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Wu Y, Qu Z, Tang W, Zheng Y, Xiong X, Ye Z, Li Z. Reducing the risk of suicidal behaviors in medical graduate students: exploration of student-supervisor relationship and subjective family socioeconomic status. Front Psychiatry 2024; 15:1381291. [PMID: 38774432 PMCID: PMC11106388 DOI: 10.3389/fpsyt.2024.1381291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/22/2024] [Indexed: 05/24/2024] Open
Abstract
Objective This study aimed to investigate the association between the risk of suicidal behaviors and student-supervisor relationships and subjective family socioeconomic status (SFSS) in medical graduate students, and to propose preventive strategies to reduce the suicidal risk among medical graduate students. Materials and methods A total of 1,310 validated questionnaires were collected from medical graduate students, which included demographic information, study programs, the Suicidal Behaviors Questionnaire-Revised (SBQ-R) questionnaire, the Leader-Member Exchange 7 (LMX-7) questionnaire, and SFSS by MacArthur Scale. Multiple regression analysis was employed to examine the associations between variables and adjust for confounders. A moderation analysis, containing simple slope analysis and Johnson-Neyman interval plots were used to analyze the moderating effect of the SFSS in the association of SBQ-R and LMX-7 scores. Results A total of 88 participants (6.7%) were at risk of suicidal behaviors. In the high-quality student-supervisor relationship group (LMX-7 score ≥ 25), SFSS was significantly higher than in the low- and moderate-quality relationship group (p=0.002). The median SBQ-R score and proportion of suicide risk was significantly lower (p<0.001) in the high-quality student-supervisor relationship group. Multiple regression analysis indicated LMX-7 scores (β=-0.098, 95% CI [-0.118, -0.077], p<0.001) and SFSS (β=-0.073, 95% CI [-0.127, -0.019], p=0.008) were significantly negatively associated with SBQ-R, whereas the interaction term of SFSS with LMX-7 (β=0.018, 95% CI [0.007, 0.029], p=0.001) showed a significant positive association with SBQ-R. The Johnson-Neyman interval showed a significant association between LMX-7 and SBQ-R scores only when SFSS was less than 7.82 (p<0.05). Conclusion The risk of suicidal behaviors was associated with student-supervisor relationships and SFSS among medical graduate students. Poor relationships with supervisor were associated with an elevated risk of suicidality, and SFSS moderated this association. Educators should pay increased attention to the suicidal risk of medical graduate students with poor supervisor relationships, especially those from families with low SFSS, and provide timely preventive strategies.
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Affiliation(s)
- Yan Wu
- College of Marxism, Sichuan University, Chengdu, China
- Department of Postgraduate Students, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Zheng Qu
- School of Allied Health Sciences, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Wanjie Tang
- Center for Health and Psychology, Sichuan University, Chengdu, China
| | - Yunhao Zheng
- West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Xiong
- West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zheng Ye
- School of Allied Health Sciences, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhenlin Li
- School of Allied Health Sciences, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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2
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Haghish EF, Nes RB, Obaidi M, Qin P, Stänicke LI, Bekkhus M, Laeng B, Czajkowski N. Unveiling Adolescent Suicidality: Holistic Analysis of Protective and Risk Factors Using Multiple Machine Learning Algorithms. J Youth Adolesc 2024; 53:507-525. [PMID: 37982927 PMCID: PMC10838236 DOI: 10.1007/s10964-023-01892-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/17/2023] [Indexed: 11/21/2023]
Abstract
Adolescent suicide attempts are on the rise, presenting a significant public health concern. Recent research aimed at improving risk assessment for adolescent suicide attempts has turned to machine learning. But no studies to date have examined the performance of stacked ensemble algorithms, which are more suitable for low-prevalence conditions. The existing machine learning-based research also lacks population-representative samples, overlooks protective factors and their interplay with risk factors, and neglects established theories on suicidal behavior in favor of purely algorithmic risk estimation. The present study overcomes these shortcomings by comparing the performance of a stacked ensemble algorithm with a diverse set of algorithms, performing a holistic item analysis to identify both risk and protective factors on a comprehensive data, and addressing the compatibility of these factors with two competing theories of suicide, namely, The Interpersonal Theory of Suicide and The Strain Theory of Suicide. A population-representative dataset of 173,664 Norwegian adolescents aged 13 to 18 years (mean = 15.14, SD = 1.58, 50.5% female) with a 4.65% rate of reported suicide attempt during the past 12 months was analyzed. Five machine learning algorithms were trained for suicide attempt risk assessment. The stacked ensemble model significantly outperformed other algorithms, achieving equal sensitivity and a specificity of 90.1%, AUC of 96.4%, and AUCPR of 67.5%. All algorithms found recent self-harm to be the most important indicator of adolescent suicide attempt. Exploratory factor analysis suggested five additional risk domains, which we labeled internalizing problems, sleep disturbance, disordered eating, lack of optimism regarding future education and career, and victimization. The identified factors provided stronger support for The Interpersonal Theory of Suicide than for The Strain Theory of Suicide. An enhancement to The Interpersonal Theory based on the risk and protective factors identified by holistic item analysis is presented.
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Affiliation(s)
- E F Haghish
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Milan Obaidi
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychology, Copenhagen University, Copenhagen, Denmark
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Line Indrevoll Stänicke
- Department of Psychology, University of Oslo, Oslo, Norway
- Nic Waals Institute, Lovisenberg hospital, Oslo, Norway
| | - Mona Bekkhus
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Bruno Laeng
- Department of Psychology, University of Oslo, Oslo, Norway
- RITMO Centre for Interdisciplinary Studies in Rhythm, Time and Motion, University of Oslo, Oslo, Norway
| | - Nikolai Czajkowski
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Cho S, Lee K. Association between insurance type and suicide-related behavior among US adults: The impact of the Affordable Care Act. Psychiatry Res 2024; 333:115714. [PMID: 38219348 DOI: 10.1016/j.psychres.2024.115714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
Abstract
This study examined the association between insurance type and suicidal ideation and attempts among adults in the United States, incorporating a comparative analysis of the pre- and post-Affordable Care Act (ACA) periods. We used a nationally representative, cross-sectional, population-based survey of individuals aged 18 years and older from the 2010-2019 National Survey on Drug Use and Health. The higher rates of suicidal ideation and attempts among Medicaid and uninsured groups compared with those with private insurance. After implementation of the ACA policy, the difference-in-differences analysis showed a significantly reduced risk of suicide in the Medicare group compared with the privately insured group, with no significant differences observed in the other groups. These findings highlight the importance of improving access to mental health services, particularly for those with lower levels of insurance coverage, such as Medicaid and Medicare.
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Affiliation(s)
- Seungwon Cho
- Department of Psychiatry, Hanyang Universtiy Medical Center, Seoul, Republic of Korea; Department of Health Policy and Management, Graduate School of Public Health, Hanyang University, Seoul, Republic of Korea
| | - Kounseok Lee
- Department of Psychiatry, Hanyang Universtiy Medical Center, Seoul, Republic of Korea; Department of Psychiatry, College of Medicine, Hanyang University, Seoul, Republic of Korea.
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4
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Moseley RL, Gregory NJ, Smith P, Allison C, Cassidy S, Baron-Cohen S. Potential Mechanisms Underlying Suicidality in Autistic People with Attention Deficit/Hyperactivity Disorder: Testing Hypotheses from the Interpersonal Theory of Suicide. AUTISM IN ADULTHOOD 2024; 6:9-24. [PMID: 38435325 PMCID: PMC10902282 DOI: 10.1089/aut.2022.0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background Autistic people with co-occurring attention deficit/hyperactivity disorder (ADHD) appear to be at heightened risk of suicide. To understand why, we explored two explanatory mechanisms from the interpersonal theory of suicide: first, that co-occurring ADHD might be associated with greater risk through greater thwarted belongingness and perceived burdensomeness and, secondly, that hyperactive/impulsive features might incur additional risk through their association with painful and provocative events, which are suggested to create "capability" for suicide. Methods Autistic adults (n = 314) completed an online survey including measures of thwarted belongingness, perceived burdensomeness, painful and provocative events, acquired capability for suicide, and ADHD features. Creating an overall index of likely ADHD, we examined associations between likely ADHD, suicide ideation, and lifetime suicide attempts through the parallel mediators of thwarted belongingness, perceived burdensomeness, anxiety, and depression. In several models, we then examined hyperactive, impulsive, and inattentive features as predictors of exposure to painful and provocative events and subsequent capability for suicide, and examined whether these two variables, sequentially or individually, mediated an association with lifetime suicide attempts. Results Likely ADHD was associated with past-year suicide ideation through greater depression and perceived burdensomeness, which also mediated its association with more suicide attempts. Hyperactive and impulsive features were associated with exposure to painful and provocative events and through this acquired suicide capability. Both features were associated with more numerous suicide attempts through these two mediators sequentially, and through exposure to painful and provocative events alone. Conclusions These data suggest that suicidality in autistic people with ADHD may be partially related to perceived burdensomeness and to acquired suicide capability after exposure to painful and provocative events. However, as we observed a pathway to suicidality associated with painful and provocative events alone, it is likely that there are also other explanatory mechanisms for the influence of traumatic events on suicide risk.
