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Schwinn T, Paul RH, Hirschmiller J, Brähler E, Wiltink J, Zwerenz R, O'Connor RC, Wild PS, Münzel T, König J, Geschke K, Moehler M, Konstantinides S, Justenhoven C, Lackner KJ, Pfeiffer N, Beutel ME, Ernst M. Prevalence of current suicidal thoughts and lifetime suicide attempts in individuals with cancer and other chronic diseases in Germany: Evidence for differential associations from a representative community cohort. J Affect Disord 2024:S0165-0327(24)01318-1. [PMID: 39178957 DOI: 10.1016/j.jad.2024.08.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 08/16/2024] [Accepted: 08/17/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Research indicates an elevated risk for suicidal thoughts and behaviors (STBs)1 among individuals with cancer, but community-based studies on the prevalence of STBs in comparison to the general population and other chronic diseases are lacking. METHODS Data was drawn from the representative population-based, prospective Gutenberg Health Study (GHS).2 Participants (N = 12,382; age: M = 59.5, SD = 10.8; 48.9 % women) completed highly standardized medical assessments and validated questionnaires such as the PHQ-9. In addition to prevalence estimates (stratified by STBs and gender), logistic regression models were calculated (controlling for confounders). RESULTS The sample included 1910 individuals with cancer, 8.2 % of whom reported current suicidal thoughts and 2.0 % reported lifetime suicide attempts. There was neither a significant association between a cancer diagnosis and suicidal thoughts (p = .077) nor suicide attempts (p = .17) in models adjusting for age, gender, and income. Other chronic diseases were linked to suicidal thoughts and attempts only in men. LIMITATIONS Although the investigation of the two kinds of STB are a strength of the study, the items' different time frames complicate comparisons. In addition, the cross-sectional design limits the ability to understand observed relationships and to identify periods of risk. CONCLUSION This study expands the evidence base regarding the vulnerability to STBs in individuals with cancer, including long-term survivors. It highlights their heterogeneity, differential risk factors underlying suicidal thoughts and attempts, and the relevance of other (contextual) factors shaping an individual's susceptibility to suicidal crises.
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Affiliation(s)
- Tamara Schwinn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Roman H Paul
- Institute for Medical Biometry, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Judith Hirschmiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Department of Medical Psychology and Medical Sociology, University Medical Center of Leipzig, Leipzig, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Philipp S Wild
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Preventive Cardiology and Preventive Medicine - Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jochem König
- Institute for Medical Biometry, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Katharina Geschke
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Markus Moehler
- I. Dept. Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Stavros Konstantinides
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Christina Justenhoven
- Cancer Registry of Rhineland-Palatinate in the Institute of Digital Health Data gGmbH, Mainz, Germany
| | - Karl J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
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2
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Darvishi N, Poorolajal J, Azmi-Naei B, Farhadi M. The Role of Social Support in Preventing Suicidal Ideations and Behaviors: A Systematic Review and Meta-Analysis. J Res Health Sci 2024; 24:e00609. [PMID: 39072545 PMCID: PMC11264453 DOI: 10.34172/jrhs.2024.144] [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: 03/04/2024] [Revised: 03/13/2024] [Accepted: 04/01/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Numerous epidemiological studies have explored the relationship between social support and suicidal behaviors; however, the overall impact remains unclear. Therefore, a systematic assessment of the association between social support and suicide is necessary. Study Design: This is a systematic review study. METHODS We conducted a comprehensive search of PubMed, Web of Science, and Scopus databases until March 2023 and screened reference lists for relevant studies. Epidemiological studies that investigated the associations between social support and suicidal behaviors were included. Furthermore, between-study heterogeneity was investigated using I2 statistics. In addition, the likelihood of publication bias was evaluated using the Begg and Egger tests, and a trim-and-fill analysis was conducted. The overall effect size was calculated as an odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model. RESULTS Out of the 21004 identified studies, 118 studies (involving 692266 participants) met the eligibility criteria. The analysis of data revealed a significant inverse association between social support and suicidal ideation (OR: 0.79, 95% CI: 0.76-0.82), suicide plans (OR: 0.86, 95% CI: 0.79-0.95), suicide attempts (OR: 0.96, 95% CI: 0.94-0.98), and suicide death (OR: 0.85, 95% CI: 0.75-0.96). Moreover, significant heterogeneity was observed across studies, but there was little concern regarding the presence of publication bias. CONCLUSION Our meta-analysis provides clear evidence for a significant inverse association between social support and suicidal behaviors. However, the observational nature of the included studies and the significant heterogeneity observed across studies highlight the need for further research, including prospective studies and intervention trials, to explore the complex relationship between social support and suicidal behaviors.
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Affiliation(s)
- Nahid Darvishi
- Department of Psychology, School of Human Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
- Consultation Center, Department of Education, Hamadan, Iran
| | - Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Bita Azmi-Naei
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehran Farhadi
- Department of Psychology, Faculty of Economics and Social Sciences, Bu-Ali Sina University, Hamadan, Iran
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Jin T, Seo J, Ye S, Lee S, Park EY, Oh JK, Han C, Kim B. Suicide mortality following the implementation of tobacco packaging and pricing policies in Korea: an interrupted time-series analysis. BMC Med 2024; 22:180. [PMID: 38679738 PMCID: PMC11057188 DOI: 10.1186/s12916-024-03372-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/26/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND To prevent tobacco use in Korea, the national quitline number was added to tobacco packages in December 2012, tobacco prices were raised by 80% in January 2015, and graphic health warning labels were placed on tobacco packages in December 2016. This study evaluated the association of these tobacco packaging and pricing policies with suicide mortality in Korea. METHODS Monthly mortality from suicide was obtained from Cause-of-Death Statistics in Korea from December 2007 to December 2019. Interrupted time-series analysis was performed using segmented Poisson regression models. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated adjusted for suicide prevention strategies. RESULTS Suicide mortality was 20 per 1,000,000 in December 2007 and showed a downward trend over the study period. After the implementation of tobacco packaging and pricing policies, suicide mortality immediately declined by - 0.09 percent points (95% CI = - 0.19 to 0.01; P > 0.05) for the national quitline number, - 0.22 percent points (95% CI = - 0.35 to - 0.09; P < 0.01) for tobacco prices, and - 0.30 percent points (95% CI = - 0.49 to - 0.11; P < 0.01) for graphic health warning labels. The corresponding RRs for these post-implementation changes compared with the pre-implementation level were 0.91 (95% CI = 0.83 to 1.00), 0.80 (95% CI = 0.70 to 0.91), and 0.74 (95% CI = 0.61 to 0.90), respectively. Significant associations between tobacco control policies and suicide mortality were observed even when stratified by sex and region. CONCLUSIONS The findings of this study provide new evidence for an association between tobacco control policies and deaths by suicide. An array of effective tobacco control policies should be considered for prevention programs targeting suicide.
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Affiliation(s)
- Taiyue Jin
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi, 10408, South Korea
| | - Juhee Seo
- Vital Statistics Division, Statistics Korea, Daejeon, South Korea
| | - Shinhee Ye
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Incheon, South Korea
| | - Seulbi Lee
- Department of Big Data Strategy, National Health Insurance Service, Wonju, South Korea
| | - Eun Young Park
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Jin-Kyoung Oh
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi, 10408, South Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Changwoo Han
- Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Byungmi Kim
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, 323 Ilsan-Ro, Ilsandong-Gu, Goyang, Gyeonggi, 10408, South Korea.
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea.
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Guo J, Wang L, Zhao X, Wang D, Zhang X. Sex difference in association between suicide attempts and lipid profile in first-episode and drug naive patients with major depressive disorder. J Psychiatr Res 2024; 172:24-33. [PMID: 38354544 DOI: 10.1016/j.jpsychires.2024.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND The relationship between suicide attempts and lipid profiles in patients with major depressive disorder (MDD) remains uncertain. The purpose of this study was to investigate sex differences in the relationship between suicide attempts and plasma lipid profiles in a large sample of first-episode and drug naive (FEDN) MDD patients. METHODS We recruited 1718 FEDN MDD patients and gathered demographic, clinical, and blood lipid data. The Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and the Positive and Negative Syndrome Scale were used to assess the symptoms of patients. RESULTS There was no significant difference in the prevalence of suicide attempts between male and female MDD patients. The suicide attempt group had higher levels of depression, anxiety, psychotic symptoms, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C), but lower levels of high-density lipoprotein cholesterol (HDL-C) levels than the non-suicide attempt group. Binary logistic regression showed that TC levels were significantly correlated with suicidal attempts in both male and female patients. Correlation analysis revealed that the levels of TC, HDL-C and LDL-C were significantly associated with the number of suicide attempts in both male and female patients. Further multiple linear regression revealed that TC levels were significantly associated with the number of suicide attempts in male patients only. CONCLUSIONS Lipid biomarkers, particularly high TC levels, are associated with suicide attempts in both male and female MDD patients. However, there is gender difference in association between lipid biomarkers, especially TC levels, and the number of suicide attempts in MDD patients.
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Affiliation(s)
- Junru Guo
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China; Department of Psychology, Guizhou Minzu University, Guiyang, 550025, China
| | - Li Wang
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Xiaoqing Zhao
- Student Affairs Office, Guizhou University, Guiyang, 550025, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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Gawronska J, Cao C, Wang R, Keon Yon D, Rahmati M, Jewiss M, Smith L. Disparities in the prevalence of suicidal ideation according to oral contraceptive pill use among US women: A cross-sectional study. Health Sci Rep 2024; 7:e2048. [PMID: 38629111 PMCID: PMC11020109 DOI: 10.1002/hsr2.2048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
Background and Aims The relationship between oral contraceptive pill (OCP) and suicidal ideation remains unclear. This study aims to estimate the prevalence of suicidal ideation among US women and evaluate their associates overall and according to OCP use status. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2005-2012 were used to calculate the prevalence and associates of suicidal ideation in women using OCP. Suicidal ideation was assessed using the Patient Health Questionnaire-9. Overall and OCP-specific weighted prevalence of suicidal ideation were estimated. Multivariable logistic regressions were used to investigate overall and OCP-specific associates. Results The prevalence of suicidal ideation was 3.6% with no evident disparity between OCP groups, suggesting that OCP use is not associated with increased prevalence of suicidal ideation. Smoking was inversely associated with suicidal ideation in the former users of OCP. In the overall population, the prevalence of suicidal ideation was greater in those who were: Black or Hispanic, smoking, taking antidepressants, those with lower educational attainment, and women with low and middle income. Conclusion Our findings suggest that OCP use was not associated with increased prevalence of suicidal ideation. Unique associates were identified among different OCP groups.
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Affiliation(s)
- Julia Gawronska
- The Center for Health, Performance and WellbeingAnglia Ruskin UniversityCambridgeUK
| | - Chao Cao
- Department of Medical Oncology Dana‐Farber Cancer InstituteBostonMassachusettsUSA
| | - Ruixuan Wang
- Department of Health Services Research, Management and Policy, College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
| | - Dong Keon Yon
- Department of PediatricsKyung Hee University College of MedicineSeoulRepublic of Korea
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical CenterKyung Hee University College of MedicineSeoulRepublic of Korea
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human SciencesLorestan UniversityKhoramabadIran
- Department of Physical Education and Sport Sciences, Faculty of Literature and HumanitiesVali‐E‐Asr University of RafsanjanRafsanjanIran
| | - Matthew Jewiss
- Cambridge Center for Sport and Exercise SciencesAnglia Ruskin UniversityCambridgeUK
| | - Lee Smith
- The Center for Health, Performance and WellbeingAnglia Ruskin UniversityCambridgeUK
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Lee PH, Tervo-Clemmens B, Liu RT, Gersten MB, Jung JY, Janes AC, Gilman J. Use of Tobacco Products and Suicide Attempts Among Elementary School-Aged Children. JAMA Netw Open 2024; 7:e240376. [PMID: 38407905 PMCID: PMC10897745 DOI: 10.1001/jamanetworkopen.2024.0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Importance The use of tobacco products, including e-cigarettes and vaping, has rapidly increased among children. However, despite consistent associations found between smoking cigarettes and suicidal behaviors among adolescents and adults, there are limited data on associations between emerging tobacco products and suicidal behaviors, especially among preadolescent children. Objective To examine whether the use of tobacco products is associated with nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts (SAs) among preadolescent children. Design, Setting, and Participants This cohort study, conducted from September 1, 2022, to September 5, 2023, included participants in the Adolescent Brain Cognitive Development study, a population-based cohort of 11 868 US children enrolled at 9 and 10 years of age. The cross-sectional investigation focused on 3-year periods starting from the baseline to year 2 of follow-up. Statistical analysis was performed from October 1, 2022, to June 30, 2023. Main Outcomes and Measures Children's use of tobacco products was assessed based on youth reports, including lifetime experiences of various nicotine-related products, supplemented with hair toxicologic tests. Main outcomes were children's lifetime experiences of NSSI, SI, and SAs, assessed using the K-SADS-5 (Kiddie Schedule for Affective Disorders and Schizophrenia for the DSM-5). Multivariate logistic regression was conducted to examine the associations of the use of tobacco products with NSSI, SI, and SAs among the study participants. Sociodemographic, familial, and children's behavioral, temperamental, and clinical outcomes were adjusted in the analyses. Results Of 8988 unrelated study participants (median age, 9.8 years [range, 8.9-11.0 years]; 4301 girls [47.9%]), 101 children (1.1%) and 151 children (1.7%) acknowledged lifetime use of tobacco products at baseline and at 18-month follow-up, respectively. After accounting for various suicide risk factors and potential confounders, children reporting use of tobacco products were at a 3 to 5 times increased risk of SAs (baseline: n = 153 [adjusted odds ratio (OR), 4.67; 95% CI, 2.35-9.28; false discovery rate (FDR)-corrected P < .001]; year 1: n = 227 [adjusted OR, 4.25; 95% CI, 2.33-7.74; FDR-corrected P < .001]; and year 2: n = 321 [adjusted OR, 2.85; 95% CI, 1.58-5.13; FDR-corrected P = .001]). Of all facets of impulsivity measures that were significant correlates of use of tobacco products, negative urgency was the only independent risk factor for SAs (adjusted OR, 1.52 [95% CI, 1.31-1.78]; FDR-corrected P < .001). In contrast, children's alcohol, cannabis, and prescription drug use were not associated with SAs. Conclusions and Relevance This study of US children suggests that the increased risk of SAs, consistently reported for adolescents and adults who smoke cigarettes, extends to a range of emerging tobacco products and manifests among elementary school-aged children. Further investigations are imperative to clarify the underlying mechanisms and to implement effective preventive policies for children.
