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Baillet M, Wathelet M, Lamer A, Frévent C, Fovet T, D'Hondt F, Notredame CE, Vaiva G, Génin M. Association Between COVID-19 and Self-Harm: Nationwide Retrospective Ecological Spatiotemporal Study in Metropolitan France. JMIR Public Health Surveill 2024; 10:e52759. [PMID: 39189893 DOI: 10.2196/52759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/08/2024] [Accepted: 05/12/2024] [Indexed: 08/28/2024] Open
Abstract
Background The COVID-19 pandemic has not been associated with increases in suicidal behavior at the national, regional, or county level. However, previous studies were not conducted on a finer scale or adjusted for ecological factors. Objective Our objective was to assess the fine-scale spatiotemporal association between self-harm and COVID-19 hospitalizations, while considering ecological factors. Methods Using the French national hospital discharge database, we extracted data on hospitalizations for self-harm of patients older than 10 years (from 2019 to 2021) or for COVID-19 (from 2020 to 2021) in metropolitan France. We first calculated monthly standardized incidence ratios (SIRs) for COVID-19 between March 2020 and December 2021, using a Besag, York, and Mollié spatiotemporal model. Next, we entered the SIRs into an ecological regression in order to test the association between hospital admissions for self-harm and those for COVID-19. Lastly, we adjusted for ecological variables with time lags of 0 to 6 months. Results Compared with a smoothed SIR of ≤1, smoothed SIRs from 1 to 3, from 3 to 4, and greater than 4 for COVID-19 hospital admissions were associated with a subsequent increase in hospital admissions for self-harm, with a time lag of 2 to 4 months, 4 months, and 6 months, respectively. Conclusions A high SIR for hospital admissions for COVID-19 was a risk factor for hospital admission for self-harm some months after the epidemic peaks. This finding emphasizes the importance of monitoring and seeking to prevent suicide attempts outside the epidemic peak periods.
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Affiliation(s)
- Maëlle Baillet
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille, France
| | - Marielle Wathelet
- Univ. Lille, INSERM, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
- F2RSM Psy - Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France, Saint-André-Lez-Lille, France
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France
| | - Antoine Lamer
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
- Univ. Lille, UFR 3S, Faculté Ingénierie et Management de la Santé, Lille, France
- F2RSM Psy - Fédération régionale de recherche en psychiatrie et santé mentale Hauts-de-France, Saint-André-Lez-Lille, France
| | - Camille Frévent
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Thomas Fovet
- Univ. Lille, INSERM, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
| | - Fabien D'Hondt
- Univ. Lille, INSERM, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France
| | | | - Guillaume Vaiva
- Univ. Lille, INSERM, CHU Lille, U1172 - Lille Neuroscience & Cognition, Lille, France
| | - Michael Génin
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
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Hode Y, Padovani R, Hikmat W, Guillard-Bouhet N, Attal J, Bralet MC, Biotteau M, Chereau Boudet I, Canceil O, Montagne Larmurier A, Roussel C, Lemestré S, Willard D. Family psychoeducation in schizophrenia and schizophrenia related disorder, treatment compliance, and suicidal risk reduction: questions about their relationship from a naturalistic observation. Front Psychiatry 2024; 15:1370566. [PMID: 38638418 PMCID: PMC11024790 DOI: 10.3389/fpsyt.2024.1370566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction The Profamille V3.2 multi-family psycho-educational program directed at caregivers of relatives with schizophrenia or schizophrenia related disorder has been shown to decrease the annual prevalence of suicide attempts. It has been reported that psychoeducation of families can sometimes improve compliance with treatment. This study investigates whether the Profamille program improves compliance and thus reduces the risk of suicide among patients. Method This is a retrospective study of 179 groups of family caregivers, encompassing 1946 participants enrolled in Module 1 of the Profamille program and followed up one year after completion of the module. Evaluations were conducted using questionnaires filled out by family caregivers at three distinct times: prior to beginning the program, upon its completion, and again one year following its conclusion. The annual prevalence of suicide attempts was measured both before the program began and one year after its conclusion, while compliance to treatment was evaluated at the start and end of the program. Result After the Profamille program, the annual prevalence of suicide attempts fell by a factor of 2 (p-value = 0.00002) and patient compliance improved (p-value <0.000001). This reduction in suicide attempts was observed independently of improved compliance. Compliance seems to have an additional effect, but only after participation in the program. Conclusion The Profamille program reduces patients' risk of suicide even when patients are not taking the treatment. When family psychoeducation is not proposed in schizophrenia or schizophrenia related disorder, this can represent a loss of chance for patients.