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Affiliation(s)
- Rachel L. Moseley
- Department of Psychology, Bournemouth University, Poole, United Kingdom
| | - Nicola J. Gregory
- Department of Psychology, Bournemouth University, Poole, United Kingdom
| | - Paula Smith
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
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5
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Jaen J, Lovett SM, Lajous M, Keyes KM, Stern D. Adverse childhood experiences and adult outcomes using a causal framework perspective: Challenges and opportunities. CHILD ABUSE & NEGLECT 2023; 143:106328. [PMID: 37379730 DOI: 10.1016/j.chiabu.2023.106328] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Research on the effect of adverse childhood experiences (ACEs) on adult outcomes has typically relied on retrospective assessment of ACEs and cumulative scores. However, this approach raises methodological challenges that can limit the validity of findings. OBJECTIVE The aims of this paper are 1) to present the value of directed acyclic graphs (DAGs) to identify and mitigate potential problems related to confounding and selection bias, and 2) to question the meaning of a cumulative ACE score. RESULTS Adjusting for variables that post-date childhood could block mediated pathways that are part of the total causal effect while conditioning on adult variables, which often serve as proxies for childhood variables, can create collider stratification bias. Because exposure to ACEs can affect the likelihood of reaching adulthood or study entry, selection bias could be introduced via restricting selection on a variable affected by ACEs in the presence of unmeasured confounding. In addition to challenges regarding causal structure, using a cumulative score of ACEs assumes that each type of adversity will have the same effect on a given outcome, which is unlikely considering differing risk across adverse experiences. CONCLUSIONS DAGs provide a transparent approach of the researchers' assumed causal relationships and can be used to overcome issues related to confounding and selection bias. Researchers should be explicit about their operationalization of ACEs and how it is to be interpreted in the context of the research question they are trying to answer.
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Affiliation(s)
- Jocelyn Jaen
- Mexican School of Public Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Sharonda M Lovett
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Martín Lajous
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, United States; Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Katherine M Keyes
- Columbia University Mailman School of Public Health, NY, NY, United States
| | - Dalia Stern
- CONAHCyT - Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
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6
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Choi M, Lee EH, Sempungu JK, Lee YH. Long-term trajectories of suicide ideation and its socioeconomic predictors: A longitudinal 8-year follow-up study. Soc Sci Med 2023; 326:115926. [PMID: 37121069 DOI: 10.1016/j.socscimed.2023.115926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/16/2023] [Accepted: 04/22/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVE Suicide ideation is the first stage of suicide behavior, and the long-term course of suicide ideation is highly variable. The aim of this study is to identify trajectories of suicide ideation over an 8-year period and explore the association of socioeconomic status (SES) with suicide ideation trajectories. METHODS We included 10,017 participants from Waves 7-15 of the Korea Welfare Panel Study; these have data on suicidal ideation (2012-2020). Trajectories analysis was conducted to identify distinct trajectories of suicidal ideation. Multinomial logistic regression was used to examine associations of SES with suicidal ideation trajectories. The interaction effects between current SES and prospective economic condition on trajectories were examined using a synergy index (SI). RESULTS We identified three suicide ideation trajectory groups: low-stable, moderate-decreasing, and high-persistent. Individuals in both moderate-decreasing and high-persistent trajectories had poorer current SES and prospective economic conditions than low-stable trajectories. Interestingly, those reporting poorer prospective economic conditions had a greater risk of being in a high-persistent trajectory than being in a moderate-decreasing trajectory. Further, individuals with poorer current SES and prospective economic conditions were more likely to be in the high-persistent trajectory. CONCLUSIONS Our findings demonstrated three distinct trajectories of suicide ideation which provide useful information for specific preventive interventions that could be developed. Moreover, poor prospective economic condition is a significant predictor of the high-persistent suicide ideation trajectory. Supporting economic difficulties and helping make goals and plans to strengthen positive thinking would help attenuate suicidal ideation and prevent suicidal behavior.
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Affiliation(s)
- Minjae Choi
- Institute for Future Public Health, Graduate School of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Eun Hae Lee
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, the Republic of Korea
| | - Joshua Kirabo Sempungu
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, the Republic of Korea
| | - Yo Han Lee
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea.
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7
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Campos AI, Garcia-Marin LM, Christensen H, Batterham PJ, van Velzen LS, Schmaal L, Rabinowitz JA, Jahanshad N, Martin NG, Cuellar-Partida G, Ruderfer D, Mullins N, Rentería ME. Genomics-driven screening for causal determinants of suicide attempt. Aust N Z J Psychiatry 2023; 57:423-431. [PMID: 35403454 DOI: 10.1177/00048674221091499] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Each year, around one million people die by suicide. Despite its recognition as a public health concern, large-scale research on causal determinants of suicide attempt risk is scarce. Here, we leverage results from a recent genome-wide association study (GWAS) of suicide attempt to perform a data-driven screening of traits causally associated with suicide attempt. METHODS We performed a hypothesis-generating phenome-wide screening of causal relationships between suicide attempt risk and 1520 traits, which have been systematically aggregated on the Complex-Traits Genomics Virtual Lab platform. We employed the latent causal variable (LCV) method, which uses results from GWAS to assess whether a causal relationship can explain a genetic correlation between two traits. If a trait causally influences another one, the genetic variants that increase risk for the causal trait will also increase the risk for the outcome inducing a genetic correlation. Nonetheless, a genetic correlation can also be observed when traits share common pathways. The LCV method can assess whether the pattern of genetic effects for two genetically correlated traits support a causal association rather than a shared aetiology. RESULTS Our approach identified 62 traits that increased risk for suicide attempt. Risk factors identified can be broadly classified into (1) physical health disorders, including oesophagitis, fibromyalgia, hernia and cancer; (2) mental health-related traits, such as depression, substance use disorders and anxiety; and (3) lifestyle traits including being involved in combat or exposure to a war zone, and specific job categories such as being a truck driver or machine operator. CONCLUSIONS Suicide attempt risk is likely explained by a combination of behavioural phenotypes and risk for both physical and psychiatric disorders. Our results also suggest that substance use behaviours and pain-related conditions are associated with an increased suicide attempt risk, elucidating important causal mechanisms that underpin this significant public health problem.
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Affiliation(s)
- Adrian I Campos
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
| | - Luis M Garcia-Marin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Laura S van Velzen
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina Del Rey, CA, USA
| | - Nicholas G Martin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Gabriel Cuellar-Partida
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Douglas Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Niamh Mullins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Miguel E Rentería
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
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8
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Su Y, Sun W, Gan Y, Zhu Q, Liu G, Hui L, Tang H, Liu Z. Mindfulness mediates the relationship between positive parenting and aggression, depression, and suicidal ideation: A longitudinal study in middle school students. Front Psychol 2022; 13:1007983. [DOI: 10.3389/fpsyg.2022.1007983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
Previous research has indicated that parenting factors affect the risk of maladaptive psychological outcomes (e.g., aggression, depression, or suicidal ideation), and that positive parenting is a prospective risk factor for maladaptive psychological outcomes. However, the mechanisms underlying the relationships between positive parenting, mindfulness, and maladaptive psychological outcomes remain unknown, as do the processes that mediate the effect of positive parenting on maladaptive psychological outcomes in adolescents. The objective of the present study was to investigate the longitudinal relationship between positive parenting, mindfulness, and maladaptive psychological outcomes in middle school students, as well as the mediating effect of mindfulness in the relationships between positive parenting and depression, aggression, and suicidal ideation. In this study, 386 middle school children (aged 12–16) were tested three times over a period of 6 months. Positive parenting was assessed at Time 1, mindfulness at Time 2, and depression, aggression, and suicidal ideation at Time 3. Using structural equation modeling, positive parenting was revealed to be longitudinally associated with mindfulness and negatively associated with maladaptive psychological outcomes. More crucially, mindfulness mediated the relationship between positive parenting and maladaptive psychological outcomes. This research provides important insights into how to effectively decrease adolescent maladaptive psychological outcomes and highlights the importance of teaching mindfulness to youths.
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Agyapong B, Shalaby R, Eboreime E, Wei Y, Agyapong VIO. Self-Reported Alcohol Abuse and the Desire to Receive Mental Health Counselling Predict Suicidal Thoughts/Thoughts of Self-Harm among Female Residents of Fort McMurray. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13620. [PMID: 36294198 PMCID: PMC9602661 DOI: 10.3390/ijerph192013620] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Suicidal ideation and thoughts of self-harm continue to be challenging public health problems. It is presently unknown what the prevalence and correlates of suicidal thoughts and self-harm are in female residents of Fort McMurray, a city that has endured wildfires, flooding, and the COVID-19 pandemic in the last five years. This study aimed to determine the prevalence and correlates of suicidal ideation and thoughts of self-harm among female residents of Fort McMurray. A cross-sectional study using an online survey questionnaire was used to collect sociodemographic and clinical information from the residents of Fort McMurray between 24 April and 2 June 2021. Suicidal ideation and thoughts of self-harm among females were assessed using the ninth question of the Patient Health Questionnaire-9, a validated screening tool used to assess depression symptoms. Likely generalized anxiety disorder (GAD), major depressive disorder (MDD), post-traumatic stress disorder (PTSD) and low resilience were measured using standardized rating scales. Data were analyzed with SPSS version 25 using chi-squared tests and multivariate logistic regression analysis. Among Fort McMurray residents, 249 accessed the online survey, while 186 ultimately completed it, yielding a survey completion rate of 74.7%. Of these, 159 (85%) were females. After controlling for other variables in the regression model, respondents who expressed a desire to receive mental health counselling were more than seven times more likely to report suicidal ideation and thoughts of self-harm compared to the respondents who did not desire to receive mental health counselling (OR: 7.29; 95% CI: 1.19-44.58). Similarly, respondents who reported having abused alcohol in the past year were nearly four times more likely to report suicidal ideation or thoughts of self-harm compared to the respondents who said they had not abused alcohol in the past year (OR: 3.91; 95% CI: 1.05-14.57). A high prevalence of suicidal thoughts and thoughts of self-harm were reported among female residents of Fort McMurray. Timely access to adequate mental health support should be offered to female residents of communities impacted by multiple natural disasters, particularly residents who self-report alcohol abuse or desire to receive mental health counselling.
