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Dehara M, Wells MB, Sjöqvist H, Kosidou K, Dalman C, Sörberg Wallin A. Parenthood is associated with lower suicide risk: a register-based cohort study of 1.5 million Swedes. Acta Psychiatr Scand 2021; 143:206-215. [PMID: 33011972 PMCID: PMC7983926 DOI: 10.1111/acps.13240] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/04/2020] [Accepted: 09/23/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To determine whether parenthood among 25- to 44-year-olds is associated with a lower suicide rate in men and women in Sweden, and whether this is explained by selection into parenthood. METHODS In total, 1,582,360 Swedish women and men, born between 1967 and 1985, and childless at their 25th birthday, were followed from 1992 to 2011. All data originated from linkage to national Swedish registers. Cox regression models were used with time-varying parenthood status to estimate adjusted hazard ratios and 95% confidence intervals (aHR;CI) for suicide. RESULTS Having one, two, three or more children was associated with 64%, 79% and 78% lower suicide rate, respectively, compared with having no children, in models with basic adjustments. When a wide range of indicators of selection into parenthood were taken into account, the suicide rate was 58% lower in parents with one child and 70% lower in parents with two or more children compared with childless individuals (aHR 0.42 [95% CI 0.36-0.48]; 0.30 [95% CI 0.25-0.35]; 0.30 [95% CI 0.21-0.42]). In fathers with one, two, three or more children suicide rate was 54%, 64% and 59% lower, respectively, compared with non-fathers whereas in mothers was 70%, 83% and 93% lower, respectively, compared with non-mothers. CONCLUSION Parenthood among 25-to 44-year-olds is associated with a lower suicide risk in both men and women but to a larger extent among women, and particularly in parents with two or more children. Although selection into parenthood is possible, a protective effect of parenthood on suicide is likely in both men and women.
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Affiliation(s)
- Marina Dehara
- Clinical Epidemiology DivisionDepartment of Medicine SolnaKarolinska InstitutetStockholmSweden,Department of Global Public HealthKarolinska InstitutetStockholmSweden
| | - Michael B. Wells
- Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
| | - Hugo Sjöqvist
- Department of Global Public HealthKarolinska InstitutetStockholmSweden
| | - Kyriaki Kosidou
- Department of Global Public HealthKarolinska InstitutetStockholmSweden,Centre for Epidemiology and Community MedicineRegion StockholmStockholmSweden
| | - Christina Dalman
- Department of Global Public HealthKarolinska InstitutetStockholmSweden,Centre for Epidemiology and Community MedicineRegion StockholmStockholmSweden
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Female reproductive factors and risk of external causes of death among women: The Japan Public Health Center-based Prospective Study (JPHC Study). Sci Rep 2019; 9:14329. [PMID: 31586153 PMCID: PMC6778214 DOI: 10.1038/s41598-019-50890-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 09/16/2019] [Indexed: 01/10/2023] Open
Abstract
Although empirical data suggest a possible link between female reproductive events and risk of nonfatal accidents and suicidal behaviors, evidence to determine these effects on mortality is scarce. This study investigated the association between female reproductive factors and the risk of external causes of death among middle-aged Japanese women. We used a population-based cohort study consisting of 71 698 women residing in 11 public health center areas across Japan between 1990 and 1994. Multivariable-adjusted Cox proportional hazard regression models were used to estimate hazard ratios (HRs) of the risk of all external causes, suicide, and accidents according to female reproductive factors at the baseline survey. During 1 028 583 person-years of follow-up for 49 279 eligible subjects (average 20.9 years), we identified 328 deaths by all injuries. Among parous women, ever versus never breastfeeding [0.67 (95% CI: 0.49–0.92)] was associated with a decreased risk of all injuries. Risk of suicide was inversely associated with ever versus never parity [0.53 (95% CI: 0.32–0.88)]. A lower risk of death by accidents was seen in ever breastfeeding [0.63 (95% CI: 0.40–0.97)] compared to never breastfeeding. This study suggests that parity and breastfeeding are associated with reduced risk of death by all external causes, suicide and/or accidents among Japanese women.
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Yang CY, Weng YH, Chiu YW. Relationship between ozone air pollution and daily suicide mortality: a time-stratified case-crossover study in Taipei. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2019; 82:261-267. [PMID: 30870114 DOI: 10.1080/15287394.2019.1589109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Several studies suggested short-term exposure to air pollution might be associated with suicide mortality, although results have been inconsistent and vary depending upon the type of air contaminants. While seasonal variation associated with suicide was reported to occur and that in the spring and early summer there are peaks in ozone (O3) distribution, the relationship between these two parameters is not known. The aim of this study was to examine the potential association between O3 levels and daily mortality rate related to suicide in Taipei for the period 2004-2008 using a time-stratified case-crossover analysis. In our single pollutant model without adjustment for other pollutants, the risk of suicide increased by 11% on warm days and 15% on cool days for each interquartile range (IQR) rise in O3 concentration, respectively. The relationship was positive but did not reach significance. In our two-pollutant models, O3 remained non-significant on warm days after inclusion of one of any other ambient air contaminants into the model. However, on cool days, a significant association was found between O3 levels and enhanced risk of mortality due to suicide after nitrogen dioxide (NO2) or carbon monoxide (CO) were included. The overall positive but not significant findings of elevated risk of mortality frequently attributed to suicide on days with higher O3 levels suggest that outdoor exposures to this gaseous contaminant may contribute to increases in daily mortality rate related to suicide.
