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Pollak OH, Sheehan AE, Walsh RFL, Stephenson AR, Zell H, Mayes J, Lawrence HR, Bettis AH, Liu RT. Assessment of suicidal thoughts and behaviors in adults: A systematic review of measure psychometric properties and implications for clinical and research utility. Clin Psychol Rev 2024; 112:102464. [PMID: 39106741 PMCID: PMC11346605 DOI: 10.1016/j.cpr.2024.102464] [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: 02/02/2024] [Revised: 06/12/2024] [Accepted: 07/06/2024] [Indexed: 08/09/2024]
Abstract
High-quality clinical care and research on suicidal thoughts and behaviors (STBs) depends on availability and implementation of reliable and valid measures of STBs. In contrast to studies examining STB risk factors, screening instruments, or treatment, little research has rigorously examined the content, characteristics, and psychometric properties of STB measures themselves. This systematic review (1) identified STB measures that conform to empirically supported definitions of STBs, and (2) identified peer-reviewed papers reporting on the psychometric properties of these measures in adults. Data on psychometric properties and other measure characteristics were extracted. A total of 21 eligible measures were identified in the first stage. In the second stage, 70 articles (with 79 independent samples) were included with psychometric data in adult samples for 19 measures. Although there was support for strong internal consistency and content validity across many measures, face validity and clinical utility concerns were prevalent. Few measures comprehensively assessed suicidal behaviors, and interview-based assessments tended to show the strongest psychometric properties and clinical utility. Findings are discussed in the context of recommendations for improving existing measures, including future research to increase utility and translatability across clinical settings, delivery methods, and diverse populations.
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Affiliation(s)
- Olivia H Pollak
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Ana E Sheehan
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Rachel F L Walsh
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Auburn R Stephenson
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Holly Zell
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Jenna Mayes
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Alexandra H Bettis
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Richard T Liu
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Liu RT, Bettis AH, Lawrence HR, Walsh RFL, Sheehan AE, Pollak OH, Stephenson AR, Kautz MM, Marlowe RM. Measures of Suicidal Thoughts and Behaviors in Children and Adolescents: A Systematic Review and Recommendations for Use in Clinical and Research Settings. Assessment 2024:10731911241249438. [PMID: 38742801 DOI: 10.1177/10731911241249438] [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: 05/16/2024]
Abstract
Empirically supported measures of suicidal thoughts and behaviors (STBs) are needed to serve as reference outcomes for suicide risk screening tools and to monitor severity and treatment progress in children and adolescents with STBs. The present paper systematically reviewed existing measures of STBs in youth and studies evaluating their psychometric properties and clinical utility. Measures were then evaluated on reliability, validity, and clinical utility. Sixteen articles (20 independent samples) were found with psychometric data with youth samples for eight measures. Interview-based measures were found to have the strongest psychometric support and clinical utility. Significant limitations exist for all self-report measures due to inherent characteristics of these measures that cannot be remedied through additional psychometric study. There is an urgent need for the development and validation of new self-report measures of STBs, particularly for preadolescent children, sexual and gender minority youth, and racial/ethnic minority youth.
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Affiliation(s)
- Richard T Liu
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Seong E, Lee KH, Lee JS, Kim S, Seo DG, Yoo JH, Han DH, Hwang H, Choi CH, Kim JW. Depression and posttraumatic stress disorder in adolescents with nonsuicidal self-injury: comparisons of the psychological correlates and suicidal presentations across diagnostic subgroups. BMC Psychiatry 2024; 24:138. [PMID: 38373899 PMCID: PMC10877746 DOI: 10.1186/s12888-024-05533-5] [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: 03/31/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) combined with suicide ideation increases the risk of suicidal behaviors. Depression and posttraumatic stress disorder (PTSD) are comorbidities of NSSI compounding this relationship. The present study compared diagnostic subgroups of NSSI based on current depression and PTSD on psychological correlates (i.e., vulnerabilities and impairment) and suicidal presentations (i.e., suicidal cognitions and behaviors) in a psychiatric sample of adolescents. METHODS Eighty-seven adolescents meeting DSM-5 criteria for NSSI and 104 age-range-matched nonclinical controls (NC) participated. Participants completed self-report measures on psychological vulnerabilities and impairment (e.g., emotion regulation difficulties, negative cognitions). Adolescents with NSSI also completed clinical interviews on psychiatric diagnoses and a recent self-injurious behavior (SIB). Scores on the psychological correlates of NSSI were compared between adolescents with NSSI and NC, and across three diagnostic subgroups of NSSI (A: NSSI+/depression-/PTSD-, n = 14; B: NSSI+/depression+/PTSD-, n = 57; C: NSSI+/depression+/PTSD+, n = 14). Differences between NSSI diagnostic subgroups were tested on the motives for SIB and accompanying suicidal presentations (e.g., desire, intent, motive, lethality). RESULTS Common comorbidities of NSSI included depression, panic disorder, generalized anxiety disorder, and PTSD. The NSSI subgroup classification was significantly associated with panic disorder, which was controlled for in the subsequent group comparisons. Overall, adolescents who engage in NSSI with vs. without depression reported more psychological vulnerabilities and impairment and a greater degree of suicidal thoughts/desire in SIB (i.e., groups B, C >A), which remained significant after controlling for panic disorder. An increased odds of the suicidal motive for SIB was found in adolescents with all three conditions (i.e., group C: NSSI+/depression+/PTSD+) compared to those with NSSI but neither depression nor PTSD (i.e., group A: NSSI+/depression-/PTSD-); however, this was not significant after controlling for panic disorder. CONCLUSIONS Psychological underpinnings of adolescent NSSI in clinical contexts may be largely associated with concurrent depression. Suicidal motives in adolescents who engage in NSSI in the presence of depression and PTSD may be confounded by the co-occurrence of panic disorder. This study warrants the importance of attending to the comorbid depression with NSSI in adolescents as it is related to an increase in suicidal desire accompanying SIB.
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Affiliation(s)
- Eunice Seong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jong-Sun Lee
- Department of Psychology, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon, Gangwon-do, 24341, Republic of Korea
| | - Sojung Kim
- Department of Psychology, Yeungnam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - Dong Gi Seo
- Department of Psychology, Hallym University, 1 Hallymdaehak-gil, Chuncheon, Gangwon-do, 24252, Republic of Korea
| | - Jae Hyun Yoo
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Chi-Hyun Choi
- Seoul Alpha Neuropsychiatric Clinic, 511 Nonhyeon-ro, Gangnam-gu, Seoul, 06131, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Psychiatry, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Affiliation(s)
- David R Rubinow
- Departments of Psychiatry and Medicine, School of Medicine, University of North Carolina at Chapel Hill
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Pavarin RM, Lia L, Tugnoli S, Caracciolo S. Suicide Attempts in an Italian Population with Cannabis Use Disorders: Results of a Follow-Up Study. J Psychoactive Drugs 2023:1-8. [PMID: 38009854 DOI: 10.1080/02791072.2023.2287674] [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: 05/06/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
The relationship between cannabis use and suicidal behavior is complex, with no consensus in the literature. We used electronic health records of national health services to identify individuals who received a diagnosis of Cannabis Use Disorder in the Metropolitan area of Bologna from 2009 to 2019. In this cohort we identified accesses to Emergency Departments for suicide attempts from 2009 to 2019. The Crude Suicide Rate for 1,000 Person Years was 2.5, higher in females, in patients with Alcohol Use Disorders, with any psychiatric diagnosis, within one year from the first visit, and during the COVID-19 period. The risk was over 22 times higher than in the general population. Considering the high prevalence of cannabis use in the general population and the consequent risk of Cannabis Use Disorders, these data suggest the importance of a clinical evaluation for suicidal risk.
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Affiliation(s)
- Raimondo Maria Pavarin
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Italian Society of Substance Abuse (SITD), Local Health Unit of Bologna, Bologna, Italy
| | - Loredana Lia
- Mental Health DSM-DP, Azienda USL Bologna, Bologna, Italy
| | - Stefano Tugnoli
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Stefano Caracciolo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Marzetti H, McDaid L, O'Connor R. A qualitative study of young people's lived experiences of suicide and self-harm: intentionality, rationality and authenticity. Child Adolesc Ment Health 2023; 28:504-511. [PMID: 36811313 DOI: 10.1111/camh.12641] [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] [Accepted: 01/11/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Suicide is a leading cause of death amongst young people and a major public health concern. Although increasing research has identified contributory and protective factors affecting youth suicide, less is known about how young people make sense of suicidal distress themselves. METHODS Using semi-structured interview methods and reflexive thematic analysis, this study explores how 24 young people aged 16-24 in Scotland, UK made sense of their lived experiences of suicidal thoughts and feelings, self-harm, and suicide attempts. RESULTS Intentionality, rationality, and authenticity formed our central themes. Suicidal thoughts were categorised by participants dependent on their intention to act on them; a distinction often used to downplay the significance of early suicidal thoughts. Escalating suicidal feelings were then described as almost rational responses to adversities; whereas suicide attempts appeared to be described as more impulsive. These narratives seemed to be somewhat shaped by dismissive attitudes participants experienced in response to their suicidal distress, both from professionals and within their close networks. This impacted how participants articulated distress and asked for support. CONCLUSION Suicidal thoughts that participants articulated as lacking the intention to act could represent key opportunities for early clinical intervention to prevent suicide. In contrast, stigma, difficulties communicating suicidal distress and dismissive attitudes could serve as barriers to seeking help, and, therefore, additional efforts should be made to ensure young people feel comfortable seeking help.
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Affiliation(s)
- Hazel Marzetti
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
- University of Glasgow, Glasgow, UK
| | - Lisa McDaid
- University of Glasgow, Glasgow, UK
- The University of Queensland Australia, Brisbane, Queensland, Australia
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MacDonald C, Caimino C, Burns-O’Connell G, Hartley D, Lockwood J, Sereda M, Whitmer W, Cima R, Turton L, Hoare DJ. Tinnitus, Suicide, and Suicidal Ideation: A Scoping Review of Primary Research. Brain Sci 2023; 13:1496. [PMID: 37891863 PMCID: PMC10605905 DOI: 10.3390/brainsci13101496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Tinnitus (the perception of sound in the absence of any corresponding external source) is highly prevalent and can be distressing. There are unanswered questions about how tinnitus, suicidal thoughts, and suicidal behaviours co-occur and interact. To establish the extent of scientific literature, this scoping review catalogued primary reports addressing the associations between tinnitus, suicidal ideation, attempted suicide, and death by suicide. We searched OvidSP, Medline, EMBASE, PsycINFO, CINAHL, Google Scholar, EThoS, and ProQuest for all studies and case reports on ideation and/or attempted and/or completed suicide in the context of tinnitus. Twenty-three studies were included, and data were charted according to study type. Several epidemiological and other observational studies gave evidence of risk factors and an association between suicidal ideation, suicidal behaviour, and tinnitus. However, there was no evidence of the direction of causality. Qualitative studies are indicated to explore the patient's experience and understand the dynamics of any interaction between tinnitus and suicidal thoughts and behaviours. A theory-informed model of tinnitus and suicide needs to be developed to inform the development of interventions and how tinnitus patients are supported clinically.