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Affiliation(s)
- Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Vincent I. O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada
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10
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Kim SY, Jeong SH, Joo HJ, Park M, Park EC, Kim JH, Lee J, Shin J. High prevalence of hypertension among smokers of conventional and e-cigarette: Using the nationally representative community dwelling survey. Front Public Health 2022; 10:919585. [PMID: 36324451 PMCID: PMC9618945 DOI: 10.3389/fpubh.2022.919585] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/12/2022] [Indexed: 01/22/2023] Open
Abstract
This study aimed to clarify the association between hypertension and conventional cigarette and electronic cigarette (e-cigarette) use, together or individually. A total of 275,762 participants were included, of which 120,766 were men and 154,996 were women. The data were drawn from the Korea Community Health Survey conducted in 2019. A multiple logistic regression model was used to examine the association between hypertension and types of smoking. Hypertension was defined as systolic blood pressure higher than 140 mmHg or diastolic blood pressure higher than 90 mmHg. Based on the types of smoking, participants were grouped as dual smokers of conventional and e-cigarettes, e-cigarette only smokers, conventional cigarette only smokers, past-smokers, and non-smokers. Compared to non-smokers, dual smokers presented the highest odds ratio for hypertension in the male [odds ratio (OR): 1.24, confidence interval (CI): 1.10 to 1.39] and female groups (OR: 1.44 CI: 0.96 to 2.15). According to the Cochran-Mantel-Haenszel test, the two-sided p-value of < 0.001 indicated an overall statistically significant association between types of smoking and hypertension. Use of both cigarette types was statistically significant in the male group, but only the use of conventional cigarettes and past smoking were statistically significant in the female group. Among smokers of the two cigarette types, those who were dual smokers of e-cigarettes and conventional cigarettes were the most likely to have the highest prevalence of hypertension.
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Affiliation(s)
- Soo Young Kim
- Department of Public Health, Yonsei University, Seoul, South Korea,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Sung Hoon Jeong
- Department of Public Health, Yonsei University, Seoul, South Korea,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Hye Jin Joo
- Department of Public Health, Yonsei University, Seoul, South Korea,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Minah Park
- Department of Public Health, Yonsei University, Seoul, South Korea,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, South Korea,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jung Hyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Junbok Lee
- Health IT Center, Yonsei University Health System, Seoul, South Korea
| | - Jaeyong Shin
- Institute of Health Services Research, Yonsei University, Seoul, South Korea,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea,*Correspondence: Jaeyong Shin
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Kim S, Son HG, Lee S, Park H, Jeong KH. A Study on the Relationship between Depression Change Types and Suicide Ideation before and after COVID-19. Healthcare (Basel) 2022; 10:1610. [PMID: 36141222 PMCID: PMC9498312 DOI: 10.3390/healthcare10091610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The purpose of this study is to explore and categorize changes in depression, and investigate the relationship between suicidal ideations before and after the COVID-19 pandemic. METHODS In this study, data from the Korea Welfare Panel Study (KoWePS) was used and included 8692 adults, 19 years of age or older, who could estimate the change in depression from 2017 (12th) to 2021 (16th) for final analysis. Depression change was classified into two types, 'low-level ascending' type (n = 7809, 80.9%), and 'increasing after reduction' type (n = 883, 10.2%). The Firth Method was used to examine the relationship between depression change types and suicidal ideation. RESULTS The lower the equivalized annual income and the lower the educational level, and the likelihood of belonging to the 'increasing after reduction' type, compared to the 'low-level ascending' type, the greater the probability of having suicidal ideation. CONCLUSION The significant impact of socioeconomic status (income and educational background) on suicidal ideation indicates the need to consider how epidemics affect inequality in society. This study is expected to provide a deeper understanding of depression, as well as to establish a foundation for long-term prevention of the rapid increase in suicide rates after COVID-19.
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Affiliation(s)
- Sunghee Kim
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Korea
| | - Hye-Gyeong Son
- College of Nursing, Kosin University, Busan 49267, Korea
| | - Seoyoon Lee
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, Seoul 03722, Korea
| | - Hayoung Park
- Institute of Symbiotic Life Technology, Yonsei University, Seoul 03722, Korea
| | - Kyu-Hyoung Jeong
- Department of Social Welfare, Semyung University, Jecheon 27136, Korea
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12
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Jung YH, Park YS, Park EC, Jang SI. Association between years with incidence of communicable diseases focused on COVID-19 and hand hygiene among adults in South Korea: a cross-sectional study. BMC Public Health 2022; 22:1526. [PMID: 35948899 PMCID: PMC9364310 DOI: 10.1186/s12889-022-13951-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background Handwashing is important considering the impact of communicable diseases on the public. We aimed to identify the association between years with incidence of communicable diseases during the coronavirus disease 2019 (COVID-19) pandemic and hand hygiene in South Korea. Methods This cross-sectional study evaluated 5 years (2013, 2015, 2017, 2019, and 2020) of data from the Korea Community Health Survey and included 1,034,422 adults. Multinomial logistic regression analysis was performed to assess handwashing frequency by year. Receiver operating characteristic analysis was used to determine the cut-off point for handwashing frequency. Results The always/frequently handwashing rate was 44.7%. This tendency was stronger in adults with each ascending year, with reference to 2013 (2015, odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.08, 1.13; 2017, OR = 1.10, 95% CI = 1.08, 1.13; 2019, OR = 1.17, 95% CI = 1.14, 1.20; 2020, OR = 3.21, 95% CI = 3.14, 3.29). Among women, the OR of frequently/always handwashing was 3.55 times higher (95% CI = 3.45, 3.66) in 2020 than in 2013. This OR was 2.95 among men (95% CI = 2.86, 3.04). In influenza-vaccinated participants, the OR of frequent/always handwashing was 3.25 times higher in 2020 than in 2013 (95% CI = 3.15, 3.36), while in non-vaccinated participants it was 3.17 (95% CI = 3.08, 3.27). Among adults who practiced physical distancing during the COVID-19 pandemic, the OR was 1.36 times higher (95% CI = 1.29, 1.42) with frequent handwashing, 1.64 times higher (95% CI = 1.57, 1.70) than those who did not practice it. Conclusions There was a strong tendency toward frequent handwashing over the years; the trend was even greater in 2020 during the COVID-19 pandemic. Given that communicable diseases and handwashing are closely related, it is necessary to promote hand hygiene for prevention. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13951-x.
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Affiliation(s)
- Yun Hwa Jung
- Department of Public Health, Graduate School, Yonsei University, 03722, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, 03722, Republic of Korea
| | - Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, 03722, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, 03722, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, 03722, Republic of Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, 03722, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Republic of Korea.
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13
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Perry SW, Rainey JC, Allison S, Bastiampillai T, Wong ML, Licinio J, Sharfstein SS, Wilcox HC. Achieving health equity in US suicides: a narrative review and commentary. BMC Public Health 2022; 22:1360. [PMID: 35840968 PMCID: PMC9284959 DOI: 10.1186/s12889-022-13596-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Suicide rates in the United States (US) reached a peak in 2018 and declined in 2019 and 2020, with substantial and often growing disparities by age, sex, race/ethnicity, geography, veteran status, sexual minority status, socioeconomic status, and method employed (means disparity). In this narrative review and commentary, we highlight these many disparities in US suicide deaths, then examine the possible causes and potential solutions, with the overarching goal of reducing suicide death disparities to achieve health equity.The data implicate untreated, undertreated, or unidentified depression or other mental illness, and access to firearms, as two modifiable risk factors for suicide across all groups. The data also reveal firearm suicides increasing sharply and linearly with increasing county rurality, while suicide rates by falls (e.g., from tall structures) decrease linearly by increasing rurality, and suicide rates by other means remain fairly constant regardless of relative county urbanization. In addition, for all geographies, gun suicides are significantly higher in males than females, and highest in ages 51-85 + years old for both sexes. Of all US suicides from 1999-2019, 55% of male suicides and 29% of female suicides were by gun in metropolitan (metro) areas, versus 65% (Male) and 42% (Female) suicides by gun in non-metro areas. Guns accounted for 89% of suicides in non-metro males aged 71-85 + years old. Guns (i.e., employment of more lethal means) are also thought to be a major reason why males have, on average, 2-4 times higher suicide rates than women, despite having only 1/4-1/2 as many suicide attempts as women. Overall the literature and data strongly implicate firearm access as a risk factor for suicide across all populations, and even more so for male, rural, and older populations.To achieve the most significant results in suicide prevention across all groups, we need 1) more emphasis on policies and universal programs to reduce suicidal behaviors, and 2) enhanced population-based strategies for ameliorating the two most prominent modifiable targets for suicide prevention: depression and firearms.
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Affiliation(s)
- Seth W Perry
- Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.
- Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.
- Department of Neurosurgery, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.
