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Lepori GM, Morgan S, Assarian BA, Mishra T. Economic activity and suicides: Causal evidence from macroeconomic shocks in England and Wales. Soc Sci Med 2024; 342:116538. [PMID: 38181719 DOI: 10.1016/j.socscimed.2023.116538] [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: 10/14/2023] [Revised: 12/03/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024]
Abstract
The relationship between economic activity and suicides has been the subject of much scrutiny, but the focus in the extant literature has been almost exclusively on estimating associations rather than causal effects. In this paper, using data from England and Wales between January 1, 1997 and December 31, 2017, we propose a plausible set of assumptions to estimate the causal impacts of well-known macroeconomic variables on the daily suicide rate. Our identification strategy relies on scheduled macroeconomic announcements and professional economic forecasts. An important advantage of using these variables to model suicide rates is that they can efficiently capture the elements of 'surprise or shock' via the observed difference between how the economy actually performed and how it was expected to perform. Provided that professional forecasts are unbiased and efficient, the estimated 'surprises or shocks' are 'as good as random', and therefore are exogenous. We employ time series regressions and present robust evidence that these exogenous macroeconomic shocks affect the suicide rate. Overall, our results are consistent with economic theory that shocks that reduce estimated permanent income, and therefore expected lifetime utility, can propel suicide rates. Specifically, at the population level, negative shocks to consumer confidence and house prices accelerate the suicide rate. However, there is evidence of behavioural heterogeneity between sexes, states of the economy, and levels of public trust in government. Negative shocks to the retail price index (RPI) raise the suicide rate for males. Negative shocks to the growth rate in gross domestic product (GDP) raise the population suicide rate when the economy is doing poorly. When public trust in government is low, increases in the unemployment rate increase the suicide rate for females.
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Affiliation(s)
| | | | - Borna A Assarian
- University of Southampton, Southampton, UK; University Hospital of Southampton, NHS, Southampton, UK.
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2
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Singh P, Gailey S, Das A, Bruckner TA. National Trends in Suicides and Male Twin Live Births in the US, 2003 to 2019: An Updated Test of Collective Optimism and Selection in Utero. Twin Res Hum Genet 2023; 26:1-8. [PMID: 38099411 PMCID: PMC11178679 DOI: 10.1017/thg.2023.49] [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] [Indexed: 06/17/2024]
Abstract
Prior research based on Swedish data suggests that collective optimism, as measured by monthly incidence of suicides, correlates inversely with selection in utero against male twins in a population. We test this finding in the US, which reports the highest suicide rate of all high-income countries, and examine whether monthly changes in overall suicides precede changes in the ratio of male twin to male singleton live births. Consistent with prior work, we also examine as a key independent variable, suicides among women aged 15-49 years. We retrieved monthly data on suicides and the ratio of male twin to singleton live births from CDC WONDER, 2003 to 2019, and applied Box-Jenkins iterative time-series routines to detect and remove autocorrelation from both series. Results indicate that a 1% increase in monthly change in overall suicides precedes a 0.005 unit decline in male twin live births ratio 6 months later (coefficient = -.005, p value = .004). Results remain robust to use of suicides among reproductive-aged women as the independent variable (coefficient = -.0012, p value = .014). Our study lends external validity to prior research and supports the notion that a decline in collective optimism corresponds with greater selection in utero.
