Sex difference in association between suicide attempts and lipid profile in first-episode and drug naive patients with major depressive disorder

BACKGROUND

The relationship between suicide attempts and lipid profiles in patients with major depressive disorder (MDD) remains uncertain. The purpose of this study was to investigate sex differences in the relationship between suicide attempts and plasma lipid profiles in a large sample of first-episode and drug naive (FEDN) MDD patients.

METHODS

We recruited 1718 FEDN MDD patients and gathered demographic, clinical, and blood lipid data. The Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and the Positive and Negative Syndrome Scale were used to assess the symptoms of patients.

RESULTS

There was no significant difference in the prevalence of suicide attempts between male and female MDD patients. The suicide attempt group had higher levels of depression, anxiety, psychotic symptoms, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C), but lower levels of high-density lipoprotein cholesterol (HDL-C) levels than the non-suicide attempt group. Binary logistic regression showed that TC levels were significantly correlated with suicidal attempts in both male and female patients. Correlation analysis revealed that the levels of TC, HDL-C and LDL-C were significantly associated with the number of suicide attempts in both male and female patients. Further multiple linear regression revealed that TC levels were significantly associated with the number of suicide attempts in male patients only.

CONCLUSIONS

Lipid biomarkers, particularly high TC levels, are associated with suicide attempts in both male and female MDD patients. However, there is gender difference in association between lipid biomarkers, especially TC levels, and the number of suicide attempts in MDD patients.

Living with suicidal thoughts: A scoping review

BACKGROUND

There is a significantly higher number of people experiencing severe levels of suicidal thoughts compared to that of suicidal deaths and suicide attempts. In suicide prevention research, there is a shift towards greater emphasis on people's experiences of living with suicidal thoughts. This can expand the existing evidence base, which is dominated by a biomedical approach. The aim of this review was to summarise and disseminate existing research on the lived experiences of living with suicidal thoughts.

METHODS

A scoping review by Arksey & O'Malley consisting of six stages: (1) formulating the research question, (2) identifying relevant studies, (3) selecting studies, (4) mapping data, (5) summarising the results and (6) consulting stakeholders. PubMed, PsycINFO and CINAHL were searched for studies in English, Danish, Swedish and Norwegian. Peer-reviewed articles examining people's experiences of living with suicidal thoughts using qualitative methods were included. The search was supplemented with a citation pearl search in the Web of Science database. Twenty-eight studies were included.

RESULTS

The findings were organised under two thematic headings: (a) the significance of social connections and (b) a loss of the personal self.

CONCLUSION

There is a need for further qualitative research of people's experiences of living with suicidal thoughts from an everyday life perspective. Awareness about social connections and attachment in mental health prevention and governance is crucial. Trauma-informed care could be a useful approach to prevent suicidal thoughts as the review found that many participants had traumatic experiences in both childhood and adulthood. As part of the treatment of suicidal thoughts, it might be useful to have a focus on narrative and communicative methods and their clinical application.

"Appreciate the Little Things": A Qualitative Survey of Men's Coping Strategies and Mental Health Impacts During the COVID-19 Pandemic

The COVID-19 pandemic has presented a suite of circumstances that will simultaneously affect mental health and mobilize coping strategies in response. Building on a lack of research specifically exploring men's mental health impacts during the COVID-19 pandemic, this study presents the results of a qualitative survey exploring men's self-reported aspects of the pandemic giving rise to mental health challenges, alongside their diverse coping strategies applied during this time. The sample comprised 555 men from North America (age M = 38.8 years; SD = 13.5 years), who participated via an online survey with two open-ended qualitative questions assessing, respectively, the aspects of the pandemic affecting their mental health, and the strategies used to manage these challenges. Free-text responses were coded using inductive content analysis. Results pertaining to the mental health impacts of COVID-19 were categorized into two overarching themes: far-reaching ramifications of COVID-19 encompassing consequences for lifestyle, work, and functioning, alongside novel anxieties related to health risks and daily uncertainty. In addition, coping strategies reported were categorized into two broad themes: efforts to avoid, dull or distract oneself from distress, alongside adapting and doing things differently, which encompassed largely approach-oriented efforts to flexibly ameliorate distress. Results signal the far-reaching impacts of COVID-19, alongside profound flexibility and diverse enactments of resilience among men in adapting to unprecedented challenges. Findings have implications for mental health promotion that should aim to leverage men's adaptive coping to encourage opportunities for social connectedness in response to the mental health impacts of the various psychosocial challenges of the COVID-19 pandemic.