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Affiliation(s)
- Chun-Yuh Yang
- a Department of Public Health, College of Health Sciences , Kaohsiung Medical University , Kaohsiung , Taiwan
- b National Institute of Environmental Health Sciences, National Health Research Institute , Miaoli , Taiwan
| | - Yi-Hao Weng
- c Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital , Chang Gung University College of Medicine , Taipei , Taiwan
| | - Ya-Wen Chiu
- d Master Program in Global Health and Development, College of Public Health and Nutrition , Taipei Medical University , Taipei , Taiwan
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Kim E, Lee S, Lim S, Chung W. Relationship between the Suicidal Ideation of the Married Women and the Characteristics of Their Children. HEALTH POLICY AND MANAGEMENT 2013. [DOI: 10.4332/kjhpa.2013.23.4.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Farias DR, Pinto TDJP, Teofilo MMA, Vilela AAF, Vaz JDS, Nardi AE, Kac G. Prevalence of psychiatric disorders in the first trimester of pregnancy and factors associated with current suicide risk. Psychiatry Res 2013; 210:962-8. [PMID: 24090486 DOI: 10.1016/j.psychres.2013.08.053] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 08/06/2013] [Accepted: 08/29/2013] [Indexed: 11/26/2022]
Abstract
This study aimed to describe the prevalence of psychiatric disorders and to identify the factors associated with Current Suicide Risk (CSR) in the first trimester of pregnancy. The Mini-International Neuropsychiatric Interview (M.I.N.I.) was employed to diagnose mental disorders in 239 women enrolled in a prospective cohort in Rio de Janeiro, Brazil. Serum lipids, leptin and socio-economic status were the independent variables. CSR, the dependent variable, was entered as binary (yes/no) variable into crude and adjusted Poisson regression models with robust variances. CSR was found to be the main psychiatric syndrome (18.4%), followed by agoraphobia (17.2%), major depressive disorder (15.1%) and generalized anxiety disorder (10.5%). Women with CSR showed higher mean levels of cholesterol (169.2 vs. 159.2; p=0.017), high density lipoprotein (50.4 vs. 47.7; p=0.031) and low density lipoprotein (102.8 vs. 95.6; p=0.022) when compared to women without CSR. The adjusted regression model showed a higher prevalence ratio (PR) of CSR among pregnant women with generalized anxiety disorder (PR=2.70, 95% CI: 1.36-5.37), with ≥ two parturitions (PR=2.46, 95% CI: 1.22-4.93), and with major depressive disorder (PR=2.11, 95% CI: 1.08-4.12). We have shown that generalized anxiety disorder, major depressive disorder and higher parity are associated with CSR in the first trimester of pregnancy.
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Affiliation(s)
- Dayana Rodrigues Farias
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, RJ, Brazil; Graduate Program in Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, RJ, Brazil
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Chen CC, Kuo CC, Wu TN, Yang CY. Death of a son is associated with risk of suicide among parous women in Taiwan: a nested case-control study. J Epidemiol 2012; 22:532-6. [PMID: 23006957 PMCID: PMC3798565 DOI: 10.2188/jea.je20120060] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The impact of the sex of a deceased child on maternal suicide has not been studied. We examined whether the death of a child, especially a son, increased the risk of suicide among parous Taiwanese women. Methods This matched case-control study was done within a cohort of 1 292 462 Taiwanese women who experienced a first and singleton childbirth between 1 January 1978 and 31 December 1987 and were followed up until 31 December 2008. From the cohort, 2701 suicide cases were identified and 2701 controls were randomly selected. Multiple logistic regression was used to estimate the risk of suicide associated with the death of a child. Results The adjusted odds ratios (ORs) for suicide among mothers whose son had died were 2.60 (95% CI = 1.18–5.73), 2.58 (1.28–5.20), and 4.20 (0.79–22.45) for death of a son aged younger than 1 year, 1 to 17 years, and 18 years or older. The ORs for suicide associated with the death of a daughter were not statistically significant: the respective adjusted ORs were 1.86 (0.82–4.62), 1.38 (0.54–3.49), and 2.48 (0.40–15.51). Conclusions The death of a child, especially a son, increased the risk of maternal suicide, which supports the notion that preference for a son is firmly rooted in traditional Chinese culture.