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Affiliation(s)
- Parvati Singh
- Division of Epidemiology, College of Public Health, The Ohio State University, Ohio, USA
| | - Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, Michigan, USA
| | - Abhery Das
- Program in Public Health, University of California, Irvine, California, USA
| | - Tim A. Bruckner
- Program in Public Health, University of California, Irvine, California, USA
- Center for Population, Inequality, and Policy, University of California, Irvine, California, USA
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3
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Messias E, Salas J, Wilson L, Scherrer JF. Temporal Location of Changes in the US Suicide Rate by Age, Ethnicity, and Race: A Joinpoint Analysis 1999-2020. J Nerv Ment Dis 2023; 211:530-536. [PMID: 37040181 PMCID: PMC10309088 DOI: 10.1097/nmd.0000000000001653] [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] [Indexed: 04/12/2023]
Abstract
ABSTRACT Suicide rates differ over time. Our objective was to determine when significant changes occurred by age, race, and ethnicity in the United States between 1999 and 2020. National Center for Health Statistics WONDER data were used in joinpoint regression. The annual percent change in suicide rate increased for all race, ethnic, and age groups, except for those 65 years and older. For American Indian/Alaska Natives, the largest increase occurred between 2010 and 2020 for those with ages 25 to 34 years. For Asian/Pacific Islander, the largest increase occurred among those 15 to 24 years old between 2011 and 2016. For Black/African-Americans, the largest increases occurred between 2010 and 2020 among 15- to 34-year-olds. For Whites, the largest increase occurred between 2014 and 2017 among 15- to 24-year-olds. Between 2018 and 2020, suicide rates significantly declined among Whites 45 to 64 years of age. Among Hispanics, significant increases in suicide rate occurred between 2012 and 2020 among those with ages 15 to 44 years. Between 1999 and 2020, the contour of suicide burden varied by age groups, race, and ethnicity.
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Affiliation(s)
- Erick Messias
- Department of Psychiatry and Behavioral Neuroscience
| | - Joanne Salas
- Department of Family and Community Medicine, School of Medicine, Saint Louis University, St. Louis, Missouri
| | - Lauren Wilson
- Department of Family and Community Medicine, School of Medicine, Saint Louis University, St. Louis, Missouri
| | - Jeffrey F. Scherrer
- Department of Psychiatry and Behavioral Neuroscience
- Department of Family and Community Medicine, School of Medicine, Saint Louis University, St. Louis, Missouri
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Johns L, Zhong C, Mezuk B. Understanding Suicide over the Life Course Using Data Science Tools within a Triangulation Framework. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2023; 8:e230003. [PMID: 37168035 PMCID: PMC10168676 DOI: 10.20900/jpbs.20230003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Suicide and suicidal behaviors are important global health concerns. Preventing suicide requires a nuanced understanding of the nature of suicide risk, both acutely during periods of crisis and broader variation over the lifespan. However, current knowledge of the sources of variation in suicide risk is limited due to methodological and conceptual challenges. New methodological approaches are needed to close the gap between research and clinical practice. This review describes the life course framework as a conceptual model for organizing the scientific study of suicide risk across in four major domains: social relationships, health, housing, and employment. In addition, this review discusses the utility of data science tools as a means of identifying novel, modifiable risk factors for suicide, and triangulation as an overarching approach to ensuring rigor in suicide research as means of addressing existing knowledge gaps and strengthening future research.
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Safaei Lari M, Emamgholipour Sefiddashti S. Socio-economic, health and environmental factors influencing suicide rates: A cross-country study in the Eastern Mediterranean region. J Forensic Leg Med 2023; 93:102463. [PMID: 36580881 DOI: 10.1016/j.jflm.2022.102463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/01/2022] [Accepted: 11/27/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Suicide is a crucial concern for public health in the world. To date, there is no synthesized evidence about the cross-country impact of suicide risk factors in the Eastern Mediterranean (EMRO). This paper aims to cover the gap and assess socio-economic, health, and environmental (SHE) factors influencing suicide rates among the EMRO countries from 1990 to 2019. METHODS This analysis is a cross-sectional time-series design which uses random-effect panel data from 17 EMRO countries. SHE variables are inflation rate, economic growth, unemployment rate, urbanization, and female labor force participation rate, mental disorders prevalence and individuals using the internet. RESULTS The models indicate that male suicide rates was positively associated with inflation rate (coefficient = 0.002, p < 0.05) unemployment rate (0.06, p < 0.01), mental disorders prevalence (0.0008, p < 0.01), and urbanization (0.08, p < 0.05). Conversely, individuals using the internet (-0.019, p < 0.01) was related to a reduction in male suicide rates. Variables correlated with an increase in female suicide rates included inflation rate (0.001, p < 0.05), mental disorders prevalence (coefficient = 0.0004, p < 0.01) and urbanization (0.03, p < 0.01). Individuals using the internet (-0.006, p < 0.01) and education index (-4.8, p < 0.01) had negative effect on female suicide rates. CONCLUSIONS This research confirms that SHE factors appear to affect suicide. So policymakers should endeavor to control them if the nations are aimed at preventing suicides. Future researches are essential to scrutinize paradoxes in the field.
