Depression and suicidal ideation among the geriatric population of Kashmir, India

Prevalence of suicidal ideation and its associated factors among the geriatric population in Vyas Municipality, Tanahun District, Nepal: a cross-sectional study

BACKGROUND

Suicidal ideation among the geriatric population is a pressing concern, particularly in regions such as Nepal where mental health resources are limited. This study aimed to determine the prevalence of suicidal ideation and its associated factors among the geriatric population in Vyas Municipality, Nepal.

METHODS

A cross-sectional study was conducted among individuals aged 60 years and above in Vyas Municipality, Nepal. A total of 311 participants were selected using multistage sampling. The data were collected through face-to-face interviews using a structured interview schedule. Multivariate logistic regression analysis was performed to identify independent variables associated with suicidal ideation.

RESULTS

The overall prevalence of suicidal ideation within the last twelve months among the geriatric population was 6.4% (n = 20). After adjustment for covariates in multivariate logistic regression analysis, living in a nuclear family (OR: 3.033, C.I. 95%:1.007-9.136), and experiencing depressive symptoms [(Mild depression:- OR: 5.358, C.I. 95%:1.548-18.539), (Moderate depression:- OR: 15.739, C.I. 95%:2.536-97.687), and (Severe depression:- OR: 17.423, C.I. 95%:2.218-136.878)] were found to be significant influencing factors for suicidal ideation.

CONCLUSION

This study emphasizes the need to enhance mental health services and strengthen family and community support systems to address suicidal ideation among older adults in Nepal. Further research is required to identify additional determinants and evaluate interventions to mitigate this risk.

An examination of levels of depression, the probability of suicide, and autistic traits in medical faculty students: A cross-sectional study

Depression and suicide attempts are reported to be high among medical students. It has also been reported that depression, suicide attempts, and autistic traits may be significantly related. The aim of this study was to determine the suicide probability and autistic traits of medical students with and without depression symptoms, and to examine the relationship between depression symptoms, suicide probability, and autistic traits together in these students. This cross-sectional study was conducted among 313 medical students, 206 female, and 107 male, who, according to the sociodemographic form, did not have any current psychiatric diagnosis, chronic medical or neurological disorders requiring treatment, or regular use of psychotropic medications, and who completed the forms in full. All the study participants completed a sociodemographic form, the Beck depression inventory (BDI), the suicide probability scale (SPS), and the autism spectrum quotient (ASQ).The entire study sample was divided into 2 groups: students with and without symptoms of depression, based on BDI scores. In the multivariate analysis, independent predictors of depression symptoms were examined using logistic regression analysis. The BDI total points (z = -13.99, P < .001), SPS total points (z = 10.61, P < .001), and subscale points of hopelessness (z = -9.28, P < .001), suicidal ideation (z = 8.48, P < .001), negative self-evaluation (z = -9.26, P < .001), and hostility (z = -8.10, P < .001), and the ASQ subscale points of communication (z = -5.05, P < .001), social skills (z = -6.05, P < .001), imagination (z = -3.27, P = .001), attention shifting (z = -4.35, P < .001), and ASQ total points (z = -6.64, P < .001) were significantly higher for the participants with BDI total points above the cutoff value compared to those with BDI total points below the cutoff value. Statistically significant positive correlations were found between BDI total points and SPS total points (R = 0.710, P < .001), ASQ total points (R = 0.451, P < .001), and between ASQ total points and SPS total points (R = 0.534, P < .001). The contribution of age, gender, ASQ, and SPS total points to explaining depression symptoms was evaluated using logistic regression analysis. This analysis showed that the SPS total points could be a significant predictor of depression symptoms (B = 0.112, P < .001). The findings of this study showed that the probability of suicide and the ASQ total and subscale points of communication, social skills, imagination, and attention shifting were significantly higher in medical students with symptoms of depression compared to those without depressive symptoms. Given the important relationship between symptoms of depression, suicidality, and autistic traits, it is crucial to raise awareness of these issues among medical education departments, health practitioners, medical students, and to provide the necessary guidance and clinical support for medical students to address these problems.

Factors influencing the level of insight and treatment attitude: a cross-sectional study of 141 elderly patients of major depression in Guangzhou, China

Objective

To explore the insight, treatment attitude, and related influencing factors of hospitalized elderly patients suffering from major depression.

Methods

A total of 141 hospitalized elderly patients with depression were selected as the research objects. Insight was evaluated by the total score of the Insight and Treatment Attitude questionnaire (ITAQ). The data collected included sociodemographic characteristics, psychiatric symptoms, delirium status, social functioning, social support, suicide risk, and cognitive function.