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Affiliation(s)
- Carol MacDonald
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK (D.J.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK
| | | | | | - Douglas Hartley
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK (D.J.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
- Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
| | - Joanna Lockwood
- NIHR MindTech MedTech Co-Operative, Institute of Mental Health, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Magdalena Sereda
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK (D.J.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - William Whitmer
- Hearing Sciences: Scottish Section, Glasgow, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Rilana Cima
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven University, 3000 Leuven, Belgium;
- Tinnitus Center of Expertise, Centre of Expertise in Rehabilitation and Audiology, Adelante, 6432 CC Hoensbroek, The Netherlands
- Experimental Health Psychology, Faculty of Psychology and Neurosciences, Maastricht University, 6200 MD Maastricht, The Netherlands
| | | | - Derek J. Hoare
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK (D.J.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
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Pavarin RM, Fabbri C, Turino E, Marani S, Sanchini S, De Ronchi D. Epidemiology and Clinical-Demographic Characteristics of Suicide Attempts in Alcohol Use Disorders in an Italian Population. J Psychoactive Drugs 2023; 55:456-463. [PMID: 35912679 DOI: 10.1080/02791072.2022.2107464] [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: 01/12/2022] [Revised: 05/03/2022] [Accepted: 05/18/2022] [Indexed: 10/16/2022]
Abstract
Suicide is a leading cause of morbidity worldwide. Among the known risk factors, alcohol use disorders (AUDs) are particularly relevant, but data on the epidemiology and characteristics of suicide attempts (SA) in this group are lacking. We used electronic health records of national health services to identify individuals who received a diagnosis of AUD in the Metropolitan area of Bologna from 2009 to 2019. In this cohort we identified accesses to Emergency Departments for SA from 2009 to 2020. The Crude Suicide Rate (CSR) for 1,000 Person Years was 2.93, higher than the general population. The CSR was higher in females, within one year from receiving the diagnosis of AUD, in patients with psychiatric comorbidities, concomitant abuse of cannabis or benzodiazepines. As for Covid-19 pandemic, the risk ratio of SA was significantly higher in 2020 compared to 2019 in females. Our results are relevant to identify clinical risk factors for SA in patients with AUDs, which are strongly associated with suicide risk but with scarce data in the previous literature and paucity of evidence-based therapeutic interventions.
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Affiliation(s)
- Raimondo Maria Pavarin
- Epidemiological Monitoring Center on Addiction, Azienda USL Bologna, Mental Health DSM-DP, Bologna, Italy
- Italian Society on Addiction (SITD), Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna Italy
| | - Chiara Fabbri
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna Italy
| | - Elsa Turino
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Local Health Unit of Bologna, Italy
| | - Silvia Marani
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Local Health Unit of Bologna, Italy
| | - Samantha Sanchini
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Local Health Unit of Romagna, Italy
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna Italy
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Bossé Chartier G, Lam F, Bergmans Y, Lofchy J, Bolton JM, Klonsky ED, Zaheer J, Kealy D. "Psychotherapy in the Pressure Cooker": A Systematic Review of Single Session Psychosocial Interventions in Emergency Departments for Suicide-related Thoughts or Behaviors. J Psychiatr Pract 2023; 29:291-307. [PMID: 37449827 DOI: 10.1097/pra.0000000000000725] [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: 07/18/2023]
Abstract
OBJECTIVES Up to 20% of individuals who die by suicide have visited an emergency department (ED) within 4 weeks of their death. Limited guidance is available regarding the modification of clinical outcomes following a psychosocial intervention in the ED for pediatric and adult populations. METHODS A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted to identify studies focused on single-session psychosocial interventions for pediatric and adult patients experiencing suicide-related thoughts or behaviors (SRTB) in the ED. Two reviewers independently screened articles identified using the key terms suicide/self-harm, emergency department, and interview. Medline, PubMed, Embase, PsycINFO, CINAHL, and CENTRAL were searched from inception to August 2018. RESULTS After screening 3234 abstracts, 29 articles were selected for full-text review and 14 articles, representing 8 distinct studies (N=782), were included. A high level of heterogeneity was present in the included articles, with 7 randomized-controlled trials, 2 nonrandomized-controlled trials, 2 cohort studies, 2 observational studies, and 1 feasibility study. Most of the included studies focused on adolescents (6 articles) or military veterans (7 articles). Strong statistical evidence of ED interventions improving outpatient service linkage was supported (χ2: 81.80, P<0.0001, 7 studies). CONCLUSIONS The findings of this study suggested promising outcomes for patients presenting to the ED with SRTB who receive a single-session psychosocial intervention. All of the studies that measured such outcomes found significantly increased follow-up care in the intervention arm. Further research is needed to strengthen the evidence base, provide better patient representation, and improve our understanding of the mechanisms by which the psychosocial intervention for SRTB in the ED ameliorates patient outcomes (CRD42020156496).
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Affiliation(s)
- Gabrielle Bossé Chartier
- BOSSÉ CHARTIER, LAM, and KEALY: Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada; BERGMANS and ZAHEER: Department of Psychiatry, University of Toronto, Toronto, ON, Canada; LOFCHY: Adult Acute Care Psychiatry, St. Joseph's Health Centre and University of Toronto, Toronto, ON, Canada; BOLTON: Department of Psychiatry, University of Manitoba, and Shared Health Manitoba Crisis Response Centre, Winnipeg, MB, Canada; KLONSKY: Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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Adrados-Pérez M, Llorca-Bofí V, Laín MM, Porcar CA, Nicolau-Subires E, Ibarra-Pertusa L, Jiménez-Mayoral A, Buil-Reiné E, Budny F, Resa-Pérez B, Velásquez-Acebey VG, Arenas-Pijoan L, Irigoyen-Otiñano M, López-Castroman J. Trajectories of children and adolescents attending a psychiatric emergency unit during the COVID-19 confinements: 2020-2022 longitudinal study. Child Adolesc Psychiatry Ment Health 2023; 17:66. [PMID: 37291582 PMCID: PMC10248990 DOI: 10.1186/s13034-023-00619-6] [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: 03/27/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023] Open
Abstract
INTRODUCTION The prevalence of psychiatric disorders has not shifted widely through the COVID pandemic, except for some specific groups such as young people or women. Our objective is to examine prospectively the evolution of children and adolescents who consulted in a psychiatric emergency service during the COVID-19 confinements. METHOD We collected prospective clinical information about 296 young people under 18 who visited a tertiary hospital for psychiatric reasons during the confinement periods in Spain. Clinical diagnoses, suicide attempts, hospital admissions, and pharmacological prescriptions were extracted from electronic health records through 2020, 2021, and 2022. Features of those who maintained psychiatric care and those who did not were compared. RESULTS Three out of four children and adolescents who visited the psychiatric emergency department during the confinements continued psychiatric care at the end of 2022. Those who did not showed better premorbid adjustment at baseline. During follow-up, diagnoses of neurodevelopmental disorders and eating disorders, as well as the dosage of psychotropic drug prescriptions, increased. The diagnoses of major depressive disorder and eating disorder at baseline were associated with attempting suicide during follow-up. Patients with internalizing symptoms were admitted earlier than those with externalizing symptoms but no differences were found in terms of suicide attempts. CONCLUSIONS The continuity of psychiatric care after an initial emergency visit during the confinements implied greater clinical severity, as reflected by changes in clinical diagnoses and pharmacological regimens. Emergent symptoms of depression or eating disorders after social distancing or isolation could predict subsequent suicidal behavior in young populations.
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Affiliation(s)
- Marina Adrados-Pérez
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
| | - Vicent Llorca-Bofí
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
- Department of Medicine, University of Barcelona School of Medicine, Barcelona, Spain
| | - María Mur Laín
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
- University of Lleida, Lérida, Spain
| | - Carla Albert Porcar
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
| | - Eugènia Nicolau-Subires
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
| | - Lucía Ibarra-Pertusa
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
| | | | - Esther Buil-Reiné
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
| | - Filip Budny
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
| | - Belén Resa-Pérez
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
| | | | | | - María Irigoyen-Otiñano
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain.
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain.
- CIBERSAM, Madrid, Spain.
| | - Jorge López-Castroman
- University of Montpellier, IGF, CNRS-INSERM, Montpellier, France
- Department of Psychiatry, Nimes University Hospital, Nimes, France
- CIBERSAM, Madrid, Spain
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Kobrinsky V, Siedlecki KL. Mediators of the Relationship Between Adverse Childhood Experiences (ACEs) and Symptoms of Anxiety, Depression, and Suicidality among Adults. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:233-246. [PMID: 37234827 PMCID: PMC10205933 DOI: 10.1007/s40653-022-00510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 05/28/2023]
Abstract
Adverse childhood experiences (ACEs) are consistently found to be negatively associated with physical, psychological, and psychosocial well-being throughout the lifespan. While previous research has established risk factors and noxious outcomes arising post-ACEs, less attention has been given to factors such as resilience, perceived social support, and subjective well-being that may help explain the relationship between ACEs and psychopathology. Hence, the objectives of this study are to examine: (1) the relationships among ACEs and symptoms of anxiety, depression, and suicidality in adulthood, and (2) whether resilience, social support, and subjective well-being mediate the relationship between ACEs and psychopathological symptoms. Cross-sectional data on ACEs, psychological factors, potential mediating variables, and sociodemographic factors were collected from a community sample of adults aged 18-81 (N = 296) via an on-line survey. Endorsing ACEs was significantly and positively correlated with symptoms of anxiety, depression, and suicidality. Results of parallel mediation analyses showed that social support, negative affect, and life satisfaction statistically mediated the relationships between ACEs and psychopathological outcomes in adulthood. These results highlight the importance of identifying potential mediators of the ACEs-psychopathological symptoms relationship to aid in the development of screening and intervention practices that could bolster developmental outcomes following traumatic childhood experiences.