Men's Experiences of Mental Illness Stigma Across the Lifespan: A Scoping Review

The stigma of men's mental illness has been described as having wide-reaching and profound consequences beyond the condition[s] itself. Stigma negatively impacts men's mental health help-seeking and the use of services amid impeding disclosures, diminishing social connection and amplifying economic hardship. Although men often face barriers to discussing their struggles with, and help-seeking for mental illness challenges, research focused on men's lived experiences of mental illness stigma is, at best, emergent. This scoping review explores men's mental illness related stigmas synthesizing and discussing the findings drawn from 21 published qualitative articles over the last 10 years. Four thematic findings were derived: (a) the weight of societal stigma, (b) stigma in male-dominated environments, (c) inequity driven stigmas, and (d) de-stigmatizing strategies. Despite evidence that stigma is a common experience for men experiencing diverse mental illness challenges, the field remains underdeveloped. Based on the scoping review findings, research gaps and opportunities for advancing the field are discussed.

"Is Life Worth Living?": The Role of Masculinity in the Way Men Aged Over 80 Talk About Living, Dying, and Suicide

Men aged 85 years and over have the highest rate of suicide of any age or gender group in Australia. However, little is known about their trajectory toward suicide. The objective of this study was to understand the role of masculine norms and other life factors in the suicidality of older men. Thirty-three men aged 80 years or more took part in a semistructured focus group or interview, and/or completed a survey. Participants were asked about the issues facing older men, well-being and aging, physical health challenges, social support, mental health and help-seeking, and suicide and suicide prevention. Five themes emerged: "finding out we're not invincible," "active and tough," "strong silent types," "decision makers," and "right to die." Participants spoke about masculine norms that had influenced their lives as providers and decision makers, and now influenced how they coped with aging and their journey toward death. For some participants, suicide was seen to be a rational alternative to dependence in their final years. Suicide prevention should adopt a gendered approach and be cognizant of the influence of gender roles and masculinity in older men's lives. Further research and prevention efforts should be mindful of the impact of masculine norms of self-reliance and control on an older man's decision to end his life. Suicide prevention efforts should work to reduce stigma around the challenges of aging, maximize opportunities for control, facilitate social connection, and improve residential aged care.

Is Suicide the End Point of Ageism and Human Rights Violations?

Ageism and human rights violations may pervade each of the potential factors underlying suicidal ideation or behavior in older persons, including physical and mental health, disability, relationships, and social factors. We outline how infringements of human rights and ageism may create or exacerbate risk factors associated with suicide in older persons. Strategies to address these issues are discussed, including tackling ageism, psychosocial interventions and education. A United Nations convention on the rights of older persons would create a uniform standard of accountability across health and social systems. Future studies are needed to evaluate the effects of alleviating ageism and human rights violations on suicide.

Sex differences in the association between suicide attempts and glucose disturbances in first-episode and drug naive patients with major depressive disorder

BACKGROUND

Glucose metabolism is related to depression, but the relationship between blood glucose and suicide attempts in patients with major depressive disorder (MDD) remains unclear. This large-scale sample explores the relationship between suicide attempts and fasting blood glucose, in addition to sex differences in first-episode and drug naive (FEDN) MDD patients.

