1
|
Moloney F, Amini J, Sinyor M, Schaffer A, Lanctôt KL, Mitchell RHB. Sex Differences in the Global Prevalence of Nonsuicidal Self-Injury in Adolescents: A Meta-Analysis. JAMA Netw Open 2024; 7:e2415436. [PMID: 38874927 PMCID: PMC11179134 DOI: 10.1001/jamanetworkopen.2024.15436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/20/2024] [Indexed: 06/15/2024] Open
Abstract
Importance Nonsuicidal self-injury (NSSI) is a strong predictor of suicide attempts. The prevalence of NSSI has been increasing among female adolescents in North America and Europe, but less is known about trends in other geographical regions. Objective To examine sex differences in the prevalence of NSSI among adolescents within and between geographical regions. Data Sources MEDLINE and PsycINFO were searched using the keywords adolescents, self-injury, sex factors, and synonyms for articles published in English between January 1, 2000, and May 10, 2022. Study Selection Studies were included if they presented original data (any study design), included adolescents aged 10 to 19 years, reported results stratified by sex, and explicitly defined self-injury as behaviors occurring without suicidal intent. Data Extraction and Synthesis This meta-analysis was registered with PROSPERO and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Articles were assessed for quality by 2 independent coders (F.M. and J.A.). A random-effects model was used to calculate prevalence. Data were analyzed from July 2022 to April 2023. Main Outcomes and Measures The prevalence of NSSI in male and female adolescents within and between regions was the main outcome. Odds ratios (OR) with 95% CIs were calculated for community samples. Results Eight hundred and two studies were screened, and 38 were included (266 491 participants). Across 17 countries, the pooled prevalence of NSSI was 17.7% (female:male OR, 1.60; 95% CI, 1.29-1.98). NSSI was twice as prevalent among female adolescents compared with male adolescents in North America (OR, 2.49; 95% CI, 2.16-2.86) and Europe (OR, 2.08; 95% CI, 1.69-2.58), but not in Asia (OR, 1.00; 95% CI, 0.71-1.41). Conclusions and Relevance In this meta-analysis of sex differences in global prevalence of NSSI, the female predominance of NSSI observed among adolescents in North America and Europe aligned with rising rates of suicide in these populations. The comparable prevalence of NSSI among male and female adolescents in Asia also aligned with the lower male-to-female suicide ratio compared with other countries. More research is needed to characterize regional (and potentially cultural) sex differences among adolescents with NSSI to prevent and treat the behavior and to understand the possible interplay with corresponding regional trends in suicide.
Collapse
Affiliation(s)
- Fiona Moloney
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jasmine Amini
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mark Sinyor
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Krista L Lanctôt
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Rachel H B Mitchell
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Gheshlagi F, Meamar R, Rastkerdar F, Akbari Jebeli A, Soleimanpour A, Haddad S, Eizadi-Mood N. Investigating the Effect of Substance Desire and Child Abuse in Adolescent Suicide Attempt. ADDICTION & HEALTH 2024; 16:115-121. [PMID: 39051037 PMCID: PMC11264480 DOI: 10.34172/ahj.2024.1448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 02/15/2024] [Indexed: 07/27/2024]
Abstract
Background This study aimed to investigate the impact of child abuse and substance desire on adolescent suicide. Methods This cross-sectional analytical study was conducted on all adolescents aged 12 to 19 who attempted suicide in 2018 at Khorshid Hospital, Isfahan, Iran. A checklist of the patients' demographic information, toxicological data, and 2 standard questionnaires, including substance desire (family, personal, social) and child abuse questionnaire (emotional abuse, physical abuse, and neglect abuse), were collected. The data were analyzed using SPSS version 15. Comparisons between the 2 groups were performed using t tests, chi-square tests, regression analysis, and crude model analysis. Odds ratio (OR) and 95% confidence interval were calculated based on logistic regression. Findings A total of 196 teenagers were included in the study, with a mean age of 16.48±1.6 years. Out of these, 155 individuals (79.1%) were female, resulting in a female-to-male ratio of 3.78. There was a significant relationship between gender and alcohol consumption in the personal aspect, as well as between the history of psychiatric diseases and alcohol consumption in the physical aspect (P<0.005). The previous history of suicide was the only variable that showed significance in all aspects of both the substance desire and child abuse questionnaires. History of neglect abuse (OR: 1.2, 95% CI [1.07-1.41]; P=0.009) was a predictive factor for suicide attempt. However, being male (OR: 0.12, 95% CI [0.039-0.37], P=0.000), having no psychiatric history (OR: 0.23, 95% CI [0.10-0.52], P<0.001) and not consuming alcohol (OR 0.33, 95% CI 0.15-0.71, P=0.005) were identified as protective factors for attempted suicide. Conclusion A public health strategy for suicide prevention includes implementing prevention strategies aimed at reducing risk factors, such as alcohol consumption and the risk of neglect abuse.
