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Tian X, Liu X, Bai F, Li M, Qiu Y, Jiao Q, Li J, Zhang X. Sex differences in correlates of suicide attempts in Chinese Han first-episode and drug-naïve major depressive disorder with comorbid subclinical hypothyroidism: A cross-sectional study. Brain Behav 2024; 14:e3578. [PMID: 38844426 PMCID: PMC11156525 DOI: 10.1002/brb3.3578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/11/2024] [Accepted: 05/18/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND This study aimed to investigate sex differences in risk factors for suicide attempts in first-episode and drug naive (FEDN) major depressive disorder (MDD) with comorbid subclinical hypothyroidism (SCH). METHODS A total of 1034 FEDN MDD patients with comorbid SCH were enrolled. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) positive subscale were used to assess patients' symptoms. Thyroid hormone levels and metabolic parameters were measured. RESULTS MDD patients with SCH had a significantly higher risk of suicide attempts than those without SCH (25.4% vs. 12.2%). Logistic regression showed that HAMA score, thyroid stimulating hormone (TSH) levels, and thyroid peroxidase antibody (TPOAb) levels were significantly associated with an increased risk for suicide attempts in both male and female MDD patients comorbid SCH, while low-density lipoprotein cholesterol (LDL-C) was significantly associated with an increased risk for suicide attempts only in male patients, HAMD score and systolic blood pressure were significantly associated with an increased risk for suicide attempts only in female patients. CONCLUSION SCH comorbidities may increase suicide attempts in MDD patients. Our results showed significant sex differences in clinical and metabolic factors associated with suicide attempts among FEDN MDD patients with comorbid SCH, highlighting appropriate sex-based preventive interventions are needed.
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Affiliation(s)
- Xue Tian
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Xiao‐En Liu
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Fengfeng Bai
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Meijuan Li
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Yuying Qiu
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Qingyan Jiao
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Jie Li
- Institute of Mental HealthTianjin Anding Hospital, Mental Health Center of Tianjin Medical UniversityTianjinChina
| | - Xiang‐Yang Zhang
- CAS Key Laboratory of Mental HealthInstitute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
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Luo G, Wang S, Gou L, Li C, Yao C, Jing Y, Xuekelaiti Z, Li J, Zhang XY. Sex differences and risk factors of self-reported suicide attempts in middle-aged Chinese Han patients with first-episode drug-naïve anxious depression: a large-scale cross-sectional study. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02779-x. [PMID: 38743092 DOI: 10.1007/s00702-024-02779-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/08/2024] [Indexed: 05/16/2024]
Abstract
This study aims to investigate sex differences and risk factors for self-reported suicide attempts among Chinese Han middle-aged patients with first-episode drug-naïve (FEDN) anxious depression (AD). A total of 1796 patients with FEDN major depressive disorder were enrolled in this study, including 341 middle-aged patients with AD. We compared the prevalence, demographics, and clinical characteristics of suicide attempts between male and female patients with FEDN middle-aged AD. We also explored the risk factors for self-reported suicide attempts in this population using binary logistic regression analysis. The male/female ratio was 91/250 and the age of onset was 51.50 ± 4.13. Our results showed that there were no significant sex differences in the prevalence of self-reported suicide attempts in middle-aged patients with FEDN AD. However, we did find significant differences in several demographic and clinical characteristics between self-reported suicide attempters and non-suicide attempters. Moreover, severe anxiety, measured by the Hamilton Anxiety Rating Scale score, was identified as a risk factor for self-reported suicide attempts in female middle-aged AD patients. Additionally, elevated thyroid peroxidase antibody (TPOAb) levels were linked to self-reported suicide attempts in male AD patients. Our findings suggest that there are no significant sex differences in the prevalence of self-reported suicide attempts in this population, but there may be sex-specific risk factors for self-reported suicide attempts in middle-aged AD. Clinical psychiatrists need to pay attention to thyroid hormone levels in middle-aged anxious depression.
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Affiliation(s)
- Guoshuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Shuo Wang
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Lei Gou
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Cui Li
- Department of Civil Engineering, Nanjing Technical Vocational College, 58 Huangshan Rd, Nanjing, 210019, China
| | - Cong Yao
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Yifan Jing
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Zaimina Xuekelaiti
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China
| | - Jie Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, 300222, China.
| | - Xiang-Yang Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, China.
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Guo J, Wang L, Zhao X, Wang D, Zhang X. Sex difference in association between suicide attempts and lipid profile in first-episode and drug naive patients with major depressive disorder. J Psychiatr Res 2024; 172:24-33. [PMID: 38354544 DOI: 10.1016/j.jpsychires.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
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.
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Affiliation(s)
- Junru Guo
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China; Department of Psychology, Guizhou Minzu University, Guiyang, 550025, China
| | - Li Wang
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Xiaoqing Zhao
- Student Affairs Office, Guizhou University, Guiyang, 550025, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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Li J, Luo X, Liu H. Dynamic bidirectional relation between state mindfulness and suicidal ideation among female college students: The moderating effect of trait mindfulness. DEATH STUDIES 2024:1-12. [PMID: 38502577 DOI: 10.1080/07481187.2024.2329180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Research has indicated that mindfulness is a protective factor against suicidal ideation. However, the dynamic reciprocal relation between them has been understudied. In this study, 110 female college students with suicidal ideation completed a measure of trait mindfulness and a 28-day diary of suicidal ideation and three-dimensional state mindfulness, including acting with awareness, present-moment attention, and nonjudgmental acceptance. Dynamic structural equation modeling was used to examine the dynamic and bidirectional effects between dimensions of state mindfulness and suicidal ideation and the moderating effect of trait mindfulness. Results showed that suicidal ideation predicted lower levels of present-moment attention the next day. More importantly, there was a dynamic and bidirectional relation between nonjudgmental acceptance and suicidal ideation for people with trait mindfulness higher than the average level (i.e., M + 0.15SD). Our findings suggested that studies and interventions on suicide should pay more attention to specific dimensions of state mindfulness and trait mindfulness.
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Affiliation(s)
- Jingxian Li
- College of Education for the Future, Beijing Normal University, Zhuhai, China
- Beijing Key Laboratory of Applied Experimental Psychology Faculty of Psychology, Beijing Normal University, Beijing, China
- Department of Mental Health Education and Consultation Center, Lingnan Normal University, Zhanjiang, China
| | - Xiaohui Luo
- Beijing Key Laboratory of Applied Experimental Psychology Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Hongyun Liu
- Beijing Key Laboratory of Applied Experimental Psychology Faculty of Psychology, Beijing Normal University, Beijing, China
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Ludwig J, Barbek R, von dem Knesebeck O. Education and suicidal ideation in Europe: A systematic review and meta-analysis. J Affect Disord 2024; 349:509-524. [PMID: 38199415 DOI: 10.1016/j.jad.2024.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Understanding predictors of suicidal ideation (SI) is crucial for preventing suicides. Given Europe's high suicide rates and the complex nature of SI, it is essential to also examine social determinants like education as potential risk factors for SI in this region. This systematic review and meta-analysis investigates the association between formal/vocational education and SI in Europe. METHODS Electronic databases (PubMed, Web of Science, PsycINFO, PSYNDEX) were searched until November 2022. Included studies involved European populations examining associations between education and SI. Pooled Odds Ratios (OR) with 95 % confidence intervals (CI) were calculated using random-effects models. Heterogeneity was assessed with the heterogeneity variance τ2 and I2 statistic; subgroup analyses were performed based on study characteristics. Risk of bias was assessed using an adaption of the Newcastle-Ottawa Scale. RESULTS From 20,564 initial studies, 41 were included in the meta-analysis (outlier-adjusted, 96,809 study participants). A negative, insignificant association (OR = 0.86, 95 % CI: 0.75; 1.00) was observed between education and SI, with significant heterogeneity (τ2 = 0.09, I2 = 73 %). Subgroup analyses indicated that population type, age group, categorization of education, timeframe of SI assessment, and study quality significantly moderated the effect size. LIMITATIONS Heterogeneity across studies limits generalizability. The cross-sectional design precludes establishing causal relationships, and social desirability bias may have underestimated the association between education and SI. CONCLUSIONS This systematic review and meta-analysis suggests a trend towards a protective effect of education on the emergence of SI in Europe. Future research, preferably with longitudinal study design examining various covariates, should systematically consider educational inequalities in SI.
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Affiliation(s)
- Julia Ludwig
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rieke Barbek
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Lam MI, Cai H, Chen P, Lok KI, Chow IHI, Si TL, Su Z, Ng CH, An FR, Xiang YT. The Inter-Relationships Between Depressive Symptoms and Suicidality Among Macau Residents After the "Relatively Static Management" COVID-19 Strategy: A Perspective of Network Analysis. Neuropsychiatr Dis Treat 2024; 20:195-209. [PMID: 38333613 PMCID: PMC10850988 DOI: 10.2147/ndt.s451031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
Background Suicidality is a global public health problem which has increased considerably during the coronavirus disease 2019 (COVID-19) pandemic. This study examined the inter-relationships between depressive symptoms and suicidality using network analysis among Macau residents after the "relatively static management" COVID-19 strategy. Methods An assessment of suicidal ideation (SI), suicide plan (SP), suicide attempt (SA) and depressive symptoms was conducted with the use of individual binary response items (yes/no) and Patient Health Questionnaire (PHQ-9). In the network analysis, central and bridge symptoms were identified in the network through "Expected Influence" and "Bridge Expected Influence", and specific symptoms that were directly associated with suicidality were identified via the flow function. Network Comparison Tests (NCT) were conducted to examine the gender differences in network characteristics. Results The study sample included a total of 1008 Macau residents. The prevalence of depressive symptoms and suicidality were 62.50% (95% CI = 59.4-65.5%) and 8.9% (95% CI = 7.2-10.9%), respectively. A network analysis of the sample identified SI ("Suicidal ideation") as the most central symptom, followed by SP ("Suicide plan") and PHQ4 ("Fatigue"). SI ("Suicidal ideation") and PHQ6 ("Guilt") were bridge nodes connecting depressive symptoms and suicidality. A flow network revealed that the strongest connection was between S ("Suicidality") and PHQ6 ("Guilt"), followed by S ("Suicidality") and PHQ 7 ("Concentration"), and S ("Suicidality") and PHQ3 ("Sleep"). Conclusion The findings indicated that reduction of specific depressive symptoms and suicidal thoughts may be relevant in decreasing suicidality among adults. Further, suicide assessment and prevention measures should address the central and bridge symptoms identified in this study.
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Affiliation(s)
- Mei Ieng Lam
- Education Department, Kiang Wu Nursing College of Macau, Macau SAR, People’s Republic of China
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, University of Macau, Macao SAR, People’s Republic of China
| | - Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, University of Macau, Macao SAR, People’s Republic of China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, People’s Republic of China
| | - Pan Chen
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, University of Macau, Macao SAR, People’s Republic of China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, People’s Republic of China
| | - Ka-In Lok
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, People’s Republic of China
| | - Ines Hang Iao Chow
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, University of Macau, Macao SAR, People’s Republic of China
| | - Tong Leong Si
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, University of Macau, Macao SAR, People’s Republic of China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, People’s Republic of China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent’s Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Feng-Rong An
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, University of Macau, Macao SAR, People’s Republic of China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, People’s Republic of China
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Zhu J, Xie P, Zhang X. Social exclusion and suicide intention in Chinese college students: a moderated mediation model. Front Psychol 2024; 15:1354820. [PMID: 38371706 PMCID: PMC10869458 DOI: 10.3389/fpsyg.2024.1354820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/16/2024] [Indexed: 02/20/2024] Open
Abstract
Given the growing incidence rates of suicide among college students and the potential lifelong consequences of suicide, it is imperative to better understand the factors that reduce the rates at which college students in a clinical sample engage in suicide. This study examines the relationship between social exclusion and suicide intention, the mediating effect of depression, and the moderating effect of meaning in life. Two hundred and ninety-nine Chinese college students, aged from 18 to 22 years (56.86% female, M age = 20.14, SD = 1.27) completed questionnaires assessing their social exclusion, suicide intention, depression, and meaning in life. The result revealed that social exclusion was positively associated with suicide intention, and depression mediated this relationship. In addition, this mediating effect of depression was moderated by meaning in life. That is, the mediation effect was stronger for students with a higher level of meaning in life. These findings provide educational suggestions for preventing and intervening in suicide intention among college students.