- Department of Public Health and Preventive Medicine, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.
| | - Jacob C Rainey
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Stephen Allison
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Tarun Bastiampillai
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Mind and Brain Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
- Department of Psychiatry, Monash University, Clayton, Australia
| | - Ma-Li Wong
- Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Julio Licinio
- Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Department of Medicine, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Pharmacology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
| | - Steven S Sharfstein
- Sheppard Pratt Health System, Baltimore, MD, USA
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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14
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da Fonsêca JR, de Oliveira CM, de Castro CCL, da Costa HVV, Galvão PVM, da Costa Ceballos AG, do Bonfim CV. Analysis of the completeness of self-harm and suicide records in Pernambuco, Brazil, 2014-2016. BMC Public Health 2022; 22:1154. [PMID: 35681172 PMCID: PMC9178859 DOI: 10.1186/s12889-022-13455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Suicides and suicide attempts are major public health problems, and coping strategies are hampered by insufficient or inadequate notifications. Data accuracy influences the formulation of public and mental health policies and suicide prevention strategies. The objective of this study was to analyze the completeness of self-harm and suicide records in the state of Pernambuco, Brazil, 2014-2016. METHODS This is an evaluative study with a descriptive design. The data were collected from suicide attempt records from the Notifiable Diseases Information System and suicide records from the Mortality Information System. Probabilistic linkage was used to relate these databases, and the degree of completeness of the variables was calculated. Completeness was classified into the following categories: good (≥ 75.1%), regular (50.1%-75.0%), low (25.1%-50.0%), and very low (≤ 25.0%). RESULTS In the analyzed period, 1,404 notifications of self-harm were studied, with an overall mean completeness of 86.2%. In addition, 1,050 suicide records were analyzed, with an overall mean completeness of 95.8%. Most variables referring to suicide attempts had good completeness, with the exception of the variables "occupation" and "education." The completeness of all suicide-related variables was rated as good. After linkage, a significant improvement was observed in the degree of completeness of the variable "occupation". CONCLUSION The results of this study showed that the completeness of self-harm and suicide variables improved from the first to the last year. The integration of data from different information systems provides an opportunity to improve suicide prevention programs and the quality of available information. Continuous efforts to increase the completeness and reliability of suicide surveillance systems are fundamental to describe the epidemiological profile and, consequently, plan preventive actions, in addition to contributing to the development and reformulation of strategies aimed at reducing morbidity and mortality related to suicidal behavior.
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Affiliation(s)
| | | | | | | | | | | | - Cristine Vieira do Bonfim
- Directorate of Social Research, Joaquim Nabuco Foundation, Rua Dois Irmãos, 92 - Ed. Anexo Anísio Teixeira - Apipucos, Recife, PE, CEP 52071-440, Brazil.
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15
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Rahman ME, Saiful Islam M, Mamun MA, Moonajilin MS, Yi S. Prevalence and Factors Associated with Suicidal Ideation Among University Students in Bangladesh. Arch Suicide Res 2022; 26:975-984. [PMID: 33073746 DOI: 10.1080/13811118.2020.1833800] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This study aimed to determine the prevalence of and factors associated with suicidal ideation among university students in Bangladesh. We collected cross-sectional data from 407 students aged between 18 and 27 years at Jahangirnagar University (Dhaka, Bangladesh), using a convenience sampling technique. Of the total sample, 13.8% reported having suicidal ideation during the past 12 months. In multiple logistic regression analysis, being female, being a fifth-year student, lower socioeconomic status, exposure to traumatic events, family suicide history, and depression were associated with suicidal ideation. The findings emphasize the need for appropriate support services for university students with a focus on mental health wellbeing and suicide prevention.
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16
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Raschke N, Mohsenpour A, Aschentrup L, Fischer F, Wrona KJ. Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence. BMC Public Health 2022; 22:129. [PMID: 35042490 PMCID: PMC8765829 DOI: 10.1186/s12889-022-12498-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background The economic and human costs of suicide to individuals, families, communities, and society make suicide a major public health problem around the world. Suicide rates in South Korea are among the highest in the world. This paper is the first systematic review investigating socioeconomic risk factors for suicidal behaviors (suicidal ideation, attempted suicides, and completed suicides) in South Korea. Methods We performed a systematic review in Medline and Web of Science. Empirical studies and peer-reviewed articles on the association between individual socioeconomic factors and suicidal behaviors have been included. A total of 53 studies were included in a descriptive synthesis. Results Overall, 35 studies focused on the association between individual socioeconomic factors and suicidal ideation, 16 were related to suicide attempts, while 10 addressed completed suicides. Low income, unemployment, and financial difficulties were identified as risk factors for all suicidal behaviors. Working in precarious conditions, long working hours, self-employment, changes in employment status, shift work/night-time work, and occupational stress were associated with an increased risk for suicidal ideation. Low educational attainment appears to increase the risk for suicide attempts and completed suicide, but the significance of educational attainment on the reporting of suicidal ideation could not be verified. The primary studies were unable to ascertain whether the place of residence impacts on suicidal behaviors. Conclusions The results highlight the relevance of socioeconomic factors for suicidal behaviors in South Korea. Governmental social spending must be increased and redirected more efficiently so that the economically most vulnerable groups are financially protected and income inequality does not widen. Furthermore, comprehensive prevention strategies at the community level are needed. Future research needs to focus on identifying vulnerable groups for whom the effects of low socioeconomic status may have particularly serious consequences with regard to suicidal behaviors. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12498-1.
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Pinheiro TDP, Warmling D, Coelho EBS. Characterization of suicide attempts and self-harm by adolescents and adults notified in Santa Catarina, Brazil, 2014-2018. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e2021337. [PMID: 34878004 DOI: 10.1590/s1679-49742021000400026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/05/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To characterize adolescent and adult suicide attempts and self-harm reported in Santa Catarina, Brazil, from 2014 to 2018. METHODS This was a cross-sectional descriptive study with data from the Notifiable Health Conditions Information System. The sociodemographic, clinical and type of self-inflicted violence characteristics among adolescents and adults were compared. RESULTS Among the 8,859 notifications analyzed, suicide attempts predominated in relation to self-mutilation; self-inflected violence was more frequent in females, those of white skin color and with mental disorders; it occurred more at home, in both age groups. Among adolescents, repeated self-mutilation (83.3%) stood out, while among adults, repeated suicide attempts (50.6%) and suspected alcohol use (18.3%) at the time of violence stood out. CONCLUSION We identified high prevalence of attempted suicide among adolescents and adults; the characteristics of violence were similar between the age groups analyzed.
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Affiliation(s)
| | - Deise Warmling
- Secretaria de Estado da Saúde de Santa Catarina, Florianópolis, SC, Brasil
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18
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Hwang IC, Ahn HY. Association between neighborhood environments and suicidal ideation among Korean adults. J Affect Disord 2021; 295:488-491. [PMID: 34507230 DOI: 10.1016/j.jad.2021.08.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/25/2021] [Accepted: 08/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The relationship between neighborhood environments and suicide has not been well studied. In the present study, relations between suicidal ideation and social and physical environments were investigated in Korean adults. METHODS This nationwide cross-sectional study was conducted using data from the 2013 Korea Community Health Survey. The final analysis included 221,038 individuals aged ≥ 19 years. A multivariate regression model was used to examine the independent effects of environments on suicidal ideation. RESULTS Approximately 9.4% of participants had experienced suicidal ideation. Stepwise multivariate regression analysis showed that trusting neighbors and all five physical environments were independently associated with suicidal ideation. As regards physical environments, relations with suicidal ideation varied across subgroups: satisfaction with overall safety was to be strongly and consistently related to less suicidal ideation. LIMITATIONS Causality and the impact of unmeasured confounders were not addressed. CONCLUSION Neighborhood environments may reduce suicidal ideation.
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Affiliation(s)
- In Cheol Hwang
- Department of Family Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea.
| | - Hong Yup Ahn
- Department of Statistics, Dongguk University, Seoul, South Korea
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19
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Chopra J, Hanlon CA, Boland J, Harrison R, Timpson H, Saini P. A case series study of an innovative community-based brief psychological model for men in suicidal crisis. J Ment Health 2021; 31:392-401. [PMID: 34643159 DOI: 10.1080/09638237.2021.1979489] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To conduct a 1-year evaluation of James' Place, a suicidal crisis centre delivering a clinical intervention in a community setting. DESIGN A case series study, following men entering the service during the first year of operation. PARTICIPANTS Men experiencing a suicidal crisis referred to the service (N = 265), with N = 176 going on to engage in therapy. INTERVENTION The James' Place Model is a therapeutic intervention offered to men who are in a suicidal crisis. Trained therapists provide a range of therapeutic approaches and interventions, focusing on decreasing suicidal distress and supporting men to develop resilience and coping strategies. MAIN OUTCOME MEASURES CORE-34 Clinical Outcome Measure (CORE-OM). RESULTS For all subscales of the CORE-OM there was a significant reduction in mean scores between assessment and discharge (p < 0.001), with all outcomes demonstrating a large effect size. All reductions illustrated a clinically significant change or a reliable change. CONCLUSIONS Our results support the use of the James' Place Model for men in suicidal distress to aid in potentially preventing suicides in this high-risk group of the population.HighlightsEvaluates a brief psychological clinical intervention delivered in the community.Model effectively reduces suicide risk and findings can inform future services.Accessed men receiving an innovative intervention at the time of suicidal crisis.
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Affiliation(s)
- J Chopra
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - C A Hanlon
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | | | - R Harrison
- Public Health Institute, Exchange Station, Liverpool John Moores University, Liverpool, UK
| | - H Timpson
- Public Health Institute, Exchange Station, Liverpool John Moores University, Liverpool, UK
| | - P Saini
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
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20
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Park M, Jung SJ. Association between menstrual cycle irregularity and suicidal ideation among Korean women: Results from the Korea national health and nutrition examination survey (2010-2012). J Affect Disord 2021; 293:279-284. [PMID: 34225207 DOI: 10.1016/j.jad.2021.06.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/18/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND We aimed to evaluate the association between menstrual cycle irregularity and suicidal ideation in Korean women. METHODS Data on 5,606 women from the 2010-2012 Korea National Health and Nutrition Examination Survey, a population-based cross-sectional study, were included. Menstrual cycle irregularity, suicidal ideation, current occupational status, age at menarche, education level, household income, and marital status were assessed through questionnaires with trained interviewers. A multivariate logistic regression analysis was performed after adjusting for age, socioeconomic status, smoking and drinking status, age at menarche, comorbid diseases, and physical activity. RESULTS In the multivariate-adjusted models, we found significant associations between menstrual cycle irregularity and suicidal ideation (odds ratio [OR], 95% confidence interval [CI] = 1.44 [1.14-1.82]). This association was particularly noticeable in women aged 12 to 29 years (OR [95% CI] = 1.45 [1.04-2.03]), in those who had menarche at a relatively early age (aged 8-13 years) (OR [95% CI] = 1.60 [1.15-2.23]), and in those who were currently employed (OR [95% CI] = 1.46 [1.05-2.04]). LIMITATIONS Suicidal ideation was evaluated based on the participants' self-reports, and were therefore subjective in nature. Additionally, due to the cross-sectional design and use of retrospective data, causal relationships could not be drawn. CONCLUSION Women with irregular menstrual cycles were 1.42 times more likely to have suicidal ideation than those with regular cycles. More attention should be paid to menstrual cycle irregularity when attempting to improve levels of suicidal ideation.