Collapse
Affiliation(s)
- Farzad Gheshlagi
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rokhsareh Meamar
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemehalsadat Rastkerdar
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Akbari Jebeli
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Soleimanpour
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shadi Haddad
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nastaran Eizadi-Mood
- Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
3
|
Braciszewski JM, Lanier A, Yeh HH, Sala-Hamrick K, Simon GE, Rossom RC, Lynch FL, Waring SC, Lu CY, Owen-Smith AA, Beck A, Daida YG, Maye M, Frank C, Hendriks M, Fabian N, Ahmedani BK. Health Diagnoses and Service Utilization in the Year Before Youth and Young Adult Suicide. Psychiatr Serv 2023; 74:566-573. [PMID: 36349497 PMCID: PMC10166760 DOI: 10.1176/appi.ps.20220145] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Suicide rates among young people are rising. Health care visits provide opportunities for identification and intervention, yet studies have been limited by small or circumscribed samples. This study sought to expand the knowledge base by examining health care encounters and diagnoses among young people who later died by suicide. METHODS This case-control study examined diagnoses of mental and general medical disorders and health care utilization in the 30 and 365 days before suicide death in nine large U.S. health care systems. Data (years 2000-2015) from 445 suicide decedents ages 10-24 years were matched with data from 4,450 control group patients. RESULTS Suicide decedents were more likely to have at least one mental disorder diagnosis (51% vs. 16%; adjusted OR [AOR]=5.74, 95% CI=4.60-7.18) and had higher rates of nearly all mental health conditions. Substance use disorders were common (12%) and more likely (AOR=8.50, 95% CI=5.53-13.06) among suicide decedents. More than one in three (42%) suicide decedents had a health care visit in the month before death, and nearly all (88%) had a visit in the previous year. CONCLUSIONS Despite the greater likelihood of suicide associated with mental disorder diagnoses, such disorders were present among only 51% of suicide decedents. High rates of health care utilization among suicide decedents indicate a need for improving identification of mental health conditions and suicide risk across the health care system. Increased substance use screening may help identify youths at high risk because substance use disorders were significantly more prevalent and likely among suicide decedents.
Collapse
Affiliation(s)
- Jordan M. Braciszewski
- Center for Health Policy & Health Services Research, Henry Ford Health System, One Ford Place, Suite 3A, Detroit, MI, 48202 USA
- Department of Psychiatry, Henry Ford Health System, Detroit, MI, One Ford Place, Suite 1F, Detroit, MI, 48202 USA
| | - Ana Lanier
- School of Medicine, Wayne State University, 540 E Canfield St, Detroit, MI 48201 USA
| | - Hsueh-Han Yeh
- Center for Health Policy & Health Services Research, Henry Ford Health System, One Ford Place, Suite 3A, Detroit, MI, 48202 USA
| | | | - Gregory E. Simon
- Health Research Institute, Kaiser Permanente Washington, 1730 Minor Ave, Suite 1600, Seattle, WA 98101 USA
| | - Rebecca C. Rossom
- HealthPartners Institute, 8170 33rd Ave S, Bloomington, MN 55425 USA
| | - Frances L. Lynch
- Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate Ave, Portland, OR 97227 USA
| | - Stephen C. Waring
- Essentia Institute of Rural Health, Essentia Health, 502 East 2nd Street, 6AV-2, Duluth, MN 55805 USA