METHODS

1718 FEDN MDD patients diagnosed for the first time were recruited, and their demographic data, clinical data, and blood glucose indicators were collected. 17-item Hamilton Depression Rating Scale (HAMD), 14-item Hamilton Anxiety Rating Scale (HAMA), and positive subscale of the Positive and Negative Syndrome Scale (PANSS) were used to assess their depression, anxiety and psychotic symptoms, respectively.

RESULTS

The depression, anxiety, psychotic symptoms and blood sugar levels of the suicide attempt group were higher than those of the non-suicide attempt group. Correlation analysis showed that blood glucose was significantly associated with suicide attempts in male and female patients. While binary logistic regression showed that blood glucose levels were significantly associated with suicide attempts in male patients, it showed that suicide attempts were not significantly associated with blood glucose levels in female patients.

LIMITATIONS

The main limitations are cross-sectional design and inability to control selection bias.

CONCLUSIONS

In male MDD patients, fasting blood glucose level is a potential biomarker of suicide attempt, which deserves attention to avoid suicide risk. However, in female patients, fasting blood glucose has no significant correlation to suicide attempts.

Segmenting or Summing the Parts? A Scoping Review of Male Suicide Research in Canada

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.

Health-related quality of life and ego integrity among the oldest old - Evidence from the multicenter AgeCoDe-AgeQualiDe study

PURPOSE

To investigate the association between health-related quality of life and ego integrity among the oldest old.

MATERIALS AND METHODS

Cross-sectional data were taken from follow-up wave 9 of the multicenter prospective cohort study "Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe). Our analytical sample comprised n = 495 observations. Mean age was 90.2 years (SD: 2.7 years). Health-related quality of life was quantified using the EQ-5D-3L questionnaire (including the visual analogue scale EQ-VAS). Ego integrity was measured using the Ego Integrity Scale.

RESULTS

Regressions showed an association between decreased ego integrity and problems with 'usual activities', 'pain/discomfort' and 'anxiety/depression'. Furthermore, regressions showed a marginally significant association between decreased ego integrity and problems with 'mobility' and a decreased EQ-VAS score. Ego integrity was not significantly associated with problems with 'self-care'.

CONCLUSIONS

Findings stress the importance of health-related quality of life for ego integrity among the oldest old. Future studies are required to clarify the underlying mechanisms.

Associations between conformity to masculine norms and depression: age effects from a population study of Australian men

Background

Strict adherence to masculine norms has been associated with deleterious consequences for the physical and mental health of men. However, population-based research is lacking, and it remains unclear whether ageing influences adherence to masculine norms and the extent to which mental health problems like depression are implicated.

Methods

This study reports on data from 14,516 males aged 15–55 years who participated in Wave 1 of the Australian Longitudinal Study of Male Health (Ten to Men). Group differences in self-reported conformity to masculine norms (CMNI-22), current depressive symptoms (PHQ-9), and self-reported 12-month depression history were examined for males aged 15–17 years, 18–25 years, 26–35 years, 36–50 years, and 51–55 years. Generalised linear models were used to examine the relationships between these variables across age groups.

Results

Conformity to masculine norms decreased significantly with age. However, models predicting depression generally showed that higher conformity to masculine norms was associated with an increased risk of current depressive symptoms, especially in the oldest age group. Conversely, higher conformity was associated with a decreased likelihood of a self-reported 12-month depression history, although nuances were present between age groups, such that this trend was not evident in the oldest age group.

Conclusions

Findings provide important insights into the complex relationship between conformity to masculine norms and depressive symptoms across the lifespan and further highlight the importance of mental health campaigns that address the complexities of gendered help-seeking behaviour for men.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-021-00533-6.

'I wanted to talk about it, but I couldn't', an H70 focus group study about experiencing depression in early late life

BACKGROUND

Knowledge about experiences of depression among younger-old adults from the general population is limited. The aim was to explore experiences of depression in early late life.

METHODS

Sixteen participants in the population-based Gothenburg H70 Birth Cohort Studies (12 women and 4 men) who had reported a history of depression between ages 60-70 took part in focus group discussions (n = 4). Data were analyzed using focus group methodology.