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Affiliation(s)
- Minseo Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Sun Jae Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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21
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Kang SH, Kim S, Park EC, Jang SI. Effects of material hardship on depression among adults in South Korea: insights from by the Korea Welfare Panel Study 2008-2017. Int J Equity Health 2021; 20:202. [PMID: 34493298 PMCID: PMC8425115 DOI: 10.1186/s12939-021-01531-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low socioeconomic status deemed by income-based measures is a risk factor for depression. Material hardship is commonly used as a multidimensional socioeconomic indicator to identify the struggles that low-income households encounter that are not captured by conventional income-based measures. The aim of this study was to examine the effect of material hardship on depression. METHODS We used wave 3 (2008) to wave 12 (2017) panel data collected by the Korea Welfare Panel Study. The material hardship measure included six dimensions: food, housing, medical care, paying utility bills, education, and financial hardship. Depression was measured using the Center for Epidemiologic Studies Depression Scale (CESD-11). A generalised estimating equation model was applied to test the causal association between material hardship and log transferred CESD-11. RESULTS The first time point comprised 3,866 participants. Those who continually experienced material hardship had higher depression scores (male: β = 2.82, female: β = 3.98, p-value: < .0001). Food hardship was the most critical risk factor (male: β = 3.29, female: β = 4.05, p-value: < .0001). CONCLUSIONS Material hardship is associated with increased risk of depression, especially food hardship. We should consider guaranteeing food security, and community and policy makers should consider material hardship in their approach when identifying low-income populations at high risk for depression.
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Affiliation(s)
- Soo Hyun Kang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Selin Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
- Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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22
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The Contribution of Material, Behavioral, Psychological, and Social-Relational Factors to Income-Related Disparities in Cardiovascular Risk Among Older Adults. J Cardiovasc Nurs 2021; 36:E38-E50. [PMID: 36036986 PMCID: PMC8201797 DOI: 10.1097/jcn.0000000000000808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Supplemental digital content is available in the text. Understanding the factors underlying health disparities is vital to developing strategies to improve health equity in old age. Such efforts should be encouraged in Korea.
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Habu H, Takao S, Fujimoto R, Naito H, Nakao A, Yorifuji T. Emergency dispatches for suicide attempts during the COVID-19 outbreak in Okayama, Japan: A descriptive epidemiological study. J Epidemiol 2021; 31:511-517. [PMID: 34176855 PMCID: PMC8328858 DOI: 10.2188/jea.je20210066] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Hardships associated with the ongoing coronavirus disease 2019 (COVID-19) pandemic can affect mental health, potentially leading to increased risk of suicide. We examined the relationship between the COVID-19 outbreak and suicide attempts in Okayama, Japan using information from emergency dispatches. Methods This was a descriptive epidemiological study. We collected information on emergency dispatches in Okayama City and Kibichuo from March to August in 2018, 2019, and 2020 (n = 47,770 cases). We compared emergency dispatches and their demographic characteristics, especially focusing on suicide attempts, during these 3 years. Results The number of emergency dispatches in 2020 decreased compared with the previous 2 years, while the number and proportion of emergency dispatches related to suicide attempts increased. This increase was more pronounced among women and those aged 25–49 years. Among women aged 25–49 years, there was a cumulative total of 43 suicide attempts in 2018 and 2019 and 73 suicide attempts in 2020. Conclusions The number and proportion of emergency dispatches related to suicide attempts increased in 2020 compared with the previous 2 years, especially among women and those aged 25–49 years. This increase may be partly explained by hardships, such as economic losses or reduced social ties, during the COVID-19 outbreak.
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Affiliation(s)
- Hiroshi Habu
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Soshi Takao
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Ryohei Fujimoto
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.,Department of Cardiovascular Medicine, Okayama University Hospital
| | - Hiromichi Naito
- Department of Emergency and Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Atsunori Nakao
- Department of Emergency and Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Takashi Yorifuji
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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The effect of income level on all-cause mortality and suicide among patients using antidepressants: A population-based cohort study. Psychiatry Res 2021; 299:113838. [PMID: 33756205 DOI: 10.1016/j.psychres.2021.113838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/23/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND To investigate whether household income levels are associated with all-cause mortality and suicide in patients using antidepressant agents. METHODS We analyzed data from 75,782 patients using antidepressants, acquired from the Korean National Health Insurance claims database (2002-2013). Each patient was monitored until December 2013 or until death, whichever occurred sooner. Cox proportional hazard models were used to compare all-cause and suicide mortalities between different income groups after adjusting for possible confounding covariates and risk factors. RESULTS The mid-low income group had a significantly higher suicide rate than the high-income group (hazard ratio [HR] 1.379; 95% confidence interval [CI] 1.102-1.762). Male patients in the low and mid-low income groups had a higher risk of suicide (HR 1.449; 95% CI, 1.006-2.087 and HR 1.410; 95% CI, 1.036-1.918, respectively), whereas there was no significant difference in suicide risk between income groups among female patients. CONCLUSION Promotion of targeted policies and priority health services for low-income patients on antidepressants may help reduce the risk of suicide in this high-risk group.
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Rahman ME, Al Zubayer A, Al Mazid Bhuiyan MR, Jobe MC, Ahsan Khan MK. Suicidal behaviors and suicide risk among Bangladeshi people during the COVID-19 pandemic: An online cross-sectional survey. Heliyon 2021; 7:e05937. [PMID: 33615003 PMCID: PMC7879153 DOI: 10.1016/j.heliyon.2021.e05937] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/01/2020] [Accepted: 01/06/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Suicide, a major public health concern, is a leading cause of injury and death worldwide. The present study aims to assess suicidal behaviors and suicide risk among Bangladeshi people during COVID-19. METHODS A cross-sectional online survey was conducted from July 10 to July 20, 2020, involving 1,415 Bangladeshi residents ages 18 years or older. Data was collected via an anonymous online questionnaire. The Suicide Behaviors Questionnaire-Revised was used to assess suicide risk. The depression and anxiety subscales of the Depression Anxiety Stress Scale 21 were used to assess depression and anxiety. Logistic regression analyses and Pearson's correlation were performed to examine the association of variables. RESULTS The prevalence of suicide ideation and planning among Bangladeshi people during the COVID-19 pandemic was 19.0% and 18.5%, respectively. Having suicidal risk during the COVID-19 pandemic was reported by 33.5% participants. Suicide risk was associated higher with females, divorced or widowed marital statuses and low educational attainment (i.e., secondary or below and higher secondary/diploma). Additionally, living in high COVID-19 prevalent areas, having economic loss due to the COVID-19 pandemic, relatives or acquaintances die from COVID-19, direct contact with COVID-19 patient(s), and fear of COVID-19 infection were associated with suicide risk. CONCLUSIONS The COVID-19 pandemic imposes significant psychological consequences on people, thus, concerned authorities should pay attention to people's mental health and focus on suicide prevention and awareness during and after the COVID-19 pandemic.
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Affiliation(s)
- Md. Estiar Rahman
- Department of Public Health & Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
| | | | | | - Mary C. Jobe
- Christopher Newport University, 1 University Place, Newport News, VA 23606, USA
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Bergmans RS, Jannausch M, Ilgen MA. Prevalence of suicide ideation, planning and attempts among Supplemental Nutrition Assistance Program participants in the United States. J Affect Disord 2020; 277:99-103. [PMID: 32799110 PMCID: PMC7572757 DOI: 10.1016/j.jad.2020.07.129] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 07/13/2020] [Accepted: 07/28/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Suicide represents a substantial public health problem in the U.S. Programs like the Supplemental Nutrition Assistance Program (SNAP)-which provides services for U.S. adults who are food insecure-could be an appropriate venue for suicide prevention strategies targeting high-risk individuals. METHODS This cross-sectional study used multiple logistic regression to determine odds ratios (ORs) and 95% confidence intervals (CIs) for suicide ideation, planning and attempt among those who participated in SNAP vs. nonparticipants. The National Survey of Drug Use and Health provided a representative sample of U.S. adults for 2012-2018 (n = 288,730). RESULTS SNAP participants were more likely than nonparticipants to have serious suicidal thoughts (crude OR=1.89; 95% CI=1.79-1.99), to have a plan for suicide (crude OR=2.35; 95% CI=2.16-2.56) or to attempt suicide (crude OR=2.89; 95% CI=2.54-3.29). Associations remained for those aged <50 in age-stratified analyses that accounted for survey year, demographics, socioeconomic status, self-rated health and mental health service use. LIMITATIONS SNAP was assessed at the household level; thus, those who reported suicidal thoughts and/or behaviors may not personally interact with SNAP. CONCLUSION Using a large, nationally-representative sample of U.S. adults, this study documented greater prevalence of suicide-related outcomes among those who participate in SNAP. Suicide prevention among SNAP participants may provide a unique means to reach individuals who are often hard to engage in other health services.