| | - Christine Y. Lu
- Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Dr #401, Boston, MA 02215 USA
| | - Ashli A. Owen-Smith
- Center for Research and Evaluation, Kaiser Permanente Georgia, 1375 Peachtree Street, N.E., Suite 380, Atlanta, Georgia 30309 USA
- School of Public Health, Georgia State University, 140 Decatur Street, Office #434, Atlanta, GA 30303 USA
| | - Arne Beck
- Institute for Health Research, Kaiser Permanente Colorado, 2550 S. Parker Rd., Suite #200, Aurora, CO 80014 USA
| | - Yihe G. Daida
- Center for Integrated Health Care Research, Kaiser Permanente Hawaii, 501 Alakawa St, Suite 201, Honolulu, HI 96817 USA
| | - Melissa Maye
- Center for Health Policy & Health Services Research, Henry Ford Health System, One Ford Place, Suite 3A, Detroit, MI, 48202 USA
| | - Cathrine Frank
- Department of Psychiatry, Henry Ford Health System, Detroit, MI, One Ford Place, Suite 1F, Detroit, MI, 48202 USA
| | - Melissa Hendriks
- Department of Psychiatry, Henry Ford Health System, Detroit, MI, One Ford Place, Suite 1F, Detroit, MI, 48202 USA
| | - Nina Fabian
- Department of Psychiatry, Henry Ford Health System, Detroit, MI, One Ford Place, Suite 1F, Detroit, MI, 48202 USA
| | - Brian K. Ahmedani
- Center for Health Policy & Health Services Research, Henry Ford Health System, One Ford Place, Suite 3A, Detroit, MI, 48202 USA
- Department of Psychiatry, Henry Ford Health System, Detroit, MI, One Ford Place, Suite 1F, Detroit, MI, 48202 USA
| |
Collapse
|
4
|
Lee WC, Lai JY, Pan CH, Su SS, Yang TW, Tsai SY, Chen CC, Kuo CJ. Healthcare utilization, psychiatric disorders, and physical illnesses shortly before suicide mortality in adolescents in Taiwan. Psychol Med 2023; 53:2885-2894. [PMID: 36104840 DOI: 10.1017/s0033291721004864] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study examined the pattern of medical utilization and the distribution of comorbidities shortly before death among adolescents who died from suicide and compared these data with those of living controls. METHODS From Taiwan's National Health Insurance Research Database, this study identified adolescents aged 10-19 years who died from suicide (n = 935) between 1 January 2000, and 31 December 2016, by linking each patient with the national mortality database. The researchers conducted a nested case-control study through risk set sampling, and for each case, 20 age- and sex-matched controls (n = 18 700) were selected from the general population. The researchers applied conditional logistic regression to investigate differences in medical utilization and physical and psychiatric comorbidities between cases and controls. RESULTS Cases had a higher proportion of contact with the psychiatric department but a similar proportion of contact with any non-psychiatric medical department within 1 year before suicide compared with controls. There were 18.6% of adolescent suicide victims who only had contacted with a psychiatric department 3 months before suicide. Moreover, cases had a higher proportion of contact with non-psychiatric services within 3 months before suicide, particularly with emergency, surgery, and internal medicine departments. Cases had higher risks of several psychiatric disorders and physical illnesses, including heart diseases, pneumonia, and ulcer disease, than did controls. CONCLUSIONS The findings of increased medical utilization and higher risks of physical and psychiatric comorbidities in adolescent suicide victims are crucial for developing specific interventions to prevent suicide in this population.
