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Wu Y, Gasevic D, Wen B, Yang Z, Yu P, Zhou G, Zhang Y, Song J, Liu H, Li S, Guo Y. Floods and cause-specific mortality in the UK: a nested case-control study. BMC Med 2024; 22:188. [PMID: 38715068 PMCID: PMC11077877 DOI: 10.1186/s12916-024-03412-0] [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: 11/27/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Floods are the most frequent weather-related disaster, causing significant health impacts worldwide. Limited studies have examined the long-term consequences of flooding exposure. METHODS Flood data were retrieved from the Dartmouth Flood Observatory and linked with health data from 499,487 UK Biobank participants. To calculate the annual cumulative flooding exposure, we multiplied the duration and severity of each flood event and then summed these values for each year. We conducted a nested case-control analysis to evaluate the long-term effect of flooding exposure on all-cause and cause-specific mortality. Each case was matched with eight controls. Flooding exposure was modelled using a distributed lag non-linear model to capture its nonlinear and lagged effects. RESULTS The risk of all-cause mortality increased by 6.7% (odds ratio (OR): 1.067, 95% confidence interval (CI): 1.063-1.071) for every unit increase in flood index after confounders had been controlled for. The mortality risk from neurological and mental diseases was negligible in the current year, but strongest in the lag years 3 and 4. By contrast, the risk of mortality from suicide was the strongest in the current year (OR: 1.018, 95% CI: 1.008-1.028), and attenuated to lag year 5. Participants with higher levels of education and household income had a higher estimated risk of death from most causes whereas the risk of suicide-related mortality was higher among participants who were obese, had lower household income, engaged in less physical activity, were non-moderate alcohol consumers, and those living in more deprived areas. CONCLUSIONS Long-term exposure to floods is associated with an increased risk of mortality. The health consequences of flooding exposure would vary across different periods after the event, with different profiles of vulnerable populations identified for different causes of death. These findings contribute to a better understanding of the long-term impacts of flooding exposure.
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Affiliation(s)
- Yao Wu
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Zhengyu Yang
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Guowei Zhou
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Yan Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Jiangning Song
- Department of Biochemistry and Molecular Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC, 3800, Australia
| | - Hong Liu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Shanshan Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Yuming Guo
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Stephenson M, Edwards AC. Investigating Associations of Substance Use and Dependence With Planned Versus Unplanned Suicide Attempt. J Stud Alcohol Drugs 2024; 85:339-348. [PMID: 38227385 PMCID: PMC11095497 DOI: 10.15288/jsad.23-00205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVE The present analyses investigated substance use and dependence as correlates of past-year suicide attempt and of unplanned versus planned suicide attempt in a nationally representative sample. METHOD Participants were 214,505 adults (52% female; 64% White, 12% Black, <1% Native American, <1% Pacific Islander, 6% Asian, 16% Hispanic, 2% multiracial) from the 2015-2019 National Surveys on Drug Use and Health. Four logistic regression models were constructed. Models 1 and 2 examined substance use and dependence, respectively, as correlates of suicide attempt. Models 3 and 4 evaluated whether substance use and dependence were related to suicide attempt in the absence of a plan. RESULTS In Models 1 and 2, higher cigarette smoking and marijuana use; any use of opioids, sedatives, and hallucinogens; and greater dependence on nicotine, alcohol, marijuana, and any illicit or prescription drug were associated with elevated risk for suicide attempt. Associations with cigarette smoking, sedative use, and dependence on nicotine, alcohol, and any illicit or prescription drug remained statistically significant in sensitivity analyses limited to individuals with suicidal ideation. In Models 3 and 4, substance use and dependence were unrelated to risk for unplanned (vs. planned) suicide attempt. CONCLUSIONS Although substance-related outcomes are consistently associated with suicide attempt, there was little evidence that substance use and dependence are related to risk for unplanned versus planned suicidal behavior.
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Affiliation(s)
- Mallory Stephenson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
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3
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Herbst E, Hoggatt KJ, McCaslin S. Cigarette Smoking Among Veterans at High Risk for Suicide: Challenges and Opportunities for Intervention. Mil Med 2024; 189:30-32. [PMID: 37525945 DOI: 10.1093/milmed/usad269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/01/2023] [Accepted: 07/06/2023] [Indexed: 08/02/2023] Open
Abstract
Preventing suicide remains a top clinical priority of the Department of Veterans Affairs (VA). In 2019, U.S. military veterans experienced a suicide rate of 52.3% higher than non-Veteran U.S. adults. Cigarette smoking has been found to be independently associated with an elevated risk of suicidal ideation, attempts, plans, and deaths among veterans and non-veterans. However, tobacco use is frequently overlooked in suicide risk assessment and mitigation and is not yet a target for intervention in VA suicide prevention protocols. In this commentary, we recommend that cigarette smoking be considered in suicide risk assessment protocols and that tobacco cessation interventions be considered as a potential beneficial treatment intervention to reduce the risk of suicide. Given the public health threat of suicide among veterans, it is essential to elucidate promising areas of intervention for those at high risk of suicide. Cigarette smoking is a modifiable target, associated with suicide risk, for which there are evidence-based interventions. Therefore, tobacco use disorder identification and treatment should be considered for inclusion in VA suicide risk protocols.