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Affiliation(s)
- Juncheng Zhu
- Hunan Key Laboratory of Children’s Psychological Development and Brain Cognitive Science, Department of Education, Hunan Frist Normal University, Hunan, Changsha, China
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Schölin L, Lee KSK, London L, Pearson M, Otieno F, Weerasinghe M, Konradsen F, Eddleston M, Sørensen JB. The role of alcohol use in pesticide suicide and self-harm: a scoping review. Soc Psychiatry Psychiatr Epidemiol 2024; 59:211-232. [PMID: 37420003 PMCID: PMC10838859 DOI: 10.1007/s00127-023-02526-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Abstract
PURPOSE Suicide and self-harm by pesticide self-poisoning is common in low- and middle-income countries (LMICs). Alcohol is an important risk factor for self-harm; however, little is known about its role in pesticide self-poisoning. This scoping review explores the role that alcohol plays in pesticide self-harm and suicide. METHODS The review followed the Joanna Briggs Institute scoping review guidance. Searches were undertaken in 14 databases, Google Scholar, and relevant websites. Articles were included if they focussed on pesticide self-harm and/or suicide and involvement of alcohol. RESULTS Following screening of 1281 articles, 52 were included. Almost half were case reports (n = 24) and 16 focussed on Sri Lanka. Just over half described the acute impact of alcohol (n = 286), followed by acute and chronic alcohol use (n = 9), chronic use, (n = 4,) and only two articles addressed harm to others. One systematic review/meta-analysis showed increased risk of intubation and death in patients with co-ingested alcohol and pesticides. Most individuals who consumed alcohol before self-harming with pesticides were men, but alcohol use among this group also led to pesticide self-harm among family members. Individual interventions were recognised as reducing or moderating alcohol use, but no study discussed population-level alcohol interventions as a strategy for pesticide suicide and self-harm prevention. CONCLUSION Research on alcohol's role in pesticide self-harm and suicide is limited. Future studies are needed to: further assess the toxicological effects of combined alcohol and pesticide ingestion, explore harm to others from alcohol including pesticide self-harm, and to integrate efforts to prevent harmful alcohol use and self-harm.
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Affiliation(s)
- Lisa Schölin
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK.
| | - K S Kylie Lee
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, Sydney, Australia
- The Edith Collins Centre (Translational Research in Alcohol, Drugs and Toxicology), Sydney Local Health District, Sydney, Australia
- Faculty of Health Sciences, National Drug Research Institute and Enable Institute, Curtin University, Perth, Australia
- Burnet Institute, Melbourne, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Leslie London
- School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Melissa Pearson
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
| | - Fredrick Otieno
- Centre for Environment Justice and Development (CEJAD), Nairobi, Kenya
| | - Manjula Weerasinghe
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
- Department of Community Medicine, Faculty of Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Flemming Konradsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
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Luo G, Ma H, Wang S, Yao C, Li Y, Sun D, Zhang X. Sex differences in prevalence and clinical correlates of suicide attempts in first-episode and drug-naïve patients with anxious depression in a Chinese Han population: A large-scale cross-sectional study. J Affect Disord 2024; 344:252-260. [PMID: 37838263 DOI: 10.1016/j.jad.2023.10.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/17/2023] [Accepted: 10/11/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUNDS Anxious depression (AD) has been extensively studied. However, fewer studies have examined sex differences in the prevalence of suicide attempts among AD patients. This study aimed to explore sex differences in suicide attempts and risk factors in patients with AD. METHODS 1380 first episode drug-naïve patients with AD were recruited. Sociodemographic and clinical characteristics were measured using a self-administered demographic questionnaire. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Inventory (HAMA), and positive subscale of the Positive and Negative Syndrome Scale (PANSS) were used to assess patients' clinical symptoms. We also measured the patient's blood glucose, lipids, and thyroid axis hormone levels. RESULTS There were no sex differences in the prevalence of suicide attempts in patients with FEDN anxious depression. In addition, binary logistic regression analysis showed that HAMA score, TSH levels, and TPOAb levels significantly predicted suicide attempts in both male and female patients with AD, while HAMD score significantly predicted suicide attempts in female patients with AD only. CONCLUSIONS The severity of anxiety and higher levels of TSH and TPOAb were associated with an increased risk for suicide attempts in both male and female patients with AD, whereas the severity of depression was only associated with suicide attempts in females.
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Affiliation(s)
- Guoshuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Hongyun Ma
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Shuo Wang
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Cong Yao
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China
| | - Yaxi Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 3210 Humin Rd, Shanghai 201108, China
| | - Daliang Sun
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin 300222, China.
| | - Xiangyang Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
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McEvoy D, Brannigan R, Cooke L, Butler E, Walsh C, Arensman E, Clarke M. Risk and protective factors for self-harm in adolescents and young adults: An umbrella review of systematic reviews. J Psychiatr Res 2023; 168:353-380. [PMID: 37972513 DOI: 10.1016/j.jpsychires.2023.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/13/2023] [Accepted: 10/13/2023] [Indexed: 11/19/2023]
Abstract
We conducted an umbrella review to synthesise the evidence from systematic reviews and meta-analyses that examined the risk and protective factors for self-harm in young people. We searched six different databases and used the AMSTAR-2 checklist for quality assessment. The importance of each risk and protective factor was determined based on (1) the number of times it was identified by general reviews examining any risk or protective factor, and (2) the effect sizes from meta-analyses. There were 61 systematic reviews included in this review. The most frequently identified risk factors for self-harm in young people included childhood abuse, depression/anxiety, bullying, trauma, psychiatric illnesses, substance use/abuse, parental divorce, poor family relationships, lack of friends, and exposure to self-harm behaviour in others. The risk factors with the strongest evidence for an association with self-harm were behavioural disorders, personality disorders and depression or anxiety. There was a dearth of systematic reviews examining protective factors but good family/friend relationships were most frequently identified. There was also evidence to show that non-suicidal and suicidal self-harm shared many of the same risk factors. Clinicians and other professionals who work with young people should be particularly cognisant of the psychiatric and adverse life event risk factors as well as the substance use, education-related and individual-level (e.g. being LGB) risk factors for self-harm. Knowledge of risk factors for self-harm can potentially be used to inform the design and implementation of prevention measures and further research is needed on the protective factors for self-harm.
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Affiliation(s)
- David McEvoy
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Ross Brannigan
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Lorcan Cooke
- School of Medicine, Royal College of Surgeons Ireland (RCSI), Dublin, 2, Ireland.
| | - Emma Butler
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Ella Arensman
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland; National Suicide Research Foundation (NSRF), Western Gateway Building, University College Cork, Ireland.
| | - Mary Clarke
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
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Lim E, Kim BJ, Lee CS, Cha B, Lee SJ, Seo JY, Choi JW, Lee YJ, Kang N, Kim SC, Lee D. Dietary Carotene Intake and Suicidal Ideation in Korean Females: Analysis of Data From the Korea National Health and Nutrition Examination Survey (2012, 2013, and 2015). Psychiatry Investig 2023; 20:897-903. [PMID: 37899212 PMCID: PMC10620338 DOI: 10.30773/pi.2022.0259] [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: 09/12/2022] [Revised: 11/06/2022] [Accepted: 11/16/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE The suicide rate in Korea was the highest among countries in the Organisation for Economic Co-operation and Development in 2019. In a previous study, higher intake of vegetables and fruits was associated with a lower risk of suicidal ideation, and carotene-rich fruits and vegetables lowered the risk of depression. This study aimed to examine the direct relationship between carotene intake and suicidal ideation, adjusting for the effect on depression. METHODS This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2012, 2013, and 2015. Carotene intake was assessed through a food intake frequency survey with a 24-hour recall. Suicidal ideation and depression were assessed using the mental health section of the KNHANES. We applied logistic regression to assess the relationship between carotene intake and suicidal ideation, adjusting for potential confounders. RESULTS A total of 5,480 females aged 19-64 years were included in this study. Carotene intake was significantly lower in the suicidal ideation group (3,034.5±1,756.4 μg/day) than in the nonsuicidal ideation group (3,225.4±1,795.1 μg/day) (p=0.015). We found a significant inverse association between carotene intake and the risk of suicidal ideation after adjusting for potential confounders (odds ratio=0.934, 95% confidence interval=0.873-0.999). CONCLUSION These results suggest that carotene intake may be inversely associated with the risk of suicidal ideation. Our findings may inform the development of new nutritional interventions to prevent increases in the risk of suicide worldwide.
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Affiliation(s)
- Eunji Lim
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea
| | - Bong-Jo Kim
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Cheol-Soon Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea
| | - Boseok Cha
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - So-Jin Lee
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ji-Yeong Seo
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jae-Won Choi
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Young-Ji Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea
| | - Nuree Kang
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Seung Chan Kim
- Biostatistics Cooperation Center, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Dongyun Lee
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
- Department of Psychiatry, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea
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Liu J, Ran G, Zhang Q, Li Y, Zhang Q. The association between callous-unemotional traits and suicide ideation among youth: A conditional process analysis. J Affect Disord 2023; 328:245-254. [PMID: 36806662 DOI: 10.1016/j.jad.2023.02.063] [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: 03/14/2022] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND The relationship between callous-unemotional (CU) traits (the affective facet of psychopathy and the psychopathy that occurs during childhood and adolescence) and suicide ideation (SI) remains unclear. The mechanisms underlying this association still have a gap in the literature. The aims of this study were to determine whether and how callous-unemotional traits were associated with suicide ideation, and to evaluate the mediating effect of negative affect (includes irritability, depression, and anxiety) and the moderating effect of future orientation on the association. METHODS Data were extracted from a longitudinal study involving middle and high school students, with 1,913 students (55.3% girls) aged 11 to 19 years (14.9 ± 1.6 years) completing a self-reported online survey. The conditional process analysis was examined using Mplus 8.3. RESULTS We found that callous-unemotional traits positively predicted youths' current suicide ideation, with the observed positive relationship partly mediated by negative affect. However, callous-unemotional traits did not predict the worst-point suicide ideation, which indicated the connection fully mediated by negative affect. Furthermore, future orientation moderated these indirect effects. LIMITATIONS Use of self-report measures and cross-sectional design. CONCLUSIONS These findings provided evidence for current debates and conflicting conclusions, and set the foundation for future research, as well as implied the important intervention goals for reducing suicide ideation in youth.
