Relationship between quantity and frequency of alcohol use and indices of suicidal behavior in an elderly Australian sample

Alcohol use and its association with suicide attempt, suicidal thoughts and non-suicidal self-harm in two successive, nationally representative English household samples

BACKGROUND

Alcohol use is a risk factor for suicidal behaviour, yet the nature of the relationship is unclear. Most research on the topic is conducted in clinical populations, with few studies exploring this association across the general population.

AIMS

We investigated the association between specific domains of alcohol use and suicide attempt, suicidal thoughts and non-suicidal self-harm in a general population sample.

METHOD

A total of 14 949 adults who completed the 2007 or 2014 Adult Psychiatric Morbidity Survey were included. We measured alcohol use with the Alcohol Use Disorders Identification Test (AUDIT). Domains of alcohol use relating to risk categories, weekly consumption, binge drinking, dependence symptoms, harmful effects and concern from others were derived from relevant AUDIT items. Self-reported past year suicide attempt, suicidal thoughts and non-suicidal self-harm were measured with the Clinical Interview Schedule, Revised.

RESULTS

We found a linear association between total AUDIT score and outcomes. Three of six specific domains of alcohol use (dependence symptoms, harmful effects of drinking and binge drinking) were associated with increased odds of all three outcomes. There was no association of outcomes with the other domains of alcohol use.

CONCLUSIONS

We found evidence of a linear association between total AUDIT score and suicide attempt, suicidal thoughts and non-suicidal self-harm in a representative English general population sample. Our analyses suggest that where alcohol use significantly disrupts day-to-day functioning, this may underpin the relationship between alcohol use and suicide-related outcomes to a greater extent than higher alcohol consumption. Longitudinal research is needed to further understand these relationships.

STROBE: The relationship between asthma and early menarche in Korean adolescents

We explored the relationship between asthma and early menarche in a representative sample of Korean adolescents.Web-based self-reported data collected from 2006 to 2015 by the Korean Youth Risk Behavior Web-based Survey were used. Menarche status was divided into "early" (<12 years of age, n = 69,520) and "not early" (≥12 years of age, n = 234,065).Adolescent girls with early menarche exhibited a higher incidence of asthma (8.1% vs 7.4%, P < .001), more frequent school absences because of asthma (10.8% vs 8.7%), and more frequent ≤4-day stretches of school absence (4.6% vs 2.4%) compared with girls with "not early" menarche (all P < .001). Multivariate analysis performed after adjusting for multiple confounders revealed a 1.04-fold (95% confidence interval [CI] 1.00-1.07) greater likelihood of asthma in the early menarche than not early menarche group. In addition, the odds ratios for missing school due to asthma for 1 to 3 and ≥4 days per year in the early menarche group were 1.00 (95% CI 1.00-1.02) and 1.21 (95% CI 1.01-1.46), respectively.Adolescents with early menarche exhibited increased incidences of asthma and severe asthma.

Association between early menarche and suicidal behaviors in Korean girl adolescents

Early menarche can be the socio-psychological problems. We studied the association between early menarche and suicidal risk behaviors among South Korean girl adolescents using national-wide data.Web-based self-report data from 2006 to 2015 the Korea Youth Risk Behavior Web-based Survey data were used in this study. Menarche status was divided into an "early menarche" group (at <12 years of age) versus "not early" menarche group (at ≥12 years of age).Participants with adolescent girls with early menarche group showed a higher prevalence of substance use, higher levels of stress, poorer self-rated health status, unhappier perceiveness, more frequent depressed mood, inter-sexual kissing or petting, inter-sexual intercourse, homosexual kissing or petting, being the victim or the assailant of sexual assaults, sexual transmitted diseases experience, pregnancy, and abortion experience than the not early menarche group. Adolescent girls with early menarche who had suicidal ideation (25.4% vs 22.2%, P < .001), suicidal plans (4.1% vs 2.6%, P < .001), and suicidal attempts (6.8% vs 5.2%, P < .001) were higher than that in the adolescent girls with not early menarche. A multivariate analysis after adjusting revealed that the odds ratios for suicidal ideation, plans, and attempts were 1.07 (95% confidence interval [CI]: 1.05-1.10), 1.35 (95% CI: 1.28-1.41), and 1.13 (95% CI: 1.09-1.18), respectively.Adolescent girl with early menarche was associated with suicidal behaviors.

Asthma and other allergic diseases in relation to suicidal behavior among South Korean adolescents

OBJECTIVES

Adolescent asthma can be the cause of social and psychological problems. We investigated the association between asthma with other allergic diseases and suicidal risk behavior among South Korean adolescents using nationally representative data.

METHODS

Web-based self-report data from the Korean Youth Risk Behavior Web-Based Survey were used in this study (N = 237,022). Complex sample logistic regression was used to define the relationship between suicidal behavior and asthma (n = 7177), with other allergic diseases [asthma with allergic rhinitis (AR) or asthma with atopic dermatitis (AD) (n = 9720), asthma with AD and AR (n = 4971)].