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Affiliation(s)
- Veronika Kobrinsky
- Department of Psychology, Fordham University, 113 W. 60th Street, New York, NY 10023 USA
| | - Karen L. Siedlecki
- Department of Psychology, Fordham University, 113 W. 60th Street, New York, NY 10023 USA
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Søndergaard R, Buus N, Berring LL, Andersen CB, Grundahl M, Stjernegaard K, Hybholt L. Living with suicidal thoughts: A scoping review. Scand J Caring Sci 2023; 37:60-78. [PMID: 36527267 DOI: 10.1111/scs.13137] [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: 06/22/2022] [Revised: 11/04/2022] [Accepted: 11/13/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND There is a significantly higher number of people experiencing severe levels of suicidal thoughts compared to that of suicidal deaths and suicide attempts. In suicide prevention research, there is a shift towards greater emphasis on people's experiences of living with suicidal thoughts. This can expand the existing evidence base, which is dominated by a biomedical approach. The aim of this review was to summarise and disseminate existing research on the lived experiences of living with suicidal thoughts. METHODS A scoping review by Arksey & O'Malley consisting of six stages: (1) formulating the research question, (2) identifying relevant studies, (3) selecting studies, (4) mapping data, (5) summarising the results and (6) consulting stakeholders. PubMed, PsycINFO and CINAHL were searched for studies in English, Danish, Swedish and Norwegian. Peer-reviewed articles examining people's experiences of living with suicidal thoughts using qualitative methods were included. The search was supplemented with a citation pearl search in the Web of Science database. Twenty-eight studies were included. RESULTS The findings were organised under two thematic headings: (a) the significance of social connections and (b) a loss of the personal self. CONCLUSION There is a need for further qualitative research of people's experiences of living with suicidal thoughts from an everyday life perspective. Awareness about social connections and attachment in mental health prevention and governance is crucial. Trauma-informed care could be a useful approach to prevent suicidal thoughts as the review found that many participants had traumatic experiences in both childhood and adulthood. As part of the treatment of suicidal thoughts, it might be useful to have a focus on narrative and communicative methods and their clinical application.
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Affiliation(s)
- Rikke Søndergaard
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
| | - Niels Buus
- Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lene Lauge Berring
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | | | - Karina Stjernegaard
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,PsykInfo, Psychiatry Region Zealand, Region Zealand, Denmark
| | - Lisbeth Hybholt
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark.,Research Unit, Mental Health Services East, Psychiatry Region Zealand, Roskilde, Denmark
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Ding X, Wu M, Zhang Y, Liu Y, Han Y, Wang G, Xiao G, Teng F, Wang J, Chen J, Zhang W, Cai M, Zhang Y, Zhou S, Hu D. The prevalence of depression and suicidal ideation among cancer patients in mainland China and its provinces, 1994-2021: A systematic review and meta-analysis of 201 cross-sectional studies. J Affect Disord 2023; 323:482-489. [PMID: 36496103 DOI: 10.1016/j.jad.2022.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
To evaluate the national prevalence depression of Chinese cancer patients and clarify its potential associated factors. Twelve databases were searched from database inception through October 31, 2022 for relevant studies published in English (PubMed MEDLINE, Ovid MEDLINE, Embase, Scopus, PsycINFO, and Cochrane and Web of Science) and Chinese (China National Knowledge Infrastructure, Wanfang, Weipu, Chinese Biomedical Literature Service System, Duxiu) that estimated point or period prevalence of depression, depressive disorder, or suicidal ideation as assessed by self-report scale or structured interview. 201 studies were eligible for inclusion in our meta-analyses. We found the national pooled prevalence rates of depression and suicidal ideation were 44.63 % (95 % CI 42.24 %-47.01 %) and 24.95 % (95 % CI 10.96 %-38.95 %), respectively. The pooled prevalence of depression was associated with study location, cancer type, comorbid chronic disease, and female sex (all P < 0.05). The distribution of the depression prevalence among cancer patients in mainland China was characterized by significant geographical variation and clustering. The highest pooled prevalence of depression was among gynecologic oncology patients. We recommend that more attention and resources be given to mental health problems such as depression and suicidal ideation among Chinese cancer patients, and that prevention programs be developed, especially in areas with a high prevalence of depression.
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Affiliation(s)
- Xiaoping Ding
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Minge Wu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yingying Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yanhong Han
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Gang Wang
- Wuhan Mental Health Center, Wuhan 430010, China
| | - Guangqin Xiao
- Department of Oncology Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Fen Teng
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jiaqing Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jie Chen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wei Zhang
- Department of Nursing, School of Medicine, Yangtze University, Jingzhou 434022, China
| | - Meijie Cai
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yan Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Su Zhou
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Suicide Attempts in an Italian Population with Substance Use Disorders: Results of a Follow-up Study. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00855-5] [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: 10/17/2022] Open
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15
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Llorca-Bofí V, Adrados-Pérez M, Sánchez-Cazalilla M, Torterolo G, Arenas-Pijoan L, Buil-Reiné E, Nicolau-Subires E, Albert-Porcar C, Ibarra-Pertusa L, Puigdevall-Ruestes M, Irigoyen-Otiñano M. Urgent care and suicidal behavior in the child and adolescent population in a psychiatric emergency department in a Spanish province during the two COVID-19 states of alarm. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 16:76-83. [PMID: 35755490 PMCID: PMC9212908 DOI: 10.1016/j.rpsm.2022.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/06/2022] [Indexed: 11/18/2022]
Abstract
Introduction The COVID-19 outbreak and lockdown may have an impact in mental health among youth, but reports of psychiatry emergency department encounters in young Spanish population are scarce. The aim of this study is to characterize the reasons for psychiatric urgent care of youth during COVID-19 pandemic in our hospital. Material and methods This cross-sectional study compare visits to the psychiatry emergency department and their characteristics in young patients in the province of Lleida before and after the pandemic with special attention to the two states of alarm and suicidal behavior. Information regarding sociodemographic status, chief complaints, diagnosis, characteristics of suicidal behavior, and other data were obtained from the electronic medical records. Results Within the total psychiatric emergency attendances, youth patients increased a 83.5% in the second state of alarm (p = 0.001). In this period patients were younger (p = 0.006), had less psychiatric history (p = 0.017) and their living conditions changed with an increase of those living with relatives (p = 0.004). Suicidal ideation care increased without statistical significance (p = 0.073). Multiple logistic regression identifies independent risk factors for suicidal behavior being female (OR: 2.88 [1.39–5.98]), living with relatives (OR: 3.49 [1.43–8.54]), and having a diagnosis of depression (OR: 6.34 [3.58–11.24]). Conclusions The number of young people seen in psychiatric emergencies during the chronic stage of the pandemic increased, and these were getting younger and without previous psychiatric contact. The trend to higher rates of suicidal ideation indicates that youth experienced elevated distress during these periods, especially women, living with relatives and presenting depression.
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Characteristics of patients treated for suicidal behavior during the pandemic in a psychiatric emergency department in a Spanish province. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022. [DOI: 10.1016/j.rpsm.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Irigoyen-Otiñano M, González-Pinto A, Llorca-Bofí V, Adrados-Pérez M, Arenas-Pijoan L, Torterolo G, Sánchez-Cazalilla M, Buil E, Nicolau-Subires E, Albert-Porcar C, Ibarra-Pertusa L, Puigdevall-Ruestes M. Increase in urgent care for patients with an eating disorder during the COVID-19 pandemic in a Spanish province. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:142-146. [PMID: 35840281 PMCID: PMC9274210 DOI: 10.1016/j.rpsmen.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/07/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has had a great impact on people's mental health. Patients with eating disorders (ED) are also highly sensitive to the pandemic situation due to their physical and mental health. The objective of this study is to evaluate the impact that the COVID-19 pandemic may have had on the reasons for the urgent care of patients with an eating disorder, comparing the reasons for care with those from a previous period. METHOD We compared the visits to the emergency room and their characteristics before and after the pandemic of patients with an eating disorder in the province of Lleida. Information regarding sociodemographic status, reason for consultation, diagnosis, characteristics of suicidal behaviour, and other data were obtained from the electronic medical records. RESULTS Within the total emergency attendances, eating disorders increased from 1.7% in the pre-pandemic period to 3.1% during the pandemic (p=0.030). Regarding the reason for consultation, a change in the pattern is observed, decreasing consultations for anxious decompensation (p<0.001) and increasing suicidal behaviour (p=0.016) and behavioural disorder (p=0.022). CONCLUSIONS In our study we ascertained an increase in urgent care given to patients with an eating disorder during the two states of alarm, while consultations for anxiety symptoms decreased notably. However, care for suicidal behaviour increased, especially in women with comorbidity of personality disorders and who were unemployed.
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Affiliation(s)
- María Irigoyen-Otiñano
- Psychiatry Service, Santa Maria University Hospital Lleida, Lleida, Spain; Biological Foundations of Mental Disorders Group, IRB Lleida, Lleida, Spain.
| | | | - Vicent Llorca-Bofí
- Psychiatry Service, Santa Maria University Hospital Lleida, Lleida, Spain
| | | | | | - Giovanni Torterolo
- Psychiatry Service, Santa Maria University Hospital Lleida, Lleida, Spain
| | | | - Esther Buil
- Psychiatry Service, Santa Maria University Hospital Lleida, Lleida, Spain
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Irigoyen-Otiñano M, González-Pinto A, Llorca-Bofí V, Adrados-Pérez M, Arenas-Pijoan L, Torterolo G, Sánchez-Cazalilla M, Buil E, Nicolau-Subires E, Albert-Porcar C, Ibarra-Pertusa L, Puigdevall-Ruestes M. Increase in urgent care for patients with an eating disorder during the COVID-19 pandemic in a Spanish province. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:142-146. [PMID: 34868411 PMCID: PMC8628540 DOI: 10.1016/j.rpsm.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Introduction The COVID-19 pandemic has had a great impact on people's mental health. Patients with eating disorders (ED) are also highly sensitive to the pandemic situation due to their physical and mental health. The objective of this study is to evaluate the impact that the COVID-19 pandemic may have had on the reasons for the urgent care of patients with an eating disorder, comparing the reasons for care with those from a previous period. Method We compared the visits to the emergency room and their characteristics before and after the pandemic of patients with an eating disorder in the province of Lleida. Information regarding sociodemographic status, reason for consultation, diagnosis, characteristics of suicidal behaviour, and other data were obtained from the electronic medical records. Results Within the total emergency attendances, eating disorders increased from 1.7% in the pre-pandemic period to 3.1% during the pandemic (p = 0.030). Regarding the reason for consultation, a change in the pattern is observed, decreasing consultations for anxious decompensation (p < 0.001) and increasing suicidal behaviour (p = 0.016) and behavioural disorder (p = 0.022). Conclusions In our study we ascertained an increase in urgent care given to patients with an eating disorder during the two states of alarm, while consultations for anxiety symptoms decreased notably. However, care for suicidal behaviour increased, especially in women with comorbidity of personality disorders and who were unemployed.