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Affiliation(s)
- Juncai Liu
- Department of Psychology, Institute of Education, China West Normal University, Nanchong 637002, China
| | - Guangming Ran
- Department of Psychology, Institute of Education, China West Normal University, Nanchong 637002, China.
| | - Qi Zhang
- College of Preschool and Primary Education, China West Normal University, Nanchong 637002, China
| | - Yinglun Li
- Sichuan Jianmenguan High School, Guangyuan 628317, China
| | - Qiongzhi Zhang
- Department of Psychology, Institute of Education, China West Normal University, Nanchong 637002, China
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Yong N, Luo J, Luo JM, Yao YS, Wu J, Yang H, Li JD, Yang S, Leng YY, Zheng HC, Fan Y, Hu YD, Ma J, Tan YW, Pan JY. Non-suicidal self-injury and professional psychological help-seeking among Chinese left-behind children: prevalence and influencing factors. BMC Psychiatry 2023; 23:291. [PMID: 37101196 PMCID: PMC10134637 DOI: 10.1186/s12888-023-04801-0] [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: 11/24/2022] [Accepted: 04/18/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a risk factor for suicide. This study aimed to investigate the prevalence of NSSI and professional psychological help-seeking status and influencing factors among left-behind children (LBC) in China. METHODS We implemented a population-based cross-sectional study in participants aged 10-18 years. Sociodemographic characteristics, NSSI, help-seeking status and coping style were measured by self-reported questionnaires. A total of 16,866 valid questionnaires were collected, including 6096 LBC. Binary logistic regression models were used to analyze the factors influencing NSSI and professional psychological help-seeking. RESULTS The incidence of NSSI among LBC was 4.6%, significantly higher than that of non-left-behind children (NLBC). This incidence was higher among girls. Moreover, 53.9% of LBC with NSSI did not receive any treatment and only 22.0% sought professional psychological help. LBC often adopt emotion-oriented coping styles, specifically, those with NSSI. LBC with NSSI who seek professional help tend to adopt problem-oriented coping styles. Logistic regression analysis revealed that girls, learning stage, single-parent, remarried families, patience, and emotional venting were risk factors for NSSI in LBC, while problem-solving and social support seeking were protective factors. Moreover, problem-solving was also a predictor for seeking professional psychological help, patience will prevent it. LIMITATIONS This was an online survey. CONCLUSIONS The prevalence of NSSI in LBC is high. Gender, grade, family structure, and coping style affect the occurrence of NSSI among LBC. Only a few LBC with NSSI seek professional psychological help, while the coping style will affect the help-seeking behavior.
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Affiliation(s)
- Na Yong
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
- Department of Child and Adolescent Psychology, Nanchong Psychosomatic Hospital, Nanchong, Sichuan, China
| | - Jing Luo
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jia-Ming Luo
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China.
| | - Yi-Song Yao
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jing Wu
- Mental Health Center, Southwest Petroleum University, Nanchong, Sichuan, China
| | - Han Yang
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jing-Dan Li
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Shuang Yang
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Yuan-Yuan Leng
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Hong-Chuan Zheng
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Yang Fan
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Ying-Dan Hu
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jin Ma
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Ya-Wen Tan
- School of Psychiatry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Ji-Yang Pan
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.
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Mendoza H, Rodriguez-Loureiro L, Gadeyne S, Lefebvre W, Vanpoucke C, Casas L. Urban green spaces and suicide mortality in Belgium (2001-2011): A census-based longitudinal study. ENVIRONMENTAL RESEARCH 2023; 216:114517. [PMID: 36220445 DOI: 10.1016/j.envres.2022.114517] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Exposure to green spaces is associated with improved mental health and may reduce risk of suicide. Here, we investigate the association between long-term exposure to residential surrounding greenness and suicide mortality. METHODS We used data from the 2001 Belgian census linked to mortality register data (2001-2011). We included all registered individuals aged 18 years or older at baseline (2001) residing in the five largest urban areas in Belgium (n = 3,549,514). Suicide mortality was defined using the tenth revision of the World Health Organisation International Classification of Diseases (ICD-10) codes X60-X84, Y10-Y34, and Y870. Surrounding greenness was measured using the Normalized Difference Vegetation Index (NDVI) within a 300 m and 1,000 m buffer around the residential address at baseline. To assess the association between residential surrounding greenness and suicide mortality, we applied Cox proportional hazards models with age as the underlying time scale. Models were adjusted for age, sex, living arrangement, migrant background, educational attainment, neighbourhood socio-economic position. We additionally explored potential mediation by residential outdoor nitrogen dioxide (NO2) concentrations. Finally, we assessed potential effect modification by various socio-demographic characteristics of the population (sex, age, educational attainment, migrant background, and neighbourhood socio-economic position). Associations are expressed as hazard ratios and their 95% confidence intervals (CI) for an interquartile range (IQR) increase in residential surrounding greenness. RESULTS We observed a 7% (95%CI 0.89-0.97) and 6% (95%CI 0.90-0.98) risk reduction of suicide mortality for an IQR increase in residential surrounding greenness for buffers of 300 m and 1,000 m, respectively. Furthermore, this association was independent of exposure to NO2. After stratification, the inverse association was only apparent among women, and residents of Belgian origin, and that it was stronger among residents aged 36 or older, those with high level of education, and residents of most deprived neighbourhoods. CONCLUSION Our results suggest that urban green spaces may protect against suicide mortality, but this beneficial effect may not be equally distributed across all strata of the population.
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Affiliation(s)
- Hilbert Mendoza
- Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Campus Drie Eiken, Doornstraat 331, BE-2610, Wilrijk, Belgium.
| | - Lucía Rodriguez-Loureiro
- Interface Demography (ID), Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 2, BE-1050, Brussels, Belgium.
| | - Sylvie Gadeyne
- Interface Demography (ID), Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 2, BE-1050, Brussels, Belgium.
| | - Wouter Lefebvre
- Vlaamse Instelling voor Technologisch Onderzoek (VITO), Boeretang 200, BE-2400, Mol, Belgium.
| | - Charlotte Vanpoucke
- Belgian Interregional Environment Agency (IRCEL-CELINE), Gaucherestraat 92-94, BE-1030, Brussel, Belgium.
| | - Lidia Casas
- Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Campus Drie Eiken, Doornstraat 331, BE-2610, Wilrijk, Belgium; Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Antwerp, Belgium.
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Chen J, Huebner ES, Tian L. Longitudinal associations among academic achievement and depressive symptoms and suicidal ideation in elementary schoolchildren: disentangling between- and within-person associations. Eur Child Adolesc Psychiatry 2022; 31:1405-1418. [PMID: 33885993 DOI: 10.1007/s00787-021-01781-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/07/2021] [Indexed: 01/18/2023]
Abstract
Prior cross-sectional and unidirectional longitudinal research has investigated the associations among academic achievement, depressive symptoms, and suicidal ideation without distinguishing between-person effects from within-person effects. Our study aimed to examine the longitudinal relations among academic achievement, depressive symptoms, and suicidal ideation in a sample of elementary school children at the within-person level using cross-lagged panel models (CLPMs) and random intercept cross-lagged panel models (RI-CLPMs). Also, multiple models replicated these findings by using three measures of academic achievement (i.e., objective academic achievement, subjective academic achievement, and teacher-assigned academic achievement). A sample of 715 Chinese elementary schoolchildren completed self-report measures of subjective academic achievement, depressive symptoms, and suicidal ideation on five occasions, using 6-month intervals. Objective academic achievement data were obtained from school records and teacher-assigned academic achievement data were reported by teachers. The results showed that: (a) In CLPMs, objective academic achievement negatively predicted suicidal ideation. However, RI-CLPMs supported the negative effect of suicidal ideation on objective academic achievement. (b) The CLPMs revealed reciprocal associations between subjective and teacher-assigned academic achievement and depressive symptoms, respectively. However, RI-CLPMs only provided support for the negative effect of depressive symptoms on subjective academic achievement. (c) Both the CLPMs and the RI-CLPMs showed bidirectional relations between depressive symptoms and suicidal ideation. These findings highlight that mental health problems (e.g., depressive symptoms and suicidal ideation) serve as antecedents of academic performance and that it is beneficial to distinguish between between-person and within-person effects in research informing the development of prevention and intervention programs.
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Affiliation(s)
- Jiahui Chen
- School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China.,Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, People's Republic of China.,Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, People's Republic of China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, People's Republic of China
| | | | - Lili Tian
- School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China. .,Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Guangzhou, People's Republic of China. .,Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, People's Republic of China. .,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, People's Republic of China.
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Zhou YM, Mak L, Zhao CX, He F, Huang XN, Tian XB, Yi-zheng, Sun J. Correlates of suicidal ideation in rural Chinese junior high school left-behind children: A socioecological resilience framework. Front Psychiatry 2022; 13:901627. [PMID: 35935415 PMCID: PMC9354399 DOI: 10.3389/fpsyt.2022.901627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Suicide is one of the top five causes of adolescent mortality around the world. The socioecological resilience framework in explaining the risk factors and protective factors for suicidal ideation in left-behind children (LBC) has not been well explored. The current study aims to compare the prevalence of suicidal ideation in LBC and non-LBC, and explore its correlations with resilience factors among LBC. Methodology This study was part of an epidemiological survey conducted by UNICEF exploring mental health outcomes in left-behind children. We implemented a cross-sectional study collecting data from 11 provinces and 1 municipal, with 5,026 participants (3,359 LBC, 1,667 controls) in year one junior high school living in impoverished areas of rural China. Data on suicidal ideation, self-harm, resilience factors including health-risk behaviors, psychological wellbeing as it was measured by the Strengths and Difficulties Questionnaire, peer relationship within the school environment, and family support were collected. Results Overall prevalence of suicidal ideation among LBC was 7.2% which is significantly different from 5.5% reported by NLBC (χ2 = 4.854, p = 0.028). LBC reported a higher prevalence of self-harm (16.4%) than NLBC (13.0%; χ2 = 10.232, p = 0.001), but there was no difference in the prevalence of suicide plan, suicide attempt or help-seeking. LBC had significantly poorer psychological feeling, and greater emotional and behavioral difficulties peer relationship in the school environment than controls. In the multiple logistic regression, history of self-harm was the greatest predictor for suicidal ideation among LBC (OR = 2.078, 95% CI: 1.394-3.100, p < 0.001). Health risk behavior including previous smoking attempt, poor psychological feeling, and emotional and behavior difficulties, and poor peer relationship within school environment, were also significant risk factors for suicidal ideation among LBC. Conclusion The prevalence of suicidal ideation and self-harm was greater among left-behind than non-left-behind children. Our results show resilience factors including previous self-harm, emotional and behavioral problems, smoking, and poor peer relationship are significantly associated with suicidal ideation in left-behind adolescents.
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Affiliation(s)
- Yu-ming Zhou
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Institute for Brain Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Leona Mak
- Menzies Health Institute Queensland, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Chun-xia Zhao
- United Nations Children's Fund (UNICEF China Office), Beijing, China
| | - Fan He
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Institute for Brain Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiao-na Huang
- United Nations Children's Fund (UNICEF China Office), Beijing, China
| | - Xiao-bo Tian
- United Nations Children's Fund (UNICEF China Office), Beijing, China
| | - Yi-zheng
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Institute for Brain Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jing Sun
- Menzies Health Institute Queensland, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
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Panfil AL, Lungeanu D, Tamasan S, Bredicean C, Papava I, Smirnova D, Fountoulakis KN. Suicidality Related to the COVID-19 Lockdown in Romania: Structural Equation Modeling. Front Psychiatry 2022; 13:818712. [PMID: 35656343 PMCID: PMC9152167 DOI: 10.3389/fpsyt.2022.818712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/19/2022] [Indexed: 12/21/2022] Open
Abstract
Background Suicidality is a serious public health concern at a global scale. Suicide itself is considered to be preventable death; worldwide, suicide rates and their trends are under constant scrutiny. As part of the international COMET-G cross-sectional study, we conducted a national level investigation to examine the individual disturbances (such as anxiety, depression, or history of life-threatening attempts) and contextual factors (such as adherence to conspiracy theories or Internet use) associated with suicidality related to the COVID-19 lockdown in a lot of Romanian adults. Participants and Methods One thousand four hundred and forty-six adults responded to an anonymous on-line questionnaire, with mean age ± standard deviation of 47.03 ± 14.21 years (1,142 females, 292 males, 12 identified themselves as non-binary). Data were analyzed using descriptive statistics and structural equation modeling (SEM). Results Univariate analysis showed strong significant correlation between anxiety and depression scorings among the respondents (Spearman R = 0.776, p < 0.001). Both the suicidality scorings and the Internet use correlated fairly with anxiety and depression, with two-by-two Spearman coefficients between R = 0.334 and R = 0.370 (p < 0.001 for each). SEM analysis substantiated the emotional disturbances, previous life-threatening attempts, and younger age as significant predictors for suicidality. The patterns of reality reading (including religious inquiries, Internet use, and beliefs in conspiracy theories) did not reach the statistical significance as influential factors in the suicidality of these respondents. There was no covariance between the Internet use and belief in conspiracy theories. Conclusion The study confirmed the suicidality risk initially hypothesized as being associated with the history of life-threatening attempts, increased depression within the younger population, and higher anxiety during the first year of the COVID-19 pandemic and its related lockdown. National strategies for effective interventions at various levels of the healthcare system should be developed.