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Affiliation(s)
- Phil H Lee
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
- Center for Genomic Medicine, Massachusetts General Hospital, Boston
| | - Brenden Tervo-Clemmens
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
- Center for Addiction Medicine, Massachusetts General Hospital, Boston
| | - Richard T Liu
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston
| | - Maia B Gersten
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
- Division of Neuropsychiatry, Massachusetts General Hospital, Boston
| | - Jae-Yoon Jung
- Department of Pediatrics, Stanford University, Stanford, California
| | - Amy C Janes
- Cognitive and Pharmacological Neuroimaging Unit, National Institute on Drug Abuse, Biomedical Research Center, Baltimore, Maryland
| | - Jodi Gilman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston
- Center for Addiction Medicine, Massachusetts General Hospital, Boston
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Minian N, Gayapersad A, Coroiu A, Dragonetti R, Zawertailo L, Zaheer J, O’Neill B, Lange S, Thomson N, Crawford A, Kennedy SH, Selby P. Prototyping the implementation of a suicide prevention protocol in primary care settings using PDSA cycles: a mixed method study. Front Psychiatry 2024; 15:1286078. [PMID: 38333892 PMCID: PMC10850298 DOI: 10.3389/fpsyt.2024.1286078] [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: 08/31/2023] [Accepted: 01/04/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction In Canada, approximately 4,500 individuals die by suicide annually. Approximately 45% of suicide decedents had contact with their primary care provider within the month prior to their death. Current versus never smokers have an 81% increased risk of death by suicide. Those who smoke have additional risks for suicide such as depression, chronic pain, alcohol, and other substance use. They are more likely to experience adverse social determinants of health. Taken together, this suggests that smoking cessation programs in primary care could be facilitators of suicide prevention, but this has not been studied. Study objectives The objectives of the study are to understand barriers/facilitators to implementing a suicide prevention protocol within a smoking cessation program (STOP program), which is deployed by an academic mental health and addiction treatment hospital in primary care clinics and to develop and test implementation strategies to facilitate the uptake of suicide screening and assessment in primary care clinics across Ontario. Methods The study employed a three-phase sequential mixed-method design. Phase 1: Conducted interviews guided by the Consolidated Framework for Implementation Research exploring barriers to implementing a suicide prevention protocol. Phase 2: Performed consensus discussions to map barriers to implementation strategies using the Expert Recommendations for Implementing Change tool and rank barriers by relevance. Phase 3: Evaluated the feasibility and acceptability of implementation strategies using Plan Do Study Act cycles. Results Eleven healthcare providers and four research assistants identified lack of training and the need of better educational materials as implementation barriers. Participants endorsed and tested the top three ranked implementation strategies, namely, a webinar, adding a preamble before depression survey questions, and an infographic. After participating in the webinar and reviewing the educational materials, all participants endorsed the three strategies as acceptable/very acceptable and feasible/very feasible. Conclusion Although there are barriers to implementing a suicide prevention protocol within primary care, it is possible to overcome them with strategies deemed both acceptable and feasible. These results offer promising practice solutions to implement a suicide prevention protocol in smoking cessation programs delivered in primary care settings. Future efforts should track implementation of these strategies and measure outcomes, including provider confidence, self-efficacy, and knowledge, and patient outcomes.
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Affiliation(s)
- Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Allison Gayapersad
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Adina Coroiu
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Laurie Zawertailo
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Juveria Zaheer
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Braden O’Neill
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Shannon Lange
- Institute of Medical Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nicole Thomson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Allison Crawford
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sidney H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Arthur Sommer Rotenberg Program in Suicide Studies, Unity Health Toronto, Toronto, ON, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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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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Schlueter DJ, Sulieman L, Mo H, Keaton JM, Ferrara TM, Williams A, Qian J, Stubblefield O, Zeng C, Tran TC, Bastarache L, Dai J, Babbar A, Ramirez A, Goleva SB, Denny JC. Systematic replication of smoking disease associations using survey responses and EHR data in the All of Us Research Program. J Am Med Inform Assoc 2023; 31:139-153. [PMID: 37885303 PMCID: PMC10746325 DOI: 10.1093/jamia/ocad205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/04/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE The All of Us Research Program (All of Us) aims to recruit over a million participants to further precision medicine. Essential to the verification of biobanks is a replication of known associations to establish validity. Here, we evaluated how well All of Us data replicated known cigarette smoking associations. MATERIALS AND METHODS We defined smoking exposure as follows: (1) an EHR Smoking exposure that used International Classification of Disease codes; (2) participant provided information (PPI) Ever Smoking; and, (3) PPI Current Smoking, both from the lifestyle survey. We performed a phenome-wide association study (PheWAS) for each smoking exposure measurement type. For each, we compared the effect sizes derived from the PheWAS to published meta-analyses that studied cigarette smoking from PubMed. We defined two levels of replication of meta-analyses: (1) nominally replicated: which required agreement of direction of effect size, and (2) fully replicated: which required overlap of confidence intervals. RESULTS PheWASes with EHR Smoking, PPI Ever Smoking, and PPI Current Smoking revealed 736, 492, and 639 phenome-wide significant associations, respectively. We identified 165 meta-analyses representing 99 distinct phenotypes that could be matched to EHR phenotypes. At P < .05, 74 were nominally replicated and 55 were fully replicated. At P < 2.68 × 10-5 (Bonferroni threshold), 58 were nominally replicated and 40 were fully replicated. DISCUSSION Most phenotypes found in published meta-analyses associated with smoking were nominally replicated in All of Us. Both survey and EHR definitions for smoking produced similar results. CONCLUSION This study demonstrated the feasibility of studying common exposures using All of Us data.
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Affiliation(s)
- David J Schlueter
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
- Department of Health and Society, University of Toronto, Scarborough, Toronto, ON, Canada
| | - Lina Sulieman
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Huan Mo
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
- The Cohort Analytics Core (CAC), Center for Precision Health Research, National Human Genome Research Institute, Bethesda, MD, USA
| | - Jacob M Keaton
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Tracey M Ferrara
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Ariel Williams
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Jun Qian
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Onajia Stubblefield
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Chenjie Zeng
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Tam C Tran
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
- The Cohort Analytics Core (CAC), Center for Precision Health Research, National Human Genome Research Institute, Bethesda, MD, USA
| | - Lisa Bastarache
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jian Dai
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Anav Babbar
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Andrea Ramirez
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Slavina B Goleva
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Joshua C Denny
- Precision Health Informatics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
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Paudel K, Gautam K, Bhandari P, Wickersham JA, Dhakal M, Sharma S, Poudel KC, Ha T, Shrestha R. Suicidal ideation, plan, and attempt among men who have sex with men in Nepal: Findings from a cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002348. [PMID: 37992034 PMCID: PMC10664887 DOI: 10.1371/journal.pgph.0002348] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/21/2023] [Indexed: 11/24/2023]
Abstract
Men who have sex with men (MSM) are at increased risk for suicide, with a much higher prevalence of suicidality than the general population. While there is a growing interest in the identification of risk factors for suicidal behaviors globally, the understanding of the prevalence and risk factors for suicidal behaviors among MSM in the context of low- and middle-income countries is almost non-existent. Therefore, this study aimed to investigate suicidal ideation, plan, and attempts, and related factors among MSM in Nepal. A cross-sectional respondent driven survey was conducted on 250 MSM between October and December 2022. Bivariate and multivariable logistic regression was used to evaluate independent correlates of suicidal behaviors of MSM. Overall, the lifetime prevalence of suicidal ideation, plans, and attempts among MSM in this study were 42.4%, 31.2%, and 21.6%, respectively. MSM with depressive symptoms (aOR = 5.7, 95% CI = 2.4-14.1), advanced education (higher secondary and above; aOR = 2.9, 95% CI = 1.4-6.1), and smoking habit (aOR = 2.5, 95% CI = 1.2-5.3) were at increased risk for suicidal ideation. Similarly, those with depressive symptoms (aOR = 2.2, 95% CI = 1.1-4.8) and advanced education (aOR = 2.7, 95% CI = 1.2-5.7) were more likely to plan suicide, whereas young MSM were significantly more prone to attempting suicide (aOR = 2.7, 95% CI = 1.3-5.8). Interestingly, MSM with moderate to severe food insecurity were 2-3 times more likely to think about, plan, or attempt suicide (ideation: aOR = 3.5, 95% CI = 1.6-7.7; plan: aOR = 3.7, 95% CI = 1.6-8.3; attempt: aOR = 2.2, 95% CI = 1.1-4.6). The results suggest the importance of early assessment of suicidal behaviors among MSM and the need for tailored interventions to simultaneously address mental health problems and food insecurity to reduce suicide-related problems among Nepalese MSM.
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Affiliation(s)
- Kiran Paudel
- Nepal Health Frontiers, Tokha-5, Kathmandu, Nepal
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States of America
| | - Kamal Gautam
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States of America
| | | | - Jeffrey A. Wickersham
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America
| | | | | | - Krishna C. Poudel
- Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA, United States of America
- Institute for Global Health, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Toan Ha
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States of America
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America
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11
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Vally Z, Helmy M. The prevalence of suicidal behaviour and its associated risk factors among school-going adolescents resident in the United Arab Emirates. Sci Rep 2023; 13:19937. [PMID: 37968503 PMCID: PMC10651901 DOI: 10.1038/s41598-023-47305-3] [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: 04/25/2023] [Accepted: 11/11/2023] [Indexed: 11/17/2023] Open
Abstract
Suicidal behaviour which includes suicidal ideation, having a plan to commit suicide and suicide attempts remains a global public health issue as it substantially impacts adolescent health and wellbeing. Suicidal behaviour, however, remains understudied in Middle Eastern contexts. This study analysed data from the 2016 Global School-based Student Health Survey collected in the United Arab Emirates (UAE). A sample of 5826 adolescents aged between 11 and 18 years were sampled. Potential risk factors associated with an elevated risk for engagement in suicidal behaviour were examined. These factors were stratified into categories for analysis (demographics, psychosocial, risky health, and socio-environmental). The age-adjusted prevalence of suicidal behaviour amongst the school-going adolescent population in the UAE was 54%. Analyses indicated that elevated risk was significantly associated with anxiety difficulties, the experience of loneliness, and amongst those who smoked tobacco. None of the socio-environmental factors emerged as significant. A dose-dependent relationship was evident in that the degree of risk that was evident appeared to compound as the number of adverse risk factors increased. The data suggest that suicidal behaviour may be highly prevalent in this location. Findings highlight the immense need to develop preventative interventions, some of which may be school-delivered and targeted at parents. Our findings provide initial indications as to which risk factors could be targeted for remediation in developing these interventions.
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Affiliation(s)
- Zahir Vally
- Department of Clinical Psychology, United Arab Emirates University, Al Ain, P. O. Box 15551, Abu Dhabi, United Arab Emirates.
| | - Mai Helmy
- Department of Psychology, Sultan Qaboos University, Al-Khod, Sultanate of Oman
- Psychology Department, Faculty of Arts, Menoufia University, Shebin El-Kom, Egypt
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12
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Themelis K, Gillett JL, Karadag P, Cheatle MD, Giordano NA, Balasubramanian S, Singh SP, Tang NK. Mental Defeat and Suicidality in Chronic Pain: A Prospective Analysis. THE JOURNAL OF PAIN 2023; 24:2079-2092. [PMID: 37392929 DOI: 10.1016/j.jpain.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/12/2023] [Accepted: 06/25/2023] [Indexed: 07/03/2023]
Abstract
Living with chronic pain has been identified as a significant risk factor for suicide. Qualitative and cross-sectional studies have reported an association between mental defeat and suicidal thoughts and behavior in patients with chronic pain. In this prospective cohort study, we hypothesized that higher levels of mental defeat would be associated with increased suicide risk at a 6-month follow-up. A total of 524 patients with chronic pain completed online questionnaires measuring variables related to suicide risk, mental defeat, sociodemographic, psychological, pain, activity, and health variables. At 6 months, 70.8% (n = 371) of respondents completed the questionnaires again. Weighted univariate and multivariable regression models were run to predict suicide risk at 6 months. The clinical suicide risk cutoff was met by 38.55% of the participants at baseline and 36.66% at 6 months. Multivariable modeling revealed that mental defeat, depression, perceived stress, head pain, and active smoking status significantly increased the odds of reporting higher suicide risk, while older age reduced the odds. Receiver operating characteristic (ROC) analysis showed that assessment of mental defeat, perceived stress, and depression is effective in discriminating between 'low' and 'high' suicide risk. Awareness of the prospective links from mental defeat, depression, perceived stress, head pain, and active smoking status to increased suicide risk in patients with chronic pain may offer a novel avenue for assessment and preventative intervention. PERSPECTIVE: Results from this prospective cohort study suggest that mental defeat is a significant predictor of increased suicide risk among patients with chronic pain, along with depression, perceived stress, head pain, and active smoking status. These findings offer a novel avenue for assessment and preventative intervention before risk escalates.
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Affiliation(s)
- Kristy Themelis
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Jenna L Gillett
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Paige Karadag
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Martin D Cheatle
- Department of Psychiatry and Anaesthesiology and Critical Care, Perelman School of Medicine University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nicholas A Giordano
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States
| | | | - Swaran P Singh
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom; Mental Health and Wellbeing, University of Warwick, Warwick Medical School, Coventry, United Kingdom
| | - Nicole Ky Tang
- Department of Psychology, University of Warwick, Coventry, United Kingdom
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13
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Akinyemi O, Ogundare T, Oladunjoye AF, Nasef KE, Lipscombe C, Akinbote JA, Bezold M. Factors associated with suicide/self-inflicted injuries among women aged 18-65 years in the United States: A 13-year retrospective analysis of the National Inpatient Sample database. PLoS One 2023; 18:e0287141. [PMID: 37788271 PMCID: PMC10547191 DOI: 10.1371/journal.pone.0287141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/30/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Suicide is a significant cause of mortality in the United States, accounting for 14.5 deaths/100,000. Although there are data on gender disparity in suicide/self-inflicted injury rates in the United States, few studies have examined the factors associated with suicide/self-inflicted injury in females. OBJECTIVE To determine factors associated with suicide/self-inflicted injuries among women aged 18-65 years in the United States. METHODS Hospitalizations for suicide or self-inflicted injuries were identified using the National Inpatient Sample database from 2003-2015 using sample weights to generate national estimates. Independent predictors of suicide/self-inflicted injuries were identified using multivariable regression models. Interaction term analysis to identify the interaction between race/ethnicity and income were conducted. RESULTS There were 1,031,693 adult women hospitalizations in the U.S. with a primary diagnosis of suicide/self-inflicted injury in the study period. The highest suicide/self-inflicted injury risk was among women aged 31-45years (OR = 1.23, CI = 1.19-1.27, p < 0.05). Blacks in the highest income strata had a 20% increase in the odds of suicide/self-inflicted injury compared to Whites in the lowest socioeconomic strata (OR = 1.20, CI = 1.05-1.37, p <0.05). Intimate partner violence increased suicide/self-inflicted injury risk 6-fold (OR = 5.77, CI = 5.01-6.65, p < 0.05). CONCLUSION Suicide risk is among women aged 31-45 years, higher earning Black women, intimate partner violence victims, uninsured, and current smokers. Interventions and policies that reduce smoking, prevents intimate partner violence, addresses racial discrimination and bias, and provides universal health coverage are needed to prevent excess mortality from suicide deaths.