RESULTS

Participants with asthma and other allergies showed a higher prevalence of substance use, greater sexual experience, greater perceived stress, poorer perceived health, more severe depression, more suicidal ideation, and more suicide attempts than those without allergy. Depression, suicidal ideation, and suicide attempts increased trend in the following order: no asthma, asthma only, asthma with one other allergy (asthma with AD or asthma with AR), and asthma with AD and AR. After adjusting for multiple confounders, the odds ratio for suicidal ideation with asthma and AD and AR was 1.13 [95% confidence interval (CI), 1.06-1.19] and that for suicide attempts was 1.31 (95% CI, 1.20-1.43).

CONCLUSIONS

Adolescent asthma and other allergies were associated with suicidal behavior.

The Connection Between Thwarted Belongingness, Alcohol Consumption, Suicidal, and Homicidal Ideation in a Criminal Justice Sample

BACKGROUND

To determine if thwarted belongingness in combination with frequent alcohol use increased suicidal and homicidal ideation when known predictors were controlled for (eg, depressive disorders, anxiety disorders, drug use, race, sex, age, and employment status).

METHOD

This study utilized an archival database. Participants were 574 individuals at an outpatient substance abuse treatment facility who were under community corrections supervision. The average age was 34.5 (SD = 10.9) years; there were 371 (64.6%) men and 287 (50.0%) Black participants. Data were originally gathered from face-to-face interviews with the participants by their case manager or an intake specialist when they entered treatment. Self-reported suicidal and homicidal ideation was used as a dependent variable in unadjusted and adjusted binary logistic regressions to determine the influence of thwarted belongingness and frequent alcohol use.

RESULTS

Thwarted belongingness alone (ie, without frequent alcohol use) was associated with risk for suicidal ideation, and was approaching significance for homicidal ideation. The combination of thwarted belongingness and frequent alcohol use was associated with the greatest risk for suicidal and homicidal ideation. Cocaine use and employment status were also identified as significant predictors for suicidal and homicidal ideation in the fully adjusted models.

CONCLUSIONS

Thwarted belongingness in combination with frequent alcohol use seems to have a large and meaningful relationship with both suicidal and homicidal ideation. Additional research is needed to better understand the relationship between alcohol, thwarted belongingness, and outcomes such as suicide and homicide.

Suicidal ideation and suicide attempts among asthma

BACKGROUND

The present study aimed to investigate the mental health status in patients with asthma and assess the effects of asthma on suicidal ideation and attempts using a representative sample from Korea.

METHODS

Individual-level data were obtained from 228,744 participants (6372 with asthma and 222,372 without asthma) of the 2013 Korean Community Health Survey. Demographic characteristics, socioeconomic status, physical health status, and mental health status were compared between patients with asthma and population without asthma. Multivariable logistic regression was performed to investigate the independent effects of the asthma on suicidal ideation and attempts.

RESULTS

A depressed mood for 2 or more continuous weeks was reported by 12.0% of subjects with asthma and 5.7% of controls (p < 0.001). Suicidal thoughts were reported by 21.4% of patients with asthma and 9.8% of controls (p < 0.001). Suicidal attempts were reported by 1.0% of the patients with asthma and 0.4% of controls (p < 0.001). Following adjustment for age, sex, income, education, job, marital status, smoking, alcohol, exercise, and presence of diabetes mellitus, hypertension, stroke, arthritis, and depression, the ORs for suicidal ideation with asthma were 1.53 (95% CI 1.42-1.65) and that for suicidal attempts was 1.32 (95% CI 1.01-1.73).

CONCLUSIONS

We found that asthma increased the risk for suicidal ideation and attempts, even controlling for the effects of socioeconomic status, physical health status, comorbid chronic medical diseases, and depressive mood. Our finding suggests that asthma per se may be an independent risk factor for suicidality.

An investigation of the interactive effects of the capability for suicide and acute agitation on suicidality in a military sample

BACKGROUND

According to the interpersonal theory of suicide (1, 2), the difficulties inherently associated with death by suicide deter many individuals from engaging in suicidal behavior. Consistent with the notion that suicide is fearsome, acute states of heightened arousal are commonly observed in individuals immediately prior to lethal and near-lethal suicidal behavior. We suggest that among individuals who possess elevated levels of the capability for suicide, the heightened state of arousal experienced during periods of acute agitation may facilitate suicidal behavior in part because it would provide the necessary energy to approach a potentially lethal stimulus. Among individuals who are low on capability, the arousal experienced during agitation may result in further avoidance.

METHODS

In the present project we examine how acute agitation may interact with the capability for suicide to predict suicidality in a large military sample (n = 1,208) using hierarchical multiple regression.

RESULTS

Results were in line with a priori hypotheses: among individuals high on capability, as agitation increases, suicidality increases whereas as agitation increases among individuals low on capability, suicidality decreases. Results held beyond the effects of thwarted belongingness, perceived burdensomeness, and suicidal cognitions.

CONCLUSIONS

Beyond further substantiating the link between agitation and suicide, findings of the present study provide evidence for the construct validity of the acquired capability as well as offer initial evidence for moderating role of capability on the effect of agitation on suicide. Limitations of the current study highlight a need for future research that improves upon the techniques used in the present study. Implications for science and practice are discussed.