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Affiliation(s)
- Anca-Livia Panfil
- Liaison Psychiatry, “Pius Brinzeu” County Emergency Hospital, Timisoara, Romania
| | - Diana Lungeanu
- Department of Functional Sciences, Center for Modeling Biological Systems and Data Analysis, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Simona Tamasan
- Liaison Psychiatry, “Pius Brinzeu” County Emergency Hospital, Timisoara, Romania
| | - Cristina Bredicean
- Discipline of Psychiatry, Department of Neuroscience, NEUROPSY-COG Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Psychiatry Compartment, “Dr. Victor Popescu” Emergency Military Clinical Hospital, Timisoara, Romania
| | - Ion Papava
- Discipline of Psychiatry, Department of Neuroscience, NEUROPSY-COG Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- “Eduard Pamfil” Psychiatry Clinic, “Pius Brinzeu” County Emergency Hospital, Timisoara, Romania
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
- Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| | - Konstantinos N. Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Mental Health Section, Research Institute, Panhellenic Medical Association, Thessaloniki, Greece
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Finding the Link between Cyberbullying and Suicidal Behaviour among Adolescents in Peninsular Malaysia. Healthcare (Basel) 2022; 10:healthcare10050856. [PMID: 35627992 PMCID: PMC9141303 DOI: 10.3390/healthcare10050856] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/29/2022] [Accepted: 05/03/2022] [Indexed: 11/23/2022] Open
Abstract
Social media engagement has contributed to the rise of cyberbullying, which has recently triggered tragic suicides among adolescents. The objective of this cross-sectional study is to determine the prevalence of cyberbullying, suicidal behaviour, and their association among adolescents in Peninsular Malaysia. The study was conducted among 1290 secondary school adolescents aged between 13 and 17 years old in Peninsular Malaysia using a self-administered and anonymous online questionnaire. Our findings reveal that the prevalence of cyberbullying victimization and perpetrator is 13.7% and 3.8%, respectively. The prevalence of suicidal behaviour among adolescents is 17.1%, in which 11.9% had suicidal thoughts, 10.2% had a suicide plan, and 8.4% had made a suicide attempt. Multiple logistic regression shows that adolescents experiencing cyberbullying victimization is a significant risk factor (p < 0.001) for suicidal behaviour after adjusting for other confounders. An alarming number of adolescents in Peninsular Malaysia found to be involved in cyberbullying and its significant association with suicidal behaviour warrant the need to strengthen current interventions. Since the study was conducted during the COVID-19 pandemic, our findings make an important contribution in reporting current trends in cyberbullying and suicide among adolescents, especially when they are becoming ever-more present in cyberspaces.
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Dong R, Haque A, Wu HE, Placide J, Yu L, Zhang X. Sex differences in the association between suicide attempts and glucose disturbances in first-episode and drug naive patients with major depressive disorder. J Affect Disord 2021; 292:559-564. [PMID: 34147968 DOI: 10.1016/j.jad.2021.05.110] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/30/2021] [Accepted: 05/31/2021] [Indexed: 01/05/2023]
Abstract
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.
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Affiliation(s)
- Rui Dong
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China
| | - Anam Haque
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hanjing Emily Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - John Placide
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Liling Yu
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Amiri S, Behnezhad S. The global prevalence of postpartum suicidal ideation, suicide attempts, and suicide mortality: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1959814] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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21
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Lifetime prevalence of suicidal attempt among homeless individuals in North America: a meta-analysis. J Affect Disord 2021; 287:341-349. [PMID: 33813254 DOI: 10.1016/j.jad.2021.03.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/10/2021] [Accepted: 03/19/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Homelessness is a compelling public health problem, and homeless individuals are at increased risk for attempting suicide. However, the reported lifetime prevalence of suicidal attempt among homeless individuals in North America varied considerably. Therefore, this meta-analysis aimed to estimate the pooled lifetime prevalence of suicidal attempt among homeless individuals in North America and explore factors that may moderate this estimation. METHODS The protocol was registered in PROSPERO database (CRD42018102593). A systematic literature search was conducted in the electronic databases of PubMed, Embase, Web of Science, PsycINFO, and Google Scholar. Observational studies exploring the lifetime prevalence of suicidal attempt among homeless individuals in North America were included. Heterogeneity across studies was evaluated using the Cochran Q test and quantified using the I2 statistic. Subgroup analyses were performed to identify possible sources of heterogeneity. RESULTS Twenty-two eligible studies with a total of 9,727 homeless individuals were included, of which 2,986 reported having attempted suicide in their lifetime. A high degree of heterogeneity (I2=96.4%, P<0.001) was observed, and the pooled lifetime prevalence was 31.83% (95% confidence interval: 26.87%-36.99%). Subgroup analyses showed that the heterogeneity was quite low when estimating the pooled lifetime prevalence of suicidal attempt among heterosexual (I2=0.0, P=0.401) and non-heterosexual homeless individuals (I2=0.0, P=0.405). LIMITATIONS All eligible studies were exclusively conducted in the US and Canada. CONCLUSIONS Nearly three tenths of homeless individuals in North America have attempted suicide in their lifetime, and the differences in sexual orientation might have contributed to the heterogeneity.
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Emotion reactivity, emotion dysregulation, and suicidality among Chinese undergraduates: A study based on the “ideation-to-action” framework. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01666-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Yuan S, Xiong Y, Michaëlsson M, Michaëlsson K, Larsson SC. Genetically predicted education attainment in relation to somatic and mental health. Sci Rep 2021; 11:4296. [PMID: 33619316 PMCID: PMC7900220 DOI: 10.1038/s41598-021-83801-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/08/2021] [Indexed: 01/02/2023] Open
Abstract
A deeper understanding of the causal links from education level to health outcomes may shed a light for disease prevention. In the present Mendelian randomization study, we found that genetically higher education level was associated with lower risk of major mental disorders and most somatic diseases, independent of intelligence. Higher education level adjusted for intelligence was associated with lower risk of suicide attempts, insomnia, major depressive disorder, heart failure, stroke, coronary artery disease, lung cancer, breast cancer, type 2 diabetes and rheumatoid arthritis but with higher risk of obsessive-compulsive disorder, anorexia nervosa, anxiety, bipolar disorder and prostate cancer. Higher education level was associated with reduced obesity and smoking, which mediated quite an extent of the associations between education level and health outcomes. These findings emphasize the importance of education to reduce the burden of common diseases.
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Affiliation(s)
- Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, 17177, Stockholm, Sweden
| | - Ying Xiong
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Madeleine Michaëlsson
- Department of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Karl Michaëlsson
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Dag Hammarskjölds Väg 14B, 75185, Uppsala, Sweden
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobelsväg 13, 17177, Stockholm, Sweden.
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Dag Hammarskjölds Väg 14B, 75185, Uppsala, Sweden.
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24
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Jing Z, Li J, Fu PP, Wang Y, Yuan Y, Zhao D, Hao W, Yu C, Zhou C. Physical multimorbidity and lifetime suicidal ideation and plans among rural older adults: the mediating role of psychological distress. BMC Psychiatry 2021; 21:78. [PMID: 33549084 PMCID: PMC7866476 DOI: 10.1186/s12888-021-03087-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/01/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Previous studies have revealed that single physical chronic condition was associated with suicidal ideation/plans, but few studies have examined the relationship between multimorbidity and suicidal ideation/plans, and no studies have explored the underlying potential mechanism on this relationship in China. This study aimed to explore association between physical multimorbidity and suicidal ideation as well as plans, and further examine the mediating role of psychological distress (PD) on this relationship. METHODS This study was based on the data from a survey about the health service of rural elderly household in Shandong, China. A total of 3242 adults aged 60 years and older were included in this study. PD was measured by Kessler Psychological Distress Scale (K10). Ordinal and binary logistic regression analyses were employed to explore the association between physical multimorbidity, PD and suicide ideation/plans. Bootstrapping analysis was further used to examine the mediation effect of PD on the association of multimorbidity and suicidal ideations/plans. RESULTS The prevalence of multimorbidity, lifetime suicidal ideation, and suicidal plan in rural older adults was 35.2, 10.6 and 2.2%, respectively. Older adults living in rural areas with two or more chronic physical conditions experienced significantly higher risk of suicidal ideation and suicidal plans. The association between multimorbidity and suicidal ideations/plans was partially mediated by PD, of which, the mediating effect of PD accounted for 31.7 and 25.5% of the total effect, respectively. CONCLUSION This study demonstrated the associations between physical multimorbidity and suicidal ideation/plans, and the mediating role of PD on this relationship among Chinese rural elderly. Healthcare providers in rural community should provide regular surveillance for the mental health status among the rural elderly with multimorbidity, and carry out various effective intervention measures to improve the mental health status, so as to reduce the risk of suicide.
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Affiliation(s)
- Zhengyue Jing
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Jie Li
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Pei Pei Fu
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China ,grid.27255.370000 0004 1761 1174NHC Key Lab of Health Economics and Policy Research, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Yi Wang
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Yemin Yuan
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Dan Zhao
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Wenting Hao
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Caiting Yu
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012, Shandong, China. .,NHC Key Lab of Health Economics and Policy Research, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012, Shandong, China.
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25
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Khoweiled AA, Gaafar Y, El Makawi SM, Kamel RM, Ayoub DR. Neurological soft signs correlation with symptom severity in borderline personality disorder. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-020-00078-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Abstract
Background
Borderline personality disorder (BPD) is a severe psychiatric disorder with multiple psychopathological domains; so studying the correlation of clinical or behavioral data with underlying structural and functional neurological findings in BPD is the focus of interest in recent years.
The aim of our study was to compare the presence of neurological soft signs (NSS) in patients with borderline personality disorder with their presence in normal controls, and to correlate the severity of different symptoms of BPD with the presence of NSS through a case-control study which was conducted on 30 patients and 30 matching controls recruited from Al Kasr Al Ainy Hospital, Cairo University, Egypt. All subjects were assessed by the Borderline Personality Questionnaire, the Barratt Impulsivity Scale-11, the Brief Non-Suicidal Self-Injury Assessment tool, and the Cambridge Neurological Inventory.
Results
The BPD group had significantly higher total NSS scores, primitive reflexes subscale score, and sensory integration subscale scores. There was also a positive correlation between NSS and overall severity of borderline symptoms.
Conclusions
The increased rates of NSS were associated with specific clinical symptoms in BPD including suicidality, self-harm, emptiness, and quasi-psychosis. Impulsivity was found to have the highest correlation with NSS.
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26
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Socioeconomic disparities in suicide: Causation or confounding? PLoS One 2021; 16:e0243895. [PMID: 33395418 PMCID: PMC7781379 DOI: 10.1371/journal.pone.0243895] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 11/30/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite an overall reduction in suicide, educational disparities in suicide have not decreased over the last decade. The mechanisms behind educational disparities in suicide, however, remain unclear: low educational status may increase the risk of suicide ("causation") or low educational status and suicide may share confounders. This paper assesses whether educational disparities in suicide (EDS) are more likely to be due to causation. METHOD The DEMETRIQ study collected and harmonized register-based data on mortality follow-up from forty population censuses from twelve European populations. More than 102,000 suicides were registered over 392 million person-years. Three analyses were carried out. First, we applied an instrumental variable approach that exploits changes in the legislation on compulsory educational age to instrument educational status. Second, we analyzed EDS by age under the hypothesis that increasing EDS over the life cycle supports causation. Finally, we compared EDS in men and women under the assumption that greater EDS in women would support causation. FINDINGS The instrumental variable analysis showed no evidence for causation between higher education and suicide, for men or women. The life-cycle analysis showed that the decrease of educational inequalities in suicide between the baseline 1991 period and the 2001 follow-up period was more pronounced and statistically significant in the first three younger age groups. The gender analysis indicated that EDS were systematic and greater in men than in women: the rate ratio of suicide for men with low level of education (RR = 2.51; 95%CI:2.44-2.58) was higher than the rate ratio in women (RR = 1.32; 95CI%:1.26-1.38). INTERPRETATION Overall, there was little support for the causation hypothesis, suggesting that the association between education and suicide is confounded. Educational inequalities in suicide should be addressed in early life by early targeting of groups who struggle to complete their education and display higher risk of mental disorder or of mental health vulnerabilities.