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van Vuuren CL, van der Wal MF, Cuijpers P, Chinapaw MJM. Sociodemographic Differences in Time Trends of Suicidal Thoughts and Suicide Attempts Among Adolescents Living in Amsterdam, The Netherlands. CRISIS 2020; 42:369-377. [PMID: 33241744 PMCID: PMC8689663 DOI: 10.1027/0227-5910/a000735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Abstract.Background: Suicidal thoughts and suicide attempts among adolescents are
major public health problems. More insight into secular changes in suicidal thoughts and
suicide attempts among adolescents from various sociodemographic groups is crucial for
adequate and targeted policy-making and prevention. We therefore examined 5-year time
trends in suicidal thoughts and suicide attempts among adolescents and potential
differences in time trends between sociodemographic groups. Methods:
Logistic regression analyses were based on annually repeated cross-sectional data
including 26,273 multi-ethnic students (13–14 years old) in the second year of various
levels of secondary education in Amsterdam, The Netherlands. Results:
Overall, the prevalence of adolescents in Amsterdam with suicidal thoughts decreased from
17.6% during 2010–2011 to 13.2% during 2014–2015. The prevalence of adolescents reporting
suicide attempts decreased from 2.9% to 1.9% over the observed 5-year period. We found
differences in these time trends between subgroups based on ethnicity and educational
level. Limitations: The use of confidential and self-reported data could
have biased the results. Conclusion: In order for prevention policy to be
effective it is important to pay attention to changes in risk groups for suicidal thoughts
and suicide attempts over time.
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Affiliation(s)
- Cornelia Leontine van Vuuren
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service (GGD) Amsterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Marcel Franciscus van der Wal
- Department of Epidemiology, Health Promotion and Healthcare Innovation, Public Health Service (GGD) Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Mai Jeanette Maidy Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
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Characteristics associated with later self-harm hospitalization and/or suicide: A follow-up study of the HUNT-2 cohort, Norway. J Affect Disord 2020; 276:369-379. [PMID: 32871667 DOI: 10.1016/j.jad.2020.03.163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 02/20/2020] [Accepted: 03/29/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND To improve suicide and self-harm prevention in adults, better knowledge on preexisting characteristics and risk factors is of great importance. METHODS This is a population-based case-control study; baseline measures were collected in the second wave of the North-Trøndelag Health Study (HUNT-2, 1995-1997) in Norway, and outcomes were observed for up to 19 years. Average follow up time was 4.9 years for self-harm and 6.8 years for suicides. Out of 93,898 eligible adult inhabitants aged 20 and above, a total of 65,229 (70%) participated in the study. The data were linked to the National Mortality Registry and hospital patient records in the three hospitals covering the HUNT-2 catchment area. RESULTS Among the participants, 332 patients (68% women) were hospitalized because of self-harm (HSH), and 91 patients (32% women) were died by suicide (SU). A total of 10% of those who died by SU had previously been HSH. People in the HSH and SU groups were younger, reported more depression and anxiety symptoms, sleeping problems, higher use of alcohol and tobacco, poorer social network and more economic problems, compared to the rest of the HUNT-2 population. In addition, the HSH group reported more somatic health problems, higher use of health services, higher sick leave, and lower work participation than the SU group. LIMITATIONS Younger adults (20-40 years) were under-represented in HUNT-2. Younger adults (20-40 years) were constituted 31.7% in HUNT-2, 50% in HSH and 33% in SU. Further, we did not identify less severe self-harm, not requiring hospitalization. Life changes, adverse events, and other possible triggers to self-harming behavior were not recorded. CONCLUSION Psychological problems were long-term predictors of both HSH and SU. Somatic health problems and lower functional performance were more present in HSH-group compared to the SU-group.
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Cenderadewi M, Franklin RC, Peden AE, Devine S. Fatal intentional drowning in Australia: A systematic literature review of rates and risk factors. PLoS One 2020; 15:e0231861. [PMID: 32442177 PMCID: PMC7244177 DOI: 10.1371/journal.pone.0231861] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 04/02/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Unintentional drowning deaths are only part of the drowning profile, with little attention being paid to intentional drowning in Australia. Strategies for the prevention of intentional drowning deaths are likely to be different from unintentional. Quality documentation, analysis and dissemination of intentional deaths data is crucial for developing appropriate strategies for prevention. OBJECTIVE To conduct a systematic literature review to investigate the mortality rates and risk factors of intentional drowning deaths in Australia. METHODS A systematic search guided by PRISMA was performed using Ovid MEDLINE, CINAHL, PsycINFO (ProQuest), Scopus, Google Scholar, and BioMed Central databases to locate relevant original research articles published between 2007 and 2018. RESULTS Ten papers reporting the mortality rates and risk factors of intentional drowning deaths in Australia published between 2007 and 2018, with study periods of the included articles spanning from 1907 to 2012, were reviewed. Most studies investigated suicidal drowning deaths in Australia, none reported homicidal drowning deaths. The downward trend of fatal suicide drowning was identified in Australia. The annual rate of intentional drowning between 1994 and 2012 can be inferred from eight studies, ranging from 0.06 to 0.21 for nation-wide mortality rates. The highest annual state-wide mortality rate was identified in the state of Queensland, ranging from 0.02 to 0.11 per 100,000 individuals. Of four studies examining the risk factors of fatal intentional drowning in Australia, being of older age groups, being female, and the presence of substance use were identified as important factors for suicidal drowning deaths. The national-scale proportion of suicide drowning in Australia, ranging from 2% to 3% of all intentional self-harm deaths, was also identified. CONCLUSION Limited publications reporting the mortality rates and risk factors of intentional drowning deaths in Australia were identified. Being of older age groups and being female were recognised as factors for suicide drowning deaths, and psychoactive substances were widely identified amongst cases. Future research on improving death reporting systems and the legal framework for medico-legal death investigation, along with the investigation of the risk factors of intentional drowning, are required to inform the planning, implementation, and evaluation of prevention interventions for intentional drowning deaths in Australia.
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Affiliation(s)
- Muthia Cenderadewi
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Royal Life Saving Society—Australia, Sydney, Australia
| | - Amy E. Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Royal Life Saving Society—Australia, Sydney, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Sue Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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Son JM, Jeong J, Ro YS, Hong W, Hong KJ, Song KJ, Do Shin S. Effect of previous emergency psychiatric consultation on suicide re-attempts - A multi-center observational study. Am J Emerg Med 2020; 38:1743-1747. [PMID: 32738470 DOI: 10.1016/j.ajem.2020.05.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The emergency department (ED) is one of the first gateways when suicide attempt patients seek health care services. The purpose of this study was to analyze the hypothesis that people who received emergency psychiatric services in previous suicide attempts will have a lower mortality rate in current ED visits owing to subsequent suicide attempts. METHOD This retrospective study included patients who visited six EDs, and participated in the injury surveillance and in-depth suicide surveillance for 10 years, from January 2008 to December 2017. The study subjects were adult patients 18 years or older who visited EDs due to suicide attempts. The main explanatory variable is whether psychiatric treatment was provided in previous suicide attempts. The main outcome variable was suicide related mortality. RESULTS The study included 2144 suicide attempt patients with a previous history of suicide attempts. Among these, 1335 patients (62.2%) had received psychiatric treatment in previous suicide attempts. Mortality was significantly different between the psychiatric consultation group (n = 33, 2.5%) and non-consultation group (n = 47, 5.8%) (P < 0.01). In multivariate logistic regression analysis, previous psychiatric consultation showed a significant association with low mortality (adjusted OR 0.41; 95% CI [0.23-0.72]) and selecting non-fatal suicide methods (adjusted OR 0.47; 95% CI [0.36-0.61]). CONCLUSION Patients who received psychiatric consultation in previous suicide attempts had a lower suicide-related mortality in current ED visits as compared to patients who did not, and this may have been related to choosing non-fatal suicide methods.
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Affiliation(s)
- Jeong Min Son
- Department of Emergency Medicine, Seoul National University Hospital, South Korea
| | - Joo Jeong
- Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea.
| | - Young Sun Ro
- Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
| | - Wonpyo Hong
- Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
| | - Kyoung-Jun Song
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea; Department of Emergency Medicine, Seoul National University Boramae Medical Center, South Korea
| | - Sang Do Shin
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea; Department of Emergency Medicine, Seoul National University College of Medicine, South Korea
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Cheung S, Woo J, Maes MS, Zai CC. Suicide epigenetics, a review of recent progress. J Affect Disord 2020; 265:423-438. [PMID: 32090769 DOI: 10.1016/j.jad.2020.01.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/17/2019] [Accepted: 01/11/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Suicide results in over 800,000 deaths every year, making it a major public health concern worldwide. It is highly complex, with genetic and environmental influences. Epigenetic mechanisms, including DNA methylation, miRNA, and histone modifications, could explain the complex interplay of environmental risk factors with genetic risk factors in the emergence of suicidal behavior. METHODS Here, we review the literature on suicide epigenetics over the past 10 years. RESULTS There has been significant progress in the field of suicide epigenetics, with emerging findings in the brain-derived neurotrophic factor and hypothalamic-pituitary-adrenal axis genes. LIMITATIONS Studying patient subgroups is needed in order to extract more comparable and reproducible epigenetic findings in suicide. CONCLUSIONS It is crucial to consider suicidal patients or suicide victims' distal and proximal past history e.g., early-life adversity and psychiatric disorder in epigenetic studies of suicidality.