Results

The sample included 74.5% of female patients, and the mean age was 67.53 (sd=7.19) years. The influencing factors of inpatients with depression included alcohol consumption, length of hospitalization, admission types, and the main caregivers (P<0.05). The various factors were further analyzed by linear regression, revealing that the insight and treatment attitude of elderly depressed hospitalized patients were mainly related to the Mini-Mental State Examination (MMSE) (β= 0.225, 95% CI 0.055-0.395, P=0.01), dependent on a caregiver (β=-5.810, 95% CI -8.086~-3.535, P<0.001), the type of admission (involuntary admission) (β=-3.365, 95% CI -5.448~-1.283, P=0.002), Functional Activities Questionnaire (FAQ) (β=-0.156, 95% CI -0.303~-0.010, P=0.037), and length of stay (≤28 days) (β=2.272, 95% CI 0.055~-4.489, P=0.045).

Conclusion

The level of insight was affected by cognitive function, involuntary admission, dependent on a caregiver, social function and length of stay. Future studies should focus on cognitive function recovery, observation of admission mode, and self-care ability in elderly patients with depression.

Association between cognitive functioning and lifetime suicidal ideation among Chinese older adults: the mediating effect of depression

PURPOSE

Existing evidence indicates an association between cognitive functioning and both geriatric depression and suicidality, with mixed evidence regarding the direction of the relationship between cognitive functioning and aspects of geriatric lifetime suicidal ideation. This study aims to examine the relationship between cognitive functioning, depression, and suicide ideation and to explore the intermediary role of depression between cognitive functioning and suicidal ideation in the older adults.

METHODS

A multi-stage random cluster sampling method was used to collect a sample of 3896 individuals aged 60 and above. Descriptive statistics of the sample data were analyzed using one-way ANOVA, and then the correlation between variables was obtained by binary logistic regression analysis. SPSS macro program PROCESS V3.5 was used to test the mediating role of depression in the relationship between cognitive function and lifetime suicidal ideation.

RESULTS

The prevalence of lifetime suicidal ideation among older adults was 3.9%. Lifetime suicidal ideation was associated with depression (OR = 1.308, P < 0.001) but was not significantly correlated with cognitive function (OR = 0.972, P > 0.05). The relationship between cognitive function and depression was also supported in this study (β = - 0.0841, P < 0.001). Depression completely mediated the relationship between cognitive function and lifetime suicidal ideation.

CONCLUSION

There was no significant correlation between cognitive impairment in older adults and a heightened risk of lifetime suicidal ideation. However, this relationship was completely mediated by depression. It is crucial to prevent the onset of depression among older adults with cognitive impairment, as depression is strongly linked to lifetime suicidal ideation.

Association between suicide attempts and anemia in late-life depression inpatients

BACKGROUND

Anemia is strongly associated with late-life depression (LLD), however, few studies have investigated the relationship between anemia and suicide attempts in LLD patients. It is still challenging to predict suicide risk in patients with depression. Therefore, there is growing interest in potential biomarkers of depressive disorders and suicidal behavior, which may play a significant role in the early diagnosis and treatment of depression. This study aimed to compare serum ferritin, folate, vitamin B12, and erythrocyte parameter levels in patients with LLD with those in healthy older adults, and the relationship between serum ferritin, folate, vitamin B12, and suicide attempts in patients.

METHODS

Serum ferritin, folate, vitamin B12, and erythrocyte parameter levels were measured in 66 hospitalized LLD patients (30 without suicide attempt, 36 with suicide attempt) and 47 healthy individuals. All participants were surveyed for basic conditions and suicide attempts, and depression was assessed in LLD patients.

RESULTS

Serum ferritin, folate, vitamin B12, red blood cell count, hemoglobin, hematocrit, mean platelet volume and plateletcrit levels were significantly lower in LLD patients compared with healthy older adults (P < 0.05). Further analysis of the relationship between serum ferritin, folate, and vitamin B12 levels and LLD patients' suicide attempts and showed a significant negative association between serum folate and vitamin B12 and suicide attempts (P < 0.05).

CONCLUSIONS

Serum ferritin, folate, vitamin B12, red blood cell count, hemoglobin, hematocrit, mean platelet volume and plateletcrit levels were significantly lower in LLD patients than in healthy older adults. In addition, reduced serum folate and vitamin B12 levels in patients may have some effect on suicide attempts. More mechanistic studies are needed to further explain this association.

Examining the determinants of health and long-term care for older adults in India through a socio-ecological model - A qualitative assessment

Background

Ageing is associated with multiple long-term health problems and requires medication management, support with activities of daily living, and attention to psychological needs. This study aimed at exploring the enablers and barriers and psychosocial determinants of long-term care.