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27
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Dos Santos JCP, Valli JB, Sesse NS, Mackenzie-Ross S, Zandonade E, Ayres LR, Sampaio KN. Sociodemographic characteristics and exposure patterns of pesticide-related cases reported to a poison service center in Brazil between 2012 and 2016. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 76:494-503. [PMID: 33252014 DOI: 10.1080/19338244.2020.1848773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Pesticide poisoning is a significant public health problem responsible for an estimated three million poisoning cases per year and more than 250,000 deaths, most of which occur in underdeveloped countries. We evaluated pesticide exposure cases reported to a toxicological service center in Brazil, between 2012 and 2016. There were 3211 cases of pesticide exposure, with a high prevalence in adults aged 20-39 years (41.2%). Attempted suicide was the leading cause of pesticide cases (48%). Occupational exposure to pesticides of agricultural use was more frequently observed among men. Accidental exposure and attempted suicide were more frequently observed in urban areas while occupational exposure was more prevalent in rural areas. A higher exposure rate was observed among men in counties with higher agricultural activities. Establishing prevalence and cause of pesticide exposure is important to provide subsidy for evidence-based interventions in the field.
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Affiliation(s)
| | | | - Nixon Souza Sesse
- Toxicological Service Center of Espírito Santo (TOXCEN), Vitória, ES, Brazil
| | - Sarah Mackenzie-Ross
- Research Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Eliana Zandonade
- Public Health Postgraduate Program, Federal University of Espírito Santo, Vitória, ES, Brazil
- Statistical Department, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Lorena Rocha Ayres
- Department of Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Karla Nívea Sampaio
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
- Department of Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
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28
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Baldaçara L, Rocha GA, Leite VDS, Porto DM, Grudtner RR, Diaz AP, Meleiro A, Correa H, Tung TC, Quevedo J, da Silva AG. Brazilian Psychiatric Association guidelines for the management of suicidal behavior. Part 1. Risk factors, protective factors, and assessment. ACTA ACUST UNITED AC 2020; 43:525-537. [PMID: 33111773 PMCID: PMC8555650 DOI: 10.1590/1516-4446-2020-0994] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/21/2020] [Indexed: 12/28/2022]
Abstract
Suicide is a global public health problem that causes the loss of more than 800,000 lives each year, principally among young people. In Brazil, the average mortality rate attributable to suicide is approximately 5.23 per 100,000 population. Although many guidelines have been published for the management of suicidal behavior, to date, there are no recent guidelines based on the principles of evidence-based medicine that apply to the reality of suicide in Brazil. The objective of this work is to provide key guidelines for managing patients with suicidal behavior in Brazil. This project involved 11 Brazilian psychiatry professionals selected by the Psychiatric Emergencies Committee (Comissão de Emergências Psiquiátricas) of the Brazilian Psychiatric Association for their experience and knowledge in psychiatry and psychiatric emergencies. For the development of these guidelines, 79 articles were reviewed (from 5,362 initially collected and 755 abstracts). In this review, we present definitions, risk and protective factors, assessments, and an introduction to the Safety Plan. Systematic review registry number: CRD42020206517
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Affiliation(s)
- Leonardo Baldaçara
- Universidade Federal do Tocantins, Palmas, TO, Brazil.,Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil
| | - Gislene A Rocha
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros, Montes Claros, MG, Brazil.,Serviço Especializado em Reabilitação em Deficiência Intelectual, Associação de Pais e Amigos dos Excepcionais, Montes Claros, MG, Brazil
| | - Verônica da S Leite
- Universidade Federal do Tocantins, Palmas, TO, Brazil.,Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Secretaria Municipal de Saúde de Palmas, Palmas, TO, Brazil
| | - Deisy M Porto
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Associação Catarinense de Psiquiatria, Florianópolis, SC, Brazil
| | - Roberta R Grudtner
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Núcleo de Dor e Neuromodulação, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Secretaria Estadual da Saúde, Porto Alegre, RS, Brazil
| | - Alexandre P Diaz
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | | | - Humberto Correa
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Teng C Tung
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.,Serviços de Pronto Socorro e Interconsultas, IPq, HCFMUSP, São Paulo, SP, Brazil
| | - João Quevedo
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Antônio G da Silva
- Associação Brasileira de Psiquiatria (ABP), Rio de Janeiro, RJ, Brazil.,Asociación Psiquiátrica de América Latina (APAL)
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29
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Carrasco-Barrios MT, Huertas P, Martín P, Martín C, Castillejos MC, Petkari E, Moreno-Küstner B. Determinants of Suicidality in the European General Population: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4115. [PMID: 32526975 PMCID: PMC7312422 DOI: 10.3390/ijerph17114115] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 12/11/2022]
Abstract
Close to one million people commit suicide each year, with suicidal attempts being the main risk factor for suicide. The aim of this systematic review and meta-analysis is to achieve a greater understanding of suicidality in the general population of Europe by studying associated factors and their statistical significance with suicidality, as well as the effect of the temporal moment in which suicidality is observed in a relationship. A search strategy was carried out in electronic databases: Proquest's Psychology Database, Scopus, PsycINFO, Medline and Embase. Odds ratios (ORs), publication bias, influential studies on heterogeneity and analysis moderators were calculated. Twenty-six studies were included after meeting the inclusion criteria. Factors statistically associated with suicidality are female gender, age over 65 years, unemployment, low social support, adulthood adversity, childhood adversity, family history of mental disorder, any affective disorder, major depression, anxiety/stress/somatoform disorders, tobacco and substance use, any mental disorder and body mass index. As a limitation, a high heterogeneity between studies was found. Factors associated with suicidality in the general population are relevant for understanding the suicidal phenomenon.
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Affiliation(s)
- María Teresa Carrasco-Barrios
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, 29010 Malaga, Spain; (M.T.C.-B.); (P.M.); (M.C.C.); (B.M.-K.)
| | - Paloma Huertas
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, 29010 Malaga, Spain; (M.T.C.-B.); (P.M.); (M.C.C.); (B.M.-K.)
| | - Paloma Martín
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, 29010 Malaga, Spain; (M.T.C.-B.); (P.M.); (M.C.C.); (B.M.-K.)
| | - Carlos Martín
- Primary Care Center of Marquesado, Área Nordeste de Granada, 18512 Granada, Spain;
| | - Mª Carmen Castillejos
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, 29010 Malaga, Spain; (M.T.C.-B.); (P.M.); (M.C.C.); (B.M.-K.)
| | - Eleni Petkari
- Social and Behavioural Sciences, European University Cyprus 6th Diogenous st., Nicosia 2063, Cyprus;
| | - Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, 29010 Malaga, Spain; (M.T.C.-B.); (P.M.); (M.C.C.); (B.M.-K.)
- Biomedical Research Institute of Malaga (IBIMA), 29010 Málaga, Spain
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30
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Cheng Y, Zhang XM, Ye SY, Jin HM, Yang XH. Suicide in Chinese Graduate Students: A Review From 2000 to 2019. Front Psychiatry 2020; 11:579745. [PMID: 33424658 PMCID: PMC7793914 DOI: 10.3389/fpsyt.2020.579745] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/30/2020] [Indexed: 11/13/2022] Open
Abstract
Suicide is an important public problem in China. The characteristics of Chinese graduate students' suicides and the reasons they occur have never been reported systematically. We conducted a systematic search of public reports on local media and medical websites in this review to gain a basic understanding of these questions. A total of 150 cases of graduate students' suicides were reported from 2000 to 2019. Among the 150 students, 65.8% were male, nearly half between 26 and 30 years old, most (83.3%) never married, and 43.4% of graduation students committed suicide in graduation year and postponed years. The top three suicide methods were jumping, hanging, and drowning. Graduation pressure, depression, and academic pressure were the three leading suicidal causes. There is an urgent need for the Chinese government and universities to pay more attention to prevent suicides among graduate students.
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Affiliation(s)
- Yun Cheng
- Division of Nephrology, Pudong Medical Center, Shanghai Pudong Hospital, Fudan University, Shanghai, China
| | - Xiao Meng Zhang
- Division of Nephrology, Pudong Medical Center, Shanghai Pudong Hospital, Fudan University, Shanghai, China
| | - Shui Ying Ye
- Division of Nephrology, Pudong Medical Center, Shanghai Pudong Hospital, Fudan University, Shanghai, China
| | - Hui Min Jin
- Division of Nephrology, Pudong Medical Center, Shanghai Pudong Hospital, Fudan University, Shanghai, China
| | - Xiu Hong Yang
- Division of Nephrology, Pudong Medical Center, Shanghai Pudong Hospital, Fudan University, Shanghai, China
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31
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Zhong Y, Xia L, Zhao TT, Zhang YL, Zhang YL, Li WZ, Hu YQ, Yao XH, Ungvari GS, Balbuena L, Liu HZ, Xiang YT. The Prevalence of Suicide Attempts and Independent Demographic and Clinical Correlates among Chronic Schizophrenia Patients in Agricultural Areas of China. Psychiatr Q 2019; 90:683-691. [PMID: 31102121 DOI: 10.1007/s11126-019-09644-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study investigated the lifetime prevalence of suicide attempts (SA) and independent demographic and clinical correlates in stabilized schizophrenia inpatients. A cross-sectional study was conducted in three psychiatric hospitals in Anhui province, an agricultural province located in east China. Psychopathology and depressive symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and Hamilton Depression Rating Scale (HAMD), respectively. A total of 315 stable schizophrenia inpatients were interviewed prior to discharge. The lifetime prevalence of SA was 22.2%. Multiple logistic regression analysis revealed that female gender (P < 0.001, OR = 3.4, 95%CI: 1.9-6.0), being married (P = 0.02, OR = 2.2, 95%CI: 1.1-4.4) and having more severe depressive symptoms (P = 0.014, OR = 1.2, 95%CI: 1.01-1.3) were independently and significantly associated with higher risk of SA. Lifetime SA is common among hospitalized schizophrenia patients living in agricultural areas of China. For suicide prevention, regular assessments, appropriate interventions and clinical management should be integrated into a community-based psychiatric service model for this population.
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Affiliation(s)
- Yi Zhong
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Tong-Tong Zhao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Yu-Long Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Ye-Lei Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China.,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China
| | - Wen-Zheng Li
- Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China.,Hefei Fourth People's Hospital, Anhui Province, China
| | - Yan-Qiong Hu
- Hefei Fourth People's Hospital, Anhui Province, China
| | - Xian-Hu Yao
- MaAnshan Fourth People's Hospital, Anhui Province, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia / Graylands Hospital, Perth, Australia.,Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| | - Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Huan-Zhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui Province, China. .,Anhui Psychiatric Center, Anhui Medical University, Anhui Province, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, 3/F, Building E12, Avenida da Universidade, Taipa, Macau, SAR, China.