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Affiliation(s)
- Oluwasegun Akinyemi
- Clive O Callender Department of Surgery, Howard University, Washington, D.C., United States of America
| | - Temitope Ogundare
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States of America
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States of America
| | - Adeolu Funsho Oladunjoye
- Department of Obstetrics and Gynecology, Howard University, Washington, D.C., United States of America
| | - Kindha Elleissy Nasef
- Department of Obstetrics and Gynecology, Howard University, Washington, D.C., United States of America
| | - Christina Lipscombe
- Department of Obstetrics and Gynecology, Howard University, Washington, D.C., United States of America
| | - John Akinshola Akinbote
- Department of Obstetrics and Gynecology, Howard University, Washington, D.C., United States of America
| | - Maureen Bezold
- Department of Health Sciences and Social Work, Western Illinois University, Macomb, Illinois, United States of America
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14
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Kim SR, Kim JY, Kim HK, Kim HY. Factors Influencing Sleep Disturbances in Adolescent Smokers in South Korea. J Addict Nurs 2023; 34:E172-E179. [PMID: 38015585 DOI: 10.1097/jan.0000000000000468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
ABSTRACT This study aimed to describe sleep disturbances and identify associated factors in adolescent smokers in South Korea. This study adopted a cross-sectional design and recruited 520 students aged 12-17 years from 35 schools to participate in a smoking cessation program. To compare demographic, smoking-related, psychological, and problem behavior characteristics between adolescent smokers with sleep disturbances and without sleep disturbances, chi-square tests and independent t tests were used. Logistic regression analysis was performed to identify the factors associated with sleep disturbances in adolescent smokers. Approximately 45.8% of adolescent smokers reported sleep disturbances. Sleep disturbances were more frequent among girls than among boys and more frequent among high school students than among middle school students. Other factors included cigarette use within 1 month, nicotine dependence, smoking cessation self-efficacy, depression, Internet addiction, and suicidal ideation. Gender (girls), school level (high school), depression, Internet addiction, and daily cigarette use (11 or more cigarettes) were significantly associated with sleep disturbances in adolescent smokers. To improve the sleep quality of adolescent smokers, health professionals should focus on sleep disturbances and associated factors and develop appropriate intervention programs.
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15
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Muroi K, Ishitsuka M, Hori D, Doki S, Ikeda T, Takahashi T, Sasahara S, Matsuzaki I. A high sense of coherence can mitigate suicidal ideation associated with insomnia. HEALTH PSYCHOLOGY REPORT 2023; 11:309-320. [PMID: 38178965 PMCID: PMC10762302 DOI: 10.5114/hpr/163068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 01/02/2023] [Accepted: 04/05/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND The present study aimed to investigate whether insomnia is associated with suicidal ideation (SI) among Japanese workers by conducting a multi-level analysis with sense of coherence (SOC) as a random effect. PARTICIPANTS AND PROCEDURE A cross-sectional survey was conducted among 19,481 workers in Tsukuba, Japan. Data from 7,175 participants aged 20-65 years were included in the analysis. The Athens Insomnia Scale (AIS) was used as the independent variable, and SI over the past year was used as the dependent variable. SOC was measured using the five-point SOC-13 scale, and socioeconomic and health factors were investigated as covariates. Participants were divided into three groups (low, medium, and high) based on their SOC scores. Multilevel logistic regression analysis was performed to calculate odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS In the high-SOC group, only one person had SI. In a multi-level logistic analysis that excluded the high SOC group, insomnia was found to be associated with SI (OR = 2.26, 95% CI [1.75, 2.93]). Furthermore, the AIS sub-items "Final awakening earlier than desired" (OR = 1.26, 95% CI [1.05, 1.50]) and "Sense of well-being during the day" (OR = 1.63, 95% CI [1.34, 1.99]) were associated with SI. 8.95% or 11% of the variation in the presence or absence of SI was found to be explained by differences between SOC groups. CONCLUSIONS The study highlights that insomnia is associated with SI, and that high SOC may reduce SI even under insomnia. Future longitudinal studies are needed to confirm whether high SOC reduces SI due to insomnia.
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Affiliation(s)
- Kei Muroi
- University of Tsukuba, Tsukuba, Japan
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16
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Lee J, Song K, Jeon S, Lee HS, Lee S, Kim HS, Chae HW. Association of maternal mental health and drinking/smoking with adolescents' mental health based on the Korea National Health and Nutrition Examination Survey. Front Psychiatry 2023; 14:1087300. [PMID: 37415692 PMCID: PMC10321712 DOI: 10.3389/fpsyt.2023.1087300] [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: 11/02/2022] [Accepted: 05/05/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Depression is one of the major concerns in adolescence, with a global prevalence of approximately 5%. Diverse environmental factors can affect the development of depression depending on the individual developmental stage. Methods Using data from the Korea National Health and Nutrition Examination Survey (KNHANES), we aimed to investigate the association between socioeconomic factors and mental health in a population of non-clinically ill adolescents in Korea totaling 6,261 adolescents aged 12-18 years. Results Drinking, smoking, stress, depressed mood, suicidal ideation in adolescents, and stress, depressed mood, and suicidal ideation in mothers were identified as factors associated with adolescent depression. In addition to depressed mood and suicidal ideation, the higher perception of stress in mothers was related to higher stress perception, depressed mood, and suicidal ideation in adolescents. The association of adolescents' mental health with fathers' mental health was weaker than that with mothers' mental health. Additionally, increased smoking and drinking were commonly reported in adolescents with higher stress perception, depressed mood, and suicidal ideation. Discussion We conclude that close monitoring of mental health is required for adolescents with drinking and smoking habits and mothers with mental health problems.
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Affiliation(s)
- Junghan Lee
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungchul Song
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Soyoung Jeon
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - San Lee
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ho-Seong Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun Wook Chae
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
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17
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Michalek IM, Caetano Dos Santos FL, Wojciechowska U, Didkowska J. Risk of suicide in patients with cancer aged 75 years or more - Follow-up of over 400,000 individuals. Maturitas 2023; 175:107785. [PMID: 37348282 DOI: 10.1016/j.maturitas.2023.107785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/04/2023] [Accepted: 06/07/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND It is well established that older patients with cancer have a significantly higher risk of suicide. However, a comprehensive understanding of the risk factors is lacking. In this study, we aimed to identify groups at an increased risk of suicide among patients aged ≥75 years with a previous cancer diagnosis. MATERIAL AND METHODS All Polish individuals diagnosed with cancer at the age of ≥75 years between 1 January 2009 and 31 December 2019 were included in this study. Standardized mortality ratios (SMRs) and 95 % confidence intervals (CIs) were calculated. RESULTS A total of 410,440 patients (211,730 men and 198,710 women) were included in this study. SMR for both sexes was 1.64 (95 % CI 1.43-1.87). When analyzed by sex, a significantly higher risk was observed only in men (SMR 1.70, 95 % CI 1.47-1.95). Among them, the risk of suicide was observed after the diagnosis of lymphoma (2.83, 1.14-5.82), lung cancer (2.63, 1.70-3.89), kidney cancer (2.16, 1.03-3.96), colorectal cancer (1.96, 1.41-2.65), urinary tract cancer (1.86, 1.22-2.70), and prostate cancer (1.40, 1.07-1.82). The highest risk of suicide in men was observed within 6 months of diagnosis (2.83, 2.11-3.71). CONCLUSIONS Men diagnosed with cancer at ≥75 years of age are at a higher risk of suicide than men of the same age in the general population. The observations from this study suggest which are the most vulnerable groups of elderly patients with cancer, and the time at which they should be given special support.
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Affiliation(s)
- Irmina Maria Michalek
- Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
| | | | - Urszula Wojciechowska
- Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Joanna Didkowska
- Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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18
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Lifestyle factors and suicide risk: A nationwide population-based study. J Affect Disord 2023; 328:215-221. [PMID: 36806600 DOI: 10.1016/j.jad.2023.02.044] [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: 05/23/2022] [Revised: 01/27/2023] [Accepted: 02/11/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVE To examine the association between lifestyle factors and suicide-related outcomes. METHODS Data from the Korea National Health and Nutrition Examination Survey in 2015 and 2017 were used. We identified lifestyle factors including smoking, physical activity, alcohol intake, and the Healthy Eating Index (HEI) in 9529 eligible subjects. We analyzed the risk of suicidal ideation, plan, attempt, and the composite of suicidality within the past year according to the lifestyle factors. In addition, stratified analyses were performed according to the diagnostic history of depression. RESULTS Compared to never-smokers, ex-smokers and current smokers showed an increased risk of suicidal ideation, suicidal plan, and the composite of suicidality. Compared to the low HEI group, those with the highest HEI showed a decreased risk of suicide ideation and the composite of suicidality. Among those with depression, the increased risk of suicide-related outcomes from smoking was more prominent and heavy drinking was associated with an increased risk of suicide attempts. CONCLUSION Smoking and heavy drinking were associated with an increased risk of suicide-related outcomes, but high-quality diets and non-heavy drinking were associated with a decreased risk. In people with depression, the associations between lifestyle factors and suicide-related outcomes were stronger than in those without depression.
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19
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Kan B, Hou J, Leslie WD, Jiang D, Zhang J, Yang S. Associations of estrogen therapy and non-estrogen anti-resorptive therapy with diabetes mellitus risk: A classical and Bayesian meta-analysis. Bone 2023; 171:116738. [PMID: 36933854 DOI: 10.1016/j.bone.2023.116738] [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: 10/17/2022] [Revised: 02/27/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Anti-resorptive therapy (AT) increases insulin resistance and decrease insulin secretion through reduced undercarboxylated osteocalcin in mice. However, there are inconsistent findings regarding the impact of AT use on the risk of diabetes mellitus in humans. We examined the association between AT and incident diabetes mellitus using classical and Bayesian meta-analysis. We searched Pubmed, Medline, Embase, Web of Science, Cochrane, and Google Scholar for studies listed from database inception to 25 February 2022. Randomized controlled trials (RCTs) and cohort studies reporting associations of estrogen therapy (ET) and non-estrogen anti-resorptive therapy (NEAT) with incident diabetes mellitus were included. Two reviewers independently extracted research data such as ET and NEAT, diabetes mellitus, risk ratios (RRs), and 95 % confidence intervals (CIs) for incident diabetes mellitus associated with ET and NEAT from individual studies. This meta-analysis included data from nineteen original studies, consisting of fourteen ET and five NEAT studies. ET was associated with reduced risk of diabetes mellitus in the classical meta-analysis (RR: 0.90; 95 % CI: 0.81-0.99). Slightly stronger results were found in the meta-analysis of RCTs (RR: 0.83; 95 % CI: 0.77-0.89). The probability that RR < 1.0 was 95 % in the overall analysis and 99 % in RCTs under weakly informative prior. Although NEAT was associated with reduced risk of diabetes mellitus overall (RR: 0.80; 95 % CI: 0.67-0.97), this was not found in the RCT meta-analysis (RR: 0.90; 95 % CI: 0.75-1.10). Under weakly informative prior, the probabilities that NEAT reduces diabetes mellitus by >0 % were 99 %, and 73 % in the overall and RCT meta-analysis, respectively. In conclusion, meta-analysis provided consistent evidence against the hypothesis that AT increases diabetes risk. ET may reduce the risk of diabetes mellitus. Whether NEAT reduces the risk of diabetes mellitus is uncertain and requires additional evidence from RCTs.
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Affiliation(s)
- Bo Kan
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Jiaoyu Hou
- Department of Geriatrics, The First Hospital of Jilin University, Changchun, Jilin, China
| | - William D Leslie
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Depeng Jiang
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Juan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Shuman Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
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Identification of Risk Factors for Suicide and Insights for Developing Suicide Prevention Technologies: A Systematic Review and Meta-Analysis. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2023. [DOI: 10.1155/2023/3923097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Suicide is a termite that engulfs close to seven hundred thousand people worldwide each year. Existing work on risk factors that predict suicide lacks statistical associations, does not consider most countries, and has a wide range of risk factor domains. The goal of this systematic review and meta-analysis is to enhance our current understanding of suicidality by identifying risk factors that are most strongly associated with suicide and their impact on developing technological interventions for suicide prevention. A search strategy was carried out on four databases: (1) PsycINFO, (2) IEEE Xplore, (3) the ACM Digital Library, and (4) PubMed, and twenty-five studies were included based on the inclusion criteria. Factors statistically associated with suicide are any diagnosed mental disorder, adverse life events, past suicide attempts, low education level, loneliness or high levels of isolation, bipolar disorder, depression, multiple chronic health conditions, family history of suicide, sexual trauma, and being female. Domain-wise, comorbid disorders, and behavior-related risk factors are most strongly associated with suicide. We present a new hierarchical model of risk factors for suicide that advances our understanding of suicide and its causes. Finally, we present open research directions and considerations for developing suicide prevention technologies.
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Campos AI, Garcia-Marin LM, Christensen H, Batterham PJ, van Velzen LS, Schmaal L, Rabinowitz JA, Jahanshad N, Martin NG, Cuellar-Partida G, Ruderfer D, Mullins N, Rentería ME. Genomics-driven screening for causal determinants of suicide attempt. Aust N Z J Psychiatry 2023; 57:423-431. [PMID: 35403454 DOI: 10.1177/00048674221091499] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Each year, around one million people die by suicide. Despite its recognition as a public health concern, large-scale research on causal determinants of suicide attempt risk is scarce. Here, we leverage results from a recent genome-wide association study (GWAS) of suicide attempt to perform a data-driven screening of traits causally associated with suicide attempt. METHODS We performed a hypothesis-generating phenome-wide screening of causal relationships between suicide attempt risk and 1520 traits, which have been systematically aggregated on the Complex-Traits Genomics Virtual Lab platform. We employed the latent causal variable (LCV) method, which uses results from GWAS to assess whether a causal relationship can explain a genetic correlation between two traits. If a trait causally influences another one, the genetic variants that increase risk for the causal trait will also increase the risk for the outcome inducing a genetic correlation. Nonetheless, a genetic correlation can also be observed when traits share common pathways. The LCV method can assess whether the pattern of genetic effects for two genetically correlated traits support a causal association rather than a shared aetiology. RESULTS Our approach identified 62 traits that increased risk for suicide attempt. Risk factors identified can be broadly classified into (1) physical health disorders, including oesophagitis, fibromyalgia, hernia and cancer; (2) mental health-related traits, such as depression, substance use disorders and anxiety; and (3) lifestyle traits including being involved in combat or exposure to a war zone, and specific job categories such as being a truck driver or machine operator. CONCLUSIONS Suicide attempt risk is likely explained by a combination of behavioural phenotypes and risk for both physical and psychiatric disorders. Our results also suggest that substance use behaviours and pain-related conditions are associated with an increased suicide attempt risk, elucidating important causal mechanisms that underpin this significant public health problem.
