Suicidal ideation in adolescents and their caregivers: a cross sectional survey in Japan

What Is Helpful and What Is Challenging for the Caregivers of Young People Receiving Interventions to Prevent Suicide? Caregivers' Perspectives-A Rapid Scoping Review

(1) Background: Suicide is a leading cause of death among young people. Preventing suicide in young people is a priority. Caregivers play a vital role in ensuring interventions for young people experiencing suicide ideation and/or attempts are implemented, and that they are maintained over time. Despite this, little is known about what caregivers find helpful and challenging in relation to suicide prevention interventions. This rapid scoping review is the first to address this gap. (2) Methods: Searches were completed on six electronic databases using keywords relating to 'suicide prevention, 'young people', and 'caregivers'. Ten studies-using both qualitative and quantitative methods, and involving >1400 carers from the United States and Europe-were selected for inclusion. (3) Results: The review shows that caregivers value interventions that are delivered by non-judgmental clinicians, that are suitable to the particular needs of their child, that are available when needed, and that support their confidence and communication. Caregivers experience difficulties with interventions that require their attendance at specific times, and that fail to recognize and/or address their own mental health needs. (4) Conclusions: The findings can be used to inform and improve the intervention design, with the aim of improving outcomes for caregivers and young people.

Parents of Adolescents Who Experience Suicidal Phenomena-A Scoping Review of Their Experience

High prevalence rates of self-harm and suicide in adolescence provide unique challenges for parents. The aim of this scoping review was to explore key gaps in our understanding of the current scientific literature on the experience of parents who have adolescent children experiencing suicide crisis or self-harm. Four academic databases were searched using three broad concepts: self-harming behaviour or suicidal crisis; adolescents or young people; and the experiences or behaviour of parents, between journal inception and March 2022. Information reporting on the parents' experience was extracted and a qualitative synthesis was conducted. Twenty-two articles met inclusion criteria and were assessed in detail. The experience of parents with an adolescent engaged in self-harm or suicidal crisis were classified into three temporal themes: discovery of the suicidal phenomena, management of suicidal phenomena, and after the suicidal phenomena had ceased. Parents caring for an adolescent experiencing self-harm or suicidal crisis experience poorer psychological wellbeing, difficulty accessing support services, and changes in the parent-child relationship. Parents desire greater support for both themselves and their child and further investigation is required to understand specifically which supports would be most appropriate at each stage.

Mental Health Comorbidities, Household Firearm Ownership, and Firearm Access Among Children

OBJECTIVES

To examine how youth and their caregivers' mental health risk factors for suicide are associated with youth firearm access inside and outside the home.

METHODS

This study examines a cross-section of the Adolescent Brain and Cognitive Development Social Development study data collected from 2016 to 2021. The sample included 2277 children aged 10 to 15 years from 5 study sites across the United States. We estimated multilevel generalized linear models of household firearm ownership and the child's reported firearm access (hard access or easy access). The primary exposures were the child's and their caregivers' mental health risk factors for suicide.

RESULTS

In the Adolescent Brain and Cognitive Development Social Development study sample, approximately 20% of children lived in a firearm-owning household and 5% of all children reported easy firearm access. In non-firearm-owning households, children with diagnosed lifetime suicidality were 2.48 times more likely (95% confidence interval [CI], 1.50-4.10) than their counterparts to report easy firearm access. In firearm-owning households, children of caregivers who self-reported any mental health history or externalizing problems were 1.67 times (95% CI, 1.10-2.54) and 2.28 times (95% CI, 1.55-3.37) more likely than their counterparts to report easy firearm access.

CONCLUSIONS

Youths with mental health risk factors for suicide may be just as likely or more likely to report firearm access as those without such risk factors. Youth suicide prevention efforts should address youths' firearm access outside the home and caregiver mental health.

Suicidal behavior, suicidal ideation and patterns among youths in Anywaa zone, Gambella, Southwest Ethiopia: a mixed-methods study

BACKGROUND

Suicide is a major public health problem and for decades, it has remained one of the leading causes of injury and death worldwide. The objectives of this study were to investigate the prevalence of suicidal behavior, suicidal ideation, and patterns among youth in the Anywaa zone of the Gambella regional state, Southwest Ethiopia.