Collapse
Affiliation(s)
- Wan-Chen Lee
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Jou-Yin Lai
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Sheng-Siang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Tien-Wei Yang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chiao-Chicy Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Psychiatry, Mackay Medical College, Taipei, Taiwan
| | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| |
Collapse
|
5
|
Mitchell RH, Ani C, Cyr C, Irvine J, Joffe AR, Skinner R, Wong S, Stang AS, Laffin M, Korczak DJ. Near-Fatal Self-Harm Among Canadian Adolescents. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:598-607. [PMID: 34846182 PMCID: PMC9301146 DOI: 10.1177/07067437211058602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the clinical features of Canadian adolescents admitted to the intensive care unit (ICU) for medically serious self-harm. METHODS 2700 Canadian paediatricians were surveyed monthly over two years (January 2017 to December 2018) through the Canadian Paediatric Surveillance Program to ascertain data from eligible cases. RESULTS Ninety-three cases (73 female; age 15.2 ± 1.5) met the case definition. Four provinces reported the majority of cases: Quebec (n = 27), Ontario (n = 26), Alberta (n = 21), and British Columbia (n = 8). There were 10 deaths, 9 by hanging. Overdose and hanging were the most frequently reported methods of self-harm (74.2% and 19.4%, respectively). Overdose was more common in females (80.8% females vs. 50% males; χ2 = 7.8 (1), p = .005), whereas hanging was more common in males (35% males vs. 15.1% females, χ2 = 3.9 (1), p = .04). More females than males had a past psychiatric diagnosis (79% vs. 58%; χ2 = 4.1 (1), p = .06), a previous suicide attempt (55.9% vs. 29.4%, χ2 = 3.8 (1), p = .05), and prior use of mental health service (69.7% vs. 27.8%, χ2 = 10.4 (1), p = .001). Family conflict was the most commonly identified precipitating factor (43%) of self-harm. CONCLUSIONS Among Canadian adolescents admitted to the ICU with medically serious self-harm, females demonstrate a higher rate of suicide attempts and prior mental health care engagement, whereas males are more likely to die by suicide. These findings are consistent with data from other adolescent samples, as well as data from working-age and older adults. Therefore, a sex-specific approach to suicide prevention is warranted as part of a national suicide prevention strategy; family conflict may be a specific target for suicide prevention interventions among adolescents.
Collapse
Affiliation(s)
- Rachel Hb Mitchell
- Department of Psychiatry, 71545Sunnybrook Health Science Centre, University of Toronto, Toronto, ON, Canada
| | - Cornelius Ani
- Division of Psychiatry, 156647Imperial College London Hammersmith Hospital Campus, London, United Kingdom
| | - Claude Cyr
- Département de Pédiatrie, Université de Sherbrooke, 33495CHUS - Hôp Fleurimont, Sherbrooke, QC, Canada
| | - James Irvine
- Department of Family Medicine, Community Health and Epidemiology, 12371University of Saskatchewan, La Ronge, SK, Canada
| | - Ari R Joffe
- Division of Critical Care Medicine, Department of Pediatrics, 103116Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
| | - Robin Skinner
- 41687Public Health Agency of Canada, Ottawa, ON, Canada
| | - Sam Wong
- Division of Critical Care Medicine, Department of Pediatrics, 103116Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.,37214Stanton Territorial Hospital, Yellowknife, NT, Canada
| | - Antonia S Stang
- Department of Pediatrics, 9978Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Melanie Laffin
- Canadian Paediatric Surveillance Program, Ottawa, ON, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| |
Collapse
|
6
|
Lengvenyte A, Olié E, Strumila R, Navickas A, Gonzalez Pinto A, Courtet P. Immediate and short-term efficacy of suicide-targeted interventions in suicidal individuals: A systematic review. World J Biol Psychiatry 2021; 22:670-685. [PMID: 33783294 DOI: 10.1080/15622975.2021.1907712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To address the extreme suicide risk period following a suicidal crisis, we aimed to assess the current evidence for specific healthcare system-based interventions on suicide-related outcomes within one-week or one-month in individuals with current suicidal ideation (SI) or a recent suicide attempt (SA). METHODS We performed a database (Medline, Academic Search Complete, PsycARTICLES, the Cochrane library, PubMed) and manual reference search for randomised controlled trials, published between March 2000 and March 2020. Antisuicidal efficacy was defined as SI, SA, or a closely related concept. Quality was assessed with the Cochrane Risk of Bias 2 tool for randomised trials. RESULTS Out of 34 trials, five reported ketamine or esketamine superiority over placebo in reducing SI in depressed subjects within one week, while five studies had negative findings. Single trials reported positive results for one-month antisuicidal efficacy of buprenorphine, paroxetine, a crisis response plan, and assertive case management. Most trials were underpowered and had moderate-to-high risk of bias. CONCLUSIONS Preliminary mixed evidence suggests the possible utility of several pharmacological (ketamine, esketamine paroxetine, and buprenorphine) and non-pharmacological (a crisis response plan, and assertive case management) interventions. Only the immediate efficacy of ketamine was supported by multiple studies, and replication is needed.