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Affiliation(s)
- Ellen Herbst
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA 94121, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA 94143, USA
| | - Katherine J Hoggatt
- Department of Medicine, University of California, San Francisco, CA 94143, USA
- Research Service, San Francisco VA Health Care System, San Francisco, CA 94121, USA
| | - Shannon McCaslin
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Healthcare System, Menlo Park, CA 94025, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
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Xu YE, Barron DA, Sudol K, Zisook S, Oquendo MA. Suicidal behavior across a broad range of psychiatric disorders. Mol Psychiatry 2023; 28:2764-2810. [PMID: 36653675 PMCID: PMC10354222 DOI: 10.1038/s41380-022-01935-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 01/20/2023]
Abstract
Suicide is a leading cause of death worldwide. In 2020, some 12.2 million Americans seriously contemplated suicide, 3.2 million planned suicide attempts, and 1.2 million attempted suicide. Traditionally, the approach to treating suicidal behavior (SB) has been to treat the "underlying" psychiatric disorder. However, the number of diagnoses associated with SB is considerable. We could find no studies describing the range of disorders reported to be comorbid with SB. This narrative review summarizes literature documenting the occurrence of SB across the lifespan and the full range of psychiatric diagnoses, not only BPD and those that comprise MDE, It also describes the relevance of these observations to clinical practice, research, and nosology. The literature searches contained the terms "suicid*" and each individual psychiatric diagnosis and identified 587 studies. We did not include case reports, case series, studies only addressing suicidal ideation or non-suicidal self-injury (NSSI), studies on self-harm, not distinguishing between SB and NSSI and studies that did not include any individuals that met criteria for a specific DSM-5 diagnosis (n = 366). We found that SB (suicide and/or suicide attempt) was reported to be associated with 72 out of 145 diagnoses, although data quality varied. Thus, SB is not exclusively germane to Major Depressive Episode (MDE) and Borderline Personality Disorder (BPD), the only conditions for which it is a diagnostic criterion. That SB co-occurs with so many diagnoses reinforces the need to assess current and past SB regardless of diagnosis, and supports the addition of charting codes to the DSM-5 to indicate current or past SB. It also comports with new data that specific genes are associated with SB independent of psychiatric diagnoses, and suggests that SB should be managed with specific suicide prevention interventions in addition to treatments indicated for co-occurring diagnoses. SB diagnostic codes would help researchers and clinicians document and measure SB's trajectory and response to treatment over time, and, ultimately, help develop secondary and tertiary prevention strategies. As a separate diagnosis, SB would preclude situations in which a potentially life-threatening behavior is not accounted for by a diagnosis, a problem that is particularly salient when no mental disorder is present, as is sometimes the case.
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Affiliation(s)
- Yingcheng E Xu
- Department of Psychiatry and Behavioral Health, Cooper Medical School of Rowan University and Cooper University Health Care, Camden, NJ, 08103, US
| | - Daniel A Barron
- Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Katherin Sudol
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
| | - Sidney Zisook
- Department of Psychiatry, University of California San Diego School of Medicine, San Diego, CA, 92103, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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Roncero C, Pérez J, Molina J, Quintano JA, Campuzano AI, Pérez J, Miravitlles M. Frequency and Associated Factors of Suicidal Ideation in Patients with Chronic Obstructive Pulmonary Disease. J Clin Med 2022; 11:jcm11092558. [PMID: 35566685 PMCID: PMC9101437 DOI: 10.3390/jcm11092558] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023] Open
Abstract
We aimed to examine the prevalence of suicidal ideation in patients with chronic obstructive pulmonary disease (COPD) and the association between demographic and clinical variables and the occurrence of suicidal thoughts. This was a cross-sectional study. Sociodemographic and clinical data were recorded, and questionnaires were used to assess depressive symptoms (Beck Depression Inventory), comorbidities (Charlson Index), cognitive performance (Mini Mental State Examination), and quality of life (EuroQoL-5 dimensions and CAT). Specific questions about suicide-related behavior were included. Multivariate logistic regression analysis identified the significant factors associated with previous suicidal ideation and suicide attempts. The analysis included 1190 subjects. The prevalence of suicidal ideation and suicide attempts were 12.1% and 2.5%, respectively. Severely depressed patients had the highest prevalence of suicide-related behavior. The adjusted logistic model identified factors significantly associated with suicidal ideation: sex (odds ratio (OR) for women vs. men = 2.722 (95% confidence interval (CI) = 1.771–4.183)), depression score (OR = 1.163 (95% IC = 1.127–1.200)), and Charlson Index (OR 1.228 (95% IC 1.082–1.394)). Suicidal ideation is common in COPD patients, especially in women. While addressing suicidal ideation and suicide prevention, clinicians should first consider the management of depressive symptomatology and the improvement of coping strategies.
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Affiliation(s)
- Carlos Roncero
- Psychiatric Service, University of Salamanca Health Care Complex, 37007 Salamanca, Spain;
- Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain
- Correspondence: (C.R.); (M.M.)
| | - Joselín Pérez
- Medical Department, Grupo Ferrer, 08029 Barcelona, Spain; (J.P.); (A.I.C.)
| | - Jesús Molina
- Centro de Salud Francia, Dirección Asistencial Oeste, 28993 Madrid, Spain;
| | | | | | - Javier Pérez
- Psychiatric Service, University of Salamanca Health Care Complex, 37007 Salamanca, Spain;
- Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain
| | - Marc Miravitlles
- Department of Pneumology, Vall d’Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d’Hebron, Vall d’Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 28029 Madrid, Spain
- Correspondence: (C.R.); (M.M.)