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Guo L, Wang W, Wang T, Li W, Gong M, Zhang S, Zhang WH, Lu C. Association of emotional and behavioral problems with single and multiple suicide attempts among Chinese adolescents: Modulated by academic performance. J Affect Disord 2019; 258:25-32. [PMID: 31382101 DOI: 10.1016/j.jad.2019.07.085] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/28/2019] [Accepted: 07/29/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND There were differences in the characteristics and prevalence rates between individuals with a history of one suicide attempt and those with multiple suicide attempts. This large-scale study was conducted to test, among Chinese adolescents, the associations of emotional and behavioral problems with single and multiple suicide attempts and whether these associations vary with adolescents' academic performance. METHODS Data were drawn from the 2019 School-based Chinese Adolescents Health Survey (n = 20,702). Information about emotional and behavioral problems, suicide attempts, suicidal ideation, academic performance, and sleep duration was gathered. Multinomial logistic regression models using Firth penalized likelihood approach and appropriate sampling weights were performed. RESULTS Compared with no suicide attempt, peer problems, emotional problems, conduct problems, and hyperactivity were associated with an elevated risk of both a single suicide attempt and multiple suicide attempts, respectively (P < 0.05); the magnitudes of these associations in multiple suicide attempters were higher than those in single suicide attempters. Further stratification analyses by academic performance showed a greater association of the four difficulties with multiple suicide attempts in adolescents reporting poor academic performance than in those with good or average academic performance. LIMITATIONS The school-based study sample only included students, and causal inference could not be delineated due to the cross-sectional design. CONCLUSIONS Emotional and behavioral problems are associated with an elevated risk of single and multiple suicide attempts with differences between multiple suicide attempters and single suicide attempters. Adolescent academic performance plays a modulating role in these associations for multiple suicide attempts.
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Affiliation(s)
- Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Wanxin Wang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Tian Wang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Wenyan Li
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Meiqian Gong
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Sheng Zhang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Wei-Hong Zhang
- Department of Public Health and Primary Care, International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium; Research Center for Public Health, Tsinghua University, Beijing, People's Republic of China
| | - Ciyong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd 2, Guangzhou 510080, People's Republic of China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.
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Wongpakaran N, Wongpakaran T, Kittipodjanasit A, Chompoosri P, Kuntawong P, Wedding D. Predictive factors for suicidal attempts: A case-control study. Perspect Psychiatr Care 2019; 55:667-672. [PMID: 31087381 DOI: 10.1111/ppc.12397] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/17/2019] [Accepted: 04/24/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To identify predictors for 12-month suicide attempt from general psychiatric outpatients. DESIGN AND METHODS A case-control study compared 55 cases of suicide attempt within the previous 12 months matched for age and sex with 55 nonsuicidal cases. All were interviewed for psychiatric and personality disorder (PD) diagnoses using a DSM-IV-TR diagnostic interview. FINDINGS Factors associated with suicide attempt included depressive disorders (odds ratio [OR] = 4.62) and borderline PD (OR = 8.99). PRACTICAL IMPLICATIONS More attention should be paid to identifying PD especially borderline PD in suicidal attempters, and further study of modifiable factors associated with depression and borderline PD is encouraged.
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Affiliation(s)
- Nahathai Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Kingdom of Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Kingdom of Thailand
| | | | - Poom Chompoosri
- School of Medicine, Mae Fah Luang University, Chiang Rai, Kingdom of Thailand
| | - Pimolpun Kuntawong
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Kingdom of Thailand
| | - Danny Wedding
- School of Humanistic and Clinical Psychology, Saybrook University, Oakland, CA, USA
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Yu Z, Xu L, Sun L, Zhang J, Qin W, Li J, Ding G, Wang Q, Zhu J, Xie S. Association between interpersonal trust and suicidal ideation in older adults: a cross-sectional analysis of 7070 subjects in Shandong, China. BMC Psychiatry 2019; 19:206. [PMID: 31269989 PMCID: PMC6610842 DOI: 10.1186/s12888-019-2186-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 06/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUNDS Suicidal ideation is an important public health issue due to devastating mortality. In the meantime, interpersonal trust was found to be negatively associated with mental disorder and physical health. Although there is increasing evidence that interpersonal trust is a significant predictor of suicidal ideation, evidence of this association is still lacking in the developing world. The aim of this study was to test the association between interpersonal trust and suicidal ideation among older adults in China. METHODS Using a multi-stage stratified sampling strategy, 7070 older adults aged 60 and above from Shandong Province, China were recruited in this study. Socio-demographic characteristics, health status, family relationship, psychological distress, interpersonal trust and suicidal ideation in the last 12 months were obtained through face to face interviews. The association between interpersonal trust and suicidal ideation was assessed using multiple logistic regression models adjusting for socio-demographic characteristics, health status, family relationship and psychological distress. RESULTS 7.1% of participants reported suicidal ideation in the past 12 months, which was related to gender, resident area, marital status, educational level, self-rated economic, chronic disease, self-rated health status and family relationship within 1 month, psychological distress and interpersonal trust. After adjusting for sociodemographic factors, health status, family relationship and psychological distress, interpersonal mistrust was associated with two times odds of suicidal ideation when compared to interpersonal trust CONCLUSIONS: The interpersonal trust was associated with suicidal ideation among elderly in Shandong, China. Intervention approaches regarding inducing and promoting interpersonal trust should be developed to prevent suicide.
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Affiliation(s)
- Zihang Yu
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012 China
| | - Lingzhong Xu
- School of Public Health, Shandong University, Jinan, 250012, China. .,NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China. .,Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012, China.
| | - Long Sun
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China
| | - Jiao Zhang
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012 China
| | - Wenzhe Qin
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012 China
| | - Jiajia Li
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012 China
| | - Gan Ding
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012 China
| | - Qian Wang
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012 China
| | - Jing Zhu
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012 China
| | - Su Xie
- 0000 0004 1761 1174grid.27255.37School of Public Health, Shandong University, Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012 China ,0000 0004 1761 1174grid.27255.37Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012 China
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Kim DH, Rodríguez Andrés A, Leigh JP. Sex-Specific Impact of Changes in Job Status on Suicidal Ideation. CRISIS 2019; 41:89-96. [PMID: 31140318 DOI: 10.1027/0227-5910/a000605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Around the globe, 800,000 people die from suicide every year. Despite being one of the leading causes of death, suicide remains a low public health priority. Korea has the second highest total suicide rate among Organisation for Economic Co-operation and Development (OECD) countries. Aims: The aim of this study was to explore how changes of job status influence suicidal risk in Korea, which lags behind other OECD countries in job security because temporary and part-time jobs are more prevalent in Korea. Method: We made use of a large longitudinal dataset, the Korea Health Panel (KHP). Results: Our findings revealed that a negative change in employment status increased the risk of suicide, but only for males. Limitations: Some individuals might intentionally change their job status, but the data do not indicate why the job status of an individual changes. Conclusion: These findings provide useful insights regarding the Korean labor market. In particular, tackling the issue of job stability, providing training polices for the unemployed and under-employed, and considering social insurance schemes may help to reduce suicide risk.
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Affiliation(s)
- Dae-Hwan Kim
- Department of Economics, Dong-A University, Busan, South Korea
| | - Antonio Rodríguez Andrés
- Department of National Economy, Faculty of Economics, Technical University of Ostrava, Czech Republic.,Department of Business, Faculty of Business and Communication, International University of La Rioja, Logroño, Spain
| | - J Paul Leigh
- Department of Public Health Science, University of California, Davis, CA, USA
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[Association of suicidal ideation with family environment and psychological resilience in adolescents]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:479-484. [PMID: 31104667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To study the association of suicidal ideation with family environment and psychological resilience in adolescents. METHODS Cluster sampling was used to perform an investigation among 3 230 junior and senior high school students in Xinxiang of Henan Province, China December 2014. A general social information questionnaire, 11-Item Kutcher Adolescent Depression Scale(KADS-11), Family Environment Scale-Chinese Version (FES-CV) and Connor-Davidson Resilience Scale (CD-RISC; Chinese version ) were used for evaluation. A multivariate logistic regression analysis and a case-control study were used to investigate the association of suicidal ideation with family environment and psychological resilience in adolescents. RESULTS A total of 2 960 usable questionnaires were received. Among the 2 960 adolescents, 247 (8.50%) had suicidal ideation (98 boys and 149 girls). The multivariate logistic regression analysis showed that after adjustment for age and sex, single-parent/remarried family was associated with an increased risk of suicidal ideation (OR=2.655). Suicidal ideation in boys was negatively correlated with family cohesion (OR=0.750, P<0.001) and organization (OR=0.855, P=0.036) and was positively correlated with family conflict (OR=1.159, P=0.017). Suicidal ideation in girls were negatively correlated with family cohesion (OR=0.771, P<0.001), emotional expression (OR=0.815, P=0.001) and intellectual-cultural orientation (OR=0.915, P=0.037). The adolescents with suicidal ideation had a significantly lower total score of psychological resilience than those without suicidal ideation (P<0.05). Compared with those without suicidal ideation, the adolescents with suicidal ideation had significantly lower scores on 4 factors of the CD-RISC (ability, tolerance of negative emotions, acceptance of changes and control) (P<0.05). CONCLUSIONS Family cohesion is a protective factor against suicidal ideation in adolescents. Family organization in boys and family emotional expression in girls are associated with a decreased risk of suicidal ideation. Enhanced psychological resilience may help to reduce the incidence of suicide ideation in adolescents.
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Cong EZ, Wu Y, Cai YY, Chen HY, Xu YF. [Association of suicidal ideation with family environment and psychological resilience in adolescents]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:479-484. [PMID: 31104667 PMCID: PMC7389414 DOI: 10.7499/j.issn.1008-8830.2019.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/14/2019] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To study the association of suicidal ideation with family environment and psychological resilience in adolescents. METHODS Cluster sampling was used to perform an investigation among 3 230 junior and senior high school students in Xinxiang of Henan Province, China December 2014. A general social information questionnaire, 11-Item Kutcher Adolescent Depression Scale(KADS-11), Family Environment Scale-Chinese Version (FES-CV) and Connor-Davidson Resilience Scale (CD-RISC; Chinese version ) were used for evaluation. A multivariate logistic regression analysis and a case-control study were used to investigate the association of suicidal ideation with family environment and psychological resilience in adolescents. RESULTS A total of 2 960 usable questionnaires were received. Among the 2 960 adolescents, 247 (8.50%) had suicidal ideation (98 boys and 149 girls). The multivariate logistic regression analysis showed that after adjustment for age and sex, single-parent/remarried family was associated with an increased risk of suicidal ideation (OR=2.655). Suicidal ideation in boys was negatively correlated with family cohesion (OR=0.750, P<0.001) and organization (OR=0.855, P=0.036) and was positively correlated with family conflict (OR=1.159, P=0.017). Suicidal ideation in girls were negatively correlated with family cohesion (OR=0.771, P<0.001), emotional expression (OR=0.815, P=0.001) and intellectual-cultural orientation (OR=0.915, P=0.037). The adolescents with suicidal ideation had a significantly lower total score of psychological resilience than those without suicidal ideation (P<0.05). Compared with those without suicidal ideation, the adolescents with suicidal ideation had significantly lower scores on 4 factors of the CD-RISC (ability, tolerance of negative emotions, acceptance of changes and control) (P<0.05). CONCLUSIONS Family cohesion is a protective factor against suicidal ideation in adolescents. Family organization in boys and family emotional expression in girls are associated with a decreased risk of suicidal ideation. Enhanced psychological resilience may help to reduce the incidence of suicide ideation in adolescents.