RESULTS

The analysis resulted in the overall theme 'I wanted to talk about it, but I couldn't'. The participants expressed unmet needs of communication about depression with family, friends, and healthcare staff. Participants wanted to know more about the causes and effects of depression, available treatment options and how to avoid recurrence. Lack of knowledge was a source of frustration; trust in health care providers was diminished. Being retired meant that opportunities for communication with co-workers were no longer available, and this made it harder to break negative thought and behavioral patterns. Being depressed meant losing one's normal self, and participants were grieving this. Thoughts of death and suicide were experienced in solitude; knowing that there was an escape could generate a feeling of comfort and control.

CONCLUSIONS

Younger-old adults have expressed a need to talk about their experiences of depression. They would like to know more about available treatments, potential side effects, and how to avoid recurrence. Care providers also need to be aware there is a need for an existential dialogue about death.

Women and men, authors and victims of workplace bullying in Italy: a literature review

INTRODUCTION

It is known in literature that women are frequently victims of murder, sexual assault and stalking. It is interesting to investigate the gender characterization when workplace bullying occurs.

OBJECTIVES

To investigate the phenomenon of workplace bullying and to understand if there are any relevant data about the gender aspects of workplace bullying by reviewing the literature in Italy.

METHODS

Review of articles on a sample of Italian workers. The research question followed the P.E.C.O. model and the article selection is based on PRISMA statement. Fourteen research strings were applied on: Pubmed, Microsoft Academic e Science Direct. A total of 32 articles were selected.

RESULTS

There are few studies in which gender differences on workplace bullying and crimes related are analysed, in some cases it is considered in the research but not in the results section (n=6 articles). In the studies selected women are predominantly victims (n=10 articles), the aggressors instead are usually men (n=2 articles). The attacks suffered by women are frequently discriminations due to family management, children and gender related issues (n=6 articles). Men have the major consequences on mental health if compared to women (n=7 articles).

CONCLUSIONS

Gender is relevant in the characterization of workplace bullying. There is a need for further investigation focusing on gender differences between perpetrators and victims of workplace bullying offences. A unique evaluation protocol is necessary for evaluating workplace bullying, the crimes linked to it and gender differences, to obtain a more accurate comparability of data.

Meaning-Centered Men's Groups: Initial Findings of an Intervention to Enhance Resiliency and Reduce Suicide Risk in Men Facing Retirement

Objectives: To assess the preliminary effectiveness of Meaning-Centered Men's Groups (MCMG), a 12-session existentially-oriented, community-based, psychological group intervention designed to enhance psychological resiliency and prevent the onset or exacerbation of suicide ideation among men who are concerned about or struggling with the transition to retirement.Methods: We recruited 30 men (n= 10 per group), 55 years and older (M= 63.7, SD= 4.1) from community settings to participate in a course of MCMG to be delivered in a community center. Participants completed eligibility, pre-, mid-, and post-group assessments of suicide ideation and psychological risk and resiliency factors.Results: Participants experienced significant increases in attitudinal sources of meaning in life, psychological well-being, life satisfaction, retirement satisfaction, and general health, and decreases in depression, hopelessness, loneliness, and suicide ideation.Conclusions: Preliminary findings suggest that MCMG is a novel men's mental health intervention that may help to enhance psychological well-being and potentially reduce the severity or prevent the onset of symptoms of depression, hopelessness, and suicide ideation.Clinical Implications: Upstream psychological interventions may serve an important role in mental health promotion and suicide prevention with potentially vulnerable individuals facing challenging life transitions.