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Affiliation(s)
- María Irigoyen-Otiñano
- Psychiatry Service, Santa Maria University Hospital Lleida, Lleida, Spain
- Biological Foundations of Mental Disorders Group, IRB Lleida, Lleida, Spain
| | | | - Vicent Llorca-Bofí
- Psychiatry Service, Santa Maria University Hospital Lleida, Lleida, Spain
| | | | | | - Giovanni Torterolo
- Psychiatry Service, Santa Maria University Hospital Lleida, Lleida, Spain
| | | | - Esther Buil
- Psychiatry Service, Santa Maria University Hospital Lleida, Lleida, Spain
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Campos RC, Morujão IS, Martins LC, Lambert CE, Tomás G, Holden RR. Results from Two Countries on How Thwarted Interpersonal Needs Contribute to Understanding Self-Harm. THE JOURNAL OF PSYCHOLOGY 2022; 156:185-199. [DOI: 10.1080/00223980.2021.2015567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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20
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Gambling Disorder in an Italian Population: Risk of Suicide Attempts and Associated Demographic-Clinical Factors using Electronic Health Records. J Gambl Stud 2021; 38:1143-1156. [PMID: 34800239 DOI: 10.1007/s10899-021-10088-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2021] [Indexed: 10/19/2022]
Abstract
To identify the demographic and clinical characteristics associated with access to Emergency Departments for Suicide Attempt in a cohort of patients with Gambling disorders. We used electronic health records of inpatient and outpatient services to identify individuals who received a diagnosis of gambling disorder (ICD-9 or ICD-10 codes) in the Metropolitan area of Bologna from 2009 to 2019. In this cohort we identified accesses to Emergency Departments for suicide attempt through cross-matching with electronic records. We calculated Crude Suicide Attempt Rates; we also included the demographic-clinical variables in a multivariate Poisson regression. We identified 692 patients with a diagnosis of gambling disorder and a total of 2733 Person Years. The Crude Suicide Attempt Rate per 1000 Person Years was 9.17 (95% CI 6.20-13.58), higher for females and much higher than the general population (incidence rate ratio = 93.72). The multivariate analysis showed a higher risk of suicide attempt in the year following the first contact with a clinical service, in patients younger than 45 years, with alcohol use disorders and personality disorders. This study evidenced a high risk of access to Emergency Departments for suicide attempt in individuals with a diagnosis of gambling disorder and highlighted important demographic and clinical factors that should be considered when evaluating suicide risk in this population.
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Lombardo F, Daly M. Analyzing suicide life stories on Wikipedia with Highway_star and other textual visualization tools. SN SOCIAL SCIENCES 2021; 1:268. [PMID: 34729497 PMCID: PMC8553402 DOI: 10.1007/s43545-021-00272-w] [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: 05/31/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022]
Abstract
Being responsible for a death every 40s, suicide is a major public health concern (Brunier et al. 2019). Even if many of its risk factors are social (Van Orden et al. 2010), there are surprisingly few qualitative sociological studies about the phenomenon. This study aim is to provide a life-story sociological analysis of suicidal trajectories. Two challenges are identified: gathering suicidal narrative and maintaining a quantitative foreground in order to deepen and rationalize the interpretation of data. They are both faced using a self-made, free to use, open access, algorithm: Highway_star (https://github.com/matheo-daly/highway_star). Two corpora of Wikipedia biographies of people who died by suicide in the 1920s (N = 82) and 2020s (N = 49) are gathered. Following an application of Fritze Schütze's methodology (Schütze, 2014), classical textual visualizations are produced. A Hierarchical Descending Classification, a Factorial Correspondence Analysis and a Similarity Analysis reveal five narration categories centered around different topics: cinema, death, family, poetry and politics. As none of those visualizations focuses on the developmental aspect of the biography, they offer limited interest for a life-story investigation. The second functionality of the Highway_star tool, which represents a narrative's unfolding with a Sankey Diagram, allows completing the analysis. It shows interesting differences between decades or gender. An example of the last being that men narratives tend to be more complex and achievement focused, while the women ones are more linear and family centered. The study's range has limitations. A major one is related to the corpus and the inability to identify clearly which parts of the narratives are associated to fame and which to suicide. Another one is linked to the Highway_star tool that sometimes lack of flexibility.
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22
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Inter-Sectoral Management of Suicidal Persons in Ghana: Tensions and Prospects. Community Ment Health J 2021; 57:1010-1016. [PMID: 32995947 DOI: 10.1007/s10597-020-00717-1] [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: 07/12/2020] [Accepted: 09/23/2020] [Indexed: 10/23/2022]
Abstract
Inter-sectoral collaboration health care model is essential for effective suicide prevention and treatment. This brief report presents three cases to illustrate two important facts in suicidology and related observed dynamics working as suicide researchers in Ghana. The first fact is that suicidal work is a multidisciplinary approach. The second: there may be contextual factors which may make a multidisciplinary approach in working with a suicidal person difficult in Ghana. The first two cases involved the work of a Clinical Psychologist/Suicidologist (First author), while the third involved the work of a Community Psychologist/Suicidologist (Second Author). Thematic analysis of experiences showed the trajectories of tensions and prospects involved when working as a team in providing help for persons in suicidal crisis in Ghana. Based on the findings, we make recommendations for scaling up mental health education and suicide training for allied professionals towards enriching and expanding inter-sectoral collaboration in preventing and treating suicidality.
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Abstract
Suicide is a preventable health problem. Multiple definitions and inconsistent use of the term suicidality can result in failure to properly recognize suicide risk and behavior and confuses suicide research. Clarification of the suicidality concept is needed to facilitate the care for individuals at risk for suicide. Using Rodgers' evolutionary concept analysis method, this analysis describes the breadth and scope of the suicidality concept. Findings indicate suicidality covers a spectrum of suicidal risk and levels of emotional suffering and intent. The analysis does not draw definite conclusions, but outlines a direction for further research.
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Affiliation(s)
- Tamara Pike Keefner
- Nursing, South Dakota State University - College of Nursing, Rapid City, South Dakota, USA
| | - Thomas Stenvig
- Graduate Nursing, South Dakota State University - College of Nursing, Brookings, Rapid City, South Dakota, USA
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Howell AJ, Cowan-Nelson ERH, Cobuz VD. Depicted Immorality Influences the Perceived Applicability of the Phrase "Committed Suicide". CRISIS 2021; 43:135-141. [PMID: 33620254 DOI: 10.1027/0227-5910/a000767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: "Committed suicide" is often deemed less acceptable than alternative phrases, but such judgments vary widely across individuals. Aim: We tested whether the endorsement of statements containing "committed suicide" is greater when a suicide death is depicted as immoral. We also assessed the degree of immorality suggested by the free-standing phrases "committed suicide" and "died by suicide." Method: Undergraduate participants (N = 154) read scenarios of a suicide depicted as immoral and one depicted more neutrally and judged the applicability of statements employing either "committed suicide" or "died by suicide" to each scenario. Participants next chose between the free-standing phrases "committed suicide" or "died by suicide" in terms of which connoted immorality and provided written justifications for their choices. Results: Participants judged "committed suicide" statements to be most applicable to the immoral-suicide scenario. A large majority of participants chose "committed suicide" over "died by suicide" as connoting immorality and participants' justifications for this choice revealed several meaningful themes. Limitations: Our manipulation of immorality employed religious overtones and our participants were undergraduate students. Conclusions: Findings contribute to the empirical basis for concerns regarding the phrase "committed suicide," with implications for stigma reduction and help-seeking.
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Affiliation(s)
- Andrew J Howell
- Department of Psychology, MacEwan University, Edmonton, AB, Canada
| | | | - Victoria D Cobuz
- Department of Psychology, MacEwan University, Edmonton, AB, Canada
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Zortea TC, Gray CM, O'Connor RC. The Relationship Between Adult Attachment and Suicidal Thoughts and Behaviors: A Systematic Review. Arch Suicide Res 2021; 25:38-73. [PMID: 31545148 DOI: 10.1080/13811118.2019.1661893] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We aimed to (1) determine the extent of the relationship between attachment and suicidal thoughts and behaviors (STB), (2) investigate whether any gender differences exist, and (3) conduct a theoretical synthesis of the included studies. A systematic search of the databases Web of Science; EBSCO Host Medical and Psychology-related resources, which includes CINAHL, Health Source: Nursing/Academic Edition, Psychology and Behavioral Sciences Collection, and PsycINFO; and EMBASE was conducted, with 52 studies meeting the inclusion criteria. While secure attachment acts as protective factor, insecure attachment orientations appear to be vulnerability factors compromising an individual's capacity to cope with relationship issues, increasing suicide risk. There is insufficient evidence about gender differences. The theoretical synthesis suggests that attachment, interacting with other psychological traits in response to negative life events, acts as a vulnerability or protective factor for STB. Implications for treatment are also discussed.
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Lübbert M, Bahlmann L, Josfeld S, Bürger J, Schulz A, Bär KJ, Polzer U, Walter M, Kastner UW, Sobanski T, Wagner G. Identifying Distinguishable Clinical Profiles Between Single Suicide Attempters and Re-Attempters. Front Psychiatry 2021; 12:754402. [PMID: 34646179 PMCID: PMC8503539 DOI: 10.3389/fpsyt.2021.754402] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/31/2021] [Indexed: 11/26/2022] Open
Abstract
More than 800,000 individuals die from suicide each year in the world, which has a devastating impact on families and society. Ten to twenty times more attempt suicide. Previous studies showed that suicide attempters represent a heterogeneous group regarding demographic characteristics, individual characteristics of a suicidal attempt, and the assumed clinical factors, e.g., hopelessness or impulsivity, thus differently contributing to the likelihood of suicidal behavior. Therefore, in the present study, we aim to give a comprehensive clinical description of patients with repeated suicide attempts compared to single attempters. We explored putative differences between groups in clinical variables and personality traits, sociodemographic information, and specific suicide attempt-related information. A sample of patients with a recent suicide attempt (n = 252), defined according to DSM-5 criteria for a suicidal behavior disorder (SBD), was recruited in four psychiatric hospitals in Thuringia, Germany. We used a structured clinical interview to assess the psychiatric diagnosis, sociodemographic data, and to collect information regarding the characteristics of the suicide attempt. Several clinical questionnaires were used to measure the suicide intent and suicidal ideations, depression severity, hopelessness, impulsivity, aggression, anger expression, and the presence of childhood trauma. Univariate and multivariate statistical methods were applied to evaluate the postulated risk factors and, to distinguish groups based on these measures. The performed statistical analyses indicated that suicide attempters represent a relatively heterogeneous group, nevertheless associated with specific clinical profiles. We demonstrated that the re-attempters had more severe psychopathology with significantly higher levels of self-reported depression, suicidal ideation as well as hopelessness. Furthermore, re-attempters had more often first-degree relatives with suicidal behavior and emotional abuse during childhood. They also exhibited a higher degree of specific personality traits, i.e., more "urgency" as a reaction to negative emotions, higher excitability, higher self-aggressiveness, and trait anger. The multivariate discriminant analysis significantly discriminated the re-attempters from single attempters by higher levels of self-aggressiveness and suicidal ideation. The findings might contribute to a better understanding of the complex mechanisms leading to suicidal behavior, which might improve the early identification and specific treatment of subjects at risk for repeated suicidal behavior.