Collapse
Affiliation(s)
- Aiste Lengvenyte
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,French Association of Biological Psychiatry and Neuropsychopharmacology
| | - Robertas Strumila
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Alvydas Navickas
- Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Ana Gonzalez Pinto
- CIBERSAM; Bioaraba, Research Group on Severe Mental Illness; Osakidetza, Araba University Hospital, Psychiatry Service; Faculty of Medicine, Department of Neurosciences, University of the Basque Country UPV / EHU, Vitoria-Gasteiz, Spain.,Spanish Society of Biological Psychiatry
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,French Association of Biological Psychiatry and Neuropsychopharmacology
| |
Collapse
|
7
|
Oliffe JL, Kelly MT, Montaner GG, Links PS, Kealy D, Ogrodniczuk JS. Segmenting or Summing the Parts? A Scoping Review of Male Suicide Research in Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:433-445. [PMID: 33719600 PMCID: PMC8107953 DOI: 10.1177/07067437211000631] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Suicide in Canadian men is high and rising. Research consistently indicates increased suicide risk in male subgroups including sexual minority, Indigenous, middle-aged, and military men. The current scoping review addresses the research question: Among male subgroups featured in Canadian suicide research, what are the key findings to inform suicide prevention efforts?. METHOD A scoping review was undertaken in accord with PRISMA-ScR guidelines. Structured searches were conducted in CIHAHL, Medline, PsychInfo, and Web of Science to identify studies reporting suicidality (suicidal ideation, plans and/or attempts) and suicide among men in Canada. Inclusion criteria comprised primary empirical studies featuring Canadian male subgroups published in English from 2009 to 2020 inclusive. RESULTS Sixty-eight articles met the inclusion criteria, highlighting significant rates of male suicidality and/or suicide in 3 categories: (1) health inequities (n = 29); (2) age-specific (n = 30); and (3) occupation (n = 9). The health inequities category included sexual minority men, Indigenous, and other marginalized males (i.e., homeless, immigrant men, and men who use opiates). Age-specific men focused on adolescents and youth, and middle-aged and older males. Active military, veterans, and first responders featured in the occupation category. Studies compared at risk male subgroups to females, general male populations, and/or other marginalized groups in emphasizing mental health disparities and increased suicide risk. Some men's suboptimal connections to existing mental health care services were also highlighted. CONCLUSION While male subgroups who are vulnerable to suicidality and suicide were consistently described, these insights have not translated to tailored upstream suicide prevention services for Canadian boys and men. There may be some important gains through integrating social and mental health care services for marginalized men, implementing school-based masculinity programs for adolescent males, orientating clinicians to the potential for men's mid-life suicide risks (i.e., separation, bereavement, retirement) and lobbying employers to norm help-seeking among activate military, veterans, and first responder males.
Collapse
Affiliation(s)
- John L. Oliffe
- School of Nursing, University of British
Columbia, Vancouver, BC, Canada
- Department of Nursing, The University of Melbourne, Melbourne,
Australia
| | - Mary T. Kelly
- School of Nursing, University of British
Columbia, Vancouver, BC, Canada
| | | | - Paul S. Links
- Department of Psychiatry and Behavioural
Neurosciences at McMaster University, Hamilton, ON, Canada
| | - David Kealy
- Department of Psychiatry, University of
British Columbia, Vancouver, BC, Canada
| | - John S. Ogrodniczuk
- Department of Psychiatry, University of
British Columbia, Vancouver, BC, Canada
| |
Collapse
|
8
|
Kwan Y, Choi S, Min S, Ahn JS, Kim H, Kim MH, Lee J. Does personality problems increase youth suicide risk?: A characteristic analysis study of youth who visit the emergency department following suicide attempt. J Affect Disord 2021; 282:539-544. [PMID: 33433383 DOI: 10.1016/j.jad.2020.12.066] [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: 11/29/2020] [Accepted: 12/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Youth suicide attempts are a major risk factor for future complete suicides. However, the characteristics of suicide attempters based on the emergency department (ED) have rarely been explored, making it challenging to comprehend the characteristics of youth suicide attempters comprehensively. This study aims to investigate the characteristics of youth suicide attempters who visited the ED. METHODS We examined the youth (age: 12-25 years) and adult (age: 26-65 years) groups of suicide attempters who visited the ED in Wonju-si, Gangwon-do, Korea. Interviews were conducted with attempters and guardians to identify sociodemographic, clinical, and suicide-related variables. Besides, we performed bivariate logistic regression analysis with statistically adjusted gender, educational age, Socioeconomic Status(SES) level, and medical illness. RESULTS Youth were diagnosed more frequently with Personality disorder compared to adults. Besides, youth tended to report interpersonal or abuse as motivations for suicide, whereas adults tended to report medical illness or economic problems. Furthermore, youth attempted suicide more impulsively and repeatedly; however, medical lethality of each attempt tended to be lower than adults. LIMITATION We experienced difficulty in collecting complete information because of poor consciousness or cooperation of patients who visited the ED immediately after suicide attempt. Also, the study cohort was only recruited from one hospital in a region. CONCLUSION Youth suicide attempters are suggested to have relatively serious and persistent problems involving personality or traits than adults. Thus, this study highlights the significance of preventive strategies based on early psychopathological evaluation and treatment.