The Role of Masculinity and Depressive Symptoms in Predicting Suicidal Ideation in Homeless Men

Men's suicide rates may be influenced by difficulties recognizing externalizing depressive symptoms in men that adhere to hegemonic masculine gender role norms. The purpose of this study was to investigate the ability of externalizing depressive symptoms, internalizing depressive symptoms, and hegemonic masculinity in predicting the existence and severity of suicidal ideation. Homeless men (n = 94) completed questionnaires at a resource center in the Rocky Mountain Western United States. Internalizing symptoms predicted the existence of suicidal ideation, and both externalizing and internalizing symptoms predicted increased severity of suicidal ideation. The masculine norms violence and playboy were correlated with men's suicidal ideation. An externalizing-internalizing model of predicting suicide in men and men's adherence to certain masculine gender role norms may be valuable to further efforts in suicide assessment and prevention.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

BACKGROUND

Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower.

AIMS

This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP.

METHOD

Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care.

RESULTS

Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?"

CONCLUSION

Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

'I don't really have any issue with masculinity': Older Canadian men's perceptions and experiences of embodied masculinity

The article explores what older Canadian men consider to be the definition of masculinity, how they evaluate their own masculinity relative to their definition, and how and why they use particular forms of body work in response to aging and their understandings of masculinity. Data are presented from qualitative interviews with 29 community-dwelling men aged 65-89. The men in our study defined masculinity relationally with femininity and homosexuality and identified three hallmarks of masculinity, namely: physical strength, leadership, and virility. While the men tended to emphasize that they were secure in their own masculine identities, some conceded that they diverged from societal definitions of masculinity with respect to their preferred activities, physical attributes, or personal qualities. Many of the men also perceived that aging and the accompanying physical and social changes were threats to their continued ability to be masculine. In an effort to slow down or redress bodily changes that were perceived to be undermining or diminishing their masculinity, the men engaged in exercise and/or were using or considering pharmaceutical interventions such as Viagra and Cialis. We discuss our findings in light of the masculinity literature and age relations theorizing.

From Social Integration to Social Isolation: The Relationship Between Social Network Types and Perceived Availability of Social Support in a National Sample of Older Canadians

It is well-documented that social isolation is detrimental to health and well-being. What is less clear is what types of social networks allow older adults to get the social support they need to promote health and well-being. In this study, we identified social network types in a national sample of older Canadians and explored whether they are associated with perceived availability of different types of social support (affectionate, emotional, or tangible, and positive social interactions). Data were drawn from the baseline questionnaire of the Canadian Longitudinal Study on Aging for participants aged 65-85 (unweighted n = 8,782). Cluster analyses revealed six social network groups. Social support generally declined as social networks became more restricted; however, different patterns of social support availability emerged for different social network groups. These findings suggest that certain types of social networks place older adults at risk of not having met specific social support needs.

Community social support as a protective factor against suicide: A gender-specific ecological study of 75 regions of 23 European countries

By studying differences in suicide rates among different geographical regions one may identify factors connected to suicidal behaviour on a regional level. Many studies have focused on risk factors, whereas less is known about protective factors, such as social support. Using suicide rates and data from the European Social Survey (ESS) we explore the association between regional level social support indicator and suicide rates in 23 European countries in 2012. Linear multiple regression analyses using region as the unit of analysis revealed inverse relationships between mean respondent valuing of social support and suicide rates for both genders, with some indication of a stronger relationship among men. Social support may have a protective effect against suicide on a regional level. Thus, increasing social support could be an effective focus of preventive activities, resulting in lowering suicide rates, with greater expected results among men.

Men's depression and suicide literacy: a nationally representative Canadian survey

BACKGROUND

Male suicide prevention strategies include diagnosis and effective management of men's depression. Fundamental to suicide prevention efforts is public awareness, which in turn, is influenced by literacy levels about men's depression and suicide.

AIM

The aim of this study is to examine sex differences in mental health literacy with respect to men's depression and suicide among a cohort of Canadian respondents.

METHODS

About 901 English-speaking Canadian men and women completed online survey questionnaires to evaluate mental health literacy levels using 10-item D-Lit and 8-item LOSS questionnaires, which assess factual knowledge concerning men's depression and suicide. Statistical tests (Chi-square, z-test) were used to identify significant differences between sex sub-groups at 95% confidence.