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Affiliation(s)
- En-Zhao Cong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
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Zhang J, Liu X, Fang L. Combined effects of depression and anxiety on suicide: A case-control psychological autopsy study in rural China. Psychiatry Res 2019; 271:370-373. [PMID: 30529321 PMCID: PMC6382523 DOI: 10.1016/j.psychres.2018.11.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 08/15/2018] [Accepted: 11/05/2018] [Indexed: 01/01/2023]
Abstract
Most of the previous researches indicated depression and anxiety were potential risk factors for suicide, and they were also highly correlated. However, few studies have explored their combined effects on suicide and the dimensions which really work. A total of 392 suicide cases aged 15-34 years and 416 community controls of the same age range were investigated. The results showed that after controlling confounding factors, people with low depression and high anxiety, with high depression and low anxiety, with high depression and high anxiety were at 2.46, 26.32, 54.77 times more risk for suicide (all P < 0.05), compared with subjects with low depression and low anxiety. Only two of seven dimensions of depression (including cognitive disturbance, helplessness, excluding anxiety dimension) and one of two dimensions of STAI anxiety (anxiety dimension, not depression dimension) were risk factors for suicide (all OR > 1). Our main findings was that combined effects of depression and anxiety on suicide were complicated, and the effects of anxiety dimension of depression and depression dimension of anxiety must be cautiously evaluated, avoiding overlapping inclusion.
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Affiliation(s)
- Jie Zhang
- School of Public Health and Center for Suicide Prevention Research, Shandong University, China,Department of Sociology, State University of New York Buffalo State, USA
| | - Xinxia Liu
- College of Humanities and Law, Northeast Agricultural University, China
| | - Le Fang
- Department of Non-communicable Diseases Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
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Chinese Sexual Minority Male Adolescents' Suicidality and Body Mass Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112558. [PMID: 30445669 PMCID: PMC6266787 DOI: 10.3390/ijerph15112558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/02/2018] [Accepted: 11/09/2018] [Indexed: 11/16/2022]
Abstract
Excess weight status may increase the risk of suicidality among sexual minority females, but few studies have examined this suicidality disparity in sexual minority males. This study examined the association between sexual minority status and suicide attempts in Chinese male adolescents and tested whether body mass index (BMI) had a moderating effect on that association. Data were collected from 7th to 12th graders from seven randomly selected provinces of China in the 2015 School-Based Chinese Adolescents Health Survey. In total, 72,409 male students completed the questionnaires regarding sexual attraction, self-reported weight and height, and suicide attempts. After adjustment for covariates, sexual minority status was associated with suicide attempts among male students (AOR = 1.74, 95% CI = 1.57–1.93). Stratification analyses showed that BMI category moderated this association; compared with the results before stratification analyses, sexual minority males who were obese had increased risk of suicide attempts (AOR = 2.15, 95% CI = 1.09–4.24), sexual minority males who were overweight had reduced odds of suicide attempts (AOR = 1.40, 95% CI = 1.01–1.92), and no significant association change was found in sexual minority males who were underweight (AOR = 1.82, 95% CI = 1.43–2.33). Our study indicated that BMI moderated the risk of suicide attempts in sexual minority males. Suicide prevention targeting sexual minority males should be focused on weight status disparity and the creation of a positive climate to reduce minority stressors due to body image.
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Sun L, Zhang J, Lamis DA. Features for medically serious suicide attempters who do not have a strong intent to die: a cross-sectional study in rural China. BMJ Open 2018; 8:e023991. [PMID: 30206093 PMCID: PMC6144317 DOI: 10.1136/bmjopen-2018-023991] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 08/15/2018] [Accepted: 08/20/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Previous studies have implied that there were many Chinese suicide attempters who did not want to die by suicide. In the current study, we explored the factors which were associated with low levels of suicide intent. We also examined features for medically serious suicide attempters who do not have a strong intent to die in rural china. DESIGN Cross-sectional study. SETTING The interviews occurred between May 2012 and July 2013 in 13 rural counties in Shandong and Hunan provinces, China. PARTICIPANTS Subjects were 791 medically serious suicide attempters whose injury and wounds were so serious they required hospitalisation or immediate medical care. RESULTS The results supported that less years of education (β=-0.11, p=0.037), religious beliefs (β=1.20, p=0.005), living alone (β=1.92, p=0.017), negative life events (β=0.29, p=0.003), low levels of impulsivity (β=-0.10, p=0.013) and mental disorders (β=2.82, p<0.001) were associated with higher levels of suicide intent. CONCLUSION Results imply that there are some medically serious suicide attempters with a higher education and/or exhibit impulsivity who do not want to die by suicide. These findings can inform practice to prevent suicide in rural China.
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Affiliation(s)
- Long Sun
- Center for Suicide Prevention Research, School of Public Health, Shandong University, Jinan, China
- Key Laboratory of Health Economics and Policy Research, National Health Commission of China, Jinan, Shandong, China
| | - Jie Zhang
- Center for Suicide Prevention Research, School of Public Health, Shandong University, Jinan, China
- Department of Sociology, State University of New York Buffalo State, Buffalo, New York, USA
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
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Huang Y, Li P, Guo L, Gao X, Xu Y, Huang G, Deng X, Lu C. Sexual minority status and suicidal behaviour among Chinese adolescents: a nationally representative cross-sectional study. BMJ Open 2018; 8:e020969. [PMID: 30093513 PMCID: PMC6089305 DOI: 10.1136/bmjopen-2017-020969] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Suicidality among sexual minority adolescents has generated worldwide concern in recent decades, and previous Western studies have demonstrated that sexual minority status is associated with adolescent suicidality. However, whether this association exists in Chinese adolescents remains largely unknown. This study aimed to estimate the associations between sexual minority status and suicidal behaviour among Chinese adolescents. DESIGN Cross-sectional survey. SETTING A total of 506 high schools in 7 provinces of China. PARTICIPANTS A total of 150 822 students in grades 7-12 who completed the questionnaires (response rate of 95.9%) were included. MAIN OUTCOME MEASURES Suicidal ideation and suicide attempts were used to measure suicidal behaviour, and sexual attraction (opposite sex, same sex or both sex) was used as a measure for sexual minority status. RESULTS Of the 150 822 adolescents analysed, 4.1% self-reported as sexual minorities and 17.3% were unsure. Compared with heterosexual and unsure adolescents, same-sex romantic attraction (SSA) and both-sex romantic attraction (BSA) adolescents reported a higher prevalence of past-year suicidal ideation (SSA: 21.6% for males and 30.4% for females; BSA: 34.7% for males and 42.3% for females) and suicide attempts (SSA: 6.9% for males and 8.9% for females; BSA: 12.2% for males and 10.9% for females). After adjustment for covariates, SSA and BSA adolescents were more likely to have past-year suicidal ideation and suicide attempts than their heterosexual and unsure peers. BSA adolescents reported the highest risk of suicidal ideation (males: adjusted OR (AOR) 2.42, 95% CI 2.03 to 2.88; females: AOR 2.61, 95% CI 2.41 to 2.82) and suicide attempts (males: AOR 3.83, 95% CI 2.85 to 5.14; females: AOR 2.59, 95% CI 2.19 to 3.06). CONCLUSIONS Our study suggested that Chinese sexual minority adolescents were at increased risk of suicidality, and those with BSA had an especially high risk in this population. These findings emphasised the urgent need to develop targeted interventions to effectively address suicide-related problems among Chinese sexual minority adolescents.
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Affiliation(s)
- Yeen Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Pengsheng Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xue Gao
- Center for Adverse Drug Reactions Monitoring of Guangdong, Guangzhou, China
| | - Yan Xu
- Center for Adverse Drug Reactions Monitoring of Guangdong, Guangzhou, China
| | - Guoliang Huang
- Center for Adverse Drug Reactions Monitoring of Guangdong, Guangzhou, China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
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Gender-specific factors related to suicidal ideation among community-dwelling stroke survivors: The 2013 Korean Community Health Survey. PLoS One 2018; 13:e0201717. [PMID: 30071085 PMCID: PMC6072110 DOI: 10.1371/journal.pone.0201717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/21/2018] [Indexed: 11/20/2022] Open
Abstract
We assessed gender-specific factors associated with suicidal ideation among community-dwelling stroke survivors. In total, 4,322 stroke survivors who participated in the 2013 Korean Community Health Survey were included in the final analysis. Sociodemographic information, socio-family relationships, health behaviors, health status, and suicidal ideation were assessed using a standardized questionnaire. On fully adjusted analysis, suicidal ideation among males was more common in those who were widowed, rather than married (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.03–2.47), those who rarely contacted neighbors (OR 1.50, 95% CI 1.10–2.06), current smokers (OR 1.54, 95% CI 1.03–2.29), and frequent drinkers (OR 1.54, 95% CI 1.05–2.24). Suicidal ideation among females was more common in older subjects, those with lower monthly household incomes, the unemployed (OR 1.75, 95% CI 1.21–2.53), and housewives/students (OR 1.46, 95% CI 1.06–2.03), those who rarely contacted friends (OR 1.43, 95% CI 1.12–1.82), and diabetics (OR 1.35, 95% CI 1.05–1.73). Perceived persistent high-level stress, depressive mood, poor self-rated health, and a diagnosis of depression were commonly associated with suicidal ideation in both genders. Gender differences should be considered by medical practitioners and community policymakers when seeking to prevent and manage suicidal ideation in stroke survivors.
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Harnod T, Lin CL, Kao CH. Prevalence of suicide attempts and their risk factors in school-aged patients with epilepsy: a population-based study. Eur Child Adolesc Psychiatry 2018; 27:1047-1053. [PMID: 29396711 DOI: 10.1007/s00787-018-1118-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/29/2018] [Indexed: 10/18/2022]
Abstract
Suicide prevention is a critical issue for young people. However, no large body of representative data on the risk of suicide attempts in school-aged patients with epilepsy in Taiwan or other developing countries is available. Patients aged ≤ 18 years who received a diagnosis of epilepsy between 2000 and 2012 were included in the epilepsy cohort (N = 9801). The comparison cohort was matched to the epilepsy cohort at a ratio of 4:1. We calculated the adjusted hazard ratio and 95% confidence intervals (CIs) for suicide attempts after adjustment for age, sex, urbanization level, parental occupation category, comorbidities, and follow-up time. Further analysis was performed to assess the dose-response effect on the risk of attempting suicide based on the average frequency of medical visits for epilepsy. The overall incidence rates of suicide attempts in the epilepsy and comparison cohorts were 15.7 and 5.89 per 100,000 people per year, respectively. The epilepsy cohort had a 2.34-fold higher risk of suicide being attempted (95% CI 2.17-2.52) than did the comparison cohort. Male sex, over 12 years of age, and parental occupation of office work were found to be the major risk factors for suicide attempts. Epilepsy might be an independent factor predisposing school-aged patients to suicide attempts. The results of this study could provide clinicians and governments with vital information on suicide prevention for young people with epilepsy in Taiwan and other developing countries.
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Affiliation(s)
- Tomor Harnod
- Department of Neurosurgery, Hualien Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan. .,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. .,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
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Todeshkchuei GG, Molaeinezhad M, Ghasemi Todeshkchuei S. Psychosocial Factors Associated with Suicidal Behavior among Iranian Women: A Meta-analysis. Adv Biomed Res 2018; 7:86. [PMID: 29930926 PMCID: PMC5991272 DOI: 10.4103/abr.abr_47_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Suicide is one of the public health problems worldwide, but it lacks regular relevant reporting system. This issue is more important among women who play an influential role in the family and society. Therefore, the assessment of recent relevant studies is important to detect suicide-related factors and to help make the decisions about public health. The aim of the current study was to determine socioeconomic and psychological factors of suicide attempts in Iranian women using a descriptive meta-analysis method. All domestic scientific databases were searched using "suicide" keyword. A search was also done using keywords of corresponding to Medical Subject Headings including "Iran," "suicide," "psychosocial determinants," "behavior," "suicide commitment," "suicide thoughts," and "women." Overall, 3061 articles were retrieved through the initial search. Finally, 69 studies from nine provinces were included for the analysis. All statistical analyses were performed using R software version 3.2.6 with Metafor package version 1.9-9. Using nine selected studies, frequency of urban family (prevalence = 85%, 95% confidence interval [CI] = 0.68-1.00), nonacademic education (prevalence = 53%, 95% CI = 0.45-0.61), and family problems (prevalence = 34%, 95% CI = 0.19-0.49) was identified as the most important related factor of suicide compared to any other related factors. According to the results, family problems and lower education are associated with suicide attempts. Thus, providing training programs and family consultant services are recommended to reduce the incidence of suicide attempts.