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Affiliation(s)
- Serina Cheung
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada
| | - Julia Woo
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Faculty of Medicine, University of Toronto, Canada
| | - Miriam S Maes
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada
| | - Clement C Zai
- Neurogenetics Section, Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Canada; Institute of Medical Science, University of Toronto, Canada; Laboratory Medicine and Pathobiology, University of Toronto, Canada; Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
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Zhong BL, Xie WX, Zhu JH, Lu J, Chen H. Prevalence and correlates of suicide attempt among Chinese individuals receiving methadone maintenance treatment for heroin dependence. Sci Rep 2019; 9:15859. [PMID: 31666637 PMCID: PMC6821703 DOI: 10.1038/s41598-019-52440-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 10/17/2019] [Indexed: 02/08/2023] Open
Abstract
To date, there have been very limited studies regarding the clinical epidemiology of attempted suicide in Chinese individuals with heroin-dependence. The objective of this study was to examine the prevalence and correlates of suicide attempt in Chinese individuals receiving methadone maintenance treatment for heroin dependence. Demographic, clinical, and psychosocial data of 603 methadone-maintained patients with heroin dependence were collected with a standardized self-administered questionnaire. The presence of suicide attempt and antisocial personality disorder was assessed by using a single question and the Mini-International Neuropsychiatric Interview 5.0. The one-month and lifetime prevalence rates of suicide attempt were 9.5% and 34.2%, respectively. In multivariable logistic regression, lifetime suicide attempt was significantly associated with female gender (OR = 2.81), being 20–39 years old (OR = 2.73), an education level of primary school or lower (OR = 2.07), poor economic status (OR = 3.06), injecting heroin before methadone maintenance treatment (OR = 2.92), depressive symptoms (OR = 3.46), anxiety symptoms (OR = 1.88), and antisocial personality disorder (OR = 2.85). Suicide attempt is very prevalent among Chinese individuals receiving methadone maintenance treatment for heroin dependence. Services for patients with heroin dependence in methadone maintenance treatment clinics in China should include psychosocial supports, periodic screening for suicide attempt and other suicidal behaviors and, when needed, psychiatric treatment and crisis intervention.
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Affiliation(s)
- Bao-Liang Zhong
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan Province, China.,Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Wu-Xiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, China
| | - Jun-Hong Zhu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei Province, China
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Hongxian Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China. .,China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan Province, China.
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Association of Bedtime with both Suicidal Ideation and Suicide Planning among Korean Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203817. [PMID: 31658695 PMCID: PMC6843598 DOI: 10.3390/ijerph16203817] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/05/2019] [Accepted: 10/06/2019] [Indexed: 12/30/2022]
Abstract
STUDY OBJECTIVES In comparison to other countries, the South Korean population has a short average sleep duration, and studies have suggested that insufficient sleep is a risk factor for suicidal behavior. This study aimed to examine the association of bedtime with suicidal ideation and with suicide planning, respectively, among Korean adolescents. METHODS This study included 48,218 participants from the 2017 Korea Youth Risk Behavior Web-based Survey. Participants were divided into three categories: pre-23:00 bedtime, 23:00-01:30 bedtime, and post-01:30 bedtime. Suicidal ideation and suicide planning were the main dependent variables, and multiple logistic regression analysis was performed to examine the target association. RESULTS For both male and female respondents, compared to those who had a pre-23:00 bedtime, those whose bedtime was after 01:30 were more likely to have suicidal ideation (post-01:30 bedtime for men: OR = 1.29, 95% CI = 1.16-1.45; for women: OR = 1.32, 95% CI = 1.20-1.44). For suicide planning, the results were also significant for both genders (post-01:30 bedtime for men: OR = 1.41, 95% CI = 1.16-1.70; for women: OR = 1.21, 95% CI = 1.03-1.43). Odds of suicidal ideation were higher for those who had a post-01:30 bedtime on weekdays but not weekends. CONCLUSIONS We found that, among adolescents, going to bed after 01:30 is significantly associated with suicidal ideation and suicide planning, after adjusting for demographic, socioeconomic, and health-related characteristics. Therefore, late bedtime should be the timepoint of a suicide intervention for adolescents, in order to prevent developing suicidal ideations and suicide planning.
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Husain MO, Umer M, Taylor P, Chaudhry N, Kiran T, Ansari S, Chaudhry IB, Husain N. Demographic and psychosocial characteristics of self-harm: The Pakistan perspective. Psychiatry Res 2019; 279:201-206. [PMID: 30851986 DOI: 10.1016/j.psychres.2019.02.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 11/29/2022]
Abstract
Self-harm is a major public health issue in Pakistan, yet the characteristics of those who self-harm are under-explored. This is a secondary analysis from a large randomized control trial on the prevention of self-harm, exploring demographic, clinical and psychological characteristics of people who self-harm in Pakistan. A total of 221 participants with a history of self-harm were recruited from medical wards of three major hospitals in Karachi. The Beck Scale for Suicidal Ideation (BSI), Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), and Suicide Attempt Self Injury Interview (SASII) assessment scales were completed. The sample consisted predominantly of females (68.8%) in their 20's. Interpersonal difficulties were most commonly reported as the main antecedent to the self-harm, followed by financial difficulties. Participants had high severity scores on BSI, BDI and BHS. Pesticide and insecticide use were (n = 167, 75.6%) the most common methods of self-harm. The findings indicate that some characteristics of those who self-harm in Pakistan are comparable to other populations. This may raise the possibility of common causal mechanisms and processes. Future research needs to examine the efficacy of interventions targeting these risk factors in reducing rates of self-harm and thus suicide.
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Affiliation(s)
- M Omair Husain
- School of Biological Sciences, University of Manchester, Manchester, United Kingdom; Pakistan Institute of Living and Learning, Karachi, Pakistan.
| | - Madeha Umer
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Peter Taylor
- Division of Psychology & Mental Health, University of Manchester, Manchester, United Kingdom
| | - N Chaudhry
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Tayyebba Kiran
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Sami Ansari
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Imran B Chaudhry
- School of Biological Sciences, University of Manchester, Manchester, United Kingdom; Pakistan Institute of Living and Learning, Karachi, Pakistan; Department of Psychiatry, Ziauddin Hospital, Karachi, Pakistan
| | - Nusrat Husain
- Division of Psychology & Mental Health, University of Manchester, Manchester, United Kingdom
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Trajectories of Suicide Ideation and Attempts from Early Adolescence to Mid-Adulthood: Associations with Race/Ethnicity. J Youth Adolesc 2019; 48:1796-1805. [DOI: 10.1007/s10964-019-01074-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/28/2019] [Indexed: 02/03/2023]
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36
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Yasuma N, Watanabe K, Matsunaga A, Nishi D, Kawakami N. Personal values in adolescence and suicidality: a cross-sectional study based on a retrospective recall. BMC Psychiatry 2019; 19:214. [PMID: 31288769 PMCID: PMC6617935 DOI: 10.1186/s12888-019-2194-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 06/23/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This study retrospectively examined the association between personal values in adolescence and suicidality in a community-representative adult sample in Japan. METHODS Data were used from wave 1 (2010) and wave 3 (2017) of a Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) survey. Personal values at age 15 were retrospectively measured in 2017 in two ways: the original value priorities we made were based on the Schwartz theory of basic values; and the Japanese version of the Personal Values Questionnaire II (PVQ-II) was used to assess the degree of commitment to the values. Multivariate logistic regression analysis was used to estimate the association of personal values in adolescence with self-reported suicidal ideation, suicidal planning, and suicide attempt (both during a lifetime and in the most recent year), adjusting for socio-demographics, smoking, alcohol consumption, and economic status among 15 year olds. RESULTS Cherishing family and friends was significantly and negatively associated with suicidal ideation over a lifetime and in the most recent year. Commitment to values was also significantly and negatively associated with suicidal ideation in the most recent year. CONCLUSIONS Investigating the association between personal values and suicidality could make a significant contribution to the literature by offering a new approach to understanding and preventing suicide.
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Affiliation(s)
- Naonori Yasuma
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033 Japan
| | - Kazuhiro Watanabe
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033 Japan
| | - Asami Matsunaga
- 0000 0000 9832 2227grid.416859.7Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Daisuke Nishi
- 0000 0001 2151 536Xgrid.26999.3dDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033 Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033, Japan.
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Money TT, Batterham PJ. Sociocultural factors associated with attitudes toward suicide in Australia. DEATH STUDIES 2019; 45:219-225. [PMID: 31190630 DOI: 10.1080/07481187.2019.1626943] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
To investigate the role of cultural and economic factors on suicide attitudes and stigma toward suicide, we recruited 230 Australian adults for an online survey, assessing demographic characteristics (including ethnicity and socioeconomic status, SES), suicide attitudes, stigma toward people who die by suicide, and public knowledge of suicide prevention (suicide literacy). Regression analyses indicated that participants affiliated with non-Anglo cultures or with higher SES had higher suicide stigma and lower suicide literacy than Anglo participants and those in lower SES areas. Increased stigma in minority cultural groups may impact help-seeking behaviors that protect against suicide.
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Affiliation(s)
- Tammie T Money
- Medical School, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australia
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Cenderadewi M, Franklin RC, Peden AE, Devine S. Pattern of intentional drowning mortality: a total population retrospective cohort study in Australia, 2006-2014. BMC Public Health 2019; 19:207. [PMID: 30782167 PMCID: PMC6381671 DOI: 10.1186/s12889-019-6476-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 01/24/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND While a downward trend in unintentional drowning deaths in Australia has been observed, little is known about intentional drowning mortality. Limited information on intentional drowning death impedes the planning, implementation, and evaluation of prevention strategies. This study aims to describe rates of intentional fatal drowning in Australia and compare these to other categories of drowning. METHODS Data were sourced from the Australian Bureau of Statistics (ABS) over a 9-year period (2006-2014). Rates and trends of intentional drowning were compared with unintentional, water-transport related and undetermined intent drowning. Rates of intentional drowning deaths across gender, age groups, states/territories, remoteness of residence and First Peoples of Australia were calculated. Relative risk (RR) (95% confidence interval [CI]) was calculated, and chi-square tests of independence were performed (p < 0.05). RESULTS The crude mortality rate for intentional drowning deaths in Australia over the study period was 0.23/100000, lower than unintentional drowning (0.89/100000). Males were 1.6 (CI: 1.4-2.0) times more likely than females to intentionally drown, however females made up a significantly larger proportion of intentional drowning deaths (38.2%) compared to unintentional deaths (22.4%) (χ2 = 47.3; df = 1; p < 0.05). A significant linear association between age group and intentional drowning was observed (χ2 = 131.3; p < 0.05), with individuals aged 75 years and over 32.6 times more likely to intentionally drown. Non-Indigenous peoples were 4.1 times more likely to intentionally drown in comparison to First Peoples of Australia. Residents of Inner Regional, Outer Regional, and Major Cities were 4.2 times (CI: 0.6-30.0), 4.1 times (CI: 0.6-29.9), and 4.0 times (CI: 0.6-28.6) more likely to intentionally drown, respectively, compared with residents of Very Remote areas. CONCLUSIONS This study adds to the limited evidence currently available about intentional drowning rates and trends in Australia. Being male, of older age groups, non-Indigenous, residing in Inner and Outer Regional areas, and Major Cities were risk factors for intentional drowning deaths. Improving data collection systems and furthering understanding of the risk factors of intentional drowning, as well as the development, implementation, and evaluation of prevention programmes, are required to reduce the risk of intentional drowning death in Australia.