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Affiliation(s)
- Majid Safaei Lari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sara Emamgholipour Sefiddashti
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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6
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Faiões VDS, Póvoa HCC, Thurler BA, Chianca GC, Assaf AV, Iorio NLPP. Two years of COVID-19 pandemic: Framework of health interventions in a Brazilian city. Front Public Health 2022; 10:1025410. [PMID: 36388316 PMCID: PMC9650536 DOI: 10.3389/fpubh.2022.1025410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/10/2022] [Indexed: 01/28/2023] Open
Abstract
The COVID-19 pandemic and its effects on public health have urgently demanded effective health policies to avoid the spread of COVID-19. Thus, public administrators have implemented non-pharmacological and pharmacological interventions to mitigate the pandemic's impacts and strengthen health services. The aim of this ecological study is to describe the scenario of COVID-19 pandemic in a Brazilian city, during 2 years. This ecological study was carried out in Nova Friburgo, a Brazilian city, for 105 weeks (two years), from March 29, 2020 (week 1) to April 02, 2022 (week 105). Data on COVID-19 cases and COVID-19 deaths, occupation of COVID-19 exclusive beds in hospitals, community mobility, vaccination, government regulation on the opening of city establishments and city risk assessment were collected from public datasets. Four waves of COVID-19 cases and deaths were observed during this period. The first case occurred in week 1 and first death in week 3 of this study. The highest peaks of cases and deaths were observed during the third wave with 1,131 cases (week 54) and 47 deaths (week 55) and where the highest occupation of COVID-19 exclusive beds in local hospitals occurred. Interventions from more restrictive to more flexible, were implemented throughout this study, including lockdown and gradual return in economic and social strata levels. Vaccination began on week 43 and at the end of this study 89.91% of the total population was vaccinated with at least one dose, being 83.22% fully vaccinated. A deep description of several interventions used to avoid COVID-19 spread in a Brazilian city during 2 years of this pandemic can help promote better decision-making in the future while it exposes the challenges of conducting public health policies in a pandemic scenario.
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Affiliation(s)
- Vanessa dos Santos Faiões
- Postgraduate Program in Dentistry, Instituto de Saúde de Nova Friburgo, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil,Department of Basic Science, Instituto de Saúde de Nova Friburgo, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Helvécio Cardoso Corrêa Póvoa
- Department of Basic Science, Instituto de Saúde de Nova Friburgo, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Bruna Alves Thurler
- Department of Basic Science, Instituto de Saúde de Nova Friburgo, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Gabriela Ceccon Chianca
- School of Pharmacy, Universidade Estácio de Sá (UNESA), Nova Friburgo, Rio de Janeiro, Brazil
| | - Andréa Videira Assaf
- Postgraduate Program in Dentistry, Instituto de Saúde de Nova Friburgo, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil,Department of Specific Formation, Instituto de Saúde de Nova Friburgo, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Natalia Lopes Pontes Póvoa Iorio
- Postgraduate Program in Dentistry, Instituto de Saúde de Nova Friburgo, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil,Department of Basic Science, Instituto de Saúde de Nova Friburgo, Universidade Federal Fluminense (UFF), Nova Friburgo, Rio de Janeiro, Brazil,*Correspondence: Natalia Lopes Pontes Póvoa Iorio
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7
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Asper M, Osika W, Dalman C, Pöllänen E, Simonsson O, Flodin P, Sidorchuk A, Marchetti L, Awil F, Castro R, Niemi ME. Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review. BJPsych Open 2022; 8:e181. [PMID: 36214114 PMCID: PMC9551492 DOI: 10.1192/bjo.2022.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors. AIMS The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health. METHOD Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health. RESULTS The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure. CONCLUSIONS Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.