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Affiliation(s)
- Chih-Cheng Chen
- Department of Pediatrics, Kaohsiung Chang-Gung Memorial Hospital and Chang-Gung University, College of Medicine, Kaohsiung, Taiwan
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Gold KJ, Singh V, Marcus SM, Palladino CL. Mental health, substance use and intimate partner problems among pregnant and postpartum suicide victims in the National Violent Death Reporting System. Gen Hosp Psychiatry 2012; 34:139-45. [PMID: 22055329 PMCID: PMC3275697 DOI: 10.1016/j.genhosppsych.2011.09.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 09/26/2011] [Accepted: 09/27/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Suicide during pregnancy and postpartum is a tragic event for the victim and profoundly impacts the baby, the family and the community. Prior efforts to study risks for pregnancy-associated suicide have been hampered by the lack of data sources which capture pregnancy and delivery status of victims. Introduction of the United States National Violent Death Reporting System (NVDRS) offers new insights into violent deaths by linking multiple data sources and allowing better examination of psychosocial risk factors. METHODS The analysis used data from 17 states reporting to the NVDRS from 2003 to 2007 to evaluate suicide patterns among pregnant, postpartum, and nonpregnant or postpartum women. Demographic factors, mental health status, substance use, precipitating circumstances, intimate partner problems and suicide methods were compared among groups. RESULTS The 2083 female suicide victims of reproductive age demonstrated high prevalence of existing mental health diagnosis and current depressed mood, with depressed mood significantly higher among postpartum women. Substance use and presence of other precipitating factors were high and similar among groups. Intimate partner problems were higher among pregnant and postpartum victims. Postpartum women were more likely to die via asphyxia as cause of death compared to poisoning or firearms. CONCLUSIONS These findings describe important mental health, substance use and intimate partner problems seen with pregnancy-associated suicide. The study highlights mental health risk factors which could potentially be targeted for intervention in this vulnerable population.
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Affiliation(s)
- Katherine J. Gold
- Department of Family Medicine, Department of Obstetrics & Gynecology, University of Michigan
| | - Vijay Singh
- Department of Emergency Medicine, Department of Family Medicine, University of Michigan
| | - Sheila M. Marcus
- Women’s Mood Disorders Program, Department of Psychiatry, University of Michigan
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Abstract
OBJECTIVE To determine whether parenthood predicts host resistance to the common cold among healthy volunteers experimentally exposed to a common cold virus. METHODS Participants were 795 healthy volunteers (age range = 18-55 years) enrolled in one of three viral-challenge studies conducted from 1993 to 2004. After reporting parenthood status, participants were quarantined, administered nasal drops containing one of four common cold viruses, and monitored for the development of a clinical cold (infection in the presence of objective signs of illness) on the day before and for 5 to 6 days after exposure. All analyses included controls for immunity to the experimental virus (prechallenge specific antibody titers), viral strain, season, age, sex, race/ethnicity, marital status, body mass, study, employment status, and education. RESULTS Parents were less likely to develop colds than nonparents were (odds ratio [OR] = 0.48, 95% confidence interval [CI] = 0.31-0.73). This was true for both parents with one to two children (OR = 0.52, 95% CI = 0.33-0.83) and three or more children (OR = 0.39, 95% CI = 0.22-0.70). Parenthood was associated with a decreased risk of colds for both those with at least one child living at home (OR = 0.46, 95% CI = 0.24-0.87) and those whose children all lived away from home (OR = 0.27, 95% CI = 0.12-0.60). The relationship between parenthood and colds was not observed in parents aged 18 to 24 years but was pronounced among older parents. CONCLUSIONS Parenthood was associated with greater host resistance to common cold viruses.
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Affiliation(s)
- Rodlescia S. Sneed
- Department of Psychology, Carnegie Mellon University, 5000 Forbes Avenue, Pittsburgh, PA 15213, Phone: (305) 785-9536, Fax: (412) 268-2798
| | - Sheldon Cohen
- Department of Psychology, Carnegie Mellon University
| | - Ronald B. Turner
- Department of Pediatrics, University of Virginia Health Science Center
| | - William J. Doyle
- Department of Otolaryngology, Children’s Hospital of Pittsburgh and the University of Pittsburgh School of Medicine
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Andermann L. Culture and the social construction of gender: mapping the intersection with mental health. Int Rev Psychiatry 2011; 22:501-12. [PMID: 21047162 DOI: 10.3109/09540261.2010.506184] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The social construction of gender is an important concept for better understanding the determinants of mental health in women and men. Going beyond physical and physiological differences and the traditional biomedical approach, interdisciplinary study of the complex factors related to culture and society, power and politics is necessary to be able to find solutions to situations of disparity in mental health, related to both prevalence of disorders, availability and response to treatment. Gender inequality continues to be a source of suffering for many women around the world, and this can lead to adverse mental health outcomes. This review focuses on developments in the literature on culture, gender and mental health over the past decade, focusing on themes around the social construction of gender, mental health and the media, a look at cultural competence through a gender lens, gender and the body, providing some examples of the intersection between mental health and gender in low-income countries as well as the more developed world, and the impact of migration and resettlement on mental health. At the clinical level, using a bio-psycho-social-spiritual model that can integrate and negotiate between both traditional and biomedical perspectives is necessary, combined with use of a cultural formulation that takes gender identity into account. Research involving both qualitative and quantitative perspectives, and in many cases an ethnographic framework, is essential in tackling these global issues.
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Affiliation(s)
- Lisa Andermann
- Department of Psychiatry, Culture, Community and Health Studies, University of Toronto, 600 University Avenue, Toronto, Ontario, Canada.
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