of those strategies typically employed, in particular in Indigenous settings, and developing this evidence base needs to be a future priority. Future research that examines in more depth the socio-demographic and clinical factors associated with suicide clusters is also warranted in order that appropriate interventions can be developed.
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Affiliation(s)
- Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10, Parkville, VIC, 3052, Australia.
| | - Lay San Too
- Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Jane Pirkis
- Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Matthew J. Spittal
- Melbourne School of Population and Global Health, Level 5, 207 Bouverie Street, Carlton, VIC 3053 Australia
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Too LS, Pirkis J, Milner A, Bugeja L, Spittal MJ. Railway suicide clusters: how common are they and what predicts them? Inj Prev 2016; 23:328-333. [PMID: 27864309 DOI: 10.1136/injuryprev-2016-042029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 10/09/2016] [Accepted: 10/27/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND A growing number of studies have sought to detect clusters of all suicides, but few have sought to identify clusters of method-specific suicides. METHODS Data on railway suicides occurring in Victoria, Australia, between 2001 and 2012 were obtained from the National Coronial Information System. We used the Poisson discrete scan statistic to identify railway suicides that occurred close together in space and/or time. We then used a case-control design to compare clustered railway suicides with non-clustered railway suicides on a range of individual and neighbourhood factors. RESULTS We detected four spatial clusters that accounted for 35% of all railway suicides. Railway suicides by individuals who were hospitalised for mental illness had nearly double the odds of being in a cluster compared with those individuals who had never been hospitalised (OR 1.80, 95% CI 1.02 to 3.18). Higher frequency train services were associated with increased odds of being in a cluster (OR 1.11, 95% CI 1.03 to 1.19). No other predictors were associated with being in a cluster. CONCLUSIONS Railway suicides that occur in clusters warrant particular attention because of the ripple effect they can have for communities and the risk that they may lead to copycat acts. Railway suicide prevention strategies should consider the fact that these suicides can occur in clusters, particularly among individuals who had previous hospitalisations for mental illness or live in areas with high-frequency train services.
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Affiliation(s)
- Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Allison Milner
- Deakin Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, Victoria, Australia.,Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Matthew J Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Joo Y. Spatiotemporal study of elderly suicide in Korea by age cohort. Public Health 2016; 142:144-151. [PMID: 27613224 DOI: 10.1016/j.puhe.2016.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 07/25/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This study analyzed the spatiotemporal pattern and spatial diffusion of elderly suicide by age cohort, in Korea. STUDY DESIGN The research investigated the elderly suicide rates of the 232 municipal units in South Korea between 2001 and 2011. METHODS The Gi* score, which is a spatially weighted indicator of area attributes, was used to identify hot spots and the spatiotemporal pattern of elderly suicide in the nation during the last 10 years. The spatial Markov matrix and spatial dynamic panel data model were employed to identify and estimate the diffusion effect. RESULTS The suicide rate among elderly individuals 75 years and older was substantially higher than the rate for those between 65 and 74 years of age; however, the spatial patterns of the suicide clusters were similar between the two groups. From 2001 to 2011, the spatial distribution of elderly suicide hot spots differed each year. For both age cohorts, elderly suicide hot spots developed around the north area of South Korea in 2001 and moved to the mid-east area and the mid-western coastal area over 10 years. The spatial Markov matrix indicates that the change in the suicide rate of one area was affected by the suicide rates of neighbouring areas from the previous year, which suggests that suicide increase in one area inflates a neighbouring area's suicide rate over time. Using a spatial dynamic panel data model, elderly suicide diffusion effects were found to be statistically significant for both age cohorts even after economic and demographic indicators and a time variable are included. For individuals 75 years and older, the diffusion effect appeared to be larger. CONCLUSIONS This study demonstrates that elderly suicide can spread spatially over time in both age cohorts. Thus, it is necessary to design a place-based and age-differentiated intervention policy that precisely considers the spatial diffusion of elderly suicide.
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Affiliation(s)
- Y Joo
- Department of Environmental Planning, Environmental Planning Institute, Seoul National University, #220, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Republic of Korea.
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Ceccato V, Uittenbogaard A. Suicides in commuting railway systems: The case of Stockholm county, Sweden. J Affect Disord 2016; 198:206-21. [PMID: 27018939 DOI: 10.1016/j.jad.2016.02.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/29/2016] [Accepted: 02/25/2016] [Indexed: 11/17/2022]
Abstract
The objective of this study is to understand the spatial and temporal dynamics of suicides in commuting railway environments. Data on suicides in Stockholm commuting railway from 2006 to 2013 was analysed. The study sets out to identify significant clusters in suicides then evaluate whether commuting railway environments affect variations in suicide rates. Fieldwork inspection, spatial cluster techniques (NNHC and Getis-Ord statistics) and regression models underlie the methodology of study. Findings show no seasonality was observed in suicide cases, but winter months concentrate a larger share of events. Suicides do not occur evenly throughout the day but tend to take place more often in weekdays. Modelling findings shows that suicide rates increase with speed trains and decrease where barriers along tracks are installed. Although high speed trains are still a motive of concern for suicide prevention, findings call for a whole railway-approach to safety - one that extends maintenance beyond the platforms and stations' vicinities.