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Affiliation(s)
| | - Mitra Molaeinezhad
- Department of Sexual and Reproductive Health, Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Suicidal ideation among Chinese cancer inpatients of general hospitals: prevalence and correlates. Oncotarget 2018; 8:25141-25150. [PMID: 28212579 PMCID: PMC5421916 DOI: 10.18632/oncotarget.15350] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/17/2017] [Indexed: 12/11/2022] Open
Abstract
Cancer patients are at high risk for suicide, particularly when they are informed about the cancer diagnosis or hospitalized for cancer treatment. Therefore, oncology healthcare settings such as large general hospitals in China, may represent an ideal setting to identify and treat suicidality in cancer patients. However, the clinical epidemiology of suicidality of Chinese cancer patients remains largely unknown. This study examined the prevalence and correlates of suicidal ideation among Chinese cancer inpatients of large general hospitals. A total of 517 cancer inpatients were consecutively recruited from two tertiary general hospitals of a metropolitan city in northern China, and administered with standardized questionnaires to collect data on sociodemographics, mental health, and cancer-related clinical characteristics. Suicidal ideation and mental health were measured with a single self-report question “In the past month, did you think about ending your life?” and Hospital Anxiety and Depression Scale, respectively. The one-month prevalence of suicidal ideation was 15.3% in Chinese cancer inpatients. In multivariable Logistic regression, depression, anxiety, moderate-to-severe pain, metastatic cancer, poor performance status, surgery, and palliative care were significantly associated with suicidal ideation. Cancer inpatients of large Chinese general hospitals have high prevalence of suicidal ideation and therefore potentially at high risk for suicide. Suicide prevention efforts for cancer inpatients should include periodic evaluation of suicidality, effective pain management, psychooncological supports, and, when necessary, psychiatric treatment and crisis intervention.
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Tang F, Byrne M, Qin P. Psychological distress and risk for suicidal behavior among university students in contemporary China. J Affect Disord 2018; 228:101-108. [PMID: 29245090 DOI: 10.1016/j.jad.2017.12.005] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 10/25/2017] [Accepted: 12/03/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Psychological distress and suicidal behavior are important mental health problems among university students and warrant research to inform strategies for effective prevention in this young population. The present study aimed to assess psychological distress and suicidal behavior and to unravel their associations among university students. METHODS A total of 5972 undergraduate students, randomly selected from six universities in central China, comprised the sample. The Chinese version of the Symptom Checklist-90-revised (SCL-90-R) was used to assess various psychological symptoms. Logistic regression analysis was used to examine the relationship between psychological distress and risk for suicidal behavior. RESULTS 40.7% of the university students reported positive in a least one of the 9 psychological symptom dimensions assessed by the SCL-90-R. 7.6% of the students reported suicidal behavior in the previous twelve months. The risk of suicidal behavior was significantly associated with psychological symptoms of all types, but there were notable differences by sex. For male students, depression and phobic anxiety increased the risk of suicidal behavior. Meanwhile, depression and obsessive-compulsiveness were positively associated with suicidal behavior in female students. Furthermore, increasing risk of suicidal behavior was associated with increasing positive symptom total (PST) score and a statistically significant trend was observed. LIMITATIONS Data collected from a cross-sectional survey does not allow any examination of causal inference. CONCLUSIONS Psychological distress and suicidal behavior were both common among university students; and psychological distress was highly associated with suicidal behavior. The findings underscore the importance of mental health care for university students.
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Affiliation(s)
- Fang Tang
- Health Management Centre, Qianfoshan Hospital Affiliated to Shandong University, China; Centre for Suicide Prevention and Research, School of Public Health, Shandong University, China
| | - Majella Byrne
- PICuP Clinic, Maudsley Psychology Centre, South London and Maudsley NHS Foundation Trust, UK; Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, UK
| | - Ping Qin
- Centre for Suicide Prevention and Research, School of Public Health, Shandong University, China; National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Norway.
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Abstract
This study aims to explore the impact of negative life events (NLEs) on attempted suicide in a Chinese cultural setting. The sample comprised 791 suicide attempters and an equal number of controls matched on age, sex, and location from selected rural counties in China. Conditional logistic regression model was used to examine the association between NLEs and suicide risk. The impact of NLEs on attempted suicide was further examined using regression-based method to explore its mediation effect. The types of NLEs that were most likely to precede a suicide attempt in rural sample included the events in marriage/love, family/home, and friend/relationship. Rural women were more likely to experience more interpersonal conflicts than rural men. Approximately 75.6% of suicide attempters had experienced at least one NLE, and NLEs were strongly associated with attempted suicide. Total effect (0.676), direct effect (0.501), and the total indirect effect (0.301) of NLEs on suicide attempts were significantly mediated by hopelessness and depression. NLEs play a crucial role in predicting suicidal attempt in rural China, and they are mediated by depression and hopelessness.
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Mental disorders and suicide attempt in rural China. Psychiatry Res 2018; 261:190-196. [PMID: 29309959 DOI: 10.1016/j.psychres.2017.12.087] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 12/06/2017] [Accepted: 12/31/2017] [Indexed: 11/22/2022]
Abstract
The prevalence of various mental disorders and their age and gender specific characteristics among suicide attempters remains unclear in rural China. This study using 1:1 paired case-control design included 409 suicide attempters and 409 paired controls matched on age, gender and place of residence. Mental disorders were assessed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders. The prevalence of mental disorders was 32.3% for suicide attempters and 4.9% for paired controls. Mental disorder constituted a significant risk factor for suicide attempt with an adjusted odds ratio of 7.16 (95%CI: 3.65-14.04). The prevalence of mental disorders was higher among male than female suicide attempters. Major depressive disorder was most common in female suicide attempters while alcohol use disorder was most common in the males. The prevalence of mental disorders seemed to increase with age. Suicide attempters of higher ages were more prone to have mood disorders, especially a major depression. Suicide attempters with mental disorders differed from those without mental disorders on a number of socio-economic characteristics and suicidal behavior features. These insights should be taken into account in strategies and efforts to improve mental health care and ultimately to reduce suicidal behavior among residents in rural China.
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Xin LM, Chen L, Su YA, Yang FD, Wang G, Fang YR, Lu Z, Yang HC, Hu J, Chen ZY, Huang Y, Sun J, Wang XP, Li HC, Zhang JB, Si TM. Risk Factors for Recent Suicide Attempts in Major Depressive Disorder Patients in China: Results From a National Study. Front Psychiatry 2018; 9:300. [PMID: 30018575 PMCID: PMC6037843 DOI: 10.3389/fpsyt.2018.00300] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 06/15/2018] [Indexed: 02/05/2023] Open
Abstract
Objective: To analyze the factors associated with recent suicide attempts including socio-demographic and clinical characteristics in major depressive disorder (MDD) patients in China. Methods: The data were from a nationwide sample from 13 major psychiatric hospitals or the psychiatric units of general hospitals in China, from September 1, 2010 to February 28, 2011. Melancholic features and suicide attempts in the past month were defined according to the melancholic feature module and the suicide module of the Mini International Neuropsychiatric Interview (MINI). Socio-demographic and clinical characteristics were compared between MDD patients with and without recent suicide attempts. Further analyses regarding the factors associated with recent suicide attempts in MDD patients were performed via multivariate logistic regression analysis. Results: Among 1,172 MDD patients, 57 (4.9%) were reported to have made a suicide attempt in the past month. Compared to the MDD patients without recent suicide attempt, significantly higher percentage of patients in the recent suicide attempters group had previous suicide attempts (χ2 = 171.861, p < 0.001) and depressive episodes with melancholic features (χ2 = 22.837, p < 0.001). Logistic regression analysis indicated that previous suicide attempts (OR = 20.81, 95% CI: 11.12-38.94, p < 0.001) and depressive episodes with melancholic features (OR = 4.43, 95% CI: 2.09-9.43, p < 0.001) were independently associated with recent suicide attempts in MDD patients. Limitations: Cross-sectional design, retrospective recall of suicide attempt data. Conclusion: Recent suicide attempts are associated with melancholic features and previous suicide attempts in MDD patients in China. These data may help clinicians to identify MDD patients at high risk of suicide attempt behavior.
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Affiliation(s)
- Li-Min Xin
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing, China.,Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Lin Chen
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Yun-Ai Su
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing, China
| | - Fu-De Yang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Gang Wang
- Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Lu
- Shanghai Tongji Hospital, Tongji University Medical School, Shanghai, China
| | - Hai-Chen Yang
- Division of Mood Disorders, Shenzhen Mental Health Centre, Shenzhen, China
| | - Jian Hu
- The First Hospital of Harbin Medical University, Harbin, China
| | - Zhi-Yu Chen
- Hangzhou Seventh People's Hospital, Hangzhou, China
| | - Yi Huang
- West China Hospital, Sichuan University, Chengdu, China
| | - Jing Sun
- The Affiliated Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Xiao-Ping Wang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hui-Chun Li
- The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jin-Bei Zhang
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Tian-Mei Si
- Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital and Peking University Institute of Mental Health, Beijing, China
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Luo Z, Feng T, Fu H, Yang T. Lifetime prevalence of suicidal ideation among men who have sex with men: a meta-analysis. BMC Psychiatry 2017; 17:406. [PMID: 29268723 PMCID: PMC5740861 DOI: 10.1186/s12888-017-1575-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 12/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide is a leading cause of death among men who have sex with men (MSM) and suicidal ideation may put individuals at higher risk of suicide. A great disparity of lifetime prevalence of suicidal ideation among MSM was observed across studies, indicating the importance of a reliable estimation of the pooled lifetime prevalence. However, the only one published meta-analysis estimating the pooled lifetime prevalence of suicidal ideation among MSM was conducted in 2008 with only 2 eligible studies. Subsequently, there was a rapid increase of publications about lifetime suicidal ideation among MSM, suggesting that an update on the pooled lifetime prevalence of suicidal ideation among MSM was necessary. Therefore, this study aimed to update the estimation of the pooled lifetime prevalence of suicidal ideation among MSM. METHODS Electronic databases of PubMed, CINAHL, Scopus (social science), Embase and PsycInfo were searched until September 2017 to identify relevant studies. Cross-sectional studies exploring the lifetime prevalence of suicidal ideation among MSM were enrolled. Heterogeneity was evaluated using the Cochran Q test and quantified using the I 2 statistic. The possibility of publication bias was assessed using both Begg's rank test and Egger's linear test, and an Egger's funnel plot for asymmetry was presented. Subgroup analyses were performed according to the geographic area, sample source and HIV status. RESULTS Nineteen studies with a total of 26,667 MSM were included, of which 9374 were identified with suicidal ideation. A high degree of heterogeneity (P ≤ 0.001, I 2 =99.2%) was observed among the eligible studies, with the reported prevalence ranging from 13.18 to 55.80%. The pooled lifetime prevalence of suicidal ideation among MSM by a random effects model was 34.97% (95% confidence interval: 28.35%-41.90%). Both the Begg's rank test and Egger's linear test indicated low possibility of publication bias. Subgroup analyses showed that the lifetime prevalence of suicidal ideation among MSM differed significantly by geographic area, sample source and HIV status (P < 0.05). CONCLUSIONS The high pooled lifetime prevalence of suicidal ideation among MSM found in this meta-analysis significantly underscores the importance of early assessment of suicidal ideation among MSM, as well as the need for strengthening the psychological interventions.
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Affiliation(s)
- Zhenzhou Luo
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China ,Shenzhen Nanshan Center for Chronic Disease Control, Guangdong, China
| | - Tiejian Feng
- Shenzhen Center for Chronic Disease Control, Guangdong, China
| | - Hanlin Fu
- 0000 0001 0379 7164grid.216417.7Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China
| | - Tubao Yang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Hunan, China.
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