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Rice T, Livshin A, Rihmer Z, Walther A, Bhuiyan M, Boude AB, Chen YY, Gonda X, Grossberg A, Hassan Y, Lafont E, Serafini G, Vickneswaramoorthy A, Shah S, Sher L. International trends in male youth suicide and suicidal behaviour. Acta Neuropsychiatr 2024:1-21. [PMID: 39397775 DOI: 10.1017/neu.2024.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2024]
Abstract
OBJECTIVE Suicide and suicidal behaviour strongly contribute to overall male youth mortality. An understanding of worldwide data contextualises suicide and suicidal behaviour in young men within any given country. METHOD Members and colleagues of the World Federation of Societies of Biological Psychiatry's Task Force on Men's Mental Health review the relevant data from several regions of the world. The review identifies notable findings across regions of relevance to researchers, policymakers, and clinicians. RESULTS Male suicide and suicidal behaviour in adolescence and emerging adulthood within North America, Latin America and the Caribbean, Europe, the Mediterranean and the Middle East, Continental Africa, South Asia, East Asia, China, and Oceania share similarities as well as significant points of divergence. CONCLUSIONS International data provide an opportunity to obtain a superior understanding of suicide and suicidal behaviour amongst young men.
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Affiliation(s)
- Timothy Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anton Livshin
- Department of Psychiatry, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Zoltan Rihmer
- Semmelweis University Department of Psychiatry and Psychotherapy, Budapest, Hungary
- Nyiro Gyula National Institute of Psychiatry and Addictology, Budapest, Hungary
| | - Andreas Walther
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Mohammed Bhuiyan
- St. George's University School of Medicine, University Center, Grenada, West Indies
| | - Adriana Bruges Boude
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ying-Yeh Chen
- Taipei City Psychiatric Centre, Taipei City Hospital, Taipei City, Taiwan
- Institute of Public Health and Department of Public Health, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Xenia Gonda
- Semmelweis University Department of Psychiatry and Psychotherapy, Budapest, Hungary
| | - Aliza Grossberg
- New York University Grossman School of Medicine, New York, NY, USA
| | - Yonis Hassan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ezequiel Lafont
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gianluca Serafini
- Department of Neuroscience, San Martino Hospital, University of Genoa, Genoa, Italy
| | | | - Salonee Shah
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leo Sher
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Upfold C, Jentz C, Heilmann P, Nathanielsen N, Chaimowitz G, Sørensen LU. Forensic psychiatry patients, services, and legislation in Nunavut and Greenland. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2023; 91:101921. [PMID: 37690360 DOI: 10.1016/j.ijlp.2023.101921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/27/2023] [Accepted: 08/26/2023] [Indexed: 09/12/2023]
Abstract
Circumpolar regions face unique challenges in establishing and maintaining mental health care systems, including forensic psychiatry services. The scarcity of data and lack of evidence concerning the forensic psychiatry patient (FPP) populations of Nunavut and Greenland exacerbates the challenges of informing best practices and healthcare planning. By comparing the prevalence of forensic psychiatry patients, the mental health care services, and the legislation in these two relatively similar but unique regions, insight may be gained that can help inform healthcare planning. This cross-sectional study includes all forensic psychiatry in- and outpatients in one year from Nunavut (2018) and on February 29, 2020, in Greenland. The Greenland sample (n = 93) was nearly four times larger than the Nunavut sample (n = 15) at the population level. Despite considerable differences in forensic legislation and service supply, the forensic psychiatry patients in the two areas share several similarities. A total of 87% (n = 13) in the Nunavut sample were diagnosed with a DSM-5 schizophrenia spectrum disorder or other psychotic disorder. In Greenland, 82% (n = 76) were diagnosed with an ICD-10 F2 diagnosis (schizophrenia, schizotypal and delusional disorders). Approximately 2/3 of the patients in both populations were diagnosed with substance use disorder, and 60% of the Nunavut FPP received long-acting antipsychotic injections versus 62% in Greenland. Nearly half of the FPPs in both populations had never been convicted prior to entering the forensic psychiatry system; Nunavut 45% versus Greenland 47%. A substantial proportion of Greenlandic FPPs were outpatients compared to Nunavut (83% versus 47%). This study is an essential first step toward describing a Model of Care for forensic psychiatry patients in circumpolar regions; furthermore, the clinical similarities between the two populations provide support for future joint Arctic research and the inclusion of artic forensic patients in international studies.
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Affiliation(s)
- Casey Upfold
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Canada
| | - Christian Jentz
- Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Denmark; Institute of Clinical Medicine, Health, Aarhus University, Denmark
| | | | | | - Gary Chaimowitz
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton, Canada; McMaster University, Department of Psychiatry and Behavioural Neurosciences, Canada.
| | - Lisbeth Uhrskov Sørensen
- Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Denmark; Institute of Clinical Medicine, Health, Aarhus University, Denmark.