METHODS AND MATERIALS

A mixed-method study design was used in which a quantitative survey was conducted along with qualitative interviews and FGDs in the Anywaa zone. A total of 136 respondents were included in the survey study from the two woredas. The survey was conducted to assess the prevalence of suicidal behavior and ideations in a sample of preparatory school youth students. A pre-tested and structured questionnaire was used for the descriptive analysis. Qualitative information was also obtained through interviews and focus group discussions to identify the patterns of suicide and to gain more nuanced participants/ survivors' experiences. Data were analyzed using SPSS version 20, for which descriptive statistics were used. Qualitative data were analyzed using thematic analysis.

RESULTS

Suicidal behaviors and ideation were high among youths in the study area. In this study 62.3% of respondents reported they had heard others talk about their wish to die by suicide, 68 (64.2%) of youth said they had heard many youths claim that "I feel like there is no way out", 48 (43.3%) reported having seen someone with the signs of planning a suicide such as obtaining a weapon or writing a suicide note. About 68 (64.2%) of participants said, "My family would be better off without me." The majority of respondents were in the age groups ranging from 26 to 30 years. The results on the patterns of suicide attempts showed that hanging and drug overdose or poisoning were the most common patterns used by both men and women.

CONCLUSION

The findings indicate that the prevalence of suicide-related behaviors and ideations was high among youths in the Anywaa zone. The results on the patterns of suicide attempts showed that hanging and drug overdose or poisoning were the most common patterns used by both men and women. As a result, we would like to recommend that Government, Non-Governmental Organizations NGOs, and Faith-Based Organizations (FBOs), along with health care providers and counselors should work together by creating awareness, and by establishing Programs that target youths. Meanwhile, early identification and management of suicide risk in youth should be strengthened.

How Worries about Interpersonal Relationships, Academic Performance, Family Support, and Classmate Social Capital Influence Suicidal Ideation among Adolescents in Japan

Suicide is an important public health issue for adolescents. To investigate the risk and protective factors for adolescent suicide, a cross-sectional questionnaire-based survey was conducted at a junior high school (n = 379) in Japan in 2018. After obtaining survey data, we conducted univariate and logistic regression analyses to test for associations between suicidal ideation and several factors, including worries (i.e., about school life, interpersonal relationships at school, family life, interpersonal relationships at home, and academic performance), perceived support from school staff and family members, and social capital. In this context, the existence of trustful relationships between classmates was used as indicators of social capital. The results showed that the prevalence of suicidal ideation was 10.5%. The risk of suicidal ideation was increased by worries about 1) interpersonal relationships at school, 2) interpersonal relationships at home, and 3) academic performance, but was decreased by social support from family members and trusting relationships. Further, the rate of suicidal ideation was higher among students who expressed all these three worries when compared to those who expressed two or fewer worries. In addition, looking at students who expressed all these three worries simultaneously, the rate of suicidal ideation was higher among those with lower levels of support from family members and fewer trustful relationships. Our results suggest that the prevention of adolescent suicide should include strategies for reducing worries about interpersonal relationships at school/home and academic performance while finding ways to enhance family support and classmate social capital.

Suicide Ideation and Its Correlates Among University Undergraduates in South Western Nigeria

Suicide is one of the leading causes of death among young people aged 15 to 29 years of age. Ideation or suicidal thoughts , which precedes suicide is sometimes normalized and excused thereby missing avertable deaths within a given context. Understanding suicide ideation and the associated social correlates within contexts can provide cues on how to mitigate suicide. This paper examines the potential social factors that are shaping suicidal ideation among young people in two universities in Nigeria. Based on a mixed-method design, a survey was conducted among a proportionate sample of 500 young people (18-25years that are undergraduates). Four Focus Group Discussion sessions were also held among the same group and six semi-structured interviews with social workers at both universities. Quantitative evidence associated irregular financial support (OR = 0.60; p < 0.05) and broken intimate relationship (OR = 1.57; P < 0.05) with suicide ideation. Findings from the qualitative component also considered undergraduates that have academic challenges, engage in substance abuse, and have parents with marital problems to be prone to suicidal ideation. Suicidal ideation among these young people is embedded in their network of relationships, which can be mitigated when the quality of support systems is responsive and adequately accessed.