Collapse
Affiliation(s)
- Yunna Kwan
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea; Department of Psychology, Duksung Women's University, 33, Samyang-ro 144-gil, Dobong-gu, 01369 Seoul, Korea
| | - SungWon Choi
- Department of Psychology, Duksung Women's University, 33, Samyang-ro 144-gil, Dobong-gu, 01369 Seoul, Korea
| | - Seongho Min
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
| | - Joung-Sook Ahn
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
| | - Huiju Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea.
| | - Jinhee Lee
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea.
| |
Collapse
|
9
|
Shin HD, Price S, Aston M. A poststructural analysis: Current practices for suicide prevention by nurses in the emergency department and areas of improvement. J Clin Nurs 2020; 30:287-297. [PMID: 32956549 DOI: 10.1111/jocn.15502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/07/2020] [Accepted: 09/06/2020] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To use a poststructuralist framework to critique historical, social and institutional constructions of emergency nursing and examine conflicting discourses surrounding suicide prevention. The aim is to also demonstrate practical guidance for enhancing emergency nursing practice and research with regard to suicide prevention. BACKGROUND Emergency departments have been historically constructed as places for treating life-threatening physical crises, thereby constructing other "nonurgent" health needs as less of a priority. Physical needs take priority over psychological needs, such as suicide-related thoughts and behaviours, negatively impacting the quality of care that certain groups of patients receive. DESIGN A theoretical analysis of the published literature on the topic of emergency nursing and suicide prevention was conducted and analysed using a poststructuralist framework. METHODS Relevant literature on the topic of emergency nursing related to suicide prevention was analysed for a poststructuralist construct of power, language, subjectivity and discourse. Implications to practice and research were identified, as well as expanding emergency nursing using a poststructuralist framework. SQUIRE guidelines were used (see Supporting Information). DISCUSSION The emergency department is a critical point of intervention for patients with urgent and life-threatening needs. However, the biomedical model and historical, social, and institutional expectations that influence emergency nurses' beliefs and values do not effectively respond to the needs of suicidal patients. One step to address this issue is to deconstruct the current understanding of emergency nursing as a treatment for only life-threatening physical crises in order to become inclusive of psychological crises such as suicide-related thoughts and behaviours. RELEVANCE TO CLINICAL PRACTICE How a poststructural framework can be used to expand emergency care is discussed. Examples include empowering nurses to challenge the "taken-for-granted" emergency nursing and recognizing the health needs that fall outside of the dominant discourse of emergency care.