Suicidal ideation and suicide attempts among diabetes mellitus: the Korea National Health and Nutrition Examination Survey (KNHANES IV, V) from 2007 to 2012

OBJECTIVE

The present study evaluated the mental health of patients with diabetes mellitus (DM) in Korea and compared it with mental health in the general Korean population.

METHODS

All data included in the final analyses were collected from 34,065 subjects (20years of age or older) who participated in the 2007-2012 Korea National Health and Nutrition Examination Survey (KNHANES). The mental health of 3846 DM patients were compared with that of 30,219 controls.

RESULTS

A depressed mood for 2 or more continuous weeks was reported by 13.6% of subjects with normal glucose tolerance (NGT), 14.3% of those with impaired glucose intolerance (IFG), and 17.6% of DM patients. Suicidal thoughts were reported by 15.3% of individuals with NGT, 15.6% of participants with IFG, and 17.6% of DM patients. Suicidal attempts were reported by 0.8% of people with NGT, 1.0% of those with IFG, and 1.3% of DM patients. In DM patients, the crude odds ratio (OR) for depressive mood was 1.376 (95% confidence interval [CI]: 1.258-1.504), the OR for suicidal ideation was 1.481 (95% CI: 1.361-1.611) and the OR for suicidal attempts was 1.413 (95% CI: 1.021-1.956). A multivariate analysis revealed that the ORs for depression, suicidal ideation, and suicidal attempts in DM patients were 1.178 (95% CI: 1.070-1.297), 1.152 (95% CI: 1.050-1.263), and 1.413 (95% CI: 1.021-1.956), respectively.

CONCLUSIONS

The present study found that DM was associated with a marked increase in suicidal behaviors.

Suicidal ideation and suicide attempts in chronic obstructive pulmonary disease: the Korea National Health and Nutrition Examination Survey (KNHANES IV, V) from 2007-2012

Background:

There is good evidence for an association between chronic obstructive pulmonary disease (COPD) and depression, but there are few studies on the relationship between COPD and suicidal ideation/suicidal attempts.

Aims:

To evaluate the mental health of patients with COPD in Korea and to compare it with that of the general population.

Methods:

We analysed data of 15,718 subjects (age ⩾40 years) who participated in the 2007–2012 Korea National Health and Nutrition Examination Survey. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for people aged ⩾40 years. We compared the mental health outcomes of 2,506 patients with COPD (2,355 GOLD stages I and II; 151 GOLD stages III and IV) with those of 13,212 controls.

Results:

Suicidal thoughts were reported by 16.0% of patients in stages I and II, by 23.8% of those in stages III and IV and by 15.7% of controls (P=0.023). Suicidal attempts were reported by 0.6% of patients in stages I and II, by 2.6% of those in stages III and IV and by 1.0% of controls (P=0.019). The crude odds ratio (OR) for suicidal ideation in those in stages III and IV was 1.68 (95% confidence interval (CI), 1.16–2.46), and the OR for suicidal attempts in stages III and IV was 2.83 (95% CI, 1.03–7.75). In multivariate analysis, the OR for suicidal ideation in stages III and IV was 1.67 (95% CI, 1.12–2.49) and that for suicidal attempts was 2.94 (95% CI, 1.03–8.31).

Conclusions:

GOLD stages III and IV COPD were associated with a marked increase in suicidal behaviour.

Suicidal Behavior and Neurological Illnesses

OBJECTIVE

Suicidal ideation and behavior have been associated with a variety of neurological illnesses. Studies are ongoing in combat veterans and other groups to examine possible mechanisms and pathways that account for such associations.

METHOD

This article provides a review of the literature on suicide ideation and suicidal behavior in patients with neurological illnesses including publications on veteran's health and military medicine. Studies of suicide attempts and deaths in people with neurological illnesses are also reviewed.

RESULTS

The studies summarized in this review indicate that there are important linkages between suicidal ideation and behavior and neurological conditions, including epilepsy, multiple sclerosis, and amyotrophic lateral sclerosis.

CONCLUSION

Additional studies are needed to further clarify why suicide ideation and suicidal behavior are associated with neurological diseases, in order to improve quality of life, alleviate patient distress, and prevent nonfatal and fatal suicide attempts in veteran and non-veteran populations.

Relationships of suicide ideation with cause-specific mortality in a longitudinal study of South Koreans

Using 7-year mortality follow-up data (n = 341) from the 1998 National Health and Nutrition Examination Surveys of South Korean individuals (N = 5,414), the authors found that survey participants with suicide ideation were at increased risk of suicide mortality during the follow-up period compared with those without suicide ideation. The cause-specific analyses showed that, in men, suicide ideation was significantly associated with mortality due to cardiovascular disease, external causes, and other causes. However, there was no significant association between suicide ideation and cause-specific mortality in women. The relationship between suicide ideation and cause-specific mortality in men was not fully explained by baseline health status, socioeconomic status, health behavior, or psychosocial factors.