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Affiliation(s)
- Adrian I Campos
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
| | - Luis M Garcia-Marin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Laura S van Velzen
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Lianne Schmaal
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina Del Rey, CA, USA
| | - Nicholas G Martin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Gabriel Cuellar-Partida
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Douglas Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Niamh Mullins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Miguel E Rentería
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
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22
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[What is the contribution of smoking to the increased risk of suicide in young smokers? A systematic review]. L'ENCEPHALE 2023; 49:72-86. [PMID: 36253173 DOI: 10.1016/j.encep.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The correlation between smoking and suicide is well documented in the general population: there is an increased risk of suicide among tobacco smokers. However, the association between smoking and suicidal behaviors (ideations, plans, attempts) in youth is poorly elucidated. This is a systematic review of the literature examined data on the relationship between active and passive smoking and suicidal ideation (SI), suicide planning (SP), and suicide attempts (SA) among youth in the general population. METHOD Medline searches were performed for the period 1980-2020. Cross-sectional, case-control, prospective population-based studies of young people (age less than 18 years) were included in this review; studies of specific populations (patients with an identified pathology of any kind) were excluded. RESULTS This review included 43 studies: 23 studies on the association between active smoking and SI, SI and/or PS, TS; three studies on the association between passive smoking and suicidal behavior, three studies on the association between smoking and suicidal behavior in young people in psychiatric hospital settings, and five studies comparing the suicidal behavior of girls and boys. Analysis of the data collected lead to the conclusion that active or passive smoking is associated with suicidal behavior in young people. Smoking appears to contribute to psychopathological disorders, including depression, the use of other psychoactive substances, or psychosocial suffering which are often associated with an increased risk of suicide in young people. The correlations between smoking and the presence of mental disorders have been highlighted; tobacco use may contribute to the development of depression, anxiety and stress. Further studies are needed to verify the existence of a causal link between smoking and suicide. CONCLUSION Smoking is associated with the risk of suicidal behavior in young people; it should be included among the criteria for assessing suicidal risk in youth. Smoking cessation, which improves psychological well-being, should be further integrated into the prevention of suicidal behavior.
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23
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Adviento BA, Regan EA, Make BJ, Han MK, Foreman MG, Iyer AS, Bhatt SP, Kim V, Bon J, Soler X, Kinney GL, Hanania NA, Lowe KE, Holm KE, Yohannes AM, Shinozaki G, Hoth KF, Fiedorowicz JG. Clinical Markers Associated With Risk of Suicide or Drug Overdose Among Individuals With Smoking Exposure: A Longitudinal Follow-up Study of the COPDGene Cohort. Chest 2023; 163:292-302. [PMID: 36167120 PMCID: PMC10083129 DOI: 10.1016/j.chest.2022.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/11/2022] [Accepted: 09/03/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Studies have shown that COPD and smoking are associated with increased suicide risk. To date, there are no prospective studies examining suicide risk among individuals with smoking exposure along a spectrum of pulmonary diseases ranging from normal spirometry to severe COPD. RESEARCH QUESTION Which clinical variables predict death by suicide or overdose of indeterminate intent in a large cohort of individuals with smoking exposure within the Genetic Epidemiology of COPD (COPDGene) study? STUDY DESIGN AND METHODS We studied data from 9,930 participants involved in COPDGene, a multisite, prospective cohort study of individuals with smoking exposure. Primary cause of adjudicated deaths was identified by using death certificates, family reports, and medical records. Time to death by suicide/overdose was examined as the primary outcome in Cox regression models including age, sex, race, BMI, pack-years, current smoking status, airflow limitation (FEV1 % predicted), dyspnea (modified Medical Research Council scale score ≥ 2), 6-min walk distance, supplemental oxygen use, and severe exacerbations in the prior year with time-varying covariates and other causes of death as a competing risk. RESULTS The cohort was 47% female and 33% Black (67% White); they had a mean ± SD age of 59.6 ± 9.0 years and a mean FEV1 % predicted of 76.1 ± 25.5. Sixty-three individuals died by suicide/overdose. Factors associated with risk of suicide/overdose were current smoking (hazard ratio [HR], 6.44; 95% CI, 2.64-15.67), use of sedative/hypnotics (HR, 2.33; 95% CI, 1.24-4.38), and dyspnea (HR, 2.23; 95% CI, 1.34-3.70). Lower risk was associated with older age (per-decade HR, 0.45; 95% CI, 0.31-0.67), higher BMI (HR, 0.95; 95% CI, 0.91-0.99), and African-American race (HR, 0.41; 95% CI, 0.23-0.74). Severity of airflow limitation (FEV % predicted) was not associated with suicide risk. INTERPRETATION In this well-characterized cohort of individuals with smoking exposure with and without COPD, risk factors for suicide/overdose were identified that emphasize the subjective experience of illness over objective assessments of lung function.
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Affiliation(s)
- Brigid A Adviento
- Department of Psychiatry, University of Iowa, Iowa City, IA; Department of Internal Medicine, University of Iowa, Iowa City, IA
| | - Elizabeth A Regan
- Division of Rheumatology, Department of Medicine, National Jewish Health, Denver, CO
| | - Barry J Make
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO; Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Marilyn G Foreman
- Pulmonary and Critical Care Medicine Division, Morehouse School of Medicine, Atlanta, GA
| | - Anand S Iyer
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL
| | - Surya P Bhatt
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL
| | - Victor Kim
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Jessica Bon
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Xavier Soler
- Department of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA
| | - Gregory L Kinney
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO
| | - Nicola A Hanania
- Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX
| | - Katherine E Lowe
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Kristen E Holm
- Division of Neurology and Behavioral Health, National Jewish Health, Denver, CO; Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Aurora, CO
| | | | - Gen Shinozaki
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA
| | - Karin F Hoth
- Department of Psychiatry, University of Iowa, Iowa City, IA; Iowa Neuroscience Institute, University of Iowa, Iowa City, IA.
| | - Jess G Fiedorowicz
- Ottawa Hospital, Ottawa Hospital Research Institute, and University of Ottawa, Ottawa, Ontario, Canada
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24
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Li QS, Shabalin AA, DiBlasi E, Gopal S, Canuso CM, Palotie A, Drevets WC, Docherty AR, Coon H. Genome-wide association study meta-analysis of suicide death and suicidal behavior. Mol Psychiatry 2023; 28:891-900. [PMID: 36253440 PMCID: PMC9908547 DOI: 10.1038/s41380-022-01828-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/22/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
Suicide is a worldwide health crisis. We aimed to identify genetic risk variants associated with suicide death and suicidal behavior. Meta-analysis for suicide death was performed using 3765 cases from Utah and matching 6572 controls of European ancestry. Meta-analysis for suicidal behavior using data across five cohorts (n = 8315 cases and 256,478 psychiatric or populational controls of European ancestry) was also performed. One locus in neuroligin 1 (NLGN1) passing the genome-wide significance threshold for suicide death was identified (top SNP rs73182688, with p = 5.48 × 10-8 before and p = 4.55 × 10-8 after mtCOJO analysis conditioning on MDD to remove genetic effects on suicide mediated by MDD). Conditioning on suicidal attempts did not significantly change the association strength (p = 6.02 × 10-8), suggesting suicide death specificity. NLGN1 encodes a member of a family of neuronal cell surface proteins. Members of this family act as splice site-specific ligands for beta-neurexins and may be involved in synaptogenesis. The NRXN-NLGN pathway was previously implicated in suicide, autism, and schizophrenia. We additionally identified ROBO2 and ZNF28 associations with suicidal behavior in the meta-analysis across five cohorts in gene-based association analysis using MAGMA. Lastly, we replicated two loci including variants near SOX5 and LOC101928519 associated with suicidal attempts identified in the ISGC and MVP meta-analysis using the independent FinnGen samples. Suicide death and suicidal behavior showed positive genetic correlations with depression, schizophrenia, pain, and suicidal attempt, and negative genetic correlation with educational attainment. These correlations remained significant after conditioning on depression, suggesting pleiotropic effects among these traits. Bidirectional generalized summary-data-based Mendelian randomization analysis suggests that genetic risk for the suicidal attempt and suicide death are both bi-directionally causal for MDD.
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Affiliation(s)
- Qingqin S Li
- Neuroscience, Janssen Research & Development, Titusville, NJ, 08560, USA.
- R&D Data Science, Janssen Research & Development, Titusville, NJ, 08560, USA.
| | - Andrey A Shabalin
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84112, USA
| | - Emily DiBlasi
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84112, USA
| | - Srihari Gopal
- Neuroscience, Janssen Research & Development, Titusville, NJ, 08560, USA
- Regeneron Pharmaceuticals Inc, Tarrytown, NY, 10591, USA
| | - Carla M Canuso
- Neuroscience, Janssen Research & Development, Titusville, NJ, 08560, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Wayne C Drevets
- Neuroscience, Janssen Research & Development, San Diego, CA, 92121, USA
| | - Anna R Docherty
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84112, USA
- Virginia Institute for Psychiatric & Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Hilary Coon
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84112, USA
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Kukoyi O, Orok E, Oluwafemi F, Oni O, Oluwadare T, Ojo T, Bamitale T, Jaiyesimi B, Iyamu D. Factors influencing suicidal ideation and self-harm among undergraduate students in a Nigerian private university. MIDDLE EAST CURRENT PSYCHIATRY 2023. [DOI: 10.1186/s43045-022-00274-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Abstract
Background
Suicide and self-harm have been documented as the main cause of death among young adults. Nigeria as well as other low-income countries is reported to have a higher prevalence rate of suicidal ideation and self-harm as compared to high-income countries. The aim of this study was to evaluate the factors that influence self-harm and suicidal ideation among university undergraduates.
Results
Four hundred fifty students consented to participate in this study where 61.3% were female with mean age of 20.02 + 1.88 years. More than 46% (208) had moderate social support while 80.4% had a high self-esteem and 72.7% low environmental factor scores. There was an association between self-esteem (p=0.001), social support (p<0.001), and self-harm but no association between social support and suicide ideation (p=0.199) as well as between gender and self-harm (p=0.118).
Conclusions
There was some form of influence from self-esteem, social support, and environmental factors on self-harm and suicidal ideation. Interventions tailored towards these factors in order to improve mental health outcomes among undergraduates are needed.
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Welty CW, Gerald LB, Nair US, Haynes PL. Vaping and Sleep as Predictors of Adolescent Suicidality. Am J Health Promot 2023; 37:39-46. [PMID: 35786017 DOI: 10.1177/08901171221112027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE To investigate sleep quantity as a moderator of vaping and self-reported suicidality among adolescents. DESIGN Cross-sectional. Setting: United States high schools. SAMPLE 10,520 high-school students with complete data on the primary outcome of suicide attempt in the past year (76.9% response rate). MEASURES 2019 Youth Risk Behaviors Survey. ANALYSIS Logistic regression to examine main effects and potential moderation. RESULTS Students with under seven sleep hours on school nights (OR = 2.6; 95% CI = 2.1-3.3) and who vaped in the past month (OR = 3.0; 95% CI = 2.1-3.9) had higher odds of attempting suicide in the last year. Sleep quantity moderated the relationship between vaping and suicidal thoughts in the past year (P = .01) but did not moderate the relationship between vaping and a suicide plan (P = .15) or suicide attempts (P = .06). Specifically, vaping had a smaller effect on suicidal thoughts among students who slept under seven hours on school nights (OR = 1.8) compared to the descriptively larger effect among participants with more sleep (OR = 2.5). CONCLUSIONS Students who vape or report low sleep quantity would be ideal participants in suicide prevention interventions as they may be at higher risk for suicidality. Organizations implementing sleep or vaping interventions should incorporate information regarding the higher odds of suicide among students with low sleep quantity or vaping habits.
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Affiliation(s)
- Cody W Welty
- Health Promotion Sciences, 48710Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Lynn B Gerald
- Health Promotion Sciences, 48710Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Uma S Nair
- Department of Family and Community Medicine, 12216College of Medicine-Tucson, Tucson, AZ, USA
| | - Patricia L Haynes
- Health Promotion Sciences, 48710Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
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27
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Kootbodien T, London L, Martin LJ, Defo J, Ramesar R. The shared genetic architecture of suicidal behaviour and psychiatric disorders: A genomic structural equation modelling study. Front Genet 2023; 14:1083969. [PMID: 36959830 PMCID: PMC10028147 DOI: 10.3389/fgene.2023.1083969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/09/2023] [Indexed: 03/09/2023] Open
Abstract
Background: Suicidal behaviour (SB) refers to behaviours, ranging from non-fatal suicidal behaviour, such as suicidal ideation and attempt, to completed suicide. Despite recent advancements in genomic technology and statistical methods, it is unclear to what extent the spectrum of suicidal behaviour is explained by shared genetic aetiology. Methods: We identified nine genome-wide association statistics of suicidal behaviour (sample sizes, n, ranging from 62,648 to 125,844), ten psychiatric traits [n up to 386,533] and collectively, nine summary datasets of anthropometric, behavioural and socioeconomic-related traits [n ranging from 58,610 to 941,280]. We calculated the genetic correlation among these traits and modelled this using genomic structural equation modelling, identified shared biological processes and pathways between suicidal behaviour and psychiatric disorders and evaluated potential causal associations using Mendelian randomisation. Results: Among populations of European ancestry, we observed strong positive genetic correlations between suicide ideation, attempt and self-harm (rg range, 0.71-1.09) and moderate to strong genetic correlations between suicidal behaviour traits and a range of psychiatric disorders, most notably, major depression disorder (rg = 0.86, p = 1.62 × 10-36). Multivariate analysis revealed a common factor structure for suicidal behaviour traits, major depression, attention deficit hyperactivity disorder (ADHD) and alcohol use disorder. The derived common factor explained 38.7% of the shared variance across the traits. We identified 2,951 genes and 98 sub-network hub genes associated with the common factor, including pathways associated with developmental biology, signal transduction and RNA degradation. We found suggestive evidence for the protective effects of higher household income level on suicide attempt [OR = 0.55 (0.44-0.70), p = 1.29 × 10-5] and while further investigation is needed, a nominal significant effect of smoking on suicide attempt [OR = 1.24 (1.04-1.44), p = 0.026]. Conclusion: Our findings provide evidence of shared aetiology between suicidal behaviour and psychiatric disorders and indicate potential common molecular mechanisms contributing to the overlapping pathophysiology. These findings provide a better understanding of the complex genetic architecture of suicidal behaviour and have implications for the prevention and treatment of suicidal behaviour.