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Affiliation(s)
- Marlehn Lübbert
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Lydia Bahlmann
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Sebastian Josfeld
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jessica Bürger
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Alexandra Schulz
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Thüringen-Kliniken Georgius Agricola GmbH, Saalfeld, Germany
| | - Karl-Jürgen Bär
- Department of Gerontopsychiatry and Psychosomatics, Jena University Hospital, Jena, Germany
| | - Udo Polzer
- Clinics for Psychiatry, Psychotherapy and Addition Disorders, Asklepios Fachklinikum Stadtroda, Stadtroda, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Ulrich W Kastner
- Department of Psychiatry and Psychotherapy, Helios Fachkliniken Hildburghausen, Hildburghausen, Germany
| | - Thomas Sobanski
- Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Thüringen-Kliniken Georgius Agricola GmbH, Saalfeld, Germany
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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Osafo J. Conducting a qualitative research on suicide in Ghana using Interpretative Phenomenological Analysis (IPA): A reflection after a decade. NEW IDEAS IN PSYCHOLOGY 2021. [DOI: 10.1016/j.newideapsych.2020.100836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Deng Y, Li X, Liu L, Chui WH. Suicide Attempts and Perceived Social Support among Chinese Drug Users: The Mediating Role of Self-Esteem and Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010208. [PMID: 33396608 PMCID: PMC7796389 DOI: 10.3390/ijerph18010208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 12/13/2020] [Accepted: 12/25/2020] [Indexed: 11/22/2022]
Abstract
Suicidal behavior is a severe problem among drug users. This study examines influential factors related to suicide attempts and analyzes possible mediators of the relationship between perceived social support and suicide attempts amongst Chinese drug users under compulsory institutional drug treatment. Taking perceived social support as the independent variable, we found that the relationship between suicide attempts and perceived social support is mediated by self-esteem as a protective factor and depression as a risk factor. Path analysis shows that self-esteem contributes relatively more to the indirect effects than depression does, accounting for 31.1% and 24.2% of the total effect, respectively. Generally speaking, the findings of this study point to an urgent need for addressing suicide attempts among Chinese drug users while treating self-esteem as the protective factor that deserves as substantial attention as depression receives.
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Affiliation(s)
- Yali Deng
- School of Social Work, University of Maryland Baltimore, Baltimore, MD 21201, USA;
| | - Xuemeng Li
- The Graduate Center, City University of New York, New York, NY 10016, USA;
| | - Liu Liu
- School of Social and Behavioral Sciences, Nanjing University, Nanjing 210023, China
- Correspondence: ; Tel.: +86-25-896-809-58 (ext. 409)
| | - Wing Hong Chui
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China;
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Pons-Baños J, Ballester-Ferrando D, Riesco-Miranda L, Escoté-Llobet S, Jiménez-Nuño J, Fuentes-Pumarola C, Serra-Millàs M. Sociodemographic and Clinical Characteristics Associated with Suicidal Behaviour and Relationship with a Nurse-Led Suicide Prevention Programme. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238765. [PMID: 33255772 PMCID: PMC7728328 DOI: 10.3390/ijerph17238765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
Suicidal behaviour is a major public health problem that needs to be tackled by all health agents including mental health nurses. Aims: The purpose of this study was to analyse the relationship between demographic and clinical characteristics and different kinds of suicidal behaviour with a nurse-led suicide prevention programme. Methods: The design was a cross-sectional study, performed in the region of Osona (Catalonia) in the five-year period 2013–2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt or completed suicide. Results: The sample included 753 patients (of whom 53 completed suicide) who experienced 931 suicidal behaviour episodes. Men represented only 38.4% of the sample but 81.1% of completed suicides. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. Two thirds (66.4%) of the individuals (0.8% (n = 4) of whom completed suicide) were participants in a nurse-led suicidal behaviour case management programme. Conclusion: The main risk factors were being a woman for suicidal behaviour and being a man and being older for completed suicide. Mental disorders, widowhood and retirement were also associated with completed suicide. The completed suicide rate was lower among participants in the nurse-led programme.
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Affiliation(s)
- Judit Pons-Baños
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Faculty of Health Sciences and Wellbeing, University of Vic—Central University of Catalonia, 08500 Vic, Spain
- Interinstitutional Research Group, Department of Mental Health and Social Innovation, 08500 Vic, Spain
| | - David Ballester-Ferrando
- Health and Healthcare Research Group, Department of Nursing, University of Girona, 17003 Girona, Spain;
- Correspondence: ; Tel.: +34-972-418771
| | - Lola Riesco-Miranda
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Faculty of Health Sciences and Wellbeing, University of Vic—Central University of Catalonia, 08500 Vic, Spain
| | - Santiago Escoté-Llobet
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Interinstitutional Research Group, Department of Mental Health and Social Innovation, 08500 Vic, Spain
| | - Jordi Jiménez-Nuño
- Vic Forensic Medicine Department, Institute of Legal Medicine and Forensic Sciences of Catalonia, 08500 Vic, Spain;
| | | | - Montserrat Serra-Millàs
- Department of Psychiatry and Mental Health, Consorci Hospitalari de Vic, 08500 Vic, Spain; (J.P.-B.); (L.R.-M.); (S.E.-L.); (M.S.-M.)
- Faculty of Health Sciences and Wellbeing, University of Vic—Central University of Catalonia, 08500 Vic, Spain
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Sharif Nia H, Heidari M, Naghavi N, Lehto RH, Haghdoost AA, Jafari-Koulaee A, Matbue YH, Yaghoobzadeh A, Goudarzian AH, Sharif SP. Age Changes and Suicidal Activity in Iran Over the Past Decade: A Systematic Review and Meta-Analysis. OMEGA-JOURNAL OF DEATH AND DYING 2020; 86:312-337. [PMID: 33106088 DOI: 10.1177/0030222820966934] [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: 11/16/2022]
Abstract
This review study fills an important gap by aiming to determine the age changes in attempted and completed suicide in Iran during the past decade. A systematic review of related articles in international and Iranian databases from January 2008 to January 2020 was first conducted and relevant studies were extracted based on established criteria. Results showed that the mean age of suicide in Iran is 29.8 (range 27.7 - 31.8) years old for men and 27.4 (range 25.8 - 28.9) for women (P < 0.0001). The youngest and oldest populations of completed suicide belong to eastern and central regions of the country respectively. Findings imply the critical importance of increasing awareness through educational programs and public health campaigns to increase awareness and reduce suicidal behavior in Iran.
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Affiliation(s)
- Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Heidari
- Department of Epidemiology and Biostatistics, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Navaz Naghavi
- Taylor's Business School, Faculty of Business and Law, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Rebecca H Lehto
- Michigan State University, College of Nursing, East Lansing, United States
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Azar Jafari-Koulaee
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Yasaman Hatef Matbue
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ameneh Yaghoobzadeh
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Saeed Pahlevan Sharif
- Taylor's Business School, Faculty of Business and Law, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
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Zortea TC, Brenna CTA, Joyce M, McClelland H, Tippett M, Tran MM, Arensman E, Corcoran P, Hatcher S, Heisel MJ, Links P, O'Connor RC, Edgar NE, Cha Y, Guaiana G, Williamson E, Sinyor M, Platt S. The Impact of Infectious Disease-Related Public Health Emergencies on Suicide, Suicidal Behavior, and Suicidal Thoughts. CRISIS 2020; 42:474-487. [PMID: 33063542 PMCID: PMC8689932 DOI: 10.1027/0227-5910/a000753] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abstract. Background: Infectious disease-related public health emergencies (epidemics) may increase suicide risk, and high-quality evidence is needed to guide an international response. Aims: We investigated the potential impacts of epidemics on suicide-related outcomes. Method: We searched MEDLINE, EMBASE, PsycInfo, CINAHL, Scopus, Web of Science, PsyArXiv, medRxiv, and bioRxiv from inception to May 13–16, 2020. Inclusion criteria: primary studies, reviews, and meta-analyses; reporting the impact of epidemics; with a primary outcome of suicide, suicidal behavior, suicidal ideation, and/or self-harm. Exclusion criteria: not concerned with suicide-related outcomes; not suitable for data extraction. PROSPERO registration: #CRD42020187013. Results: Eight primary papers were included, examining the effects of five epidemics on suicide-related outcomes. There was evidence of increased suicide rates among older adults during SARS and in the year following the epidemic (possibly motivated by social disconnectedness, fears of virus infection, and concern about burdening others) and associations between SARS/Ebola exposure and increased suicide attempts. A preprint study reported associations between COVID-19 distress and past-month suicidal ideation. Limitations: Few studies have investigated the topic; these are of relatively low methodological quality. Conclusion: Findings support an association between previous epidemics and increased risk of suicide-related outcomes. Research is needed to investigate the impact of COVID-19 on suicide outcomes.