Prevalence and associated factors of suicidality in Japanese adolescents: results from a population-based questionnaire survey

Background

Suicide is the leading cause of death among Japanese adolescents. However, knowledge gaps regarding contemporary demographics and factors associated with suicidality among Japanese adolescents are a major concern. This study examined the prevalence of suicidality among Japanese adolescents and investigated associated factors.

Methods

A population-based questionnaire survey investigating general health was administered to 22,419 adolescents aged 13–18 years. The 29-item questionnaire covered emotional status, family function, cyberbullying, suicidality, and stressors (e.g., relationships with parents/friends, school performance, and sexual identity). We conducted multiple logistic regression analysis to identify factors associated with suicidality in this population.

Results

The prevalence of suicidal ideation was 21.6% in males and 28.5% in females, and that of attempted suicide was 3.5% in males and 6.6% and in females. Bullying and stress related to family relationships had the strongest associations with suicidality. Exposure to cyberbullying had the highest odds ratio for both junior high (3.1, 95% confidence interval [CI] 2.1–4.4) and high school students (3.6, 95% CI 2.5–5.3). Other factors significantly associated with suicidality were sex, emotional status, and stress about relationships with friends, sexual identity, school records, and academic course. Adolescents accessed a variety of resources to cope with stressors, with the Internet being the most common resource consulted.

Conclusions

Suicidality is commonly experienced among Japanese adolescents. Although there are many associated risk factors, cyberbullying is of particular concern. Recognition of factors associated with adolescent suicidality will inform further research and suicide prevention efforts for healthcare providers and families.

Suicidal ideation from parents to their children: An association between parent's suicidal ideation and their children's suicidal ideation in South Korea

BACKGROUND

Suicide has been a major social and public health issue for Koreans, and currently, we are witnessing an increasing rate of teen suicides. This study's purpose was to investigate suicidal ideation in families by examining the associations between suicidal ideation between parents and their offspring using a representative sample of the Korean population.

METHODS

This cross-sectional study used data collected for the Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2013 and 2015. The study population consisted of 2324 adolescents 12 to 18 years-old and both parents. We used the chi-square test and logistic regression for the data analyses. The outcome variable was suicide ideation among adolescents adjusted for depressive symptoms, stress level, and the parental variables.

RESULTS

In total, 16.1% of the parents had suicidal ideation and 18.4% of the adolescents experienced suicidal ideation that was influenced by their parents. The adjusted odds ratio between the suicidal ideation of the parents and adolescents was 2.01 (95% CI 1.32-3.05). Depressive symptoms (AOR: 5.43, 95% CI 3.66-8.04) and stress level (AOR: 15.51 95% CI 6.14-39.19) were major risk factors for offspring's suicidal ideation. The association of the fathers' suicidal ideation with their offspring's suicidal ideation was greater than that of the mothers.

CONCLUSION

Knowing the risk factors of the offspring's suicidal ideation can prevent teen suicide and protect adolescents at risk. Thus, suicide prevention at the family level should be examined in relation to traditional risk factors at the individual level.

Fatigue and Suicidal Ideation in People With Multiple Sclerosis: The Role of Social Support

Fatigue and poor sleep quality are among the most common patient-reported problems associated with multiple sclerosis (MS). Social support, on the other hand, is often found to be positively associated with quality of life in patients with neurological diseases. Studies also show that suicidal ideation (SI) levels in MS are elevated compared to the general population. Thus, the aim of this study is to assess the associations between fatigue, social support, and SI in patients with MS. Out of 184 MS patients asked to participate in this cross-sectional study, 156 agreed (RR 69.8%; 75% female; mean age: 39.95 ± 9.97 years). Patients filled-in the Multidimensional Fatigue Inventory-20, the Pittsburgh Sleep Quality Index, the Multidimensional Scale of Perceived Social Support and the subscale of the General Health Questionnaire-28 focused on assessing SI. Models were controlled for age, gender, disease duration, functional disability, and sleep quality. Data were analyzed using multiple linear regressions. SI was positively associated with lower sleep quality and four types of fatigue: general, mental, reduced activity, and reduced motivation (p < 0.05). Physical fatigue was not significantly associated with SI. Social support was negatively associated with SI in all models. The final models under study explained from 24.3 to 29.7% of the total variance in SI. SI yielded associations with both sleep quality and fatigue, with the exception of physical fatigue. Information provided by physicians on sleep management, and a psychosocial intervention focused on people who provide support for patients with MS (family, friends, and significant others) may reduce levels of SI.