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Marengo L, Douaihy A, Zhong Y, Krancevich K, Brummit B, Sakolsky D, Deal M, Zelazny J, Goodfriend E, Saul M, Murata S, Thoma B, Mansour H, Tew J, Ahmed N, Marsland A, Brent D, Melhem NM. Opioid use as a proximal risk factor for suicidal behavior in young adults. Suicide Life Threat Behav 2022; 52:199-213. [PMID: 34767271 PMCID: PMC10697688 DOI: 10.1111/sltb.12806] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 06/14/2021] [Accepted: 08/12/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There is a concomitant rise in suicide rates with the prevalence of opioids involved in overdose deaths, especially among adolescents and young adults. However, there are limited studies on whether opioid use prospectively predicts suicidal behavior in youth. METHODS Our sample included 183 psychiatric patients (18-30 years) admitted for a suicide attempt (SA), have current suicidal ideation (SI), and psychiatric controls without ideation or attempt (PC). Suicidal behavior was assessed using the Columbia Suicide Severity Rating Scale. We also recruited a healthy control group (HC; n = 40). Patients and controls were followed over a year. ANOVA, regression, and cox regression were used. RESULTS Suicide attempt (β = 0.87, CI [0.1-1.6], p = 0.02) and SI [(β = 0.75, CI [0.03-1.5], p = 0.04) were significantly more likely than HCs to have used opioids in the past year at baseline. Opioid use was associated with increased anxiety symptoms (β = 0.75, CI [0.001-1.5], p = 0.05), PTSD symptoms (β = 3.90, CI [1.1-6.7], p = 0.01), and aggression (β = 0.02, CI [0.01-0.04], p = 0.02). Opioid use in the month prior to hospitalization predicted SA at 6 months (OR = 1.87, CI [1.06-3.31], p = 0.032). CONCLUSIONS Opioid use is a proximal predictor for SA. These findings may help clinicians better identify patients at risk for suicidal behavior, allowing for more personalized treatment approaches.
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Affiliation(s)
- Laura Marengo
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Antoine Douaihy
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Yongqi Zhong
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Katie Krancevich
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Bradley Brummit
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Dara Sakolsky
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Meredith Deal
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jamie Zelazny
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| | - Eli Goodfriend
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Melissa Saul
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Stephen Murata
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Brian Thoma
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Hader Mansour
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jamie Tew
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Nadeem Ahmed
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Anna Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - David Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Nadine M Melhem
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Colbert SM, Hatoum AS, Shabalin A, Li QS, Coon H, Nelson EC, Agrawal A, Docherty AR, Johnson EC. Exploring the genetic overlap of suicide-related behaviors and substance use disorders. Am J Med Genet B Neuropsychiatr Genet 2021; 186:445-455. [PMID: 34821019 PMCID: PMC8692412 DOI: 10.1002/ajmg.b.32880] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/26/2021] [Accepted: 10/22/2021] [Indexed: 02/03/2023]
Abstract
Suicide-related behaviors are heterogeneous and transdiagnostic, and may demonstrate varying levels of genetic overlap with different substance use disorders (SUDs). We used linkage disequilibrium score regression, genomic structural equation models, and Mendelian randomization to examine the genetic relationships between several SUDs and suicide-related behaviors. Our analyses incorporated summary statistics from the largest genome-wide association studies (GWAS) of problematic alcohol use, the Fagerström test for nicotine dependence, cannabis use disorder, and opioid use disorder (Ns ranging from 46,213-435,563) and GWAS of ever self-harmed, suicide attempt, and suicide death (Ns ranging from 18,223-117,733). We also accounted for genetic liability to depression (N = 500,199) and risk tolerance (N = 315,894). Suicide-related behaviors were significantly genetically correlated with each other and each SUD, but there was little evidence of causal relationships between the traits. Simultaneously correlating a common SUD factor with each specific suicide indicator while controlling for depression and risk tolerance revealed significant, positive genetic correlations between the SUD factor and suicide-related behaviors (rg = 0.26-0.45, SE = 0.08-0.09). In the model, depression's association with suicide death (β = 0.42, SE = 0.06) was weaker compared to ever-self harmed and suicide attempt (β = 0.58, SE = 0.05 and β = 0.50, SE = 0.06, respectively). We identify a general level of genetic overlap between SUDs and suicide-related behaviors, which is independent of depression and risk tolerance. Additionally, our findings suggest that genetic and behavioral contributions to suicide death may somewhat differ from nonlethal suicide-related behaviors.
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Affiliation(s)
- Sarah M.C. Colbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Alexander S. Hatoum
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Andrey Shabalin
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Qingqin S. Li
- Neuroscience and JRD Data Science, Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Hilary Coon
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Elliot C. Nelson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Anna R. Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Emma C. Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
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8
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A genetically informed study on the association of cannabis, alcohol, and tobacco smoking with suicide attempt. Mol Psychiatry 2021; 26:5061-5070. [PMID: 32507850 DOI: 10.1038/s41380-020-0785-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 12/17/2022]
Abstract
Use of substances such as cannabis, alcohol, and tobacco, has been associated with increased risk of suicide attempt in several observational studies. However, establishing whether these associations are causal is challenging when using observational designs. To evaluate the potential causal contributions of cannabis use, alcohol use, and tobacco smoking to suicide attempt, we applied two-sample Mendelian randomization, an instrumental variable approach using single-nucleotide polymorphisms (SNPs) as instrumental variables for three exposures: lifetime cannabis use (yes/no; 42 instrument SNPs; GWAS sample size [N] = 162,082), alcohol use (drinks-per-week; 53 instrument SNPs; N = 941,280), and tobacco smoking (initiation, yes/no; 156 instrument SNPs; N = 1,232,091; heaviness; 27 instrument SNPs; N = 337,334). The main outcome was suicide attempt measured from hospital records (N = 50,264). All data come from publicly available summary statistics of genome-wide association studies of participants of European ancestry. We found evidence supporting a possible causal role of cannabis (OR = 1.18; 95% CI = 1.01-1.37, P = 0.032), alcohol (OR = 1.95; 95% CI = 1.15-3.32, P = 0.013), and smoking (initiation, OR = 1.90; 95% CI = 1.54-2.34, P < 0.001; heaviness, OR = 2.13; 95% CI = 1.13-3.99; P = 0.019) on suicide attempt. Using multivariable Mendelian randomization, we found that only cannabis showed a direct pathway to suicide attempt (P = 0.001), suggesting that the effect of alcohol and smoking was mediated by the other substance use phenotypes. No evidence was found for reverse causation, i.e., associations of suicide attempt on cannabis (P = 0.483), alcohol (P = 0.234), smoking initiation (P = 0.144), and heaviness (P = 0.601). In conclusion, evidence from this quasi-experimental study based on genetic data from large-scale GWASs are consistent with a causal role of cannabis, alcohol, and tobacco smoking on suicide attempt.