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Affiliation(s)
- Tiago C. Zortea
- Suicidal Behaviour Research Laboratory, University of Glasgow, UK
| | | | - Mary Joyce
- National Suicide Research Foundation, Cork, Ireland
| | | | - Marisa Tippett
- Western Libraries, University of Western Ontario, London, ON, Canada
| | | | - Ella Arensman
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University College Cork, Ireland
| | - Paul Corcoran
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University College Cork, Ireland
| | - Simon Hatcher
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Marnin J. Heisel
- Departments of Psychiatry and of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Paul Links
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Rory C. O'Connor
- Suicidal Behaviour Research Laboratory, University of Glasgow, UK
| | | | - Yevin Cha
- Departments of Psychiatry and of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Giuseppe Guaiana
- Departments of Psychiatry and of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | | | - Mark Sinyor
- Department of Psychiatry, University of Toronto, ON, Canada
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Juel A, Berring LL, Hybholt L, Erlangsen A, Larsen ER, Buus N. Relatives' experiences of providing care for individuals with suicidal behaviour conceptualized as a moral career: A meta-ethnographic study. Int J Nurs Stud 2020; 113:103793. [PMID: 33161331 DOI: 10.1016/j.ijnurstu.2020.103793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/21/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND An increasing number of qualitative research articles have reported on relatives' experiences of providing care for individuals displaying suicidal behaviour. To contribute more fully to theory and practice, these reported experiences must be synthesized. OBJECTIVES To identify original qualitative studies of relatives' experiences of providing care for individuals with non-fatal suicidal behaviour and to systematically review and synthesize this research using a meta-ethnographic approach. DESIGN Systematic review and meta-ethnography. DATA SOURCES Literature searches were undertaken in six bibliographic databases (PubMed, CINAHL, Embase, PsycINFO, Web of Science and Scopus) and limited to peer-reviewed original studies. Eligible studies reported relatives' experiences of providing care for individuals with suicidal behaviour, published in English or a Scandinavian language. REVIEW METHODS One reviewer screened the titles, abstracts and full texts and then collaborated with another reviewer on excluding ineligible studies. A two-step strategy was used while reviewing publications: 1) appraising study quality, and 2) classifying study findings according to degree of data interpretation. This strategy was used for each study by two independent reviewers who subsequently reached a shared decision on inclusion. Noblit and Hare's methodology for translation and synthesis was followed in developing a novel theoretical interpretation of relatives' experiences. The concept of moral career was adopted in producing this synthesis. RESULTS Of 7,334 publications screened, 12 studies were eligible for inclusion. The synthesis conveyed relatives' moral career as comprising four stages, each depicting relatives' different perspectives on life and felt identities. First, relatives negotiated conventional ideas about normalcy and positioned themselves as living abnormal family lives in the stage from normal to abnormal. The first career movement could be mediated by social interactions with professionals in the stage feeling helpful or feeling unhelpful. For some relatives, this negotiated perspective of abnormality got stuck in an impasse. They did not interact with their surroundings in ways that would enable them to renegotiate these fixed views, and this stage was named stuck in abnormality. For other relatives, career movement took place as relatives re-positioned themselves as negotiating an alternative perspective of normalcy in the stage from abnormal to normal. CONCLUSIONS Interactions with other people facing similar difficulties enabled relatives to shift perspectives and alleviated experiences of distress.
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Affiliation(s)
- A Juel
- Center for Relationships and De-escalation, Psychiatry Region Zealand, Fælledvej 6, 1, Slagelse 4200, Denmark; Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 4, Hellerup, Copenhagen 2900, Denmark; Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, Odense 5000, Denmark.
| | - L L Berring
- Center for Relationships and De-escalation, Psychiatry Region Zealand, Fælledvej 6, 1, Slagelse 4200, Denmark; Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, Odense 5000, Denmark.
| | - L Hybholt
- Center for Relationships and De-escalation, Psychiatry Region Zealand, Fælledvej 6, 1, Slagelse 4200, Denmark.
| | - A Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 4, Hellerup, Copenhagen 2900, Denmark; Department of mental health, Johns Hopkins Bloomberg School of Public Health, 624N. Broadway, S850, Baltimore, MD 21205, United States; Center of Mental Health Research, The Australian National University, Building 63, Canberra ACT 2601, Australia; Copenhagen Research Center for Mental Health, Mental Health Centre Copenhagen, Gentofte Hospitalsvej 15, 4, Hellerup 2900, Denmark.
| | - E R Larsen
- Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, Odense 5000, Denmark; Mental Health Department Odense, University Clinic, Mental Health Service, J. B. Winsløws Vej 18, Odense 5000, Denmark.
| | - N Buus
- Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, Odense 5000, Denmark; Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, 88 Mallett St, Camperdown, NSW 2050, Australia; The Centre for Family-Based Mental Health Care, St. Vincent's Private Hospital. 390 Victoria St, Darlinghurst, NSW 2010, Australia; St. Vincent's Hospital Sydney, 390 Victoria St., Darlinghurst, NSW 2010, Australia.
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Fox ML, James TG, Barnett SL. Suicidal Behaviors and Help-Seeking Attitudes Among Deaf and Hard-of-Hearing College Students. Suicide Life Threat Behav 2020; 50:387-396. [PMID: 31721275 PMCID: PMC9351548 DOI: 10.1111/sltb.12595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 08/27/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to examine the prevalence of suicidal ideation, suicide attempts, and help-seeking attitudes among D/HH and hearing college students. METHOD A total of 500,860 students completed the ACHA-NCHA-IIb (Fall 2011-Spring 2015). Survey administration and sampling methods differed across institutions. We randomly selected hearing students to have a 1:1 ratio of D/HH and hearing students (analytic N = 12,056). The mean age was 20.3 years, and the sample was predominantly white (68%) and female (65%). Multinomial and binary logistic regressions determined the relation between hearing status, suicide ideation and attempt, and help-seeking. RESULTS D/HH college students were more likely than hearing college students to have seriously considered suicide or attempted suicide in their lifetime. [Correction added on November 26, 2019, after first online publication: The phrase "but not in the past year" was deleted in the previous sentence.] In adjusted analyses, D/HH college students were more likely than hearing college students to have attempted suicide in the past year (OR 2.42, 95% CI 1.85, 3.17). There were no differences between D/HH and hearing groups in help-seeking attitudes. CONCLUSIONS Findings from this national data set indicate that D/HH college students are more likely to consider or attempt suicide. These results underscore the need for focused suicide risk prevention interventions with this population.
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Affiliation(s)
| | - Tyler G. James
- State University System of Florida, Tallahassee, FL, USA
| | - Steven L. Barnett
- National Center for Deaf Health Research, University of Rochester Medical Center National, Rochester, NY, USA
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Sander L, Gerhardinger K, Bailey E, Robinson J, Lin J, Cuijpers P, Mühlmann C. Suicide risk management in research on internet-based interventions for depression: A synthesis of the current state and recommendations for future research. J Affect Disord 2020; 263:676-683. [PMID: 31757622 DOI: 10.1016/j.jad.2019.11.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/05/2019] [Accepted: 11/09/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND The number of studies examining internet-based interventions (IBIs) for depression is increasing. Although many individuals with depression experience suicidal ideation, there is only insufficient information available on how to manage and support individuals at risk of suicide in IBI trials. Here, we examined the current practice regarding the management of individuals experiencing suicidal thoughts or behaviors in studies of IBIs for depression. METHODS Information pertaining to the management of suicidality was extracted from 24 studies. Additionally, researchers in the field completed a questionnaire (n = 13) before being interviewed (n = 11) about their procedures and considerations regarding the management of suicidality. RESULTS In most trials (N = 17; 71%), individuals at risk of suicide were excluded based on varying criteria. N = 7 studies used structured interviews and N = 5 studies used single items of self-report questionnaires for assessing suicidality. The nature and degree of support provided to individuals at risk of suicide varied and only one intervention comprised suicide-specific content. LIMITATIONS Most experts referred to research on interventions with some level of human support (e.g. written feedback) which might limit the representativeness of the results of the interviews for unguided interventions. CONCLUSIONS Suicidality is often treated more as an exclusion criterion rather than a treatable condition in research on IBIs for depression. This paper provides an overview of the current practice and gives recommendations for the design of future trials.
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Affiliation(s)
- Lasse Sander
- Department of Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs-University Freiburg, Institute of Psychology, Engelbergerstr. 41, D-79085 Freiburg, Germany.
| | - Katharina Gerhardinger
- Department of Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs-University Freiburg, Institute of Psychology, Engelbergerstr. 41, D-79085 Freiburg, Germany
| | - Eleanor Bailey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia; Swinburne University of Technology, Melbourne, Australia
| | - Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, University of Melbourne, Australia
| | - Jiaxi Lin
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, D-79104 Freiburg, Germany
| | - Pim Cuijpers
- Department of Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, BT 1081, Amsterdam, the Netherlands
| | - Charlotte Mühlmann
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Hellerup, Denmark; The University of Copenhagen, Denmark
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Fehling KB, Selby EA. Suicide in DSM-5: Current Evidence for the Proposed Suicide Behavior Disorder and Other Possible Improvements. Front Psychiatry 2020; 11:499980. [PMID: 33613330 PMCID: PMC7891495 DOI: 10.3389/fpsyt.2020.499980] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
Suicide continues to be one of the greatest challenges faced by mental health clinicians and researchers, an issue made worse by increasing trends in the global suicide rate. Suicide behavior disorder (SBD) was introduced in DSM-5 as a disorder for further consideration and potential acceptance into the diagnostic system. There are numerous positive developments that would arise from the addition of a suicide-related diagnosis. Utilizing the 2009 guidelines established by Kendler and colleagues, the present review examines the evidence for SBD's validity and discusses the diagnosis' potential clinical benefits and limitations. Altogether, growing evidence indicates that SBD has preliminary validity and benefit. SBD presents with several significant limitations, however, and possible alternative additions to future DSMs are highlighted.
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Affiliation(s)
| | - Edward A Selby
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
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Thienel R, Bryant M, Hazel G, Skehan J, Tynan R. Do Australian media apply recommendations when covering a suicide prevention campaign? JOURNAL OF PUBLIC MENTAL HEALTH 2019. [DOI: 10.1108/jpmh-10-2018-0071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Media reporting and portrayals of mental illness and suicide can play an important role in shaping and reinforcing community attitudes and perceptions. Depending on the content, a report about suicide can have either a negative (Werther-) or a positive (Papageno-) effect. Evidence-informed recommendations for the reporting of suicide in Australia are provided under the Mindframe initiative. The purpose of this paper is to assess the application of these recommendations in broadcasts associated with one of the largest national campaigns to promote suicide prevention, the R U OK? Day, a yearly campaign of the Australian suicide prevention charity R U OK?
Design/methodology/approach
The sample consisted of 112 (32 TV, 80 radio) Australian broadcasts discussing the R U OK? Day suicide prevention campaign during the month preceding the 2015 campaign and on the national R U OK? Day itself. Broadcasts were coded for medium (TV or radio), content (suicide focus, mental illness focus or both) and consistency with Mindframe recommendations.
Findings
Over 97 per cent of broadcasts used language consistent with Mindframe recommendations. None of the broadcasts used images that negatively portrayed mental illness or suicide; there were no instances of using mental illness to describe a person’s behaviour; and no sensationalizing or glamorising terminology was used in the broadcasts. However, less than 40 per cent of the broadcasts included help-seeking information (e.g. helplines) and some of the broadcasts used negative or outdated terminology (e.g. “commit” suicide; “suffering” from mental illness).
Originality/value
The present study is the first to examine consistency with reporting recommendations around a national suicide prevention campaign (R U OK? Day). The results can steer improvements in current reporting and inform strategies to optimise future reporting.
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Goodfellow B, Kõlves K, de Leo D. Contemporary Definitions of Suicidal Behavior: A Systematic Literature Review. Suicide Life Threat Behav 2019; 49:488-504. [PMID: 29574910 DOI: 10.1111/sltb.12457] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 11/11/2017] [Indexed: 01/22/2023]
Abstract
To address the lack of comparability around the world, we conducted a systematic review of existing definitions of suicide and suicidal behaviors. In the literature, four key features appear to cover the vast majority of concepts underpinning definitions: agency, knowledge of a potential fatal outcome, intent, and outcome. Intent and outcome appear to be the most consensual features of definitions of suicide, albeit revealing interesting conceptual variations. The four key features could be used to devise a research tool able to explore the meanings of suicide across different countries and different cultures.