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Affiliation(s)
- Tahira Kootbodien
- UCT/MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute for Infectious Diseases and Molecular Medicine, University of Cape Town and Affiliated Hospitals, Cape Town, South Africa
- *Correspondence: Tahira Kootbodien,
| | - Leslie London
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Lorna J. Martin
- Division of Forensic Medicine and Toxicology, Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Joel Defo
- UCT/MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute for Infectious Diseases and Molecular Medicine, University of Cape Town and Affiliated Hospitals, Cape Town, South Africa
| | - Raj Ramesar
- UCT/MRC Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, Institute for Infectious Diseases and Molecular Medicine, University of Cape Town and Affiliated Hospitals, Cape Town, South Africa
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28
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Manouchehri A, Marznaki ZH, Atim LM, Mohammadian amiri M, Kaggwa MM. The relationship between causes of suicidal attempts in Iran and individual and social variables: a retrospective study. BMC Psychiatry 2022; 22:780. [PMID: 36503535 PMCID: PMC9743690 DOI: 10.1186/s12888-022-04449-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Determine the prevalence of suicide attempts and the relationships between the different causes of attempts with sociodemographic and clinical characteristics among individuals in Iran. METHODS A retrospective review of data about suicide attempts from poisoning care centers in Babol city between 2017 and 2021. Multinomial regression analysis (with mental illness being the reference variable) was used to determine the factors associated with the different causes of suicide attempts (addiction, romantic relationship problems, and economic problems). RESULTS The overall prevalence of completed suicide in the population sampled was 10.8% (95% confidence interval 9.5-12.1) (244/2,263). Relative to mental disorder, given that other variables in the model are held constant the following were associated with suicide attempts. A previous history of suicide attempts was associated with increasing the relative risk ratio of attempting suicide while having no positive history of smoking was associated with reducing the relative risk ratio of a suicidal attempt. However, the use of multiple drugs to attempt suicide was associated with an increased relative risk ratio of attempting suicide with romantic relationship problems and addiction as causes of suicide attempts. The first year of data collection (2017) and the female gender were both associated with an increased relative risk ratio of having a suicide attempt due to romantic relationships and economic problems. A family history of suicide was associated with an increased relative risk ratio of suicide attempts due to romantic relationship problems. However, using Pesticides-aluminum phosphide and detergent and javel water to attempt reduced the relative risk ratio of attempting due to romantic relationship problems. Age, self-employment, middle income, and married were associated with an increased relative risk ratio of suicide attempts among individuals due to addiction. However, staying longer at the emergency department was associated with a reduced relative risk ratio of having had a suicide attempt due to addiction. CONCLUSIONS This study highlights the interplay between romantic hardships, addiction, economic hardships as reasons for suicide attempts and various sociable variables in a population in Northern Iran. The most associated reason for suicide attempts was romantic relationship hardships. Therefore, interventions such as sessions on conflict resolution, boundary setting, and management of grieving would greatly benefit this society and reduce the rate of suicide, especially among individuals with a history of suicide attempts.
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Affiliation(s)
- Aliasghar Manouchehri
- grid.411495.c0000 0004 0421 4102Department of Internal Medicine, Shahid Beheshti Hospital Babol University of Medical Sciences, Babol, Iran
| | | | - Letizia Maria Atim
- African Centre for Suicide Prevention and Research, Mbarara, Uganda ,grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mehdi Mohammadian amiri
- grid.411495.c0000 0004 0421 4102Department of Emergency Medicine, School of Medicine, Babol University of Medical Sciences, Mazandaran, Iran
| | - Mark Mohan Kaggwa
- African Centre for Suicide Prevention and Research, Mbarara, Uganda ,grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Sciences, McMaster University, Hamilton, Ontario Canada
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29
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Onaemo VN, Fawehinmi TO, D’Arcy C. Risk of suicide ideation in comorbid substance use disorder and major depression. PLoS One 2022; 17:e0265287. [PMID: 36477246 PMCID: PMC9728854 DOI: 10.1371/journal.pone.0265287] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Suicidal behaviour is commonly associated with major depression (MD) and substance use disorders (SUDs). However, there is a paucity of research on risk for suicide ideation among individuals with comorbid SUDs and MD in the general population. OBJECTIVES This study investigated the associated risk of suicide ideation in comorbid SUDs-cannabis use disorder (CUD), alcohol use disorder (AUD), drug use disorder (DUD) with major depressive episode (MDE) in a nationally representative sample. METHODS Multilevel logistic regression models were used to analyze the 2012 Canadian Community Health Survey- Mental Health (CCHS-MH) data. This is a cross-sectional survey of nationally representative samples of Canadians (n = 25,113) aged 15 years and older residing in the ten Canadian provinces between January and December 2012. Diagnoses of MDE, AUD, DUD, and CUD were based on a modified WHO-CIDI, derived from DSM-IV diagnostic criteria. RESULTS Comorbidity was found to be the strongest predictor of suicide ideation. Compared to those with no diagnosis of either a SUD or MDE, individuals with a comorbid diagnosis of AUD with MDE, CUD with MDE, or DUD with MDE were 9, 11 and 16 times more likely to have 12-month suicide ideation respectively. A diagnosis of MDE was a significant predictor of 12-month suicide ideation with about a 7-fold increased risk compared with individuals not diagnosed with either MDE or a SUD. CONCLUSION Suicide is a preventable public health issue. Our study found a significantly increased risk of suicide ideation among persons who have comorbid SUD with MD. Effective integration of mental health and addictions services could mitigate the risk of suicide and contribute to better outcomes.
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Affiliation(s)
- Vivian N. Onaemo
- Division of Public Health and Preventive Medicine, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- * E-mail:
| | | | - Carl D’Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Abstract
Little is known about the patterns of household gun ownership among Black Americans, so little is known about the relationship between the patterns of Black household gun ownership and the patterns of Black firearm suicide. We analyze data from the 2001-2004 Behavioral Risk Factor Surveillance System, the first and last years for which a gun question was part of the core questions. We compare household gun ownership patterns for Black men compared to White men across geographic (region, urbanicity), demographic (age, education, married, children at home), and health-related characteristics (binge drinking, smoking), and find that the patterns are quite similar for all eight variables. However, when we compare these race-specific patterns to the race-specific firearm suicide patterns for 2001-2004, while the White firearm suicide patterns follow their gun ownership patterns, the Black patterns do not. While gun ownership increases with age, adult male Black firearm suicide rates are highest in the younger age group-an age group that also has a high proportion of suicides that are firearm suicides. Differences in unadjusted demographic patterns in firearm suicide between Black men and White men cannot be explained by differences in the self-reported patterns of household gun ownership.
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Hemenway D, Zhang W. Publisher's note: Patterns of household gun ownership and firearm suicide among black men compared to white men. Prev Med 2022; 164:107261. [PMID: 36155840 DOI: 10.1016/j.ypmed.2022.107261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022]
Abstract
Little is known about the patterns of household gun ownership among Black Americans, so little is known about the relationship between the patterns of Black household gun ownership and the patterns of Black firearm suicide. We analyze data from the 2001-2004 Behavioral Risk Factor Surveillance System, the first and last years for which a gun question was part of the core questions. We compare household gun ownership patterns for Black men compared to White men across geographic (region, urbanicity), demographic (age, education, married, children at home), and health-related characteristics (binge drinking, smoking), and find that the patterns are quite similar for all eight variables. However, when we compare these race-specific patterns to the race-specific firearm suicide patterns for 2001-2004, while the White firearm suicide patterns follow their gun ownership patterns, the Black patterns do not. While gun ownership increases with age, adult male Black firearm suicide rates are highest in the younger age group-an age group that also has a high proportion of suicides that are firearm suicides. Differences in unadjusted demographic patterns in firearm suicide between Black men and White men cannot be explained by differences in the self-reported patterns of household gun ownership.
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Affiliation(s)
- David Hemenway
- Harvard University TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States of America.
| | - Wilson Zhang
- Harvard University TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States of America
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32
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Heated Tobacco Product Use and Mental Health: Korean National Health and Nutrition Examination Survey (2018–2020). Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00907-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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Asri AK, Tsai HJ, Wong PY, Lee HY, Pan WC, Guo YL, Wu CS, Su HJ, Wu CD, Spengler JD. Examining the Benefits of Greenness on Reducing Suicide Mortality Rate: A Global Ecological Study. Front Public Health 2022; 10:902480. [PMID: 35865246 PMCID: PMC9294351 DOI: 10.3389/fpubh.2022.902480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
Objective This study applied an ecological-based analysis aimed to evaluate on a global scale the association between greenness exposure and suicide mortality. Methods Suicide mortality data provided by the Institute for Health Metrics and Evaluation and the Normalized Difference Vegetation Index (NDVI) were employed. The generalized additive mixed model was applied to evaluate with an adjustment of covariates the association between greenness and suicide mortality. Sensitivity tests and positive-negative controls also were used to examine less overt insights. Subgroup analyses were then conducted to investigate the effects of greenness on suicide mortality among various conditions. Results The main finding of this study indicates a negative association between greenness exposure and suicide mortality, as greenness significantly decreases the risk of suicide mortality per interquartile unit increment of NDVI (relative risk = 0.69, 95%CI: 0.59–0.81). Further, sensitivity analyses confirmed the robustness of the findings. Subgroup analyses also showed a significant negative association between greenness and suicide mortality for various stratified factors, such as sex, various income levels, urbanization levels, etc. Conclusions Greenness exposure may contribute to a reduction in suicide mortality. It is recommended that policymakers and communities increase environmental greenness in order to mitigate the global health burden of suicide.
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Affiliation(s)
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Pei-Yi Wong
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Yun Lee
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wen-Chi Pan
- Institute of Environmental and Occupational Health Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yue-Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Huey-Jen Su
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
- *Correspondence: Chih-Da Wu
| | - John D. Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Miller M, Zhang Y, Prince L, Swanson SA, Wintemute GJ, Holsinger EE, Studdert DM. Suicide Deaths Among Women in California Living With Handgun Owners vs Those Living With Other Adults in Handgun-Free Homes, 2004-2016. JAMA Psychiatry 2022; 79:582-588. [PMID: 35476016 PMCID: PMC9047728 DOI: 10.1001/jamapsychiatry.2022.0793] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/02/2022] [Indexed: 01/07/2023]
Abstract
Importance Little is known about the extent to which secondhand exposure to household firearms is associated with risk of suicide in adults who do not own guns, most of whom are women. Objective To evaluate changes in risk of suicide among women living in gun-free households after one of their cohabitants became a handgun owner. Design, Setting, and Participants This cohort study observed participants for up to 12 years and 2 months from October 18, 2004, to December 31, 2016. Data were analyzed from April to November 2021. The study population included 9.5 million adult women in California who did not own guns and who entered the study while living with 1 or more adults in a handgun-free home. Exposures Secondhand exposure to household handguns. Main Outcomes and Measures Suicide, firearm suicide, nonfirearm suicide. Results Of 9.5 million women living in handgun-free homes, 331 968 women (3.5% of the study population; mean [SD] age, 41.6 [18.0] years) became exposed to household handguns during the study period. In the entire study population, 294 959 women died: 2197 (1%) of these were by suicide, 337 (15%) of which were suicides by firearm. Rates of suicide by any method during follow-up were higher among cohort members residing with handgun owners compared with those residing in handgun-free homes (hazard ratio, 1.43; 95% CI, 1.11-1.84). The excess suicide rate was accounted for by higher rates of suicide by firearm (hazard ratio, 4.32; 95% CI, 2.89-6.46). Women in households with and without handguns had similar rates of suicide by nonfirearm methods (hazard ratio, 0.90; 95% CI, 0.63-1.27). Conclusions and Relevance In this study, the rate of suicide among women was significantly higher after a cohabitant of theirs became a handgun owner compared with the rate observed while they lived in handgun-free homes.
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Affiliation(s)
- Matthew Miller
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Yifan Zhang
- Department of Health Policy, Stanford University School of Medicine, Stanford, California
| | - Lea Prince
- Department of Health Policy, Stanford University School of Medicine, Stanford, California
| | - Sonja A. Swanson
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- CAUSALab, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | | | - Erin E. Holsinger
- Department of Health Policy, Stanford University School of Medicine, Stanford, California
| | - David M. Studdert
- Department of Health Policy, Stanford University School of Medicine, Stanford, California
- Stanford Law School, Stanford, California
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35
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Ebrahimi B, Doosti-Irani A, Rezapur-Shahkolai F, Poorolajal J. High-Risk Behaviors and Associated Factors among Iranian Adult Population: A National Survey. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:1107-1117. [PMID: 36407734 PMCID: PMC9643248 DOI: 10.18502/ijph.v51i5.9426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/18/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is no official and representative information on certain health-risk behaviors in Iran. This national survey was performed to determine the prevalence of five high-risk behaviors among the adult population and underlying factors. METHODS This cross-sectional study was performed in 23 provinces of Iran in 2019 involving 10,957 participants. The following five risky behaviors were evaluated: (a) using illicit drugs in the past month, (b) drinking alcohol in the past month, (c) having extramarital sex in the past year, (d) having suicidal thoughts in the past month, (e) and attempting suicide in the past year. The logistic regression model was used for analyses and associations were reported using odds ratio (OR) with its 95% confidence interval (CI). RESULTS The prevalence of health-risk behaviors was as follows: illicit drug use 10.4%, drinking alcohol 16.8%, extramarital sex 9.9%, suicidal thoughts 8.8%, and suicide attempt 5.4%. Almost 27.6% of the participants were involved in at least one risky behavior. There was a strong association between illicit drugs use and male gender 2.51 (2.11-2.98) and using psychiatric medications 2.96 (2.46-3.55); between drinking alcohol and male gender 2.23 (1.93-2.58); between extramarital sex and divorced/widowed status 2.43 (1.72-3.44) and having an intimate friend of the opposite sex 3.75 (3.13-4.51); between suicidal thoughts and using psychiatric medications 2.23 (1.83-2.72); between suicide attempt and a history of running away from home 2.10 (1.64-2.68). CONCLUSION More than one-fourth Iranian adult population is involved in at least one risky behavior. Engaging in any risky behavior may increase the possibility of engaging in other high-risk behaviors.
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Affiliation(s)
- Bahram Ebrahimi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amin Doosti-Irani
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Forouzan Rezapur-Shahkolai
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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36
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Mills J. Varenicline (Chantix): The Smoking Cessation Medication Prescribers May Be Avoiding. Issues Ment Health Nurs 2022; 43:489-494. [PMID: 35412411 DOI: 10.1080/01612840.2022.2061806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jeremy Mills
- Peninsula, A Division of Parkwest Medical Center, Knoxville, Tennessee, USA
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37
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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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Alrasheed FK, Alowairdhi YA, Alkharashi YM, Alomar AO, Alqirnas MQ, Alhussaini NA, Albassam A, Almosa AS, Alkhars AZ, Alhelail M. Suicide Attempts by Poisoning: An Experience From a High-Volume Emergency Department. Cureus 2022; 14:e23330. [PMID: 35464598 PMCID: PMC9015061 DOI: 10.7759/cureus.23330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 11/05/2022] Open
Abstract
Background There has been a tremendous increase in self-poisoning behavior worldwide, with different trends depending on cultural and geographic aspects. Objectives Our study aims to assess the trends, outcomes, and predictors in patients of suicide attempts by poisoning at King Abdulaziz Medical City (KAMC) ED. Materials and methods A retrospective cohort study took place at KAMC. Frequencies and percentages were used to display categorical variables. Minimum, maximum, mean, and SD were used to display continuous variables. Chi-squared test and independent t-test were utilized to test for factors associated with suicidal intention. Results A total of 130 cases were identified. The participants were mostly females (73.8%, n = 96). Most of the participants were pediatric patients (57.7%, n = 75). The most consumed agents were acetaminophen in 59 (45.83%) and non-steroidal anti-inflammatory drugs (NSAIDs) in 22 (16.92%). The ICU admission rate was 8.5% (n = 11). The management for both populations was unspecific, involving observation, supportive measures, and symptomatic treatment. BMI (p < 0.001), gender (p < 0.001), age (p = 0.012), and a history of neuropsychiatric disorders (p < 0.001) were associated factors. Conclusion It is crucial that the trends and risk factors of self-poisoning suicide attempts are identified to provide support to those in need. Several variables of interest were noted since the two most observed agents share several key features, such as accessibility and availability. However, contradicting literature reports warrant further investigation to confirm or negate the evidence.