Collapse
Affiliation(s)
| | - Sheri Price
- Dalhousie University School of Nursing, Halifax, NS, Canada.,IWK Health Centre, Halifax, NS, Canada
| | - Megan Aston
- Dalhousie University School of Nursing, Halifax, NS, Canada.,IWK Health Centre, Halifax, NS, Canada
| |
Collapse
|
10
|
Affiliation(s)
- Alan L Berman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Morton M Silverman
- Department of Psychiatry, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
11
|
Krysinska K, Curtis S, Lamblin M, Stefanac N, Gibson K, Byrne S, Thorn P, Rice SM, McRoberts A, Ferrey A, Perry Y, Lin A, Hetrick S, Hawton K, Robinson J. Parents' Experience and Psychoeducation Needs When Supporting a Young Person Who Self-Harms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3662. [PMID: 32456022 PMCID: PMC7277421 DOI: 10.3390/ijerph17103662] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Self-harm in young people can have a substantial negative impact on the well-being and functioning of parents and other carers. The "Coping with Self-Harm" booklet was originally developed in the UK as a resource for parents and carers of young people who self-harm, and an adaptation study of this resource was conducted in Australia. This paper presents qualitative analysis of interviews with parents about their experiences and psychoeducational needs when supporting a young person who engages in self harm. METHODS The qualitative study drew on semi-structured individual and group interviews with parents (n = 19 participants) of young people who self-harm. Data were analysed using Thematic Analysis. RESULTS The analysis identified six themes: (1) the discovery of self-harm, (2) challenges in the parent-young person relationship, (3) parents' need to understand self-harm, (4) parents' emotional reactions to self-harm, (5) the importance of self-care and help-seeking among parents, and (6) the need for psychoeducational resources. CONCLUSION The study highlights the need for support for parents and carers of young people who engage in self-harm, including development and adaptation of resources, such as the "Coping with Self-Harm" booklet, of which an Australian version has now been developed.
Collapse
Affiliation(s)
- Karolina Krysinska
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Sophie Curtis
- North Western Mental Health, Parkville, VIC 3050, Australia
| | - Michelle Lamblin
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Nina Stefanac
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Kerry Gibson
- School of Psychology, The University of Auckland, Auckland 1142, New Zealand
| | - Sadhbh Byrne
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Pinar Thorn
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | - Simon M Rice
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| | | | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Nedlands, WA 6009, Australia
| | - Sarah Hetrick
- Orygen, Parkville, VIC 3052, Australia
- Department of Psychological Medicine, The University of Auckland, Auckland 1142, New Zealand
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford OX3 7JX, UK
- Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Jo Robinson
- Orygen, Parkville, VIC 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3052, Australia
| |
Collapse
|
12
|
Timpka T, Spreco A, Dahlstrom O, Jacobsson J, Kowalski J, Bargoria V, Mountjoy M, Svedin CG. Suicidal thoughts (ideation) among elite athletics (track and field) athletes: associations with sports participation, psychological resourcefulness and having been a victim of sexual and/or physical abuse. Br J Sports Med 2020; 55:198-205. [PMID: 32102912 PMCID: PMC7873412 DOI: 10.1136/bjsports-2019-101386] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine associations between suicidal ideation and sexual and physical abuse among active and recently retired elite athletics (track and field) athletes. METHODS The study population consisted of all athletes (n=402) selected for a Swedish Athletics team between 2011 and 2017. Data on suicidal ideation, suicidal events (estimated through the 1 year non-sports injury prevalence), lifetime abuse experiences, sociodemographics, sense of coherence and coping strategies were collected using a cross-sectional survey. The data were analysed using binary logistic regression with suicidal ideation and non-sports injury as outcomes. RESULTS 192 athletes (47.8%) returned data. The prevalence of suicidal ideation was 15.6% (men 17.4%; women 14.2%) and the non-sports injury prevalence was 8.0% (men 11.6%; women 5.7%). Among women, suicidal ideation was associated with having been sexually abused (OR 5.94, 95% CI 1.42 to 24.90; p=0.015) and lower sense of coherence (OR 0.90, 95% CI 0.85 to 0.96; p=0.001) (Nagelkerke R2=0.33). Among men, suicidal ideation was only associated with use of behavioural disengagement for coping (OR 1.51, 95% CI 1.18 to 1.95; p=0.001) (R2 =0.25). Among women, non-sports injury prevalence was associated with having been sexually abused (OR 8.61, 95% CI 1.34 to 55.1; p=0.023) and participating in an endurance event (OR 7.37, 95% CI 1.11 to 48.9; p=0.039 (R2 =0.23), while among men, having immigrant parents (OR 5.67, 95% CI 1.31 to 24.5; p=0.020) (R2 =0.11) was associated with injury outside sports. CONCLUSIONS About one out of six international athletics athletes reported having experienced suicidal ideation. World Athletics and National Olympic Committees need to include suicide prevention in their athlete protection programmes.