RESULTS

Overall, respondents correctly identified 67% of questions measuring literacy levels about male depression. Respondents' male suicide literacy was significantly poorer at 53.7%. Misperceptions were especially evident in terms of differentiating men's depressive symptoms from other mental illnesses, estimating prevalence and identifying factors linked to male suicide. Significant sex differences highlighted that females had higher literacy levels than men in regard to male depression.

CONCLUSIONS

Implementing gender sensitive and specific programs to target and advance literacy levels about men's depression may be key to ultimately reducing depression and suicide among men in Canada.

Stigma in Male Depression and Suicide: A Canadian Sex Comparison Study

Stigma in men's depression and suicide can restrict help-seeking, reduce treatment compliance and deter individuals from confiding in friends and family. In this article we report sex comparison findings from a national survey of English-speaking adult Canadians about stigmatized beliefs concerning male depression and suicide. Among respondents without direct experience of depression or suicide (n = 541) more than a third endorsed the view that men with depression are unpredictable. Overall, a greater proportion of males endorsed stigmatizing views about male depression compared to female respondents. A greater proportion of female respondents endorsed items indicating that men who suicide are disconnected, lost and lonely. Male and female respondents with direct personal experience of depression or suicide (n = 360) strongly endorsed stigmatizing attitudes toward themselves and a greater proportion of male respondents indicated that they would be embarrassed about seeking help for depression.

Antenatal Care and Couples' HIV Testing in Rural Northern Uganda: A Gender Relations Analysis

HIV rates continue to increase among heterosexual couples in many countries including Uganda. This article examines approaches to antenatal care and heterosexual partners' HIV testing in Amuru subcounty, northern Uganda, drawing on findings derived from fieldwork and interviews. The study findings reveal how institutional structures influence the uptake of HIV testing amid power dynamics, wherein many male partners refuse to be tested. Discussed are the coercive approaches to HIV testing in which couples' participation in HIV testing is leveraged by connecting testing to future maternity care. This article advances understandings about how heterosexual gender relations at the local, regional, and global levels affect the health of women, men, and families in Amuru subcounty.

The association between suicidality and treatment with selective serotonin reuptake inhibitors in older people with major depression: a systematic review

BACKGROUND

Suicide among the elderly is an emerging public health issue. In Australia, suicide is a leading cause of death, most notably amongst elderly men over the age of 75. Depression is one of the main causes of suicide in older people. Selective serotonin reuptake inhibitors are considered to be a safe pharmacological therapy in the management of depression in adults. The risk of suicidality/suicide associated with the use of antidepressants in older people is unclear.

OBJECTIVES

The objective of this review was to determine the association between treatment with selective serotonin reuptake inhibitors and suicidality/suicide in older people who suffer from major depression.

INCLUSION CRITERIA

TYPES OF PARTICIPANTS

  Consideration was given to studies that included older people aged 60 years and over, regardless of gender or ethnic background, with Diagnostic and Statistical Manual of Mental Disorders Fourth Edition or equivalent diagnostic criteria for Major Depressive Disorder without psychotic features.  Types of intervention(s)/phenomena of interest:  The review considered treatments using any selective serotonin reuptake inhibitors medication. Comparators included placebo or a different class of antidepressants including monoamine oxidase inhibitors or tricyclic antidepressants.  Types of studies:  This review considered both experimental and observational study designs including randomized controlled trials, non-randomized controlled trials, prospective and retrospective cohort studies and case control studies.  Types of outcomes:  The primary outcome measures of interest in this systematic review were worsening or emergent suicidal ideation, attempted suicide and completed suicide. For this systematic review, the term 'suicide attempt' referred to potentially self-injurious behavior with a non-fatal outcome.