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Jang H, Lee W, Kim YO, Kim H. Suicide rate and social environment characteristics in South Korea: the roles of socioeconomic, demographic, urbanicity, general health behaviors, and other environmental factors on suicide rate. BMC Public Health 2022; 22:410. [PMID: 35227243 PMCID: PMC8887086 DOI: 10.1186/s12889-022-12843-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide is a serious worldwide public health concern, and South Korea has shown the highest suicide rate among Organisation for Economic Co-operation and Development (OECD) countries since 2003. Nevertheless, most previous Korean studies on suicide had limitations in investigating various social environment factors using long-term nationwide data. Thus, this study examined how various social environment characteristics are related to the suicide rate at the district-level, using nationwide longitudinal data over 11 years. METHODS We used the district-level age-standardized suicide rate and a total of 12 annual social environment characteristics that represented socioeconomic, demographic, urbanicity, general health behaviors, and other environmental characteristics from 229 administrative districts in South Korea. A Bayesian hierarchical model with integrated Laplace approximations (INLA) was used to examine the spatiotemporal association between the rate of suicide and the social environment indicators selected for the study. RESULTS In the total population, the indicators "% of population aged 65 and older eligible for the basic pension", "% vacant houses in the area", "% divorce", "% single elderly households", "% detached houses", "% current smokers", and "% of population with obesity" showed positive associations with the suicide rate. In contrast, "% of people who regularly participated in religious activities" showed negative associations with suicide rate. The associations between these social environment characteristics and suicide rate were generally more statistically significant in males and more urbanized areas, than in females and less urbanized areas; however, associations differed amongst age groups, depending on the social environment characteristic variable under study. CONCLUSIONS This study investigated the complex role of social environments on suicide rate in South Korea and revealed that higher suicide rates were associated with lower values of socioeconomic status, physical exercise, and religious activities, and with higher social isolation and smoking practice. Our results can be used in the development of targeted suicide prevention policies.
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Affiliation(s)
- Hyemin Jang
- Department of Statistics, Ewha Womans University, Seoul, Korea
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, USA
| | - Yong-Ook Kim
- Population Research Lab, Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, & Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, Republic of Korea.
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Salama E, Castaneda AE, Suvisaari J, Rask S, Laatikainen T, Niemelä S. Substance use, affective symptoms, and suicidal ideation among Russian, Somali, and Kurdish migrants in Finland. Transcult Psychiatry 2022; 59:37-51. [PMID: 32164497 PMCID: PMC8859688 DOI: 10.1177/1363461520906028] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Comorbidity of substance use with affective symptoms and suicidality has been well documented in the general population. However, population-based migrant studies about this association are scarce. We examined the association of affective symptoms and suicidal ideation with binge drinking, daily smoking, and lifetime cannabis use among Russian, Somali, and Kurdish migrants in comparison with the Finnish general population. Cross-sectional data from the Finnish Migrant Health and Wellbeing Study (Maamu, n = 1307) and comparison group data of the general Finnish population (n = 860) from the Health 2011 Survey were used. Substance use included self-reported current binge drinking, daily smoking, and lifetime cannabis use. Affective symptoms and suicidal ideation were measured using the Hopkins Symptom Checklist-25 (HSCL-25). We performed multivariate logistic regression analyses, including age, gender, and additional socio-demographic and migration-related factors. Suicidal ideation (OR 2.4 95% CI 1.3-4.3) was associated with binge drinking among Kurds and lifetime cannabis use among Russians (OR 5.6, 95% CI 1.9-17.0) and Kurds (OR 5.5, 95% CI 1.9-15.6). Affective symptoms were associated with daily smoking (OR 1.6, 95% CI 1.02-2.6) and lifetime cannabis use (OR 6.1, 95% CI 2.6-14.5) among Kurdish migrants. Our results draw attention to the co-occurrence of suicidal ideation, affective symptoms, and substance use, especially among Kurdish migrants. These results highlight the variation of comorbidity of substance use and affective symptoms between the different populations. This implies that screening for substance use in mental healthcare cannot be neglected based on presumed habits of substance use.
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Affiliation(s)
- Essi Salama
- Doctoral Programme in Clinical Research, Faculty of Medicine, University of Turku, Finland.,Child Psychiatry, Turku University Hospital, Finland
| | - Anu E Castaneda
- National Institute for Health and Welfare (THL), Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | | | - Shadia Rask
- National Institute for Health and Welfare (THL), Finland
| | - Tiina Laatikainen
- National Institute for Health and Welfare (THL), Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.,Joint municipal authority for North Karelia social and health services (Siun sote), Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, Finland.,Addiction Psychiatry Unit, Turku University Hospital, Finland
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Mullins N, Kang J, Campos AI, Coleman JRI, Edwards AC, Galfalvy H, Levey DF, Lori A, Shabalin A, Starnawska A, Su MH, Watson HJ, Adams M, Awasthi S, Gandal M, Hafferty JD, Hishimoto A, Kim M, Okazaki S, Otsuka I, Ripke S, Ware EB, Bergen AW, Berrettini WH, Bohus M, Brandt H, Chang X, Chen WJ, Chen HC, Crawford S, Crow S, DiBlasi E, Duriez P, Fernández-Aranda F, Fichter MM, Gallinger S, Glatt SJ, Gorwood P, Guo Y, Hakonarson H, Halmi KA, Hwu HG, Jain S, Jamain S, Jiménez-Murcia S, Johnson C, Kaplan AS, Kaye WH, Keel PK, Kennedy JL, Klump KL, Li D, Liao SC, Lieb K, Lilenfeld L, Liu CM, Magistretti PJ, Marshall CR, Mitchell JE, Monson ET, Myers RM, Pinto D, Powers A, Ramoz N, Roepke S, Rozanov V, Scherer SW, Schmahl C, Sokolowski M, Strober M, Thornton LM, Treasure J, Tsuang MT, Witt SH, Woodside DB, Yilmaz Z, Zillich L, Adolfsson R, Agartz I, Air TM, Alda M, Alfredsson L, Andreassen OA, Anjorin A, Appadurai V, Soler Artigas M, Van der Auwera S, Azevedo MH, Bass N, Bau CHD, Baune BT, Bellivier F, Berger K, Biernacka JM, Bigdeli TB, Binder EB, Boehnke M, Boks MP, Bosch R, Braff DL, Bryant R, Budde M, Byrne EM, Cahn W, Casas M, Castelao E, Cervilla JA, Chaumette B, Cichon S, Corvin A, Craddock N, Craig D, Degenhardt F, Djurovic S, Edenberg HJ, Fanous AH, Foo JC, Forstner AJ, Frye M, Fullerton JM, Gatt JM, Gejman PV, Giegling I, Grabe HJ, Green MJ, Grevet EH, Grigoroiu-Serbanescu M, Gutierrez B, Guzman-Parra J, Hamilton SP, Hamshere ML, Hartmann A, Hauser J, Heilmann-Heimbach S, Hoffmann P, Ising M, Jones I, Jones LA, Jonsson L, Kahn RS, Kelsoe JR, Kendler KS, Kloiber S, Koenen KC, Kogevinas M, Konte B, Krebs MO, Landén M, Lawrence J, Leboyer M, Lee PH, Levinson DF, Liao C, Lissowska J, Lucae S, Mayoral F, McElroy SL, McGrath P, McGuffin P, McQuillin A, Medland SE, Mehta D, Melle I, Milaneschi Y, Mitchell PB, Molina E, Morken G, Mortensen PB, Müller-Myhsok B, Nievergelt C, Nimgaonkar V, Nöthen MM, O'Donovan MC, Ophoff RA, Owen MJ, Pato C, Pato MT, Penninx BWJH, Pimm J, Pistis G, Potash JB, Power RA, Preisig M, Quested D, Ramos-Quiroga JA, Reif A, Ribasés M, Richarte V, Rietschel M, Rivera M, Roberts A, Roberts G, Rouleau GA, Rovaris DL, Rujescu D, Sánchez-Mora C, Sanders AR, Schofield PR, Schulze TG, Scott LJ, Serretti A, Shi J, Shyn SI, Sirignano L, Sklar P, Smeland OB, Smoller JW, Sonuga-Barke EJS, Spalletta G, Strauss JS, Świątkowska B, Trzaskowski M, Turecki G, Vilar-Ribó L, Vincent JB, Völzke H, Walters JTR, Shannon Weickert C, Weickert TW, Weissman MM, Williams LM, Wray NR, Zai CC, Ashley-Koch AE, Beckham JC, Hauser ER, Hauser MA, Kimbrel NA, Lindquist JH, McMahon B, Oslin DW, Qin X, Agerbo E, Børglum AD, Breen G, Erlangsen A, Esko T, Gelernter J, Hougaard DM, Kessler RC, Kranzler HR, Li QS, Martin NG, McIntosh AM, Mors O, Nordentoft M, Olsen CM, Porteous D, Ursano RJ, Wasserman D, Werge T, Whiteman DC, Bulik CM, Coon H, Demontis D, Docherty AR, Kuo PH, Lewis CM, Mann JJ, Rentería ME, Smith DJ, Stahl EA, Stein MB, Streit F, Willour V, Ruderfer DM. Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors. Biol Psychiatry 2022; 91:313-327. [PMID: 34861974 PMCID: PMC8851871 DOI: 10.1016/j.biopsych.2021.05.029] [Citation(s) in RCA: 99] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/07/2021] [Accepted: 05/26/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. METHODS We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. RESULTS Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. CONCLUSIONS Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.
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Affiliation(s)
- Niamh Mullins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - JooEun Kang
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Adrian I Campos
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jonathan R I Coleman
- National Institute for Health Research Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, United Kingdom; Social Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom
| | - Alexis C Edwards
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Hanga Galfalvy
- Department of Biostatistics, Columbia University, New York, New York; Department of Psychiatry, Columbia University, New York, New York
| | - Daniel F Levey
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, Connecticut; Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Adriana Lori
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Andrey Shabalin
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah
| | - Anna Starnawska
- Centre for Genomics and Personalized Medicine, Aarhus University, Aarhus, Denmark; Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
| | - Mei-Hsin Su
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hunna J Watson
- School of Psychology, Curtin University, Perth, Western Australia, Australia; Division of Paediatrics, The University of Western Australia, Perth, Western Australia, Australia; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mark Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Gandal
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | | | - Akitoyo Hishimoto
- Department of Psychiatry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Minsoo Kim
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Satoshi Okazaki
- Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ikuo Otsuka
- Department of Psychiatry, Columbia University, New York, New York; Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Universitätsmedizin Berlin, Berlin, Germany; Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts; Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Erin B Ware
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan; Survery Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Andrew W Bergen
- BioRealm, LLC, Walnut, California; Oregon Research Institute, Eugene, Oregon
| | - Wade H Berrettini
- Department of Psychiatry, Center for Neurobiology and Behavior, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Martin Bohus
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Harry Brandt
- Center for Eating Disorders at Sheppard Pratt, Baltimore, Maryland
| | - Xiao Chang
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Steven Crawford
- Center for Eating Disorders at Sheppard Pratt, Baltimore, Maryland
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Emily DiBlasi
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah
| | - Philibert Duriez
- Hôpital Sainte-Anne, GHU Paris Psychiatrie et Neurosciences, Paris, France; Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Université de Paris, Paris, France
| | | | - Manfred M Fichter
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Schön Klinik Roseneck affiliated with the Medical Faculty of the University of Munich, Munich, Germany
| | - Steven Gallinger
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephen J Glatt
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, New York
| | - Philip Gorwood
- Hôpital Sainte-Anne, GHU Paris Psychiatrie et Neurosciences, Paris, France; Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Université de Paris, Paris, France
| | - Yiran Guo
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Hakon Hakonarson
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Katherine A Halmi
- Department of Psychiatry, Weill Cornell Medical College, New York, New York
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Sonia Jain
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, La Jolla, California
| | - Stéphane Jamain
- Inserm U955, Institut Mondor de recherches Biomédicales, Laboratoire, Neuro-Psychiatrie Translationnelle, and Fédération Hospitalo-Universitaire de Précision Médecine en Addictologie et Psychiatrie, University Paris-Est-Créteil, Créteil, France
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital Bellvitge-IDIBELL and CIBEROBN, Barcelona, Spain
| | | | - Allan S Kaplan
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Walter H Kaye
- Department of Psychiatry, Department of Psychiatry, University of California San Diego, San Diego, California
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - James L Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kelly L Klump
- Department of Psychology, Michigan State University, Lansing, Michigan
| | - Dong Li
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center, Mainz, Germany
| | - Lisa Lilenfeld
- Department of Clinical Psychology, The Chicago School of Professional Psychology, Washington, DC
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Pierre J Magistretti
- BESE Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia; Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Christian R Marshall
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - James E Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - Eric T Monson
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah
| | - Richard M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - Dalila Pinto
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Nicolas Ramoz
- Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Université de Paris, Paris, France
| | - Stefan Roepke
- Department of Psychiatry, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Vsevolod Rozanov
- Department of Psychology, St. Petersburg State University, Saint Petersburg, Russian Federation; Department of Borderline Disorders and Psychotherapy, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Saint Petersburg, Russian Federation
| | - Stephen W Scherer
- Department of Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marcus Sokolowski
- National Centre for Suicide Research and Prevention of Mental Ill-Health, LIME, Karolinska Institutet, Stockholm, Sweden
| | - Michael Strober
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, United Kingdom; National Institute for Health Research Biomedical Research Centre, King's College London and South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Ming T Tsuang
- Center for Behavioral Genomics, Department of Psychiatry, University of California San Diego, San Diego, California
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - D Blake Woodside
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Centre for Mental Health, University Health Network, Toronto, Ontario, Canada; Program for Eating Disorders, University Health Network, Toronto, Ontario, Canada
| | - Zeynep Yilmaz
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Rolf Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University Medical Faculty, Umeå, Sweden
| | - Ingrid Agartz
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tracy M Air
- Discipline of Psychiatry, University of Adelaide, Adelaide, South Australia, Australia
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; National Institute of Mental Health, Klecany, Czech Republic
| | - Lars Alfredsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institut of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ole A Andreassen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, University of Oslo, Oslo, Norway
| | - Adebayo Anjorin
- Psychiatry, Berkshire Healthcare NHS Foundation Trust, Bracknell, United Kingdom
| | - Vivek Appadurai
- Institute of Biological Psychiatry, Copenhagen Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
| | - María Soler Artigas
- Department of Psychiatry, Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Department of Genetics, Microbiology & Statistics, University of Barcelona, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - M Helena Azevedo
- Department of Psychiatry, University of Coimbra, Coimbra, Portugal
| | - Nicholas Bass
- Division of Psychiatry, University College London, London, United Kingdom
| | - Claiton H D Bau
- Laboratory of Developmental Psychiatry, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Department of Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia; Department of Psychiatry, University of Münster, Münster, Nordrhein-Westfalen, Germany
| | - Frank Bellivier
- Department of Psychiatry and Addiction Medicine, Assistance Publique Hôpitaux de Paris, Paris, France; Paris Bipolar and TRD Expert Centres, FondaMental Foundation, Paris, France; UMR-S1144 Team 1: Biomarkers of relapse and therapeutic response in addiction and mood disorders, INSERM, Paris, France; Psychiatry, Université Paris Diderot, Paris, France
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Nordrhein-Westfalen, Germany
| | | | - Tim B Bigdeli
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, New York, New York; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Elisabeth B Binder
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia; Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Michael Boehnke
- Center for Statistical Genetics and Department of Biostatistics, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Marco P Boks
- Department of Psychiatry, UMC Utrecht Hersencentrum, Utrecht, the Netherlands
| | - Rosa Bosch
- Department of Psychiatry, Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - David L Braff
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Enda M Byrne
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia; Centre for Children's Health Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Wiepke Cahn
- Department of Psychiatry, UMC Utrecht Hersencentrum, Utrecht, the Netherlands
| | - Miguel Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Castelao
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jorge A Cervilla
- Mental Health Unit, Department of Psychiatry, Faculty of Medicine, Granada University Hospital Complex, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Boris Chaumette
- Institut de Psychiatrie, CNRS GDR 3557, Paris, France; Department of Evaluation, Prevention and Therapeutic innovation, GHU Paris Psychiatrie et Neurosciences, Paris, France; Team Pathophysiology of psychiatric diseases, Université de Paris, Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Paris, France
| | - Sven Cichon
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich, Germany; Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland; Department of Biomedicine, University Hospital Basel, Basel, Switzerland; Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Nicholas Craddock