Collapse
Affiliation(s)
- Toomas Timpka
- Athletics Research Center, Linköping University, Linköping, Sweden .,Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.,Unit for Health Analysis, Centre for Healthcare Development, Region Östergötland, Linköping, Sweden
| | - Armin Spreco
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.,Unit for Health Analysis, Centre for Healthcare Development, Region Östergötland, Linköping, Sweden
| | - Orjan Dahlstrom
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Jenny Jacobsson
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Jan Kowalski
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Victor Bargoria
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.,Department Orthopaedics and Rehabilitation, Moi University, Eldoret, Kenya
| | - Margo Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Carl Göran Svedin
- Athletics Research Center, Linköping University, Linköping, Sweden.,Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.,Ersta Sköndal Bräcke University College, Stockholm, Sweden
| |
Collapse
|
13
|
Gardner W, Pajer K, Cloutier P, Zemek R, Currie L, Hatcher S, Colman I, Bell D, Gray C, Cappelli M, Duque DR, Lima I. Changing Rates of Self-Harm and Mental Disorders by Sex in Youths Presenting to Ontario Emergency Departments: Repeated Cross-Sectional Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:789-797. [PMID: 31184929 PMCID: PMC6882075 DOI: 10.1177/0706743719854070] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To document the rates of intentional self-harm and mental disorders among youths aged 13 to 17 years visiting Ontario emergency departments (EDs) from 2003-2017. METHODS This was a repeated cross-sectional observational design. Outcomes were rates of adolescents with (1) at least 1 self-harm ED visit and (2) a visit with a mental disorder code. RESULTS Rates of youths with self-harm visits fell 32% from 2.6/1000 in 2003 to 1.8 in 2009 but rose 135% to 4.2 by 2017. The slope of the trend in self-harm visits changed from -0.18 youths/1000/year (confidence interval [CI], -0.24 to -0.13) during 2003 to 2009 to 0.31 youths/1000/year (CI, 0.27 to 0.35) during 2009 to 2017 (P < 0.001). Rates of youths with mental health visits rose from 11.7/1000 in 2003 to 13.5 in 2009 (15%) and to 24.1 (78%) by 2017. The slope of mental health visits changed from 0.22 youths/1000/year (CI, 0.02 to 0.42) during 2003 to 2009 to 1.84 youths/1000/year (CI, 1.38 to 2.30) in 2009 to 2017 (P < 0.001). Females were more likely to have self-harm (P < 0.001) and mental health visits (P < 0.001). Rates of increase after 2009 were greater for females for both self-harm (P < 0.001) and mental health (P < 0.001). CONCLUSIONS Rates of adolescents with self-harm and mental health ED visits have increased since 2009, with greater increases among females. Research is required on the determinants of adolescents' self-harm and mental health ED visits and how they can be addressed in that setting. Sufficient treatment resources must be supplied to address increased demands for services.
Collapse
Affiliation(s)
- William Gardner
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Kathleen Pajer
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Paula Cloutier
- Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Roger Zemek
- Department of Pediatrics & Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lisa Currie
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Simon Hatcher
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Dayna Bell
- Department of Pediatrics & Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Clare Gray
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Daniel Rodriguez Duque
- Department of Epidemiology, Biostatistics, and Public Health, McGill University, Montreal, Quebec, Canada
| | - Isac Lima
- ICES Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
14
|
Calderón-Garcidueñas L, González-Maciel A, Kulesza RJ, González-González LO, Reynoso-Robles R, Mukherjee PS, Torres-Jardón R. Air Pollution, Combustion and Friction Derived Nanoparticles, and Alzheimer’s Disease in Urban Children and Young Adults. J Alzheimers Dis 2019; 70:343-360. [DOI: 10.3233/jad-190331] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
| | | | - Randy J. Kulesza
- Department of Anatomy, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | | | | | | | - Ricardo Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, UNAM, Mexico City, Mexico
| |
Collapse
|