Methods

A qualitative study, using semi-structured interviews and thematic analysis, was carried out from February to June 2018. One-on-one in-depth interviews were carried out with 28 participants, including care recipients (n = 12), caregivers (n = 12), and primary-care physicians (n = 4) at the Community Health Centre in the state of Jammu and Kashmir of India.

Results

Attention from family members, leisure activities, faith in the healthcare provider, and a positive attitude towards life were found to be enablers of long-term care. Resource constraints and alienation from the community were barriers. Incorporating the psychosocial needs of care recipients and problems faced by family caregivers is essential in providing good quality care to individuals with chronic illness.

Conclusion

The lack of a targeted, nationwide policy has resulted in considerable variability in long-term care services across the country. There is an urgent need to make long-term care an integral part of the Indian health system utilizing a holistic framework to address the health needs of older adults and implementing it through an equitable community-based comprehensive primary health and community-based model.

Moral injury and suicidal ideation among health professionals: The role of mental health

BACKGROUND

The prolonged COVID-19 pandemic has burdened health professionals mentally and physically. This study aims to explore the relationship between moral injury (MI) and suicidal ideation (SI), and the role of mental health conditions in this relationship.

METHODS

Three-wave repeated online cross-sectional study with a total of 10,388 health professionals were conducted in different stages (2020-2022) of the COVID-19 pandemic in mainland China. Participants completed the Chinese version of the Moral Injury Symptoms Scale-Health Professional, Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5 coupled with a blanket of scales.

RESULTS

The prevalence of SI and MI among health professionals was 9.8 % and 40.2 %, respectively. The prevalence risk of SI was lower in wave 2 (OR = 0.64, 95 % CI: 0.54-0.77) and wave 3 (OR = 0.71, 95 % CI: 0.60-0.84) when compared with wave 1. MI (OR = 4.66, 95 % CI: 3.99-5.43), medical error (OR = 1.15, 95 % CI: 1.00-1.32), workplace violence (OR = 1.13, 95 % CI: 0.97-1.32), depression (OR = 94.08, 95 % CI: 63.37-139.69), anxiety (OR = 25.54, 95 % CI: 21.22-30.74), PTSD (OR = 24.51, 95 % CI: 19.01-31.60) were associated with a higher risk of SI. The mediation model revealed that depressive, anxiety, and PTSD symptoms explained 90.6 % of the total variance in the relationship between MI and SI.

CONCLUSIONS

The risk of SI has reduced among health professionals since the first peak of the COVID-19 pandemic in China. MI may contribute to prevalent SI, and mental health conditions, especially depressive symptoms, play a significant role as mediators.

LIMITATIONS

Cross-sectional design precludes the investigation of casual relationships. The nonrandom sampling method limits the generalization.

Suicidal behavior sociocultural factors in developing countries during COVID-19

OBJECTIVES

Sociocultural factors in the aftermath of any pandemic can play a role in increasing suicidal behavior like suicidal ideation, suicidal attempts, or suicide. The authors discuss the risk and predisposing factors for suicidal ideation among mental health patients in four developing countries (Bangladesh, Colombia, India and Pakistan), this aims to grasp the heterogeneity of these motivators and to elaborate specific interventions regarding suicide in the COVID-19 pandemic.

METHODS

We searched PubMed, Medline, and Google Scholar through March, 2021 for articles using a combination of the keywords and generic terms for suicide, suicide ideation, COVID-19, developing countries, low-middle-income countries, Sociocultural factors, Suicidal behavior, predisposing factors and predictive factors, for articles in English language only, and without publication time restriction.

RESULTS

This narrative review summarizes the sociocultural risk and predisposing factors for suicidal behavior in developing countries during the COVID-19 pandemic. The findings reveal those factors such as fear of being infected, growing economic pressure, lack of resources due to lockdown are mostly responsible in the four countries for the current increase in suicides. There are a few cultural differences that are specified in the narrative.

CONCLUSION

The COVID-19 pandemic is a public health challenge, in which prevention and intervention of suicidal behavior have been suboptimal, especially in low-middle-income countries. Based on literature results, we provide practical suggestions (e.g., reducing infodemic, specialized helplines, improving mental health services availability) in order to tackle main challenges of suicide prevention, such as lack of adequate manpower, fragile health system and poverty.

Clinical symptoms and their relationship with cognitive impairment in elderly patients with depressive disorder

OBJECTIVE

To evaluate the correlation between clinical symptoms and cognitive impairment in elderly patients with depressive disorder.

METHODS

In this retrospective study, a total of 123 elderly patients with depressive disorder admitted to our hospital from January 2020 to February 2021 were included. Patients' cognitive function was assessed by the Montreal Cognitive Assessment Scale (MoCA). According to the combination of cognitive impairment or not, patients were divided into the combined group (64 cases) and the depressive disorder group (59 cases). In addition, 70 healthy people who came to our hospital for physical examination during the same period were randomly selected as the healthy group.