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9
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Proposal for the Inclusion of Tobacco Use in Suicide Risk Scales: Results of a Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116103. [PMID: 34198855 PMCID: PMC8201119 DOI: 10.3390/ijerph18116103] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/21/2021] [Accepted: 06/04/2021] [Indexed: 11/16/2022]
Abstract
There is an association between smoking and suicide, even though the direction and nature of this relationship remains controversial. This meta-analysis aimed to evaluate the association between smoking and suicidal behaviours (ideation, planning, suicide attempts, and death by suicide). On 24 August 2020, we searched the PubMed, Cochrane library, Scopus, Web of Science, TRIP, and SCIENCE DIRECT databases for relevant articles on this topic. Twenty prospective cohort studies involving 2,457,864 participants were included in this meta-analysis. Compared with never smokers, former and current smokers had an increased risk of death by suicide (relative risk [RR] = 1.31; 95% CI [1.13, 1.52] and RR = 2.41; 95% CI [2.08, 2.80], respectively), ideation (RR = 1.35; 95% CI [1.31, 1.39] and RR = 1.84; 95% CI [1.21, 2.78]), and attempted suicide (RR = 1.27; 95% CI [0.56, 2.87] and RR = 1.71; 95% CI [0.73, 3.97]). Moreover, compared to never smokers, current smoker women (RR = 2.51; 95% CI [2.06-3.04] had an increased risk of taking their own life (Q = 13,591.53; p < 0.001) than current smoker men (RR = 2.06; 95% CI [1.62-2.62]. Furthermore, smoking exposure (former and current smokers) was associated with a 1.74-fold increased risk (95% CI [1.54, 1.96]) of suicidal behaviour (death by suicide, ideation, planning, or attempts). Thus, because of the prospective relationship between smoking and suicidal behaviours, smoking should be included in suicide risk scales as a useful and easy item to evaluate suicide risk.
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10
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Aubin HJ, Legleye S, Thomas D, Berlin I. Tobacco smoking: the likely confounder of the association between heart diseases and suicide. J Intern Med 2020; 288:605-606. [PMID: 32237242 DOI: 10.1111/joim.13065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/23/2020] [Indexed: 01/05/2023]
Affiliation(s)
- H-J Aubin
- Inserm, CESP, Villejuif, France.,AP-HP, Université Paris Saclay, Villejuif, France
| | | | - D Thomas
- AP-HP, Sorbonne Université, Paris, France
| | - I Berlin
- AP-HP, Sorbonne Université, Paris, France.,Centre Universitaire de Médecine Générale et Santé Publique, Lausanne, Switzerland
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11
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Pérez-López FR, Pérez-Roncero GR, López-Baena MT, Santabárbara J, Chedraui P. Hormonal contraceptives and the risk of suicide: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 251:28-35. [PMID: 32470654 DOI: 10.1016/j.ejogrb.2020.04.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To assess the effect of hormonal contraceptive use over the risk of suicide. METHOD Systematic review and meta-analysis of observational studies retrieved from five search engines until September 2019, comparing the use of any hormonal contraceptive versus non-hormonal contraceptive use or no use. Primary outcome was consumed suicide, and secondary outcomes were suicidal attempt and ideation. Random effects meta-analyses with the inverse variance method were used to evaluate the effects of exposure over outcomes. Effect was calculated as risk ratio (RR) with their corresponding 95% confidence interval (CI). Risk of bias was assessed with the Newcastle-Otawa Scale. RESULTS There were no randomized controlled trials concerning suicide and hormonal contraceptive use. Only three cohort studies (n = 184,721 women), that evaluated the primary outcome (consumed suicide), were included in the meta-analysis. Hormonal contraceptive use was associated to a higher risk of consumed suicide (RR = 1.36, 95% CI 1.06 to 1.75, P = 0.015, I2 = 0%). There were no secondary outcomes in at least two cohorts. CONCLUSION This meta-analysis found a positive association between hormonal contraceptive use and consumed suicides. Prior to their use, populations at suicidal risk should be properly evaluated.
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Affiliation(s)
- Faustino R Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza, Faculty of Medicine, Zaragoza, Spain; Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain.
| | | | | | - Javier Santabárbara
- Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain; Department of Preventive Medicine and Public Health University of Zaragoza, Faculty of Medicine, Zaragoza, Spain
| | - Peter Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador; Facultad de Ciencias de la Salud, Universidad Católica Nuestra Señora de la Asunción, Asunción, Paraguay
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12
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Oliveira RMD, Santos JLF, Furegato ARF. Prevalence and smokers' profile: comparisons between the psychiatric population and the general population. Rev Lat Am Enfermagem 2019; 27:e3149. [PMID: 31038640 PMCID: PMC6528629 DOI: 10.1590/1518-8345.2976.3149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 02/07/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives: to identify the prevalence of smokers between the psychiatric population and
the general population; to compare the personal, socio-demographic and
clinical profile of smokers and non-smokers in the psychiatric population
and the general population; to compare the reasons for smoking of these two
population groups. Method: this is a cross-sectional descriptive-analytical epidemiological study with
378 patients from three services: Ambulatory Mental Health, Psychiatric
Hospital, and Basic Health Unit. Interviews were conducted with three
questionnaires. The Chi-square and Kruskal-Wallis tests were applied. Results: in the total of the 378 participants, 67% were women and 69% were over 40
years old. There was a higher prevalence of smokers among men, young people,
illiterates, singles and with more than one government benefit. Smokers
prevailed among schizophrenics, chronic patients, who used ≥ 3 psychotropic
drugs and had a history of ≥ 4 psychiatric hospitalizations and/or suicide
attempts. The main reason for smoking was the improvement of negative
feelings. Conclusion: the prevalence of smokers is higher in the psychiatric population (especially
among severely ill patients) and among men, young people, unmarried and with
socioeconomic losses. The main reason for smoking is tension/relaxation
relief. This study provides nurses and other professionals with knowledge
capable of subsidizing the planning of smoking interventions in the
Brazilian population.