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Affiliation(s)
- Vania Ceccato
- Housing and Safety Research Group, Department of Urban Planning and Environment, School of Architecture and the Built Environment (ABE), Royal Institute of Technology (KTH), Drottning Kristinasväg, 30 10044 Stockholm, Sweden.
| | - Adriaan Uittenbogaard
- Housing and Safety Research Group, Department of Urban Planning and Environment, School of Architecture and the Built Environment (ABE), Royal Institute of Technology (KTH), Drottning Kristinasväg, 30 10044 Stockholm, Sweden
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Benard V, Vaiva G, Masson M, Geoffroy P. Lithium and suicide prevention in bipolar disorder. Encephale 2016; 42:234-41. [DOI: 10.1016/j.encep.2016.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 03/27/2015] [Indexed: 11/16/2022]
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Affiliation(s)
- Nav Kapur
- Centre for Suicide Prevention, Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester M13 9PL, UK.
| | - Roger Webb
- Centre for Suicide Prevention, Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester M13 9PL, UK
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Cavazos-Rehg PA, Krauss MJ, Sowles S, Connolly S, Rosas C, Bharadwaj M, Bierut LJ. A content analysis of depression-related Tweets. COMPUTERS IN HUMAN BEHAVIOR 2016; 54:351-357. [PMID: 26392678 DOI: 10.1016/j.chb.2015.08.023] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examines depression-related chatter on Twitter to glean insight into social networking about mental health. We assessed themes of a random sample (n=2,000) of depression-related tweets (sent 4-11 to 5-4-14). Tweets were coded for expression of DSM-5 symptoms for Major Depressive Disorder (MDD). Supportive or helpful tweets about depression was the most common theme (n=787, 40%), closely followed by disclosing feelings of depression (n=625; 32%). Two-thirds of tweets revealed one or more symptoms for the diagnosis of MDD and/or communicated thoughts or ideas that were consistent with struggles with depression after accounting for tweets that mentioned depression trivially. Health professionals can use our findings to tailor and target prevention and awareness messages to those Twitter users in need.
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Affiliation(s)
| | - Melissa J Krauss
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Shaina Sowles
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah Connolly
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Carlos Rosas
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Meghana Bharadwaj
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
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Mueller AS, Abrutyn S, Stockton C. Can Social Ties be Harmful? Examining the Spread of Suicide in Early Adulthood. SOCIOLOGICAL PERSPECTIVES : SP : OFFICIAL PUBLICATION OF THE PACIFIC SOCIOLOGICAL ASSOCIATION 2015; 58:204-222. [PMID: 26120243 PMCID: PMC4480869 DOI: 10.1177/0731121414556544] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Durkheim posited that social relationships protect individuals against suicide; however, substantial research demonstrates that suicide can spread through the very ties Durkheim theorized as protective. With this study, we use Waves I, III, and IV of the National Longitudinal Study of Adolescent Health, to investigate whether young adults' suicide attempts and thoughts are in part products of exposure to suicidal behaviors via their social relationships. We find that young adults who have had family members or friends attempt suicide are more likely to report suicide ideation or even suicide attempts, over both the short and long run. This finding is robust to many important controls for risk and protective factors for suicide. Our findings have implications for the sociology of suicide, not the least of which, is that social ties have the power to harm in addition to the power to protect.
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Suicide acceptability as a mechanism of suicide clustering in a nationally representative sample of adolescents. Compr Psychiatry 2015; 59:17-20. [PMID: 25720563 DOI: 10.1016/j.comppsych.2015.02.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 01/28/2015] [Accepted: 02/04/2015] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The goal of the present study was to examine suicide acceptability as a mechanism of suicide clustering in adolescents. METHODS Data were drawn from The National Annenberg Survey of Youth, a sample of 3302 adolescents aged 14-22 collected between 2002 and 2004. RESULTS Results indicated that beliefs of the acceptability of suicide partially mediated the effect of exposure to suicide (defined as knowing someone who attempted or completed suicide) on 1) serious suicidal ideation and 2) suicide planning behaviors. CONCLUSIONS The present study demonstrated that suicide acceptability is in small part a possible reason why suicides tend to cluster in adolescents. It contributes not only to the knowledge of how the phenomenon of suicide clustering might occur, but more broadly highlights the importance of examining mediators of suicide clustering.
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