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - David Craig
- Department of Translational Genomics, University of Southern California, Pasadena, California
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Howard J Edenberg
- Department of Medical & Molecular Genetics, Indiana University, Indianapolis, Indiana; Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Ayman H Fanous
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, New York, New York; Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Jerome C Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andreas J Forstner
- Institute of Neuroscience and Medicine, Research Centre Jülich, Jülich, Germany; Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany; Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Mark Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota
| | - Janice M Fullerton
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Justine M Gatt
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Pablo V Gejman
- Department of Psychiatry and Behavioral Sciences, NorthShore University HealthSystem, Evanston, Illinois; Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Ina Giegling
- Department of Psychiatry, University of Munich, Munich, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - Melissa J Green
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Eugenio H Grevet
- ADHD Outpatient Program, Adult Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Blanca Gutierrez
- Department of Psychiatry, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Jose Guzman-Parra
- Mental Health Department, University Regional Hospital, Biomedicine Institute, Málaga, Spain
| | - Steven P Hamilton
- Psychiatry, Kaiser Permanente Northern California, San Francisco, California
| | - Marian L Hamshere
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Annette Hartmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Joanna Hauser
- Department of Psychiatry, Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznań, Poland
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Per Hoffmann
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland; Department of Biomedicine, University Hospital Basel, Basel, Switzerland; Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Ian Jones
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Lisa A Jones
- Department of Psychological Medicine, University of Worcester, Worcester, United Kingdom
| | - Lina Jonsson
- Department of Psychiatry and Neuroscience, University of Gothenburg, Gothenburg, Sweden
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, UMC Utrecht Hersencentrum, Utrecht, the Netherlands
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, California; Institute for Genomic Medicine, University of California San Diego, La Jolla, California
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia
| | - Stefan Kloiber
- Max Planck Institute of Psychiatry, Munich, Germany; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Karestan C Koenen
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | | | - Bettina Konte
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Marie-Odile Krebs
- Institut de Psychiatrie, CNRS GDR 3557, Paris, France; Department of Evaluation, Prevention and Therapeutic innovation, GHU Paris Psychiatrie et Neurosciences, Paris, France; Team Pathophysiology of psychiatric diseases, Université de Paris, Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Paris, France
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychiatry and Neuroscience, University of Gothenburg, Gothenburg, Sweden
| | - Jacob Lawrence
- Psychiatry, North East London NHS Foundation Trust, Ilford, Cheshire, United Kingdom
| | - Marion Leboyer
- Faculté de Médecine, University Paris-Est-Créteil, Créteil, France; Department of Psychiatry and Addiction Medicine, Assistance Publique Hôpitaux de Paris, Paris, France; INSERM, Paris, France
| | - Phil H Lee
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts; Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts; Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Douglas F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Calwing Liao
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Québec, Canada; Montreal Neurological Institute and Hospital, Montreal, Québec, Canada
| | - Jolanta Lissowska
- Cancer Epidemiology and Prevention, Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland
| | | | - Fermin Mayoral
- Mental Health Department, University Regional Hospital, Biomedicine Institute, Málaga, Spain
| | | | - Patrick McGrath
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York
| | - Peter McGuffin
- Social Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom
| | - Andrew McQuillin
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sarah E Medland
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Divya Mehta
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; School of Psychology and Counseling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ingrid Melle
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Division of Mental Health and Addiction, University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit and GGZ inGeest, Amsterdam, Netherlands
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Esther Molina
- Department of Nursing, Faculty of Medicine, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Gunnar Morken
- Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway; Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | - Preben Bo Mortensen
- Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark; National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
| | - Bertram Müller-Myhsok
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany; Munich Cluster for Systems Neurology, Munich, Germany; University of Liverpool, Liverpool, United Kingdom
| | - Caroline Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Vishwajit Nimgaonkar
- Psychiatry and Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Michael C O'Donovan
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Roel A Ophoff
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, California; Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Michael J Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Carlos Pato
- College of Medicine Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, New York; Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, New York
| | - Michele T Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, New York
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit and GGZ inGeest, Amsterdam, Netherlands
| | - Jonathan Pimm
- Division of Psychiatry, University College London, London, United Kingdom
| | - Giorgio Pistis
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - James B Potash
- Department of Psychiatry, University of Iowa, Iowa City, Iowa
| | - Robert A Power
- Social Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom; Genetics, BioMarin Pharmaceuticals, London, United Kingdom; University of Oxford, St. Edmund Hall, Oxford, United Kingdom
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Digby Quested
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Marta Ribasés
- Department of Psychiatry, Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Department of Genetics, Microbiology & Statistics, University of Barcelona, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Vanesa Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Margarita Rivera
- Social Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom; Department of Biochemistry and Molecular Biology II and Institute of Neurosciences, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Andrea Roberts
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Guy A Rouleau
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Québec, Canada; Montreal Neurological Institute and Hospital, Montreal, Québec, Canada
| | - Diego L Rovaris
- Department of Physiology and Biophysics, Instituto de Ciencias Biomedicas Universidade de Sao Paulo, São Paulo, Brazil
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Cristina Sánchez-Mora
- Department of Psychiatry, Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Department of Genetics, Microbiology & Statistics, University of Barcelona, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Alan R Sanders
- Department of Psychiatry and Behavioral Sciences, NorthShore University HealthSystem, Evanston, Illinois; Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Peter R Schofield
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Thomas G Schulze
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig-Maximilians-University, Munich, Germany; Human Genetics Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Laura J Scott
- Center for Statistical Genetics and Department of Biostatistics, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Stanley I Shyn
- Behavioral Health Services, Kaiser Permanente Washington, Seattle, Washington, DC
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Pamela Sklar
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Olav B Smeland
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, University of Oslo, Oslo, Norway
| | - Jordan W Smoller
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts; Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Edmund J S Sonuga-Barke
- Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, United Kingdom
| | - Gianfranco Spalletta
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas; Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
| | - John S Strauss
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Beata Świątkowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lódz, Poland
| | - Maciej Trzaskowski
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Gustavo Turecki
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Québec, Canada
| | - Laura Vilar-Ribó
- Department of Psychiatry, Hospital Universitari Vall d'Hebrón, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - John B Vincent
- Molecular Brain Science, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Mecklenburg-Vorpommern, Germany
| | - James T R Walters
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Cynthia Shannon Weickert
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Myrna M Weissman
- Columbia University College of Physicians and Surgeons, New York, New York; Division of Translational Epidemiology, New York State Psychiatric Institute, New York, New York
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Naomi R Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia; Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Clement C Zai
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Molecular Brain Science, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Allison E Ashley-Koch
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, North Carolina
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina; VISN 6 Mid-Atlantic Mental Illness Research, Durham Veterans Affairs Health Care System, Durham, North Carolina
| | - Elizabeth R Hauser
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, North Carolina; Cooperative Studies Program Epidemiology Center, Education, and Clinical Center, Durham Veterans Affairs Health Care System, Durham, North Carolina
| | - Michael A Hauser
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, North Carolina
| | - Nathan A Kimbrel
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina; VISN 6 Mid-Atlantic Mental Illness Research, Durham Veterans Affairs Health Care System, Durham, North Carolina
| | - Jennifer H Lindquist
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, North Carolina
| | - Benjamin McMahon
- Theoretical Division, Los Alamos National Laboratory, Los Alamos National Laboratory, Los Alamos, New Mexico
| | - David W Oslin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; VISN 4 Mental Illness Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Xuejun Qin
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, North Carolina
| | - Esben Agerbo
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Anders D Børglum
- Centre for Genomics and Personalized Medicine, Aarhus University, Aarhus, Denmark; Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
| | - Gerome Breen
- National Institute for Health Research Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, United Kingdom; Social Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom
| | - Annette Erlangsen
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark; Department of Mental Health, Johns Hopkins University School of Medicine, Baltimore, Maryland; Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Center of Mental Health Research, Australian National University, Canberra, Australia
| | - Tõnu Esko
- Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts; Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Joel Gelernter
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, Connecticut; Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - David M Hougaard
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Henry R Kranzler
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; VISN 4 Mental Illness Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Qingqin S Li
- Neuroscience, Janssen Research & Development, LLC, Titusville, New Jersey
| | - Nicholas G Martin
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Ole Mors
- Psychosis Research Unit, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Merete Nordentoft
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Catherine M Olsen
- Department of Population Health, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | - David Porteous
- Institute for Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Robert J Ursano
- Department of Psychiatry, Uniformed University of the Health Sciences, Bethesda, Maryland
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health, LIME, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Werge
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Institute of Biological Psychiatry, Copenhagen Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Lundbeck Foundation GeoGenetics Centre, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - David C Whiteman
- Department of Population Health, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hilary Coon
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah; Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Ditte Demontis
- Centre for Genomics and Personalized Medicine, Aarhus University, Aarhus, Denmark; Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark; Department of Biomedicine, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
| | - Anna R Docherty
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia; Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Cathryn M Lewis
- Department of Medical & Molecular Genetics, King's College London, London, United Kingdom; Social Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom
| | - J John Mann
- Departments of Psychiatry and Radiology, Columbia University, New York, New York
| | - Miguel E Rentería
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Eli A Stahl
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York; Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts
| | - Murray B Stein
- Department of Psychiatry and School of Public Health, University of California San Diego, La Jolla, California
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Douglas M Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
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Sher L. Smoking enhances suicide risk-a significant role in the COVID-19 pandemic? QJM 2022; 114:767-769. [PMID: 34694396 PMCID: PMC8574319 DOI: 10.1093/qjmed/hcab271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Indexed: 11/20/2022] Open
Abstract
The COVID-19 outbreak has severely affected the whole world. Considerable evidence suggests that tobacco smoking is associated with increased severity of COVID-19 and death in COVID-19 patients. Tobacco smoking cessation is necessary to decrease COVID-19-related hospitalizations and deaths. In this commentary, I suggest that tobacco smoking cessation is also needed to reduce suicidal behavior during and after the COVID-19 pandemic. Significant evidence suggests that the COVID-19 pandemic leads to increased tobacco consumption as smokers use more tobacco to cope with pandemic-related stress, anxiety, depression and loneliness. Multiple studies have demonstrated that tobacco smoking is associated with suicidal ideation, suicide attempts, suicide death and a contributing factor in the pathophysiology of suicide. Smoking may increase the probability of development of post-COVID syndrome because it increases severity of COVID-19. Suicide risk may be increased in individuals with post-COVID syndrome. Smoking prevention and cessation should be a target of suicide prevention interventions during and after the COVID-19 pandemic. The COVID-19 pandemic enhances the need to act to integrate tobacco smoking cessation in the health care as a standard of patient care.
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Affiliation(s)
- Leo Sher
- James J. Peters VA Medical Center, Bronx, NY
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Address correspondence to : Leo Sher, M.D., James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA, Tel: 1-718-584-9000, Fax: 1-718-741-4703,
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Rodriguez-Cano R, Paulus DJ, Derrick JL, Blalock JA, Zvolensky MJ. Emotion dysregulation and hazardous drinking in relation to suicidal ideation among Spanish-speaking Latinx daily-smokers. J Subst Abuse Treat 2022; 132:108508. [PMID: 34098209 PMCID: PMC8630077 DOI: 10.1016/j.jsat.2021.108508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Suicidal ideation has increased among Latinx individuals in the last decade. Smoking increases the likelihood of suicidal ideation but work on Latinx smokers is minimal. Hazardous drinking and emotion dysregulation could be factors related to suicidal ideation among Latinx smokers, as has been evident in non-Latinx White samples. The current study sought to examine the main and interactive effects of emotion dysregulation and hazardous drinking in relation to suicidal ideation among Latinx daily-smokers. METHODS Participants were 371 Spanish-speaking daily-smokers (58.8% female; Mage = 33.3; SDage = 9.8) recruited from the United States through Qualtrics. We used structural equation modeling (SEM) to test an interactive model of emotion dysregulation and hazardous alcohol consumption in relation to suicidal ideation; we also tested the effect of emotion dysregulation on suicidal ideation as a function of hazardous drinking status. RESULTS Results indicated that latent emotional dysregulation was associated with greater suicidal ideation (p < 0.001); however, hazardous drinking was not related to suicidal ideation (p = 0.186). The interactive term of emotional dysregulation and hazardous drinking was significantly related to suicidal ideation (p = 0.017). Specifically, greater emotion dysregulation was significantly related to suicidal ideation among Latinx smokers who engaged in hazardous drinking (p < 0.001) but not those who did not engage in hazardous drinking (p = 0.123). CONCLUSIONS The current findings suggest that smoking combined with hazardous drinking may be related to increased suicidal ideation among Latinx smokers. Findings are discussed in relation to the potential role of intervention strategies that focus on emotion dysregulation and hazardous drinking among Latinx current daily smokers to mitigate suicidal risk among this established health disparities population.
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Affiliation(s)
- Ruben Rodriguez-Cano
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Daniel J Paulus
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jaye L Derrick
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Janice A Blalock
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA.