SEARCH STRATEGY

A three-step search strategy was employed that aimed to locate both published and unpublished studies in the English language. An initial search in PubMed was followed by a second search using all identified keywords and index terms across multiple databases and grey literature sites. Finally, the reference list of all identified reports and articles were searched for additional studies. METHODOLOGICAL QUALITY : Critical appraisal was undertaken by two independent reviewers using the standard critical appraisal instrument from the Joanna Briggs Institute Mata-Analysis of Statistical Assessment and Review Instrument. The McMaster Quality Assessment Scale for Harms was used to analyse reporting quality on suicide related harm.

DATA COLLECTION

The primary data on the number of emergent or worsening of suicidal ideation, attempted suicide and completed suicides, in both arms of randomized controlled trials and observational studies was extracted using the standardized data extraction tool from the Joanna Briggs Institute Mata-Analysis of Statistical Assessment and Review Instrument. Baseline demographic data on each study was collected for presentation in tabular format.

DATA SYNTHESIS

The data from randomized controlled trials and observational studies was pooled separately in statistical meta-analysis using RevMan V 5.1 software (The Cochrane Collaboration). Population demographic and other study characteristics were presented in tables and as a narrative summary.

RESULTS

Following critical appraisal, eight randomized controlled trials and five observational studies (i.e. population cohort and retrospective case control studies) with data on suicide-related events were included in the systematic review. Based on the data on TRUNCATED AT 500 WORDS.

Differential impact of types of social support in the mental health of formerly incarcerated Latino men

The role of social support in the mental health of formerly incarcerated Latino men (FILM) is an issue overlooked in public health prevention efforts. The objectives of this analysis were to (a) describe the levels of social support perceived and received by FILM; (b) identify the associations, if any, between levels of social support and mental health indicators such as depression and anxiety; and (c) explore the impact of familism and hypermasculinity on the receptivity of social support and the potential role of these factors in mediating associations between social support and mental health indicators. To accomplish the objectives, we conducted a cross-sectional survey with FILM (n = 259), ages 18 to 59, in New York City, and one nominated member of their social network (n = 130 dyads). In this analysis, we examined four dimensions of social support (instrumental, informational, appraisal, and emotional) from two perspectives: provided (as reported by members of the social networks) and perceived (as reported by FILM). The major outcome variables for this analysis were the presence/absence of major anxiety and depressive symptoms. Our logistic regression analyses suggest that perceived emotional support was inversely associated with both anxiety and depression. Our findings suggest that familism mediated the association between perceived emotional support and anxiety/depression. Therefore, we must consider designing network enhancement interventions that focus on both FILM and their social support systems.

Cognitive-behavioral treatment of depression in men: tailoring treatment and directions for future research

Depression is a significant public health issue and many researchers have suggested that modifications to conventional cognitive-behavioral therapy (CBT) are required to address infrequent help-seeking in men and counter negative effects of traditional masculinity on therapeutic engagement. This narrative review summarizes recommended alterations to CBT in the areas of therapeutic setting, process, and content. Key themes from this literature include a focus on behavioural interventions, and harmful cognitions that orginate from the traditional male gender stereotype. This literature is marked by limited empirical support for many of the recommended treatment modifications, and several options for future research are outlined.

Qualitative research on suicide in East Asia: a scoping review

BACKGROUND

Suicide is a serious problem in East Asia. Yet, there is a significant lack of research on the topic, particularly using qualitative methodology.

OBJECTIVES

This scoping review reports on findings drawn from 11 qualitative studies, providing up-to-date knowledge and understandings about suicide in East Asian populations.

METHODS

A web-based literature search was performed to identify empirical qualitative research articles addressing suicide in East Asia, published from January 2002 to December 2011.

RESULTS

Three themes were identified within the reviewed studies; (1) influence of cultural beliefs; (2) the role of caregivers; and (3) specific sociological contexts. These themes are interrelated rather than mutually exclusive.