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Affiliation(s)
- Michaela Asper
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Walter Osika
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Elin Pöllänen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | | | | | - Rosa Castro
- Federation of European Academies of Medicine, Belgium
| | - Maria E Niemi
- Department of Global Public Health, Karolinska Institutet, Sweden
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8
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Lebedev AV, Abé C, Acar K, Deco G, Kringelbach ML, Ingvar M, Petrovic P. Large-scale societal dynamics are reflected in human mood and brain. Sci Rep 2022; 12:4646. [PMID: 35301376 PMCID: PMC8931098 DOI: 10.1038/s41598-022-08569-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
The stock market is a bellwether of socio-economic changes that may directly affect individual well-being. Using large-scale UK-biobank data generated over 14 years, we applied specification curve analysis to rigorously identify significant associations between the local stock market index (FTSE100) and 479,791 UK residents' mood, as well as their alcohol intake and blood pressure adjusting the results for a large number of potential confounders, including age, sex, linear and non-linear effects of time, research site, other stock market indexes. Furthermore, we found similar associations between FTSE100 and volumetric measures of affective brain regions in a subsample (n = 39,755; measurements performed over 5.5 years), which were particularly strong around phase transitions characterized by maximum volatility in the market. The main findings did not depend on applied effect-size estimation criteria (linear methods or mutual information criterion) and were replicated in two independent US-based studies (Parkinson's Progression Markers Initiative; n = 424; performed over 2.5 years and MyConnectome; n = 1; 81 measurements over 1.5 years). Our results suggest that phase transitions in the society, indexed by stock market, exhibit close relationships with human mood, health and the affective brain from an individual to population level.
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Affiliation(s)
- Alexander V Lebedev
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. .,Center for Cognitive and Computational Neurosceince (CCNP), Karolinska Institutet, Stockholm, Sweden.
| | - Christoph Abé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kasim Acar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain.,Institució Catalana de la Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Morten L Kringelbach
- Centre for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK.,Center for Music in the Brain, Aarhus University, Aarhus, Denmark
| | - Martin Ingvar
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Predrag Petrovic
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Center for Cognitive and Computational Neurosceince (CCNP), Karolinska Institutet, Stockholm, Sweden
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9
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Opposite nonlinear effects of unemployment and sentiment on male and female suicide rates: Evidence from Australia. Soc Sci Med 2021; 292:114536. [PMID: 34772521 DOI: 10.1016/j.socscimed.2021.114536] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 11/23/2022]
Abstract
We investigate gender differences in the effects of unemployment and sentiment on suicide rates. Using monthly Australian data, we find a positive relationship between the unemployment rate and the suicide rate, and a negative relationship between consumer sentiment and the suicide rate. However, there is strong evidence of nonlinearity in the effects of both unemployment and sentiment on suicide rates, with substantial gender differences. For men, an increase in the unemployment rate increases the suicide rate, but an unemployment decrease has no effect; we find the opposite for women. For men, an increase in sentiment has stronger effects on the suicide rate than a decrease in sentiment. Again, we observe the opposite effect for women. Among sentiment components, forward-looking expectations are stronger predictors of suicide rates than present conditions. Sentiment has a much stronger effect on male suicide rates than on female suicide rates.