RESULTS

The incidence of severe cognitive impairment in the combined group (33, 51.56%) was significantly higher than that in the depression group (19, 32.20%), the difference was statistically significant (P = 0.003). The incidence of somatization symptoms, suicidal tendency, retardation of thinking, diminution of energy, anxiety and sleep disorder in the combined group were higher than that in the depressive disorder group with significant difference [30 (56.88%) vs. 16 (27.12%), P = 0.024; 12 (18.75%) vs. 3 (5.08%), P = 0.021; 33 (51.56%) vs. 14 (23.73%), P = 0.002; 37 (57.81%) vs. 23 (38.98%), P = 0.029; 42 (65.63) vs. 25 (42.37), P = 0.011; 50 (78.13) vs. 42 (71.19), P = 0.031, respectively]. Spearman rank correlation analysis suggested that somatic symptom, mood change, suicidal tendency, retardation of thinking, diminution of energy, anxiety, and sleep disorder were negatively correlated with cognitive impairment, respectively (r =-0.161, -0.672, -0.262, -0.871, -0.421, -0.571, -0.512, P < 0.001).

CONCLUSION

The clinical symptoms of depressive disorder were negatively correlated with cognitive impairment. Somatic symptoms, suicidal tendency, retardation of thinking, diminution of energy, anxiety, and sleep disorder were the risk factors for cognitive impairment.

Prevalence of Major Depressive Disorder and Correlates of Thoughts of Death, Suicidal Behaviour, and Death by Suicide in the Geriatric Population-A General Review of Literature

Background: There has been an increase in deaths by suicide in old age in the last decade. Depression and suicide in the elderly, 60 years and above, is a major global public health concern. Determining the prevalence of depression, and correlates of death by suicide in the geriatric population, is an important first step toward addressing this public health concern. This literature review aims to determine the prevalence of major depressive disorders and the correlates of death by suicide in the geriatric population. Methods: This general review of the literature was performed using relevant search terms to determine both the prevalence of depression and the correlates of death by suicide among the geriatric population. Databases such as MEDLINE, PsycINFO, CINAHL, and PubMed were searched. Relevant and current articles were extracted, reviewed, and analyzed. The elderly population was defined as individuals 60 years and above. Only full texts articles in English were reviewed. Findings: The prevalence estimates of major depressive disorder in the elderly ranged from 5.37 to 56%. Adults aged 60 years and older have a high risk of depression that exposes them to suicide. Moreover, elderly women are more likely to experience depression than elderly men, but successful suicide is more common in men. Depression and other mental health conditions (schizophrenia, anxiety disorders) and perceived stress were found to be predictors of suicide in the elderly. Other predictors included physical illnesses such as malignancies, financial constraints, cuckoldry, and sexual dysfunction, and also social factors like living alone triggers depressive symptoms and increases suicidal risk in the elderly. Hanging was found to be the most common method of death by suicide for both sexes. While elderly women preferred poisoning, elderly men in Western countries preferred firearms. Differences in gender, the aging process and social issues were also contributing factors to methods used for suicide. Conclusions: Depression and debilitating physical illnesses were identified as significant contributors to suicide risk in the elderly population, and emphasis should be placed on identifying these factors early and treating them. Recognizing and addressing factors that predict suicide in the elderly will help to improve the mental wellbeing of the elderly.

Quality of Newspaper Reporting of Suicide in Kashmir: Adherence to World Health Organization Guidelines

Background: Sensible media reporting of suicide is one of the important prevention strategies. However, there has been no report assessing the quality of media reporting of suicide in Kashmir, India.Aim: We aimed to assess the quality of newspaper reporting of suicide in Kashmir, India against the World Health Organization (WHO) reporting guidelines.Methods: We searched the available contents in four English and two Urdu newspapers of Jammu Kashmir and assessed the adherence to the WHO media guidelines. We collected the reports between 25 January 2016 and 18 September 2020.Results: A total of 152 reports were scrutinized. Almost all the reports mentioned the name of the person and the method of suicide (99.34%), occupation (85.53%) of the person. The life events were mentioned in 35.53% of the reports. Among the reports, 38.82% explained suicide on the basis of the mono-causality, and 3.95% mentioned suicide notes. Only 3.29% of reports had traced mental illness, and none of the reports mentioned evidence of substance abuse. Only three reports mentioned expert opinion, and none of the reports mentioned any research findings, statistics, prevention programs, educational information, and contact information for help.Conclusion: The study revealed that news reports of suicide in Kashmir adhere poorly to the WHO media reporting guidelines. Identifying information of the deceased was explicitly mentioned in almost every report while almost none of the reports mentioned educational information.