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Affiliation(s)
- Yann Hode
- Association Psychoeducation PROFAMILLE, Chatenois, France
| | | | - Wydad Hikmat
- Psychiatric Hospital of Kelaa Sraghna, Ministry of Health, Morocco, Kelâa des Sraghna, Morocco
| | - Nathalie Guillard-Bouhet
- CREATIV Centre de REhabilitation et d'Activités Thérapeutiques Intersectoriel de la Vienne, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Jérome Attal
- La Colombière, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Marie-Cecile Bralet
- CRISALID-HDF (Department Support of cognitive remediation and psychosocial rehabilitation- South Hauts de France area), Etablissement Public de Santé Mentale Oise, Clermont de l Oise, France
- INSERM Unit Research 1247 GRAP, Picardie Jules Vernes University, Amiens, France
- GDR 3557 Research network, Addiction and Psychiatry, Paris, France
- Centre Hospitalier Isarien, Clermont de l’Oise, France
| | | | - Isabelle Chereau Boudet
- Centre Expert Schizophrenie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont Ferrand, France
| | - Olivier Canceil
- Fondation Santé des Etudiants de France, Paris, France
- Sante Mentale France, Paris, France
| | | | - Céline Roussel
- Centre Hospitalier Annecy Genevois (CH Annecy), Metz-Tessy, France
| | - Stéphanie Lemestré
- Association de psychoéducation des Familles Profamille Liège Belgique, Liège, Belgium
| | - Dominique Willard
- Pôle PEPIT (Pôle Hospitalo-Universitaire d’Evaluation Prévention et Innovation Thérapeutique), Groupe Hospitalier Universitaire Paris psychiatrie et neurosciences, Paris, France
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Abascal-Peiró S, Alacreu-Crespo A, Peñuelas-Calvo I, López-Castromán J, Porras-Segovia A. Characteristics of Single vs. Multiple Suicide Attempters Among Adult Population: A Systematic Review and Meta-Analysis. Curr Psychiatry Rep 2023; 25:769-791. [PMID: 37740850 DOI: 10.1007/s11920-023-01461-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE OF REVIEW We aimed to examine the factors that differentiate single and multiple suicide attempters in adult population. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to conduct this review and meta-analysis. The review protocol was registered in PROSPERO. We carried out a systematic literature search in three databases to identify original studies that explored the differences between single and multiple suicide attempters among adult population. RECENT FINDINGS There might be meaningful differences between those individuals that attempt suicide once in their lifespan and those who make multiple attempts in terms of sociodemographic and clinical characteristics. There are no previous meta-analysis addressing this topic in the adult population. A total of 75 studies were included in the review and 69 were included in the meta-analysis. Multiple attempters were more likely to present certain disorders such as mood and psychotic disorders, as well as personality or substance use disorders. Higher suicide ideation and suicide intent scores also characterized this group. Childhood trauma experiences, stressful life events, and higher rates of hopelessness were statistically significant in multiple attempters. Identifying the factors predicting multiple suicide attempts helps to delineate a high-risk suicidal profile that should be taken into account in the clinical and suicide prevention scenario.