Influence of parental stress, depressed mood, and suicidal ideation on adolescents' suicidal ideation : The 2008-2013 Korean National Health and Nutrition Examination Survey

BACKGROUND

Maternal depression and suicidal ideation (SI) predict adolescent SI. However, the influence of paternal psychopathology is less clear. This study examines how parental psychopathology contributes to adolescent SI.

METHODS

Data from a cross-sectional, nationwide, population-based survey was used. It assessed 4,073 adolescents (12-18 years) and their parents identified through random sampling of the non-institutionalized population in Korea. Stress, depressed mood, and SI of parents and adolescents were assessed using multivariate logistic regression to determine the association of adolescents' SI with parental stress, depressed mood, and SI.

RESULTS

Adolescents who reported SI were more likely to be girls, have shorter sleep duration, more stress, and a depressed mood than were adolescents without SI. Logistic regression analysis showed estimated odds ratios for SI of 1.444 (p < .05), 1.485 (p < .05) and 1.801 (p < .05) for girls who had mothers with stress, depressed mood, and SI, respectively, and 2.113 (p < .05) and 3.091 (p < .05) for girls who had fathers with depressed mood and SI, respectively. Boys' SI was associated with father's depressed mood (OR: 2.608, p < .05).

LIMITATIONS

Cross-sectional design and use of self-report measures.

CONCLUSIONS

Girls' SI was related to both parents' stress, depressed mood, and SI except for father's stress, and boys' SI was related to father's depressed mood. Evaluations and therapeutic interventions for adolescents with SI should consider both adolescents and their parents, and family-based interventions could be one method for adolescent suicide prevention.

Suicidal ideation in patients with obstructive sleep apnoea and its relationship with disease severity, sleep-related problems and social support

We aimed to assess the prevalence of suicidal ideation and to examine the relationships between obstructive sleep apnoea severity, sleep-related problems, social support and suicidal ideation in obstructive sleep apnoea patients. We included 149 patients (68% male; mean age, 48.99 ± 9.57 years) with diagnosed obstructive sleep apnoea (Apnoea–Hypopnoea Index ⩾5) based on full-night polysomnography. The prevalence of suicidal ideation among obstructive sleep apnoea patients was 20.1 per cent. Structural equation modelling showed that suicidal ideation in obstructive sleep apnoea was strongly related to poor sleep quality and high fatigue levels. No relationship between social support and suicidal ideation in obstructive sleep apnoea patients was found.

Current Challenges and Future Opportunities for Child and Adolescent Psychiatry in Japan

Japan has been facing a serious shortfall of child and adolescent psychiatric workforce relative to increasing service needs. Likely because of a combination of limited workforce supply and limited trust or perception of effectiveness, mental health services are under-utilized by the educational and child welfare systems. Child and adolescent psychiatry (CAP) has not been a formally established specialty in Japan. The lack of basic structure in the specialty most likely contributes to a lack of training facilities, limited exposure to and interest in the specialty, and hence an inadequate workforce. To date, there exists no standardized training program for CAP in Japan and each training hospital determines its own teaching curriculum and training content. Clinical experience in CAP varies greatly among hospitals. To solve current problems in child and adolescent psychiatry in Japan, we advocate for the development and establishment of a more standardized child and adolescent psychiatry training system that is akin to what exists in the US and that teaches and evaluates according to specific competencies. Through standardizing care and education and ultimately improving workforce, the quality of mental health services can be raised. The tragic and costly consequences of unidentified and untreated mental illness in youth can be avoided by taking timely evidence based actions in partnership with others.