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Affiliation(s)
| | | | - Antonia Regina Ferreira Furegato
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
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13
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The role of substance use, smoking, and inflammation in risk for suicidal behavior. J Affect Disord 2019; 243:33-41. [PMID: 30223137 PMCID: PMC6241516 DOI: 10.1016/j.jad.2018.09.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/09/2018] [Accepted: 09/06/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Alcohol and substance use disorders are important predictors for suicidal behavior. However, the role of individual substances as proximal risk factors for suicidal behavior and the mechanisms through which substance use affect risk are not entirely clear. We examine whether the frequency of substance use and whether biological markers in the HPA axis and inflammatory pathways are associated with clinical risk factors of suicidal behavior of aggression, impulsivity, hopelessness, and poor sleep. METHODS The sample consisted of psychiatric inpatients, aged 15-30 years, admitted for suicide attempt (n = 38), suicidal ideation (n = 40); and healthy controls (n = 37). We measured hair cortisol concentrations, glucocorticoid receptor (GR) sensitivity, stimulated production of interleukin- or IL-6, C-reactive protein, and mRNA expression of GR, SKA2, FKBP5, TNF-α, and IL-1β. RESULTS Smoking was associated with increased aggression [β = 2.9, 95% CI (-0.03, 6), p = 0.05], impulsivity [β = 3.1, 95% CI (1.6, 4.6), p < 0.001], and poor sleep [β = 0.5, 95% CI (0.03, 0.95), p = 0.04] even after controlling for demographics and group. Similarly, TNF-α mRNA was associated with impulsivity [β = 0.07, 95% CI (0.01, 0.1), p = 0.02] and hopelessness [β = 0.03, 95% CI (0.004, 0.05), p = 0.03]. Smoking tobacco (r = 0.32, p < 0.001) was positively associated with TNF-α mRNA. LIMITATIONS Study limitations include the cross-sectional design, retrospective assessment, and relatively small sample size. CONCLUSIONS Future longitudinal studies are needed to test whether inflammatory markers mediate the relationships between smoking, clinical risk factors, and suicidal behavior; and to examine whether smoking cessation could reduce the risk for suicidal behavior in at-risk patients.
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14
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Gender and Time-Related Differences in a Large Cohort of Heavy Smokers Applying for Treatment to a Tobacco Centre in Italy. J Smok Cessat 2018. [DOI: 10.1017/jsc.2017.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction: Attempts to quit smoking have increased in recent years, but the patterns of variations over time are unknown. We aimed at describing time- and sex-related changes in a population of 2,231 subjects who adhered to a smoking-cessation programme lasting 13 years in Italy.Methods: We measured baseline expired carbon monoxide (expired-CO), Fagerstrom nicotine dependence, Q-MAT test, Zung depression and anxiety scale, Hospital anxiety and depression scale (HADS).Results: Study population included 1,278 men and 953 women who smoked a median of 25 (interquartile range, IQR: 20–32) and 20 (IQR: 20–30) cigarettes/day, respectively (p < 0.001). The proportion of female smokers increased from 37.5% in 2001–2003 to 46.9% in 2010–2013 (p = 0.003). There was a significant time-related reduction of median daily cigarette consumption, with a more noticeable decrease in men. Median expired-CO (parts per million (ppm)) increased only in women, from 18 (IQR: 14–23) in 2001–03 to 20 (IQR: 14–28) in 2010–13 (p = 0.001), whereas Fagerstrom test for nicotine dependence did not vary. Differences in psychological characteristics in the last 3 years showed that women were more clinically depressed than men (16.6% versus 7.6%, p < 0.001).Conclusions: Despite a decrease in the number of daily cigarettes with time, expired-CO tends to increase in women, who are also more clinically depressed and anxious than men. A personalised approach to specific subgroups of smokers, with special emphasis on a psychological support for women, seems appropriate.
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15
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Consommation de tabac et usage de cigarette électronique en France. Rev Mal Respir 2018; 35:673-685. [DOI: 10.1016/j.rmr.2018.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 01/14/2018] [Indexed: 11/22/2022]
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16
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Oliveira RMD, Santos JLF, Furegato ARF. Tobacco addiction in the psychiatric population and in the general population. Rev Lat Am Enfermagem 2017; 25:e2945. [PMID: 29211192 PMCID: PMC5738870 DOI: 10.1590/1518-8345.2202.2945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/02/2017] [Indexed: 11/21/2022] Open
Abstract
Objective: To estimate the degree of tobacco addiction and identify independently associated
factors by comparing the psychiatric population of secondary and tertiary care
with the general population of the primary healthcare network. Method: This is a cross-sectional epidemiological study, conducted in a municipality of
São Paulo, with 134 smokers of a Mental Health Outpatient Unit (MHOU), a
Psychiatric Hospital (PH), and a Primary Healthcare Unit (PHU). Data were
collected by means of individual interviews, recorded on a mobile device. Data
were statistically processed using Stata/12 Results: Of the 134 participants, 54.5% were women. While 49.1% of the psychiatric
population (MHOU/PH) had medium/high nicotine addiction, 58.3% of smokers of the
general population had very low/low dependency. The Poisson regression model
indicated a higher prevalence of smokers with high dependence among men (PR =
1.41), people aged 49 years or less (15 - 29 years, PR = 4.06, 30 - 39 PR = 2.96
years, 40 - 49 years PR = 1.84), with severe mental disorders (PR = 3.05), with
anxiety disorders/other (PR = 3.98), and with high suicide risk (PR = 1.55). Conclusion: Nicotine dependence was greater in the psychiatric population than in the general
population. The independent factors associated with severe dependence were sex,
age group, diagnosis, and current risk of suicide. These results trigger
reflection among nurses on the need to focus more attention on a neglected subject
in mental health services.