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Guerra O, Eboreime E. The Impact of Economic Recessions on Depression, Anxiety, and Trauma-Related Disorders and Illness Outcomes-A Scoping Review. Behav Sci (Basel) 2021; 11:119. [PMID: 34562956 PMCID: PMC8464685 DOI: 10.3390/bs11090119] [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] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
In the wake of a global economic recession secondary to the COVID-19 pandemic, this scoping review seeks to summarize the current quantitative research on the impact of economic recessions on depression, anxiety, traumatic disorders, self-harm, and suicide. Seven research databases (PsycINFO, MEDLINE, Embase, Web of Science: Core Collection, National Library of Medicine PubMed, PubMed Central, and Google Scholar) were searched for keywords returning 3412 preliminary results published since 2008 in Organisation for Economic Coordination and Development (OECD)nations. These were screened by both authors for inclusion/exclusion criteria resulting in 127 included articles. Articles included were quantitative studies in OECD countries assessing select mental disorders (depression, anxiety, and trauma-/stress-related disorders) and illness outcomes (self-harm and suicide) during periods of economic recession. Articles were limited to publication from 2008 to 2020, available online in English, and utilizing outcome measures specific to the disorders and outcomes specified above. A significant relationship was found between periods of economic recession and increased depressive symptoms, self-harming behaviour, and suicide during and following periods of recession. Results suggest that existing models for mental health support and strategies for suicide prevention may be less effective than they are in non-recession times. It may be prudent to focus public education and medical treatments on raising awareness and access to supports for populations at higher risk, including those vulnerable to the impacts of job or income loss due to low socioeconomic status preceding the recession or high levels of financial strain, those supporting others financially, approaching retirement, and those in countries with limited social safety nets. Policy makers should be aware of the potential protective nature of unemployment safeguards and labour program investment in mitigating these negative impacts. Limited or inconclusive data were found on the relationship with traumatic disorders and symptoms of anxiety. In addition, research has focused primarily on the working-age adult population with limited data available on children, adolescents, and older adults, leaving room for further research in these areas.
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Affiliation(s)
- Olivia Guerra
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada;
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11
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Global Imbalances: The Role of Institutions, Financial Development and FDI in the Context of Financial Crises. SUSTAINABILITY 2021. [DOI: 10.3390/su13010356] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper examines the role of the quality of institutions, financial development and FDI on current account imbalances, which narrowed during the Global Financial Crisis. In doing so, we utilize (i) a sample of 49 advanced and emerging economies during 1984–2014; (ii) a novel three-clustered indices of institutional quality and (iii) two measures of financial development, the share of FDI and a measure of financial crisis in addition to standard determinants of the current account. We find that the better the quality of institutions and the greater the financial development, the larger are current account deficits; meanwhile, FDI contributes to boost current account balances. Moreover, financial crisis episodes tend to improve current account balances, particularly for countries that are highly open to trade and to receive FDI, as in the case of advanced economies and East Asian countries.
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Abstract
Suicide rates have continued to rise in the United States. Speculations for this rise proliferate but the causes for the increase remain unknown. While research focuses on identifying causes, the health care system is an important site for identification of patients at risk. Forty percent of individuals who die by suicide were seen in primary care in the month prior to suicide. The Zero Suicide model describes a comprehensive approach for health care systems to aid in identification and intervention of suicidal patients. While this model promises to improve care of suicidal patients, the need for innovation in our approach to understanding and caring for suicidal patients is pressing. Use of technology to enhance moment-to-moment monitoring of at-risk individuals offers promise and the possibility of intervening close to escalation of acute suicidal states. Further, once identified, suicidal individuals are often difficult to engage in treatment. Novel approaches to engagement and treatment that are effective and acceptable to suicidal patients ought to be developed. Specifically, males are much more likely than females to die by suicide. At the same time, males are less likely to seek and remain in the treatments we have to offer. Innovation should seek to identify strategies that are acceptable to males. Additionally, while about half of psychiatric inpatient admissions are suicide related, there is a paucity of suicide-specific psychosocial interventions available for inpatient settings. Innovation in monitoring and treatment offer promise in helping to reduce suicidal behavior in the United States.
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Affiliation(s)
- Barbara Stanley
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons, New York
| | - J John Mann
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons, New York
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13
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Can Financial Support Reduce Suicide Mortality Rates? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234797. [PMID: 31795379 PMCID: PMC6926693 DOI: 10.3390/ijerph16234797] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 01/09/2023]
Abstract
After the launch of governmental financial support for the development of a regional suicide prevention programme, ‘Emergency Fund to Enhance Community-Based Suicide Countermeasure’ in 2009, suicide mortality rates in Japan have decreased from 25.7 (in 2009) to 16.5 (in 2018) per 100,000 population. Therefore, to explore the effects of governmental financial support on suicide mortality rates in Japan, the present study determined the relationship between the trends of empirical Bayes standardised Mobile Ratio of suicide mortality ratio in all 47 Japanese prefectures (EBSMR-RR) and the execution amounts of 10 sub-divisions of ‘Emergency Fund to Enhance Community-Based Suicide Countermeasure’ using stepwise multiple regression analysis. The female EBSMR-RR was only significantly/inversely related to the municipal ‘development of listeners and leaders’, whereas male EBSMR-RR was significantly/inversely related to prefectural ‘enlightenment’, and ‘intervention models’, but significantly/directly related to prefectural ‘personal consultation support’. The present findings suggest the inverse relationship between financial support and the suicide mortality rates in Japan. Furthermore, the independent factors in the reduction of suicide mortality rates between males and females provide important information for planning a scientifically evidence-based and more cost-effective regional suicide prevention programmes.