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Høilo Granheim IP, Kvernmo S, Silviken A, Lytken Larsen CV. The association between suicidal behaviour and violence, sexual abuse, and parental substance abuse among Sami and Greenlandic adolescents: the WBYG study and the NAAHS. Scand J Child Adolesc Psychiatr Psychol 2023; 11:10-26. [PMID: 37082430 PMCID: PMC10111208 DOI: 10.2478/sjcapp-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Background For young Indigenous people, suicide is one of the leading causes of death, and high rates in Arctic areas indicate serious health and societal concerns. More knowledge is needed, as suicidal behaviour predicts later death by suicide. The aim of this study was to investigate associations between suicidal thoughts and suicide attempts and negative life events, including violence, sexual abuse, and parental substance abuse, in Sami and Greenlandic adolescents, within and between groups and gender. Method Working samples included 442 Sami and 399 Greenlandic Inuit (15-16-year-olds), in The Norwegian Arctic Adolescent Health Study (NAAHS) and the Well-Being among Youth in Greenland (WBYG) study. Multivariable logistic regression explored associations between suicidal behaviour and violence, sexual abuse, and parental substance abuse. Results Across Indigenous groups, suicidal thoughts and attempts were significantly associated with violence and sexual abuse. The association between suicidal behaviour; especially suicidal thoughts, and sexual abuse was significant and strong among Sami females. Sami and Inuit adolescents with a history of childhood violence reported significantly more suicide attempts; the strongest association was found among Sami males. Conclusion To Sami and Greenlandic Inuit, the experiences of negative life events, such as violence or sexual abuse are significant risk factors for suicidal behaviour. Public health programmes and prevention strategies targeting youth mental health and suicide should be culturally sensitive and sensitive to gender differences in the association between negative life events and suicidal behaviour.
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Affiliation(s)
- Ida Pauline Høilo Granheim
- Department of clinical medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Siv Kvernmo
- Department of clinical medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Silviken
- Centre for Sami Health Research, Faculty of Health Sciences, UiT The Arctic University of Norway, Karasjok, Norway
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Pedersen HB, Pedersen BB, Biilmann M, Møller M, Lohse N, Vedsted P, Mikkelsen S. Medical evacuations in Greenland in 2018: a descriptive study. Int J Circumpolar Health 2022; 81:2014634. [PMID: 34939902 PMCID: PMC8725698 DOI: 10.1080/22423982.2021.2014634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/05/2022] Open
Abstract
Information regarding medical evacuations in Greenland is sparse. This study provides an overview of incidence, costs, and diagnoses leading to medical evacuations in Greenland in 2018. This is a retrospective, observational study. Patients with a valid Danish civil personal registration number were included. Data were obtained by scrutinising the itinerary of the Greenland travel coordination office and the medical records. 481 patients were identified. Forty-nine patients were excluded. 432 patients were analysed. Two-thirds of the evacuations were carried out within Greenland. The overall incidence of evacuations was 7.7 evacuations per 1,000 inhabitants per year. This differed, however, between the five different health regions. The cost of a medical evacuation ranged from less than 4,800 US dollars to more than 50,000 US dollars per case. Pregnancy and childbirth accounted for the majority of evacuations in women (31.2%) while diseases within the circulatory system and digestive tract accounted for the majority of evacuations in men (39.8%). The costs of medical evacuations may be reduced when combining evacuations of more than one patient. This indicates that combining evacuations of multiple patients from one health region by applying mandatory use of a central coordinating service may be beneficial.
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Affiliation(s)
- Helena Breum Pedersen
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Bastian Breum Pedersen
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Mark Biilmann
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Malik Møller
- Department of Emergency Medicine, Holbæk Hospital, Holbæk, Denmark
| | - Nicolai Lohse
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
- Department of Emergency Medicine, Copenhagen University Hospital Nordsjælland, Hillerød, Denmark
| | - Peter Vedsted
- Ilulissat Hospital, Ilulissat, Greenland
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren Mikkelsen
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Jentz C, Heilmann P, Nathanielsen N, Upfold C, Kleist I, Sørensen LU. Suicide attempts among Greenlandic forensic psychiatric patients - prevalence and determinants. Int J Circumpolar Health 2022; 81:2037257. [PMID: 35289239 PMCID: PMC8928785 DOI: 10.1080/22423982.2022.2037257] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This nationwide cross-sectional study of the lifetime prevalence and determinants of suicide attempts includes 90% of Greenlandic forensic psychiatric patients. Retrospective data were collected from electronic patient files, court documents, and forensic psychiatric assessments using a coding form from a similar study. We used unpaired t-tests and chi2 or Fisher's exact test. The lifetime prevalence of suicide attempts was 36% (n = 32), and no difference in prevalence was found between male and female patients (p = 0.95). Patients having attempted suicide had a higher rate of physical abuse in childhood (p = 0.04), family history of substance misuse (p = 0.007), and criminal convictions among family members (p = 0.03) than patients who had never attempted suicide. Women primarily used self-poisoning in their latest suicide attempts (67%), whereas men more often used sharp objects or a firearm (42%). Over a third of Greenlandic forensic patients have attempted suicide at some point in their life, and patients with traumatic childhood experiences are at higher risk of suicidal behaviour. It is not possible to conclude whether the lifetime prevalence of suicide attempts among Greenlandic forensic patients is comparable to that of other high-risk groups in other Arctic regions due to methodological differences among the very few other comparable studies.