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Affiliation(s)
| | - Jair Lício Ferreira Santos
- PhD, Full Professor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Antonia Regina Ferreira Furegato
- PhD, Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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17
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Agrawal A, Tillman R, Grucza RA, Nelson EC, McCutcheon VV, Few L, Conner KR, Lynskey MT, Dick DM, Edenberg HJ, Hesselbrock VM, Kramer JR, Kuperman S, Nurnberger JI, Schuckit MA, Porjesz B, Bucholz KK. Reciprocal relationships between substance use and disorders and suicidal ideation and suicide attempts in the Collaborative Study of the Genetics of Alcoholism. J Affect Disord 2017; 213:96-104. [PMID: 28213124 PMCID: PMC5434702 DOI: 10.1016/j.jad.2016.12.060] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/22/2016] [Accepted: 12/21/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Substance use and misuse and suicidal thoughts and behaviors tend to co-occur. The purpose of this study was to examine whether (a) suicidal ideation and attempt are related to onset of alcohol, nicotine and cannabis use and dependence; (b) early use of alcohol, nicotine and cannabis is associated with onset of suicidal ideation and attempt; and (c) whether these associations persist while controlling for covariates, such as family history of alcohol problems, major depression and other internalizing and externalizing disorders. METHODS The prospective cohort of the Collaborative Study of the Genetics of Alcoholism (COGA; N=3277) was used. Cross-sectional and discrete time logistic regression (i.e. survival) analyses examined associations between suicidal ideation and attempt and onset of alcohol, nicotine and cannabis use and dependence. Survival models also examined whether individual early substance use was related to onset of ideation and attempt. RESULTS Ideation was related to 0.71-0.77 odds of onset of subsequent alcohol, nicotine and cannabis use. Attempt was associated with 1.44-1.61 odds of later alcohol, nicotine and cannabis dependence, even after accounting for covariates. Evidence for early substance use being related to subsequent onset of ideation or attempt was limited. Several sex and race differences emerged. LIMITATIONS The sample was ascertained for family history of alcoholism; not all participants had been followed up allowing for censored observations; reporting bias. CONCLUSION Suicide attempts are associated with increased likelihood of onset of substance dependence.
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Affiliation(s)
- Arpana Agrawal
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA.
| | - Rebecca Tillman
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Richard A Grucza
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Elliot C Nelson
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Vivia V McCutcheon
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Lauren Few
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
| | - Kenneth R Conner
- University of Rochester Medical Center, Dept. of Emergency Medicine, Rochester, NY, USA
| | - Michael T Lynskey
- Kings College, Institute of Psychiatry, Dept. of Addiction, London, UK
| | - Danielle M Dick
- Virginia Commonwealth University, Dept. of African-American Studies, Richmond, VA, USA
| | - Howard J Edenberg
- Indiana University, Dept. of Biochemistry and Molecular Biology, Indianapolis, IN, USA
| | | | - John R Kramer
- University of Iowa Carver College of Medicine, Dept. of Psychiatry - Div. of Psychology, Iowa City, IA, USA
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Depts. of Psychiatry and Pediatrics, Iowa City, IA, USA
| | - John I Nurnberger
- Indiana University School of Medicine, Dept. of Psychiatry, Indianapolis, IN, USA
| | - Marc A Schuckit
- University of California San Diego, Dept. of Psychiatry, San Diego, CA, USA
| | - Bernice Porjesz
- SUNY Downstate Medical Center, Dept. of Psychiatry, Brooklyn, NY, USA
| | - Kathleen K Bucholz
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
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18
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Gates ML, Turney A, Ferguson E, Walker V, Staples-Horne M. Associations among Substance Use, Mental Health Disorders, and Self-Harm in a Prison Population: Examining Group Risk for Suicide Attempt. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030317. [PMID: 28335531 PMCID: PMC5369153 DOI: 10.3390/ijerph14030317] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/07/2017] [Accepted: 03/15/2017] [Indexed: 12/22/2022]
Abstract
Substance use disorders (SUD) and mental health disorders are significant public health issues that co-occur and are associated with high risk for suicide attempts. SUD and mental health disorders are more prevalent among offenders (i.e., prisoners or inmates) than the non-imprisoned population, raising concerns about the risk of self-harm. This cross-sectional study examined the population of a state prison system (10,988 out of 13,079) to identify associations among SUD (alcohol, cannabis, intravenous drugs, narcotics, and tobacco smoking), mental health disorders (anxiety, bipolar, depression, and psychotic disorders), and suicide attempts. The primary aim was to determine which groups (SUD, mental health disorders, and co-occurrences) were strongly association with suicide attempts. Groups with a documented SUD or mental health disorders compared to peers without these issues had 2.0 and 9.2 greater odds, respectively, for attempting suicide, which was significant at p < 0.0001 for both conditions. There were also significant differences within SUD and mental health disorders groups in regard to suicide attempts. Groups with the greatest odds for suicide attempts were offenders with comorbid bipolar comorbid and anxiety, alcohol combined with depression, and cannabis co-occurring with depression. Documentation of suicide attempts during imprisonment indicates awareness, but also suggest a need to continue enhancing screening and evaluating environmental settings.