CONCLUSION

The findings drawn from this scoping review reveal specific as well as broad contexts where suicidal ideation and behaviours occur among East Asians. To advance understandings, future studies should focus on comparative and longitudinal research to distil prevailing trends as well as the specificities that reside among particular East Asian subgroups (i.e. gender, sexual identity and generational) as a means to developing culturally sensitive and targeted suicide prevention programs.

Psychological Gender of Men With Systolic Heart Failure

Diminished exercise capacity is a fundamental symptom of heart failure (HF), which is particularly disadvantageous for men for whom exercise capacity contributes significantly to their gender identity, self-esteem, and quality of life. In this study, we aimed to examine whether psychological gender would be different in men with systolic HF as compared with their healthy peers. The authors examined 48 men with systolic HF (age = 64 ± 10 years; body mass index = 28.3 ± 3.4 kg/m2; NYHA I/II/III [%] = 25/65/10; left ventricular ejection fraction [LVEF] = 32.1 ± 7.8%) and 15 age-matched healthy men. Based on the results of the Polish version of the Bem Sex Role Inventory, the examined men were divided into four types of psychological gender: “masculine” (M), “feminine” (F), “unspecified” (U), and “androgynous” (A). None of the men with HF presented M type of psychological gender, whereas this type was found in 27% of the healthy men ( p = .0002). The prevalence of both A (38% vs. 47%) and F (10% vs. 20%, both p > .05) types of psychological gender was similar between men with HF versus without HF. More men with HF fulfilled the criteria of the U type of psychological gender as compared with healthy peers (51% vs. 7%, p = .002). Men with HF and the F type of psychological gender were treated with spironolactone more frequently than those classified with the U and A types (both p < .05). The lack of “psychologically masculine” and the overrepresentation of “psychologically unspecified” gender types in the HF group suggests that psychological gender may be affected among men with HF.

Beyond workers' compensation: men's mental health in and out of work

The mental health of men is an important issue with significant direct and indirect costs emerging from work-related depression and suicide. Although the merits of men's community-based and workplace mental health promotion initiatives have been endorsed, few programs are mandated or formally evaluated and reported on. Conspicuously absent also are gender analyses detailing connections between masculinities and men's work-related depression and suicide on which to build men-centered mental health promotion programs. This article provides an overview of four interconnected issues, (a) masculinities and men's health, (b) men and work, (c) men's work-related depression and suicide, and (d) men's mental health promotion, in the context of men's diverse relationships to work (including job insecurity and unemployment). Based on the review, recommendations are made for advancing the well-being of men who are in as well as of those out of work.

Fear of crime and psychological and physical abuse associated with ill health in a Swedish population aged 65-84 years

OBJECTIVES

To assess the association between fear of crime and/or psychological and/or physical abuse in relation to self-reported physical and psychological health, using a large representative sample of elderly women and men in Sweden.

STUDY DESIGN

Cross-sectional national survey.

METHODS

Data were taken from a nationwide representative public health survey (2006). Men and women between the ages of 65 and 84 years were selected for the present analyses (4386 men and 4974 women). The response rate for this age group was 59% for men and 70% for women.

RESULTS

Psychological and physical abuse against elderly women and men led to higher odds ratios for negative health outcomes, independently of socio-economic status. Strong correlation was found between psychological abuse and negative health outcomes in both men and women, while the correlation was less strong for physical abuse, especially among women. The men had high odds ratios for suicidal thoughts and even for attempted suicide in connection with physical and psychological abuse and fear of crime.

CONCLUSIONS

The study provides representative results addressing an extensive negative health outcome panorama caused by fear of crime and exposure to abuse.

[The sociology of gender: an original perspective for a better understanding of suicide in men]

There is a general consensus that suicide is a social problem. But what exactly is the contribution of sociology to research on suicide? This paper proposes a brief overview of the historical bases of the sociology of suicide and its evolution through the study of deviance and exclusion. On the level of application, the sociology of gender contributed to better understand how some aspects of male socialisation, such as the rigid relations with norms of the male role, may act as suicide risk factors or as a path to recovery.