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Affiliation(s)
- Christian Jentz
- Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | | | - Naaja Nathanielsen
- The Directorate of Correctional Services, Prison and Probation Service, Nuuk, Greenland
| | - Casey Upfold
- Forensic Psychiatry Program, St. Joseph's Healthcare Hamilton - West 5th Campus, Hamilton, ON, Canada
| | - Inaluk Kleist
- Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Lisbeth Uhrskov Sørensen
- Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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Granheim IPH, Silviken A, Larsen CVL, Kvernmo S. Socio-demographic, psychosocial and environmental factors associated with suicidal behaviour in Indigenous Sami and Greenlandic Inuit adolescents; the WBYG and NAAHS studies. Int J Circumpolar Health 2021; 80:1913939. [PMID: 33856268 PMCID: PMC8057081 DOI: 10.1080/22423982.2021.1913939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background. For young Indigenous people, suicide is one of the leading causes of death, and high rates in Arctic areas indicate serious health- and societal concerns. More knowledge is needed, as suicidal behaviour predictslater death by suicide.Objectives. The objective was to study associations between suicidal thoughts and suicide attempts and socio-demographic, psychosocial, and environmental factors in Sami and Greenlandic adolescents, within and between groups and gender.Methods. Working samples included 442 Sami and 399 Greenlandic Inuit (15-16-year-olds), in "The Norwegian Arctic Adolescent Health Study" (NAAHS) and "Well-being among Youth in Greenland" (WBYG). Multivariable logistic regression explored associations between suicidal behaviour and family , ethnic language , school, friendship, and suicide in close relations.Results. Across Indigenous groups, suicidal behaviour was associated with the female gender, relationships with parents, suicide of friends, and rural living. Sami adolescents in stepparent families reported more suicidal behaviour. Inuit adolescents living outside the family and with poor school performance reported more suicidal thoughts. Inuit adolescents spending less time with friends reported more attempts. Gender differences occurred in both groups.Conclusion. To Sami and Greenlandic Inuit, family and peer relations are important factors of suicidal behaviour. Prevention programmes should be sensitive to gender and bereavement.
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Affiliation(s)
- Ida Pauline Høilo Granheim
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsoe; the Arctic University of Norway, Tromsoe, Norway
| | - Anne Silviken
- Sámi Norwegian National Advisory Unit for Mental Health and Substance Use, Sámi Klinihkka, Finnmark Hospital Trust, Karasjok, Norway.,Centre of Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, University of Tromsoe; the Arctic University of Norway, Tromsoe, Norway
| | - Christina Viskum Lytken Larsen
- Centre for Public Health in Greenland, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.,Greenland Centre for Health Research, University of Greenland, Nuuk, Greenland
| | - Siv Kvernmo
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsoe; the Arctic University of Norway, Tromsoe, Norway
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Sargeant H, Forsyth R, Pitman A. The Epidemiology of Suicide in Young Men in Greenland: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2442. [PMID: 30388882 PMCID: PMC6266058 DOI: 10.3390/ijerph15112442] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 10/25/2018] [Accepted: 10/27/2018] [Indexed: 12/03/2022]
Abstract
Suicide is the leading cause of death among young men aged 15⁻29 in Greenland, but few epidemiological studies have described this problem. We aimed to summarise descriptive epidemiological studies of suicide in young men in Greenland compared with other demographic groups in Denmark and Greenland to inform future suicide prevention strategy. We searched PubMed, PsycINFO, and Embase using an agreed search strategy to identify English-language papers describing suicide epidemiology in Greenlandic men aged 15⁻29. We followed PRISMA guidelines in screening and appraising eligible publications. Eight articles fulfilled inclusion criteria of 64 meeting search criteria. Findings covering 1970⁻2011 supported a dramatic rise in suicide rates in Greenlandic men aged 15⁻24 from 1976, who remained the highest-ranking demographic group over 1976⁻2011 compared with men and women of all age groups in Denmark and Greenland. Highest rates recorded were almost 600 per 100,000 per year in men aged approximately 20⁻23 over 1977⁻1986. No studies described suicide epidemiology after 2011, and no studies described risk factors for suicide in young men. Given the very high suicide rates recorded for young men over 1976⁻2011, such studies will be essential for informing the development and evaluation of appropriate preventive interventions.
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Affiliation(s)
| | | | - Alexandra Pitman
- UCL Division of Psychiatry, London W1W 7NF, UK.
- Camden & Islington NHS Foundation Trust, London NW1 0PE, UK.
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