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Affiliation(s)
- Madison L Gates
- Department of Family Medicine, Medical College of Georgia, Institute of Public and Preventive Health, Augusta University, 1120 15th Street, CJ 2300, Augusta, GA 30912, USA.
| | - Asher Turney
- Centurion, LLC, 53 Century Blvd, Suite 150, Nashville, TN 37214, USA.
| | - Elizabeth Ferguson
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, 997 St. Sebastian Way, Augusta, GA 30912, USA.
| | - Veronica Walker
- Lexington Public Library, 3628 Walden Drive, Lexington, KY 40517, USA.
| | - Michelle Staples-Horne
- Georgia Department of Juvenile Justice, Central Office, 3408 Covington Highway, Decatur, GA 30032, USA.
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Abstract
BACKGROUND Many studies have reported a positive association between smoking and suicide, but the results are inconsistent. This meta-analysis was carried out to estimate the association between smoking and suicidal ideation, suicide plan, suicide attempt, and suicide death. METHODS Major electronic databases including PubMed, Web of Science, Scopus, and ScienceDirect were searched until May 2015. The reference lists of included studies were screened too. Epidemiological studies addressing the association between smoking and suicidal behaviors were enrolled. The heterogeneity across studies was explored by Q-test and I2 statistic. The possibility of publication bias was assessed using Begg's and Egger's tests and Trim & Fill analysis. The results were reported based on risk ratio (RR) and odds ratio (OR) with 95% confidence intervals (CI) using a random-effects model. RESULTS We identified a total of 8062 references and included 63 studies with 8,063,634 participants. Compared to nonsmokers, the current smokers were at higher risk of suicidal ideation (OR = 2.05; 95% CI: 1.53, 2.58; 8 studies; I2 = 80.8%; P<0.001), suicide plan (OR = 2.36; 95% CI: 1.69, 3.02; 6 studies; I2 = 85.2%; P<0.001), suicide attempt (OR = 2.84; 95% CI: 1.49, 4.19; 5 studies; I2 = 89.6%; (P<0.001), and suicide death (RR = 1.83; 95% CI: 1.64, 2.02; 14 studies; I2 = 49.7%; P = 0.018). CONCLUSIONS There is sufficient evidence that smoking is associated with an increased risk of suicidal behaviors. Therefore, smoking is a contributing factor for suicide. Although this association does not imply causation, however, smoking prevention and cessation should be the target of suicide prevention programs.
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Affiliation(s)
- Jalal Poorolajal
- Modeling of Noncommunicable Diseases Research Center and Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nahid Darvishi
- Psychological Counseling Center, Hamadan University of Medical Sciences, Hamadan, Iran
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20
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Han B, Compton WM, Blanco C. Tobacco Use and 12-Month Suicidality Among Adults in the United States. Nicotine Tob Res 2016; 19:39-48. [PMID: 27190402 DOI: 10.1093/ntr/ntw136] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 04/29/2016] [Indexed: 12/29/2022]
Abstract
INTRODUCTION To examine how 12-month prevalences of suicidality vary by tobacco use. METHODS Data were from 325 800 adults who participated in the 2008-2014 National Survey on Drug Use and Health. Descriptive analyses and multivariable multinomial logistic regression models were applied. RESULTS Among adults aged 18 or older in the United States during 2008-2014, 27.4% (annual average, standard error [SE] = 0.14%) were never tobacco users, 38.8% (SE = 0.17%) were former tobacco users, 5.9% (SE = 0.07%) were past-year users of other types of tobacco (non-cigarette), 20.2% (SE = 0.13%) were past-year cigarette-only users, and 7.7% (SE = 0.07%) were past-year users of cigarettes plus other types of tobacco; 2.6% (SE = 0.04%) had suicidal ideation only, 0.7% (SE = 0.02%) had suicidal ideation and suicide plan only, and 0.5% (SE = 0.02%) attempted suicide. After controlling for covariates, compared with never tobacco users, past-year users of cigarettes plus other types of tobacco were at elevated risk of all examined suicidality outcomes (adjusted relative risks [ARRs] = 1.2-1.7), and past-year cigarette-only users were at higher risk of suicide attempt (ARR = 1.4). Early age of first tobacco use was associated with higher risk of suicidal ideation and suicide plan among former tobacco users, past-year tobacco users, and past-year cigarette users (ARRs = 1.2-1.6). Among past-year tobacco users, frequencies of cigarette and cigar use were associated with suicide attempt (ARRs = 1.4-1.7). Nicotine dependence was associated with suicide attempt among past-year cigarette users (ARR = 1.2). CONCLUSIONS Tobacco use is associated with 12-month suicidality among adults. Patients who use tobacco should be assessed further for mental health status and suicide risk. IMPLICATIONS Our results revealed that tobacco use is independently associated with the 12-month suicidality outcomes among adults and identified how the prevalences of 12-month suicidality outcomes vary by tobacco use status and use characteristics among adults. These results have important clinical implications. Future research should assess the effectiveness of tobacco use questions as simple screeners for more extensive assessment of mental health status and suicide risk.