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Affiliation(s)
- Sofía Abascal-Peiró
- Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
| | - Adrián Alacreu-Crespo
- Department of Psychology and Sociology, Area of Personality, Assessment and Psychological Treatment, Universidad of Zaragoza, Teruel, Spain
| | - Inmaculada Peñuelas-Calvo
- Department of Child and Adolescent Psychiatry, Hospital 12 de Octubre, Madrid, Spain
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain
| | - Jorge López-Castromán
- Department of Psychiatry, CNRS-INSERM, University of Montpellier, CHU Nîmes & IGF, Montpellier, France
| | - Alejandro Porras-Segovia
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain
- Division of Psychiatry, Imperial College, London, UK
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Ramos-Martín J, Gómez Sánchez-Lafuente C, Martínez-García AI, Castillo-Jiménez P, Guzmán-Parra J, Moreno-Küstner B. Suicidal behavior in persons attended in out-of-hospital emergency services in Spain. Front Psychiatry 2023; 14:1235583. [PMID: 37654995 PMCID: PMC10466888 DOI: 10.3389/fpsyt.2023.1235583] [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: 06/06/2023] [Accepted: 07/27/2023] [Indexed: 09/02/2023] Open
Abstract
Background The aims of this study were to describe the use of health services by patients attended for suicidal behavior by out-of-hospital emergency services and to identify the variables associated with the repetition of this behavior in Spain. Methods An analytical, observational, retrospective study was carried out. A total of 554 patients attended by the mobile teams of the Primary Care Emergency (mt-PCES) of the Malaga Health District (Spain), after being coordinated by the 061 Emergency Coordination Center (ECC) were analyzed. Results Of the total, 61.9% of the patients were women and the mean age was 43.5 years. Ninety-six percent (N = 532) of the patients attended by mt-PCES were transferred to hospital emergency services. Regarding clinical decision, of those transferred 436 persons (82%) were discharged home. Of the total sample 25.5% (N = 141) were referred to primary care, while 69% (N = 382) were referred to outpatient mental health care. Regarding follow up in the 6 months after being seen by emergency services, among those referred to a mental health facility, 64.4% (N = 246) attended the follow-up appointment while out of the total sample only 50.5% (N = 280) attended a follow-up appointment with an outpatient mental health service. Finally, it should be noted that 23.3% presented a relapse of suicidal behavior in the 6 months following index episode. The variables associated with repetition of suicidal behavior were older age, greater number of previous suicide attempts and having any contact with mental health services in the following 6 months. Conclusion We believe that selective suicide prevention initiatives should be designed to target the population at risk of suicide, especially those receiving both out-of-hospital and in-hospital emergency services.
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Affiliation(s)
- Javier Ramos-Martín
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
| | - Carlos Gómez Sánchez-Lafuente
- Instituto de Investigación Biomedicina de Málaga (IBIMA), Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Ana I. Martínez-García
- Unidad de Gestión Clínica (UGC) del Servicio de Urgencias de Atención Primaria (SUAP) del Distrito Sanitario Málaga, Málaga, Spain
- Grupo Andaluz de Investigación Psicosocial (GAP) (CTS-945), Málaga, Spain
| | - Pilar Castillo-Jiménez
- Unidad de Gestión Clínica (UGC) del Servicio de Urgencias de Atención Primaria (SUAP) del Distrito Sanitario Málaga, Málaga, Spain
| | - José Guzmán-Parra
- Instituto de Investigación Biomedicina de Málaga (IBIMA), Málaga, Spain
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Berta Moreno-Küstner
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomedicina de Málaga (IBIMA), Málaga, Spain
- Grupo Andaluz de Investigación Psicosocial (GAP) (CTS-945), Málaga, Spain
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Shin HD, Durocher K, Sequeira L, Zaheer J, Torous J, Strudwick G. Information and communication technology-based interventions for suicide prevention implemented in clinical settings: a scoping review. BMC Health Serv Res 2023; 23:281. [PMID: 36959599 PMCID: PMC10037806 DOI: 10.1186/s12913-023-09254-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/07/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND A large number of information and communication technology (ICT) based interventions exist for suicide prevention. However, not much is known about which of these ICTs are implemented in clinical settings and their implementation characteristics. In response, this scoping review aimed to systematically explore the breadth of evidence on ICT-based interventions for suicide prevention implemented in clinical settings and then to identify and characterize implementation barriers and facilitators, as well as evaluation outcomes, and measures. METHODS We conducted this review following the Joanna Briggs Institute methodology for scoping reviews. A search strategy was applied to the following six databases between August 17-20, 2021: MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Library, Information Science and Technology Abstracts. We also supplemented our search with Google searches and hand-searching reference lists of relevant reviews. To be included in this review, studies must include ICT-based interventions for any spectrum of suicide-related thoughts and behaviours including non-suicidal self-injury. Additionally, these ICTs must be implemented in clinical settings, such as emergency department and in-patient units. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist to prepare this full report. RESULTS This review included a total of 75 citations, describing 70 studies and 66 ICT-based interventions for suicide prevention implemented in clinical settings. The majority of ICTs were computerized interventions and/or applications (n = 55). These ICTs were commonly used as indicated strategies (n = 49) targeting patients who were actively presenting with suicide risk. The three most common suicide prevention intervention categories identified were post-discharge follow-up (n = 27), screening and/or assessment (n = 22), and safety planning (n = 20). A paucity of reported information was identified related to implementation strategies, barriers and facilitators. The most reported implementation strategies included training, education, and collaborative initiatives. Barriers and facilitators of implementation included the need for resource supports, knowledge, skills, motivation as well as engagement with clinicians with research teams. Studies included outcomes at patient, clinician, and health system levels, and implementation outcomes included acceptability, feasibility, fidelity, and penetration. CONCLUSION This review presents several trends of the ICT-based interventions for suicide prevention implemented in clinical settings and identifies a need for future research to strengthen the evidence base for improving implementation. More effort is required to better understand and support the implementation and sustainability of ICTs in clinical settings. The findings can also serve as a future resource for researchers seeking to evaluate the impact and implementation of ICTs.
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Affiliation(s)
- Hwayeon Danielle Shin
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
| | - Keri Durocher
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
- School of Health, Community Service & Creative Design, Lambton College, Sarnia, Ontario, Canada
| | - Lydia Sequeira
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Juveria Zaheer
- Health Outcomes and Performance Evaluation (HOPE) Research Unit, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Gerald Sheff and Shanitha Kachan Emergency Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Gillian Strudwick
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Rusé J, Clenet A, Vaiva G, Debien C, Arbus C, Salles J. The association between reattempted suicide and incoming calls to the brief contact intervention service, VigilanS: a study of the clinical profile of callers. BMC Psychiatry 2023; 23:21. [PMID: 36624409 PMCID: PMC9829445 DOI: 10.1186/s12888-022-04503-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 12/27/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Suicide is a major health problem globally. As attempted suicide is a major risk factor for suicide, specific prevention strategies have been designed for use thereafter. An example is the brief contact intervention (BCI). In this regard, France employs a composite BCI, VigilanS, which utilizes three types of contact: phone calls, postcards and a 'who to contact in a crisis' card. Previous studies have found that this system is effective at preventing suicide. Nevertheless, VigilanS was not effective in the same way for all the patients included. This observation raises the question of specific adaptation during follow-up for populations that were less receptive to the service. In consideration of this issue, we identified one study which found that incoming calls to the service were linked with a higher risk of suicide reattempts. However, this study did not document the profiles of the patients who made these calls. Better understanding of why this population is more at risk is important in terms of identifying factors that could be targeted to improve follow-up. This research therefore aims to bring together such data. METHODS We performed a retrospective analysis of 579 patients referred to VigilanS by Toulouse University Hospital (France). We examined the sociodemographics, clinical characteristics, and follow-ups in place and compared the patients who made incoming calls to the service versus those who did not. Subsequently, we conducted a regression analysis using the significantly associated element of patients calling VigilanS. Then, in order to better understand this association, we analyzed the factors, including such calls, that were linked to the risk of suicide reattempts. RESULTS We found that 22% of the patients in our sample called the VigilanS service. These individuals: were older, at 41.4 years versus 37.9 years for the non-callers; were more likely to have a borderline personality disorder (BPD) diagnosis (28.9% versus 19.3%); and had a history of suicide attempts (71.9% versus 54.6%). Our analysis confirmed that incoming calls to VigilanS (OR = 2.9) were associated with reattempted suicide, as were BPD (OR = 1.8) and a history of suicide attempts (OR = 1.7). CONCLUSION There was a high risk that the patients calling VigilanS would make another suicide attempt. However, this association was present regardless of the clinical profile. We postulate that this link between incoming calls and reattempted suicide may arise because this form of contact is, in fact, a way in which patients signal that a further attempt will be made.