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Bou Khalil R. The psychological wellbeing of the Lebanese society lies between incremental suicide rates and financial stress. Asian J Psychiatr 2019; 42:85-86. [PMID: 30978558 DOI: 10.1016/j.ajp.2019.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 02/14/2019] [Accepted: 04/07/2019] [Indexed: 10/27/2022]
Abstract
Suicide rates have been suspected to increase in Lebanon during the last couple of years. While these rates might be increasing due to an increase in the probability of declaring suicide, it seems important to study why suicide, as a phenomenon, might be possibly increasing in the Lebanese society. One of the most important reasons behind this rise in suicide rates could be related to the economical crisis that has been striking the country for more than two years.
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Affiliation(s)
- Rami Bou Khalil
- Hotel Dieu de France, Beirut, Lebanon; Saint Joseph University, Beirut, Lebanon.
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15
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Brown LA, Wakschal E, Russman-Block S, Boisseau CL, Mancebo MC, Eisen JL, Rasmussen SA. Directionality of change in obsessive compulsive disorder (OCD) and suicidal ideation over six years in a naturalistic clinical sample ✰. J Affect Disord 2019; 245:841-847. [PMID: 30699868 PMCID: PMC6361538 DOI: 10.1016/j.jad.2018.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/17/2018] [Accepted: 11/02/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is associated with elevated suicide risk, but the directionality of the association between OCD severity and suicidal ideation has not been established, which was the goal of this study. METHODS Participants (n = 325) were adults with either a current or past diagnosis of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) OCD who were assessed annually for suicidal ideation and OCD symptom severity for six years. Cross-lagged panel analyses statistically compared unidirectional and bidirectional models over time. Serious suicide-related adverse events were reported. RESULTS The best-fitting and most parsimonious model included paths predicting suicidal ideation from OCD symptom severity, but not vice versa. These results were confirmed by comparing a model with cross-lagged paths constrained equal to a freely estimated model. Higher OCD symptom severity in a given year was associated with a higher suicidal ideation severity in the subsequent year. Five suicide-related adverse events were reported throughout the duration of the study, including two suicide deaths and three suicide attempts. LIMITATIONS The study relied on a single-item, annual measure of suicidal ideation in adults, with substantial variability in severity of suicide risk, and missing data increased with later observations in the study. DISCUSSION OCD symptom severity predicted next year suicidal ideation severity. In contrast, suicidal ideation severity in a given year did not predict next-year OCD symptom severity in this OCD sample. Thus, rather than waiting for suicidal ideation to resolve, clinicians should consider providing empirically supported treatments for OCD.
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Affiliation(s)
- Lily A. Brown
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA,Corresponding author information: Lily A. Brown, Center for the Treatment and Study of Anxiety, 3535 Market St, Suite 600 North Philadelphia, PA 19104; 215-746-3346; Fax: 215-746-3311;
| | - Emily Wakschal
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Stefanie Russman-Block
- Warren Alpert Medical School of Brown University, Providence RI, USA,Michigan State University, East Lansing, MI, USA
| | - Christina L. Boisseau
- Warren Alpert Medical School of Brown University, Providence RI, USA,Butler Hospital, Providence RI, USA
| | - Maria C. Mancebo
- Warren Alpert Medical School of Brown University, Providence RI, USA,Butler Hospital, Providence RI, USA
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