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Affiliation(s)
- Benjamin Goodfellow
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia.,Centre Hospitalier Albert Bousquet, Nouméa, New Caledonia
| | - Kairi Kõlves
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia
| | - Diego de Leo
- Australian Institute of Suicide Research and Prevention, World Health Organization Collaborating Centre for Research in Suicide Prevention and Training, Griffith University, Mt Gravatt, Australia
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Park CHK, Lee JW, Lee SY, Moon JJ, Jeon DW, Shim SH, Cho SJ, Kim SG, Lee J, Paik JW, Kim MH, Kim S, Park JH, You S, Jeon HJ, Rhee SJ, Ahn YM. The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior: Study rationale, methodology, and baseline sample characteristics of a long-term, large-scale, multi-center, prospective, naturalistic, observational cohort study. Compr Psychiatry 2019; 88:29-38. [PMID: 30468986 DOI: 10.1016/j.comppsych.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study is a prospective, naturalistic, observational cohort study, aiming to identify predictors of suicide attempt and suicide characteristics in the Korean suicidal population. The findings intend to contribute to a thorough understanding of suicidal phenomena and development of suicide prevention guidelines. The present cross-section study examines the study rationale, methodology, and baseline characteristics of the participants. METHODS Participants were enrolled via the hospital and community gateways, establishing the hospital-based cohort (HC) and community-based cohort (CC), respectively. Baseline assessment was conducted on sociodemographic, clinical, diagnostic, and psychopathological aspects. The Columbia-Suicide Severity Rating Scale was used to investigate suicidality. RESULTS A total of 800 suicidal people aged 15 years or older were enrolled from 8 university hospitals and 8 community mental health welfare centers (CMHWCs), among whom 480 (60%) were suicidal ideators and 320 (40%) were attempters. The ideators comprised 207 CC and 273 HC participants, whereas the attempters, 34 CC and 286 HC participants. Despite their lower severity in some measures, including suicidal ideation, compared with their HC counterparts, the CC participants within each group of ideators or attempters presented clinically significant psychopathology. Moreover, alcohol use problems and past suicide attempt were more likely to be found in CC participants. Only 11.1% to 21.6% of the participants in each of the four groups (defined by the cohorts and the ideators/attempters) were on any type of psychiatric treatment. CONCLUSIONS Suicidal visitors to CMHWCs need to be as closely monitored as suicidal patients in university hospitals, especially considering their association with problem drinking and past suicide attempt. A cautious assumption is that the high suicide rate in Korea might be partly attributable to the low proportion of patients receiving psychiatric services.
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Affiliation(s)
- C Hyung Keun Park
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Jae Won Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Sang Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, 895 Muwangno, Iksan, Jeollabuk-do 54538, Republic of Korea
| | - Jung-Joon Moon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Dong-Wook Jeon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soon Chun Hyang University Cheonan Hospital, Soon Chun Hyang University, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, 21 Namdongdea-ro 774 gil, Namdong-gu, Incheon 21565, Republic of Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14584, Republic of Korea.
| | - Jeewon Lee
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14584, Republic of Korea
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Wonju Severance Christian Hospital, 20 Ilsan-ro, Wonju, Gangwon-do, Republic of Korea.
| | - Seokho Kim
- Department of Sociology, College of Social Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University College of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon 16419, Republic of Korea
| | - Sungeun You
- Department of Psychology, College of Social Sciences, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungcheongbuk-do 28644, Republic of Korea.
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
| | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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Zhong QY, Mittal LP, Nathan MD, Brown KM, Knudson González D, Cai T, Finan S, Gelaye B, Avillach P, Smoller JW, Karlson EW, Cai T, Williams MA. Use of natural language processing in electronic medical records to identify pregnant women with suicidal behavior: towards a solution to the complex classification problem. Eur J Epidemiol 2018; 34:153-162. [PMID: 30535584 DOI: 10.1007/s10654-018-0470-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 12/01/2018] [Indexed: 12/17/2022]
Abstract
We developed algorithms to identify pregnant women with suicidal behavior using information extracted from clinical notes by natural language processing (NLP) in electronic medical records. Using both codified data and NLP applied to unstructured clinical notes, we first screened pregnant women in Partners HealthCare for suicidal behavior. Psychiatrists manually reviewed clinical charts to identify relevant features for suicidal behavior and to obtain gold-standard labels. Using the adaptive elastic net, we developed algorithms to classify suicidal behavior. We then validated algorithms in an independent validation dataset. From 275,843 women with codes related to pregnancy or delivery, 9331 women screened positive for suicidal behavior by either codified data (N = 196) or NLP (N = 9,145). Using expert-curated features, our algorithm achieved an area under the curve of 0.83. By setting a positive predictive value comparable to that of diagnostic codes related to suicidal behavior (0.71), we obtained a sensitivity of 0.34, specificity of 0.96, and negative predictive value of 0.83. The algorithm identified 1423 pregnant women with suicidal behavior among 9331 women screened positive. Mining unstructured clinical notes using NLP resulted in a 11-fold increase in the number of pregnant women identified with suicidal behavior, as compared to solely reliance on diagnostic codes.
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Affiliation(s)
- Qiu-Yue Zhong
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA.
| | - Leena P Mittal
- Division of Women's Mental Health, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Margo D Nathan
- Division of Women's Mental Health, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Kara M Brown
- Division of Women's Mental Health, Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Deborah Knudson González
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Tianrun Cai
- Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA
| | - Sean Finan
- Children's Hospital Informatics Program, Boston Children's Hospital, Boston, MA, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
| | - Paul Avillach
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA.,Children's Hospital Informatics Program, Boston Children's Hospital, Boston, MA, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Jordan W Smoller
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA.,Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth W Karlson
- Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA
| | - Tianxi Cai
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle A Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
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Barczyk AN, Piper K, Duzinski SV, Klingensmith M, Lawson KA. Youth Suicide Attempt Nomenclature Used in Two Central Texas Hospitals. CRISIS 2018; 39:461-468. [DOI: 10.1027/0227-5910/a000521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Surveillance systems capturing instances of self-directed violence (SDV) continue to lack uniform nomenclature and classification methodology. Aims: To apply and compare two retrospective surveillance approaches to youth experiencing SDV presenting to two urban hospitals with Level I Trauma Centers. Method: Two suicide attempt surveillance methods where retrospectively applied to our SDV cohort: (a) a rigorous method facilitated by medical record review and application of standardized classification; and (b) a common surveillance method conducted by systematic queries of suicide attempt key terms and diagnosis codes among hospital databases. Results: Rigorous surveillance identified 249 patients attempting suicide. The common method's querying suicide attempt in the chief complaint field had a high positive predictive value and specificity; however, sensitivity was low. Limitations: Authors were unable to determine whether all SDV encounters during the study timeframe were identified for initial screening owing to the hospital's lack of a uniform nomenclature or classification system. Conclusion: Results showed underreporting of suicide attempt cases, inadequate sensitivity and specificity in common surveillance methods, and skewed demographic representation compared with the rigorous surveillance method. This study elucidates the negative impact of inconsistent SDV nomenclature including impeding effective patient identification, treatment, surveillance, and generalizable research.
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Affiliation(s)
| | - Karen Piper
- Dell Children's Trauma and Injury Research Center, Austin, TX, USA
| | | | | | - Karla A. Lawson
- Dell Children's Trauma and Injury Research Center, Austin, TX, USA
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41
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Goodfellow B, Kõlves K, de Leo D. Contemporary Nomenclatures of Suicidal Behaviors: A Systematic Literature Review. Suicide Life Threat Behav 2018; 48:353-366. [PMID: 28485508 DOI: 10.1111/sltb.12354] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/02/2017] [Indexed: 11/29/2022]
Abstract
Addressing the lack of comparability of research results around the world, a systematic literature review of existing nomenclatures was conducted. After distinguishing the concepts of nomenclature and classification, 13 contributions to nomenclature of suicidal behavior are described and summarized using outcome and intent as guiding concepts for analysis. The issue of what is being defined in nomenclatures is fundamental and impacts the way intent and outcome are used. The existing confusion between classification and nomenclature stems from conflicting purposes of the nature of definition; that is, to communicate concepts versus to be descriptive of reality.
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Affiliation(s)
- Benjamin Goodfellow
- Centre Hospitalier Albert Bousquet, Nouméa, New Caledonia.,Australian Institute of Suicide Research and Prevention, Mt Gravatt, Qld, Australia
| | - Kairi Kõlves
- Australian Institute of Suicide Research and Prevention, Mt Gravatt, Qld, Australia
| | - Diego de Leo
- Australian Institute of Suicide Research and Prevention and Griffith University, Mt Gravatt, Qld, Australia
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42
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Rueda-Jaimes GE, Castro-Rueda VA, Rangel-Martínez-Villalba AM, Moreno-Quijano C, Martinez-Salazar GA, Camacho PA. Validation of the Beck Hopelessness Scale in patients with suicide risk. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2018; 11:86-93. [PMID: 27914883 DOI: 10.1016/j.rpsm.2016.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 07/30/2016] [Accepted: 09/26/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Only a few scales have been validated in Spanish for the assessment of suicide risk, and none of them have achieved predictive validity. OBJECTIVE To determine the validity and reliability of the Beck Hopelessness Scale in patients with suicide risk attending the specialist clinic. METHODS The Beck Hopelessness Scale, reasons for living inventory, and the suicide behaviour questionnaire were applied in patients with suicide risk attending the psychiatric clinic and the emergency department. A new assessment was made 30 days later to determine the predictive validity of suicide or suicide attempt. RESULTS The evaluation included a total of 244 patients, with a mean age of 30.7±13.2 years, and the majority were women. The internal consistency was .9 (Kuder-Richardson formula 20). Four dimensions were found which accounted for 50% of the variance. It was positively correlated with the suicidal behaviour questionnaire (Spearman .48, P<.001), number of suicide attempts (Spearman .25, P<.001), severity of suicide risk (Spearman .23, P<.001). The correlation with the reasons for living inventory was negative (Spearman -.52, P<.001). With a cut-off ≥12, the negative predictive value was 98.4% (95% CI: 94.2-99.8), and the positive predictive value was 14.8% (95% CI: 6.6-27.1). CONCLUSION The Beck Hopelessness Scale in Colombian patients with suicidality shows results similar to the original version, with adequate reliability and moderate concurrent and predictive validity.