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Affiliation(s)
- Muthia Cenderadewi
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811 Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811 Australia
- Royal Life Saving Society – Australia, Sydney, NSW 2007 Australia
| | - Amy E. Peden
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811 Australia
- Royal Life Saving Society – Australia, Sydney, NSW 2007 Australia
| | - Sue Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811 Australia
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Budhwani H, Hearld KR, Milner AN, Charow R, McGlaughlin EM, Rodriguez-Lauzurique M, Rosario S, Paulino-Ramirez R. Transgender Women's Experiences with Stigma, Trauma, and Attempted Suicide in the Dominican Republic. Suicide Life Threat Behav 2018; 48:788-796. [PMID: 28950402 DOI: 10.1111/sltb.12400] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 06/29/2017] [Indexed: 12/01/2022]
Abstract
Studies on attempted suicide in transgender populations, particularly those in resource-limited settings, are scarce. We examined the relationships between stigma, trauma, and suicide attempts in a national sample of transgender women from the Dominican Republic. Bivariate analysis examined differences between suicide attempters and nonattempters (n = 298). Multivariate analysis reported odds ratios with attempted suicide as the outcome (n = 260). About a quarter of respondents (23.9%) experienced sexual abuse, 12.3% were tortured, and 20.3% experienced a murder attempt. More than a quarter reported using illegal drugs. Independent sample t tests found significant differences between suicide attempters and nonattempters. Attempters were more likely to have experienced sexual abuse, psychological abuse, torture, and a murder attempt (p < .001 for all). Respondents who experienced psychological abuse had over three times higher odds of attempting suicide, compared to respondents who had not (OR = 3.203, p < .01). Experience with torture and attempted murder were associated with higher odds of attempting suicide (OR = 2.967, p < .05 and OR = 2.894, p < .05, respectively). Although some nations have implemented antidiscrimination policies protecting transgender citizens, these policies are often not consistently enforced. Eliminating stigmatizing policies may reduce rates of negative health outcomes and subsequently improving population health.
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Affiliation(s)
- Henna Budhwani
- University of Alabama at Birmingham, University Boulevard, Birmingham, USA
| | - Kristine R Hearld
- University of Alabama at Birmingham, University Boulevard, Birmingham, USA
| | | | - Rebecca Charow
- Centro de Orientación e Investigación Integral (COIN), Santo Domingo, Dominican Republic
| | | | - Mayra Rodriguez-Lauzurique
- Centro de Orientacion e Investigación Integral (COIN), Santo Domingo, and Institute for Tropical Medicine & Global Health, Universidad Iberoamericana, Santo Domingo, Dominican Republic
| | - Santo Rosario
- Centro de Orientación e Investigación Integral (COIN), Santo Domingo, Dominican Republic
| | - Robert Paulino-Ramirez
- Institute for Tropical Medicine & Global Health, Universidad Iberoamericana, Santo Domingo, and Centro de Orientación e Investigación Integral (COIN), Santo Domingo, Dominican Republic
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Kim J, Yoon SY. Association between socioeconomic attainments and suicidal ideation by age groups in Korea. Int J Soc Psychiatry 2018; 64:628-636. [PMID: 30084278 DOI: 10.1177/0020764018792592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Suicidal ideation is a strong antecedent of suicidal behavior, associated with increased likelihood of suicide. Thus, suicidal ideation serves to identify which groups are at more risk of suicide and has policy implications for targeting groups to prevent suicide. AIMS: A substantial body of research has addressed potential determinants of suicide ideation in Korea. Little attention has been paid, however, to analyzing the extent to which socioeconomic attainments (education, household income, and employment status) are associated with risk of suicidal ideation, drawing on nationally representative data. METHODS: Data were drawn from the 2012 Korea Welfare Panel Study (KOWEPS). Among the 12,606 respondents, the findings are based on 1,500 young adults (age 18-35) and 3,469 middle-aged adults (age 36-55) who answered a question about suicidal ideation. RESULTS: For young adults, respondents from 2-year and 4-year colleges and higher had lower probabilities of suicidal ideation compared with respondents from high school. People out of the labor force also exhibited an elevated risk of suicidal ideation compared with those in waged employment. Middle-aged adults displayed different patterns. Middle-aged respondents from 4-year colleges or higher had an increased likelihood of suicidal ideation. The likelihood of reporting suicidal ideation was predicted to decrease as household income increased only for middle-aged adults. CONCLUSIONS: The information about suicidal ideation was obtained from only one question of self-response, which limits the validity of the suicidal ideation measurement. The cross-sectional setting of the data prevents us from estimating causal relationships. Nevertheless, the findings imply that age-specific policy should be implemented to ameliorate differential risk for suicidal ideation and benefit public mental health in the long run.
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Tomek S, Burton S, Hooper LM, Bolland A, Bolland J. Suicidality in Black American Youth Living in Impoverished Neighborhoods: Is School Connectedness a Protective Factor? SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-017-9241-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Posttraumatic Stress and Distress Tolerance: Associations With Suicidality in Acute-Care Psychiatric Inpatients. J Nerv Ment Dis 2017; 205:531-541. [PMID: 28604417 DOI: 10.1097/nmd.0000000000000690] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Trauma and posttraumatic stress disorder (PTSD) symptomatology have been associated with suicidality, including ideation and behavior. The current investigation evaluated, in acute-care psychiatric inpatients, the mediating role of perceived (self-reported) distress tolerance in the association between PTSD symptom severity and suicidality, defined as a) suicidal ideation, intent, or behavior leading to current psychiatric hospitalization; b) self-reported severity of suicidal desire; and c) percentage of days of suicidality during current hospitalization. Participants were composed of 105 adults (55.2% women; mean age, 33.9; SD, 10.9) admitted to a public psychiatric acute-care inpatient hospital in a large metropolitan area; 52.3% of the participants were hospitalized for suicidality. Results indicated that PTSD symptom severity (and severity of each PTSD symptom cluster) may exert an indirect effect on suicidality, specifically suicidality as a basis for current hospital admission and self-reported severity of suicidal desire, through perceived distress tolerance. Effects were documented after controlling for theoretically relevant covariates.
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Stevovic LI, Vodopic S. Attempted suicide in Podgorica, Montenegro: higher rates in females and unemployed males. Ann Gen Psychiatry 2017; 16:27. [PMID: 28680456 PMCID: PMC5496181 DOI: 10.1186/s12991-017-0151-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 06/27/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A change in suicide attempts is associated with comprehensive changes in mental and physical health and social environment. Attempted suicide and suicide are one of the biggest problems nowadays worldwide, not only in the field of mental health but also in the field of public health. The aim of the research was to determine the number of attempted suicides as well as the influence of clinical and demographic variables on the attempted suicide rate. METHODS The data on the attempted suicide were analysed in the period 2012-2016 based on the data from the Emergency Ward of the Clinical Centre of Montenegro in Podgorica. The rate of attempted suicides as well as the unemployment rate was calculated. The statistical analysis included descriptive statistics of the raw data and relative numbers, Chi-squared test, Fisher's test and Spearman coefficient. RESULTS The average age of males who attempted suicide was 38.35 ± 14.11, min 15 and max 88 years of age, and the age of women was 38.97 ± 16.81, min 16 and max 93 years of age. Women attempted suicide more frequently (p < 0.05). Female/male ratio during the investigation period slightly declined (1.93 in 2012 vs. 1.29 in 2016). The attempted suicide rates ranged from 103 per 100,000 residents in 2016 to 142 per 100,000 residents in 2015. Crude attempt rate was the highest in women in 2012 (102.42 per 100,000 residents) and for men in 2014 and 2015 (84.48 vs. 83.06 per 100,000 residents). Poisoning with psychotropic drugs was the dominant manner of attempt (93.2%), while the largest number of attempts was in the late spring and summer (May, June and July). Attempted suicide rate in man was associated with higher unemployment rate. CONCLUSIONS Although women make the majority of attempted suicide cases, there has been a decline in the value of the rate for women and a rise for men. The attempted suicide rates in Podgorica belong to lower rates compared to the WHO European multicentre study on parasuicide. Poisoning with psychotropic drugs was the predominant manner, while the highest number of attempted suicides was in the late spring and summer (May, June and July). Unemployment influences men to attempt suicide much more frequently.
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Affiliation(s)
- Lidija Injac Stevovic
- Clinical Department of Psychiatry, Clinical Centre of Montenegro, Podgorica, Montenegro.,Department of Psychiatry, School of Medicine, University of Montenegro, Dzona Dzeksona bb, Podgorica, Montenegro
| | - Sanja Vodopic
- Clinical Department of Neurology, Clinical Centre of Montenegro, Dzona Dzeksona bb, Podgorica, Montenegro
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