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Fu J, Abiodun O, Lowery Wilson M, Shaikh MA. Adolescent suicide attempts in three diverse island nations: patterns, contextual differences and demographic associations. BMC Res Notes 2021; 14:464. [PMID: 34949211 PMCID: PMC8697498 DOI: 10.1186/s13104-021-05804-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/10/2021] [Indexed: 12/04/2022] Open
Abstract
Objective Most epidemiological studies on suicidal behavior have been focused on high-income country settings. This study examine factors associated with suicidal behaviors among school-attending adolescents in three island nations. In this secondary analysis of the publicly available 2015 nationally representative GSHS data, we tested demographic, social, and behavioral attributes using multivariable logistic regression to association with suicide attempts. Results Within the recall period, 13.6% of participants reported having attempted suicide one or more times in the Cook Islands, 10.8% in Curaçao, and 9.8% in East Timor. In the Cook Islands, suicide ideation (AOR = 19.42, 95% CI = 9.11–41.41), anxiety (AOR = 2.51, 95% CI = 1.08–5.82), physical bullying (AOR = 3.3, 95% CI = 1.10–9.91), and cigarette smoking (AOR = 3.82, 95% CI = 1.38–10.54) were associated with suicide attempts. For Curaçaoo, suicide ideation (AOR = 7.88, 95% CI = 5.20–11.95) and suicide planning (AOR = 7.01, 95% CI = 4.24–11.60) were statistically significant. While for East Timor, suicide ideation (AOR = 4.59, 95% CI = 2.14–9.88), suicide planning (AOR = 3.36, 95% CI = 1.76–6.29), bullying victimization (AOR = 2.69, 95% CI = 1.02–7.12), and serious injuries (AOR = 2.22, 95% CI = 1.31–3.74) were statistically significant. Suicide attempt is relatively common in each of the three island nations. The socioeconomic context of adolescents might play a significant role in moderating suicidal behavior. Therefore, prevention efforts should be grounded in view of geographic, demographic, and socioeconomic contexts of the populations at risk. Supplementary Information The online version of this article 10.1186/s13104-021-05804-4 contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jinrong Fu
- Centre for Injury Prevention and Community Safety (CIPCS), PeerCorps Trust Fund, 352/64 Makunganya Street, Co-Architecture Building, 4th Floor, P.O. Box 22499, Dar es Salaam, Tanzania.,Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Olumide Abiodun
- ICT University, 1 Avenue Dispensaire Messassi, Zoatoupsi, Yaounde, Cameroon
| | - Michael Lowery Wilson
- Centre for Injury Prevention and Community Safety (CIPCS), PeerCorps Trust Fund, 352/64 Makunganya Street, Co-Architecture Building, 4th Floor, P.O. Box 22499, Dar es Salaam, Tanzania.
| | - Masood Ali Shaikh
- Centre for Injury Prevention and Community Safety (CIPCS), PeerCorps Trust Fund, 352/64 Makunganya Street, Co-Architecture Building, 4th Floor, P.O. Box 22499, Dar es Salaam, Tanzania
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Li X, Chi G, Taylor A, Chen ST, Memon AR, Zhang Y, Song Y, Li J, Luo X, Zou L. Lifestyle Behaviors and Suicide-Related Behaviors in Adolescents: Cross-Sectional Study Using the 2019 YRBS Data. Front Public Health 2021; 9:766972. [PMID: 34926387 PMCID: PMC8678606 DOI: 10.3389/fpubh.2021.766972] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022] Open
Abstract
Objective: The purpose of this research was to investigate the prevalence of lifestyle behaviors and suicide-related behaviors and the association between them using a nationally representative sample of adolescents from the USA. Methods: 13,677 high school students aged 14-18 years were included in this cross-sectional study. The research data were retrieved from the Youth Risk Behavior Surveillance System Survey in 2019. All data on age, sex, grade, race, physical activity, television time, fruit intake, and suicide-related behavior were self-reported by students. Logistic regression models were adopted to examine the association between lifestyle behaviors and the suicide-related behaviors. Results: Students who played video/computer games for ≥2 h had higher risk of suicide attempt (OR = 1.55, 95%CI: 1.30-1.85). Daily sleep duration of ≤8 h was positively associated with considering a suicide attempt (OR = 1.99, 95%CI: 1.62-2.43). In addition, participants who did not engage in any sport team were more likely to report considering a suicide attempt (OR = 1.50, 95%CI: 1.24-1.81). Conclusion: This research suggests that some lifestyle behaviors (e.g., time for video or computer use, sleep duration, sports team participation, regular breakfast intake, and substance use) are associated with increased risk of suicidal behavior and ideation in high school students. To identify the specific effect of multiple lifestyle factors in influencing the risk of suicide-related behaviors in high school students, longitudinal studies are warranted in future.
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Affiliation(s)
- Xiaozhi Li
- Department of Physical Education, Southeast University, Nanjing, China
| | - Guijun Chi
- China Volleyball College, Beijing Sport University, Beijing, China
- Department of Physical Education, Tangshan Normal University, Tangshan, China
| | - Alyx Taylor
- School of Rehabilitation, Sport and Psychology, AECC University College, Bournemouth, United Kingdom
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Aamir R. Memon
- Institute of Physiotherapy and Rehabilitation Sciences, Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan
| | - Yanjie Zhang
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea
- Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong-Shenzhen, Shenzhen, China
| | - Yagang Song
- Department of Physical Education Teaching, Shanghai Sanda University, Shanghai, China
| | - Jinming Li
- Exercise Psychophysiology Laboratory, Institute of KEEP Collaborative Innovation, School of Psychology, Shenzhen University, Shenzhen, China
| | - Xun Luo
- Exercise Psychophysiology Laboratory, Institute of KEEP Collaborative Innovation, School of Psychology, Shenzhen University, Shenzhen, China
| | - Liye Zou
- Exercise Psychophysiology Laboratory, Institute of KEEP Collaborative Innovation, School of Psychology, Shenzhen University, Shenzhen, China
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Waters AF, Peltier MR, Roys MR, Stewart SA, Copeland AL. Smoking and suicidal ideation among college students: Smoking expectancies as potential moderators. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:951-958. [PMID: 32027235 DOI: 10.1080/07448481.2020.1719112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Objective: In the present study, we sought to establish a link between suicidal ideation (SI) and smoking in college students, determine whether psychopathology accounted for the association, and determine whether smoking expectancies were moderators. Participants: Participants (N = 607) were identified as nonsmokers, exsmokers, infrequent smokers, or daily smokers. Methods: Participants were assessed for smoking patterns, smoking expectancies, psychopathology, SI, and past suicide attempts. Results: Daily smokers had the highest level of SI. There was a dose-response relationship between smoking and SI, such that the higher the daily smoking rate, the greater the SI, even when controlling for depression, alcohol use, and drug use. Trend-level results indicated that at lower smoking rates, elevated smoking-related negative affect reduction (NAR) expectancies were associated with lower SI, while elevated NAR expectancies in combination with higher smoking rates were associated with greater SI. Conclusion: Smoking cessation programs for college students should screen for SI.
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Affiliation(s)
- Aaron F Waters
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - MacKenzie R Peltier
- Psychology Service, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Melanie R Roys
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Shelby A Stewart
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Amy L Copeland
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
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Poorolajal J, Goudarzi M, Gohari-Ensaf F, Darvishi N. Relationship of religion with suicidal ideation, suicide plan, suicide attempt, and suicide death: a meta-analysis. J Res Health Sci 2021; 22:e00537. [PMID: 36511249 PMCID: PMC9315464 DOI: 10.34172/jrhs.2022.72] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Suicide is a significant public health problem and one of the leading causes of death worldwide. The effect of religion on suicidal behaviors (i.e., ideation, plan, attempt, and death) is an important issue worthy of consideration. METHODS Major electronic databases, including MEDLINE, Web of Science, and Scopus, were searched for the articles published until 26 April 2021. Reference lists were also screened. Observational studies addressing the associations between religion and suicidal behaviors were also examined. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The probability of publication bias was explored using the Begg and Egger tests, as well as trim-and-fill analysis. The effect size was expressed as odds ratio (OR) with 95% confidence intervals (CIs) using a random-effects model. RESULTS Out of 11 389 identified studies, 63 articles were eligible, involving 8,053,697 participants. There was an inverse association between religion and suicidal ideation OR = 0.83 (95% CI: 0.78, 0.88; P < 0.001), suicidal plan OR = 0.93 (95% CI: 0.83, 1.04; P = 0.200), suicide attempt OR = 0.84 (95% CI: 0.79, 0.89; P < 0.001), and completed suicide OR = 0.31 (95% CI: 0.14, 0.72; P = 0.006). There was a no evidence of publication bias. CONCLUSIONS The results of this meta-analysis support the notion that religion can play a protective role against suicidal behaviors. Nonetheless, the effect of religion on suicidal behaviors varies across countries with different religions and cultures. Although this association does not necessarily imply causation, an awareness of the relationship between religion and suicide risk can be of great help in suicide prevention policies and programs.
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Affiliation(s)
- Jalal Poorolajal
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran,Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahmoud Goudarzi
- Department of Family Counseling, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Fatemeh Gohari-Ensaf
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nahid Darvishi
- Department of Psychology, School of Human Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran,Corresponding author: Nahid Darvishi (MSc) E-mail: Zipcode: 6616935391 Tel:+98 87 3328 8661
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Park S, Lee KS. Association of heated tobacco product use and secondhand smoke exposure with suicidal ideation, suicide plans and suicide attempts among Korean adolescents: A 2019 national survey. Tob Induc Dis 2021; 19:72. [PMID: 34602935 PMCID: PMC8448199 DOI: 10.18332/tid/140824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/14/2021] [Accepted: 08/03/2021] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The consumption of heated tobacco products (HTPs) is increasing among adolescents worldwide. Although suicide and HTP use are linked, the association between suicide-related behavior, HTP use, and indirect smoking exposure are not yet properly studied. This study examined the association of HTP use and exposure to secondhand smoke (SHS) with suicidal ideation, suicide plans, and suicide attempts among South Korean adolescents. METHODS Data from 57303 respondents (95.3% response rate) were obtained from the 2019 Korean Youth Risk Behavior Web-based Survey. Chi-squared tests and multivariable logistic regression analyses were used to examine the association of HTP use and SHS exposure with suicidal ideation, suicide plans, and suicide attempts among adolescents. Multivariable logistic regression analyses included: Model 1, which was adjusted for demographic characteristics such as sex, school type, perceived school performance, economic status, and residence type; and Model 2, which was adjusted for demographics, depression, and drug use. RESULTS The risk of suicidal ideation was 1.37 (95% CI: 1.10–1.70) and 1.44 (95% CI: 1.18–1.75) times higher among HTP users who were exposed to SHS at home and at public places, respectively, compared to non-users. The risk of suicide attempts was 1.88 (95% CI: 1.37–2.57), 1.45 (95% CI: 1.63–2.00), and 2.21 (95% CI: 1.63–3.00) times higher among HTP users exposed to SHS at home, school, and at public places, respectively. CONCLUSIONS HTP use, and SHS exposure are likely indicators of risk behaviors. Our findings suggest possible directions for initiating, implementing, and evaluating programs and services to monitor HTP use and SHS exposure among Korean adolescents.
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Affiliation(s)
- Soyoon Park
- Department of Public Health, Graduate School, The Catholic University of Korea, Seoul, Korea
| | - Kang-Sook Lee
- Department of Public Health, Graduate School, The Catholic University of Korea, Seoul, Korea.,Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Park M, Jung SJ. Association between menstrual cycle irregularity and suicidal ideation among Korean women: Results from the Korea national health and nutrition examination survey (2010-2012). J Affect Disord 2021; 293:279-284. [PMID: 34225207 DOI: 10.1016/j.jad.2021.06.052] [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: 12/29/2020] [Revised: 03/18/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND We aimed to evaluate the association between menstrual cycle irregularity and suicidal ideation in Korean women. METHODS Data on 5,606 women from the 2010-2012 Korea National Health and Nutrition Examination Survey, a population-based cross-sectional study, were included. Menstrual cycle irregularity, suicidal ideation, current occupational status, age at menarche, education level, household income, and marital status were assessed through questionnaires with trained interviewers. A multivariate logistic regression analysis was performed after adjusting for age, socioeconomic status, smoking and drinking status, age at menarche, comorbid diseases, and physical activity. RESULTS In the multivariate-adjusted models, we found significant associations between menstrual cycle irregularity and suicidal ideation (odds ratio [OR], 95% confidence interval [CI] = 1.44 [1.14-1.82]). This association was particularly noticeable in women aged 12 to 29 years (OR [95% CI] = 1.45 [1.04-2.03]), in those who had menarche at a relatively early age (aged 8-13 years) (OR [95% CI] = 1.60 [1.15-2.23]), and in those who were currently employed (OR [95% CI] = 1.46 [1.05-2.04]). LIMITATIONS Suicidal ideation was evaluated based on the participants' self-reports, and were therefore subjective in nature. Additionally, due to the cross-sectional design and use of retrospective data, causal relationships could not be drawn. CONCLUSION Women with irregular menstrual cycles were 1.42 times more likely to have suicidal ideation than those with regular cycles. More attention should be paid to menstrual cycle irregularity when attempting to improve levels of suicidal ideation.
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Affiliation(s)
- Minseo Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Sun Jae Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Bulik CM, Bertoia ML, Lu M, Seeger JD, Spalding WM. Suicidality risk among adults with binge-eating disorder. Suicide Life Threat Behav 2021; 51:897-906. [PMID: 34080227 PMCID: PMC8597150 DOI: 10.1111/sltb.12768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 02/25/2021] [Accepted: 03/10/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To estimate relative suicidality risk associated with binge-eating disorder (BED). METHODS Retrospective study of patients identified as having BED (N = 1042) and a matched general population cohort (N = 10,420) from the Optum electronic health record database between January 2009 and September 2015. Patients had ≥1 outpatient encounter with a provider who recognized BED during the 12-month baseline preceding entry date. Incidence and relative risk of suicidality were assessed. RESULTS Incidence per 1000 person-years (95% CI) of suicidal ideation and suicide attempts, respectively, was 31.1 (23.1, 41.0) and 12.7 (7.9, 19.4) in the BED cohort and 5.8 (4.7, 7.1) and 1.4 (0.9, 2.2) in the comparator cohort. Risk of suicidal ideation and suicide attempts was greater in the BED cohort (HR [95% CIs], 6.43 [4.42, 9.37]) than in the comparator cohort (HR [95% CI], 9.47 [4.99, 17.98]) during follow-up. After adjusting for psychiatric comorbidities, associations of suicidal ideation and suicide attempts with BED remained elevated in patients with BED having histories of suicidality. CONCLUSIONS Findings suggest that history of suicidality may result in an increased risk of suicidal ideation and suicide attempts in patients with BED relative to the general population. Psychiatric comorbidity burden may explain the elevated risk of these conditions in BED.
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Affiliation(s)
- Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina School of MedicineChapel HillNCUSA,Department of NutritionGillings School of Global Public HealthUniversity of North CarolinaChapel HillNCUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | | | - Mei Lu
- Takeda Pharmaceuticals USALexingtonMAUSA
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