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Affiliation(s)
- German Eduardo Rueda-Jaimes
- Grupo de Neuropsiquiatría, Centro de Investigaciones en Ciencias de la Salud y Psicosociales, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia.
| | - Vanessa Alexandra Castro-Rueda
- Grupo de Neuropsiquiatría, Centro de Investigaciones en Ciencias de la Salud y Psicosociales, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | | | - Catalina Moreno-Quijano
- Grupo de Neuropsiquiatría, Centro de Investigaciones en Ciencias de la Salud y Psicosociales, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | - Gustavo Adolfo Martinez-Salazar
- Grupo de Neuropsiquiatría, Centro de Investigaciones en Ciencias de la Salud y Psicosociales, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | - Paul Anthony Camacho
- Dirección de Investigaciones, Desarrollo e Innovación Tecnológica, FOSCAL, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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43
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Thompson C, Ong ELC. The Association Between Suicidal Behavior, Attentional Control, and Frontal Asymmetry. Front Psychiatry 2018; 9:79. [PMID: 29593586 PMCID: PMC5861137 DOI: 10.3389/fpsyt.2018.00079] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 02/26/2018] [Indexed: 12/18/2022] Open
Abstract
It can be difficult to identify those at risk of suicide because suicidal thoughts are often internalized and not shared with others. Yet to prevent suicide attempts it is crucial to identify suicidal thoughts and actions at an early stage. Past studies have suggested that deficits in attentional control are associated with suicide, with the argument that individuals are unable to inhibit negative thoughts and direct resources away from negative information. The current study aimed to investigate the association of suicidal behavior with neurological and behavioral markers, measuring attentional bias and inhibition in two Stroop tasks. Fifty-four participants responded to the color of color words in a standard Stroop task and the color of positive, negative, and neutral words in an emotional Stroop task. Electroencephalographic (EEG) activity was recorded from frontal areas during each task and at resting. Participants were separated into a low-risk and high-risk group according to their self-reported suicidal behavior. Participants in the high-risk group showed slower response times in the color Stroop and reduced accuracy to incongruent trials, but faster response times in the emotional Stroop task. Response times to the word "suicide" were significantly slower for the high-risk group. This indicates an attentional bias toward specific negative stimuli and difficulties inhibiting information for those with high levels of suicidal behavior. In the emotional Stroop task the high-risk group showed reduced activity in leftward frontal areas, suggesting limitations in the ability to regulate emotional processing via the left frontal regions. The findings support the argument that deficits in attentional control are related to suicidal behavior. The research also suggests that under certain conditions frontal asymmetry may be associated with suicidal behavior.
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Affiliation(s)
- Catherine Thompson
- School of Health Sciences, University of Salford, Salford, United Kingdom
| | - Elsie Li Chen Ong
- School of Health Sciences, University of Salford, Salford, United Kingdom.,Division of Information and Technology Studies, Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong
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44
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Howard M, Krannitz M. A Reanalysis of Occupation and Suicide: Negative Perceptions of the Workplace Linked to Suicide Attempts. THE JOURNAL OF PSYCHOLOGY 2017; 151:767-788. [DOI: 10.1080/00223980.2017.1393378] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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45
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Rueda-Jaimes G, Castro-Rueda V, Rangel-Martínez-Villalba A, Corzo-Casasadiego J, Moreno-Quijano C, Camacho P. Validity of the Suicide Behaviors Questionnaire-Revised in patients with short-term suicide risk. EUROPEAN JOURNAL OF PSYCHIATRY 2017. [DOI: 10.1016/j.ejpsy.2017.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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46
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Subcortical brain structure and suicidal behaviour in major depressive disorder: a meta-analysis from the ENIGMA-MDD working group. Transl Psychiatry 2017; 7:e1116. [PMID: 28463239 PMCID: PMC5534952 DOI: 10.1038/tp.2017.84] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 02/25/2017] [Accepted: 02/28/2017] [Indexed: 11/08/2022] Open
Abstract
The aetiology of suicidal behaviour is complex, and knowledge about its neurobiological mechanisms is limited. Neuroimaging methods provide a noninvasive approach to explore the neural correlates of suicide vulnerability in vivo. The ENIGMA-MDD Working Group is an international collaboration evaluating neuroimaging and clinical data from thousands of individuals collected by research groups from around the world. Here we present analyses in a subset sample (n=3097) for whom suicidality data were available. Prevalence of suicidal symptoms among major depressive disorder (MDD) cases ranged between 29 and 69% across cohorts. We compared mean subcortical grey matter volumes, lateral ventricle volumes and total intracranial volume (ICV) in MDD patients with suicidal symptoms (N=451) vs healthy controls (N=1996) or MDD patients with no suicidal symptoms (N=650). MDD patients reporting suicidal plans or attempts showed a smaller ICV (P=4.12 × 10-3) or a 2.87% smaller volume compared with controls (Cohen's d=-0.284). In addition, we observed a nonsignificant trend in which MDD cases with suicidal symptoms had smaller subcortical volumes and larger ventricular volumes compared with controls. Finally, no significant differences (P=0.28-0.97) were found between MDD patients with and those without suicidal symptoms for any of the brain volume measures. This is by far the largest neuroimaging meta-analysis of suicidal behaviour in MDD to date. Our results did not replicate previous reports of association between subcortical brain structure and suicidality and highlight the need for collecting better-powered imaging samples and using improved suicidality assessment instruments.
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47
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Kwok CL, Yip PSF. Diminishing seasonality of self-harm: Temporal trends in Hong Kong SAR. J Affect Disord 2017; 207:63-68. [PMID: 27710780 DOI: 10.1016/j.jad.2016.09.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/05/2016] [Accepted: 09/22/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The study of temporal variation in self-harm is important to understanding the underlying mechanisms of its occurrence. There are fewer studies on temporal variation in self-harm than in suicide. The aim of this study was to examine the seasonality of self-harm in Hong Kong and to test the hypothesis of diminishing seasonality. METHODS We used secondary data from medical records of self-harm obtained from all the public hospitals in Hong Kong under the management of the Hospital Authority. We identified 59,473 distinct episodes involving 36,411 patients. From these, monthly statistics of self-harm from January 2002 to December 2011 were calculated. Harmonic analysis was conducted to examine the presence and magnitude of seasonality. RESULTS A bi-seasonal pattern alongside a stronger one-cycle pattern from 2002 to 2006 was identified. During the period 1997-2001, this contracted to a one-cycle pattern with a peak in summer (May to July) and a nadir in winter (December). The magnitude of seasonality diminished greatly, as shown by harmonic analysis. The extent of diminishing seasonality was larger among women and people under 55 years old. LIMITATIONS The study covered only self-harm patients who had visited a hospital. Cases which required no medical attention and those where the patient consulted private doctors could not be included, indicating bias towards more severe cases of injury and poisoning. CONCLUSION This study provides some evidence of diminishing and even vanishing seasonality of self-harm in Hong Kong, a phenomenon mainly found in younger individuals. It could be related to the increasing use of social media to connect people, especially the younger generation. The impact of seasonal events and activities, as in the past, has become less significant in the social media era.
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Affiliation(s)
- Chi-Leung Kwok
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Paul S F Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.
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48
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Nielsen E, Padmanathan P, Knipe D. Commit* to change? A call to end the publication of the phrase 'commit* suicide'. Wellcome Open Res 2016; 1:21. [PMID: 28286872 PMCID: PMC5341764 DOI: 10.12688/wellcomeopenres.10333.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. Countering stigma is a fundamental facet of suicide prevention efforts. Integral to this is the promotion of accurate and sensitive language. The phrase ‘commit* suicide’ has prompted marked opposition primarily due to the connotations of immorality and illegality.
Methods. The study investigated the frequency of the use of the wordstem ‘commit’, in relation to self-harm and suicidal behaviours, in the three leading suicide-specific academic journals between 2000 and 2015.
Results. One third (34%) of articles published since the year 2000 used the word ‘commit*’ when describing an act of self-harm or suicide. Over half of these articles (57%) used the phrase on more than one occasion, with 6% using it more than 10 times in the same manuscript. The percentage of papers utilising the word ‘commit*’ has fluctuated over time, but there is a promising downward trend in the use of this phrase from 33% in 2000 to 13% in 2015 (
p < 0.001).
Discussion. We advocate for the implementation of publication requirements regarding the language used when discussing suicide. Whilst we call for collective responsibility amongst academics and clinicians, editors hold a unique position in ensuring that outdated, inaccurate and stigma-laden terms are expunged from the scientific literature.
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Affiliation(s)
- Emma Nielsen
- Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, UK
| | | | - Duleeka Knipe
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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49
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Rezaeian M, Zarghami M. Algorithm Characterization of Suicide: Introducing an Informative Categorization System. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e4544. [PMID: 27822281 PMCID: PMC5097447 DOI: 10.17795/ijpbs-4544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 04/11/2015] [Accepted: 10/29/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Mohsen Rezaeian
- Epidemiology and Biostatistics Department, Occupational Environmental Research Center, Rafsanjan Medical School, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
| | - Mehran Zarghami
- Department of Psychiatry, School of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Sari, IR Iran; Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Mazandaran, Sari, IR Iran
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50
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Cwik JC, Teismann T. Misclassification of Self-Directed Violence. Clin Psychol Psychother 2016; 24:677-686. [PMID: 27481725 DOI: 10.1002/cpp.2036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 07/01/2016] [Accepted: 07/01/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Inconsistent nomenclature and classification of suicidal behaviour have plagued the field of suicidology for a long time. Recently, the United States Centers for Disease Control (CDC) advocated for the usage of a specific classification system. Aim of the current study was to determine the extent of misdiagnosed acts of self-directed violence-controlling for the level of expertise in psychology/psychotherapy. Additionally, the effect of gender and diagnosis on misclassifications was assessed. METHOD A total of 426 participants (laypersons, psychology students, psychotherapists-in-training, licensed psychotherapists) were presented with an array of case vignettes describing different acts of self-directed violence (e.g., non-suicidal self-directed violence, suicide attempt, suicide ideation) and were asked to make a classification. Gender and given diagnosis were varied systematically in two vignettes. RESULTS Overall 51.6% of the cases were misclassified (according to the Self-Directed Violence Classification System). The level of expertise was almost unrelated to classification correctness. Yet, psychotherapists were more confident about their judgments. Female gender of the character described in the vignette and an ascribed diagnosis of Borderline Personality Disorder were associated with higher misclassification rates. LIMITATIONS The validity of case vignettes is discussible. CONCLUSIONS The results highlight the importance of more methodological and diagnostic training of psychologists regarding suicidal issues. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE Misclassification of non-suicidal and suicidal events is common. Expertise is only weakly associated with classification correctness. Misclassification of suicide attempts occurs more often in women. Misclassification of suicide attempts occurs more often in Borderline Personality Disorder. The use of standardized diagnostic tools in relation to self-directed violence is highly recommended.
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Affiliation(s)
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Germany
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