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Affiliation(s)
- Jeanne Rusé
- grid.411175.70000 0001 1457 2980Department of Psychiatry, University Hospital of Toulouse, CHU Toulouse, Toulouse, France
| | - Adeline Clenet
- grid.411175.70000 0001 1457 2980Department of Psychiatry, University Hospital of Toulouse, CHU Toulouse, Toulouse, France
| | - Guillaume Vaiva
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France ,grid.410463.40000 0004 0471 8845Department of Psychiatry, Centre Hospitalier Universitaire de Lille, Inserm, U1172-LilNCog-Lille Neuroscience and Cognition, Lille, France
| | - Christophe Debien
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France ,grid.410463.40000 0004 0471 8845Department of Psychiatry, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Christophe Arbus
- grid.411175.70000 0001 1457 2980University Hospital of Toulouse, CHU Toulouse, Department of Psychiatry, Toulouse NeuroImaging Center, ToNIC, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Juliette Salles
- University Hospital of Toulouse, CHU Toulouse, Department of Psychiatry, Infinity (Toulouse Institute for Infectious and Inflammatory Diseases), INSERM UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France.
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Liu BP, Jia CX, Qin P, Zhang YY, Yu YK, Luo X, Li SX. Associating factors of suicide and repetition following self-harm: A systematic review and meta-analysis of longitudinal studies. EClinicalMedicine 2022; 49:101461. [PMID: 35747199 PMCID: PMC9126760 DOI: 10.1016/j.eclinm.2022.101461] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Longitudinal evidence for sociodemographic and clinic factors deviating risk for suicide and repetition following SH (self-harm) varied greatly. METHODS A comprehensive search of PubMed, Web of Science, EMBASE, and PsycINFO was conducted from January 1st, 2010 to April 5th, 2022. Longitudinal studies focusing on examining associating factors for suicide and repetition following SH were included. PROSPERO registration CRD42021248695. FINDINGS The present meta-analysis synthesized data from 62 studies published from Jan. 1st, 2010. The associating factors of SH repetition included female gender (RR, 95%CI: 1.11, 1.04-1.18, I2=82.8%), the elderly (compared with adolescents and young adults, RR, 95%CI: 0.67, 0.52-0.87, I2=86.3%), multiple episodes of SH (RR, 95%CI: 1.97, 1.51-2.57, I2=94.3%), diagnosis (RR, 95%CI: 1.60, 1.27-2.02, I2=92.7%) and treatment (RR, 95%CI: 1.59, 1.40-1.80, I2=93.3%) of psychiatric disorder. Male gender (RR, 95%CI: 2.03, 1.80-2.28, I2=83.8%), middle-aged adults (compared with adolescents and young adults, RR, 95%CI: 2.40, 1.87-3.08, I2=74.4%), the elderly (compared with adolescents and young adults, RR, 95%CI: 4.38, 2.98-6.44, I2=76.8%), physical illness (RR, 95%CI: 1.95, 1.56-2.43, I2=0), multiple episodes of SH (RR, 95%CI: 2.02, 1.58-2.58, I2=87.4%), diagnosis (RR, 95%CI: 2.13, 1.67-2.71, I2=90.9%) and treatment (RR, 95%CI: 1.36, 1.16-1.58, I2=58.6%) of psychiatric disorder were associated with increased risk of suicide following SH. INTERPRETATION Due to the substantial heterogeneity for clinic factors of suicide and repetition following SH, these results need to be interpreted with caution. Clinics should pay more attention to the cases with SH repetition, especially with poor physical and psychiatric conditions. FUNDING This work was supported by National Natural Science Foundation of China (NSFC) [No: 82103954; 30972527; 81573233].
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
- Corresponding author at: Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine of University of Oslo, Oslo, Norway
| | - Ying-Ying Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
| | - Yao-Kun Yu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
| | - Xiao Luo
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
| | - Shi-Xue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Corresponding author at: Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
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