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Affiliation(s)
- Beth Han
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD;
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD
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Berlin I, Luquiens A, Aubin HJ. Smoking as a confounder of the association of suicidality with serum lipid levels. J Psychiatry Neurosci 2016; 41:E24. [PMID: 26898729 PMCID: PMC4764488 DOI: 10.1503/jpn.150361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Ivan Berlin
- From the Département de pharmacologie, Hôpital Pitié-Salpêtrière - Université P. & M. Curie, Paris, France; and the Département de psychiatrie et d'addictologie, Villejuif, France
| | - Amandine Luquiens
- From the Département de pharmacologie, Hôpital Pitié-Salpêtrière - Université P. & M. Curie, Paris, France; and the Département de psychiatrie et d'addictologie, Villejuif, France
| | - Henri-Jean Aubin
- From the Département de pharmacologie, Hôpital Pitié-Salpêtrière - Université P. & M. Curie, Paris, France; and the Département de psychiatrie et d'addictologie, Villejuif, France
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Wilhelm K, Handley T, Reddy P. Exploring the validity of the Fantastic Lifestyle Checklist in an inner city population of people presenting with suicidal behaviours. Aust N Z J Psychiatry 2016; 50:128-34. [PMID: 26681263 DOI: 10.1177/0004867415621393] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Although patients demonstrate a range of problematic health-related lifestyle behaviours preceding suicidal behaviour, there is little research that routinely measure these behaviours. This paper seeks to establish the utility of health-related lifestyle measure (Fantastic Lifestyle Checklist) in people presenting to a major inner city Emergency Department with a range of suicidal behaviours. METHODS From 2007-2014, data from the 366 patients who had completed the Fantastic Lifestyle Checklist, after referral by the Emergency Department to a service for people with deliberate self-harm or suicidal ideation, were included in the analysis study. A Maximum Likelihood factor analysis was performed to assess the factor structure of the Fantastic Lifestyle Checklist and the resultant factors were explored in relation to measures of health; namely the Depression, Anxiety and Stress Scale and the 12-item Short-Form Health Survey. RESULTS A three-component factor structure emerged comprising Component 1 'positive life investments', Component 2 'poor emotional regulation' and Component 3 'poor health behaviours'. There was a significant negative correlation between 'positive life investments' and each of the Depression, Anxiety and Stress scales subscales and significant positive associations with 'poor emotional regulation' and Short Form Health Survey-12 mental health scores. Only the Short Form Health Survey-12 physical health subscale was weakly correlated with 'poor health behaviours', in females. CONCLUSION Our findings support the construct and concurrent validity of the Fantastic Lifestyle Checklist measure. The three factors obtained for the Fantastic Lifestyle Checklist were coherent and seem useful for research and clinical practice.
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Affiliation(s)
- Kay Wilhelm
- School of Psychiatry, Faculty of Medicine and Black Dog Institute, University of New South Wales, Randwick, NSW, Australia Faces in the Street, Urban Mental Health and Wellbeing Research Institute, St Vincent's Hospital Sydney, Sydney, NSW, Australia Consultation Liaison Psychiatry Service, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Tonelle Handley
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Prasuna Reddy
- Faces in the Street, Urban Mental Health and Wellbeing Research Institute, St Vincent's Hospital Sydney, Sydney, NSW, Australia School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
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23
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Ostacher MJ, Nierenberg AA, Rabideau D, Reilly-Harrington NA, Sylvia LG, Gold AK, Shesler LW, Ketter TA, Bowden CL, Calabrese JR, Friedman ES, Iosifescu DV, Thase ME, Leon AC, Trivedi MH. A clinical measure of suicidal ideation, suicidal behavior, and associated symptoms in bipolar disorder: Psychometric properties of the Concise Health Risk Tracking Self-Report (CHRT-SR). J Psychiatr Res 2015; 71:126-33. [PMID: 26476489 PMCID: PMC6778403 DOI: 10.1016/j.jpsychires.2015.10.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 08/11/2015] [Accepted: 10/01/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE People with bipolar disorder are at high risk of suicide, but no clinically useful scale has been validated in this population. The aim of this study was to evaluate the psychometric properties in bipolar disorder of the 7- and 12-item versions of the Concise Health Risk Tracking Self-Report (CHRT-SR), a scale measuring suicidal ideation, suicidal behavior, and associated symptoms. METHODS The CHRT was administered to 283 symptomatic outpatients with bipolar I or II disorder who were randomized to receive lithium plus optimized personalized treatment (OPT), or OPT without lithium in a six month longitudinal comparative effectiveness trial. Participants were assessed using structured diagnostic interviews, clinician-rated assessments, and self-report questionnaires. RESULTS The internal consistency (Cronbach α) was 0.80 for the 7-item CHRT-SR and 0.90 for the 12-item CHRT-SR with a consistent factor structure, and three independent factors (current suicidal thoughts and plans, hopelessness, and perceived lack of social support) for the 7-item version. CHRT-SR scores are correlated with measures of depression, functioning, and quality of life, but not with mania scores. CONCLUSIONS The 7- and 12-item CHRT-SR both had excellent psychometric properties in a sample of symptomatic subjects with bipolar disorder. The scale is highly correlated with depression, functioning, and quality of life, but not with mania. Future research is needed to determine whether the CHRT-SR will be able to predict suicide attempts in clinical practice.
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Affiliation(s)
- Michael J. Ostacher
- VA Palo Alto Health Care System, Palo Alto, CA, USA,Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA,Corresponding author. VA Palo Alto Health Care System 3801 Miranda Ave, Mail Code 151-T Palo Alto, CA 94304, USA. (M.J. Ostacher)
| | - Andrew A. Nierenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Dustin Rabideau
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Noreen A. Reilly-Harrington
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Louisa G. Sylvia
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| | - Alexandra K. Gold
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Leah W. Shesler
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Terence A. Ketter
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Charles L. Bowden
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Joseph R. Calabrese
- Bipolar Disorders Research Center, University Hospital’s Case Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Edward S. Friedman
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dan V. Iosifescu
- Department of Psychiatry, Icahn School of medicine at Mount Sinai, New York, NY, USA
| | - Michael E. Thase
- Department of Psychiatry, University of Pennsylvania School of Medicine, USA
| | - Andrew C. Leon
- Biostatistics in Psychiatry & Public Health, Weill Cornell Medical College, New York, NY, USA
| | - Madhukar H. Trivedi
- Department of Psychiatry, The University of Texas Southwestern Medical Center, USA
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