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Yip PSF, Caine ED, Yeung CY, Law YW, Ho RTH. Suicide prevention in Hong Kong: pushing boundaries while building bridges. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101061. [PMID: 38616984 PMCID: PMC11011221 DOI: 10.1016/j.lanwpc.2024.101061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 04/16/2024]
Abstract
Hong Kong is a natural laboratory for studying suicides-small geographic footprint, bustling economic activity, rapidly changing socio-demographic transitions, and cultural crossroads. Its qualities also intensify the challenges posed when seeking to prevent them. In this viewpoint, we showed the research and practices of suicide prevention efforts made by the Hong Kong Jockey Club Centre for Suicide Research and Prevention (CSRP), which provide the theoretical underpinning of suicide prevention and empirical evidence. CSRP adopted a multi-level public health approach (universal, selective and indicated), and has collaboratively designed, implemented, and evaluated numerous programs that have demonstrated effectiveness in suicide prevention and mental well-being promotion. The center serves as a hub and a catalyst for creating, identifying, deploying, and evaluating suicide prevention initiatives, which have the potential to reduce regional suicides rates when taken to scale and sustained.
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Affiliation(s)
- Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pofulam, Hong Kong SAR, China
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Eric D. Caine
- Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, NY, USA
- Canandaigua VA Center of Excellence for Suicide Prevention, Canandaigua, NY, USA
| | - Cheuk Yui Yeung
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pofulam, Hong Kong SAR, China
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Yik Wa Law
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pofulam, Hong Kong SAR, China
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Rainbow Tin Hung Ho
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Zhou J, Hu T, Xue S, Dong Z, Tang W. The association of childhood trauma with suicidality in adult psychiatric patients: The mediating role of NSSI and the moderating role of self-esteem. J Clin Psychol 2024; 80:664-677. [PMID: 38265412 DOI: 10.1002/jclp.23646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND The contribution of specific childhood trauma subtypes to suicidal thoughts and the associated mechanisms remains unclear, particularly in psychiatric patients. METHODS Face-to-face interviews were conducted with 449 psychiatric patients aged 18-73. Childhood trauma, self-esteem, nonsuicidal self-injury (NSSI), and suicidality were assessed retrospectively. Regression and moderated mediation model were employed to examine these relationships. RESULTS Emotional and sexual abuse were independently associated with suicidality. Female patients reported higher levels of emotional and sexual abuse, lower self-esteem, and a heightened risk of suicide. Self-esteem moderated the links between childhood trauma and NSSI, as well as between NSSI and suicidality. NSSI served as a mediator between childhood trauma and suicidality. CONCLUSIONS Suicide prevention in mentally ill patients should involve targeted programs addressing specific childhood trauma. Additionally, psychological interventions to enhance self-esteem and assist individuals engaging in NSSI behavior are crucial.
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Affiliation(s)
- Jing Zhou
- Department of Psychosomatic Medicine, Leshan People's Hospital, Leshan, Sichuan, China
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Hu
- School of Education and Psychology, Chengdu Normal University, Chengdu, China
- Business School, Sichuan University, Chengdu, China
| | - Shuang Xue
- Department of Sociology and Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - Zaiquan Dong
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Wanjie Tang
- Department of Psychiatry, Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Yockey RA, Vidourek R, King K. Suicide Among Older Hispanic Adults: A Call to Action. HISPANIC HEALTH CARE INTERNATIONAL 2023; 21:3. [PMID: 36579801 DOI: 10.1177/15404153221149790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- R Andrew Yockey
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Rebecca Vidourek
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
| | - Keith King
- School of Human Services, University of Cincinnati, Cincinnati, OH, USA
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Azra KK, Nielsen A, Kim C, Dusing GJ, Chum A. Investigating suicide related behaviours across sexual orientation and neighbourhood deprivation levels: A cohort study using linked health administrative data. PLoS One 2023; 18:e0282910. [PMID: 36989270 PMCID: PMC10058080 DOI: 10.1371/journal.pone.0282910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 02/24/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND There have been no studies examining how neighbourhood deprivation modifies the effects of sexual minority status on suicide-related behaviours (SRB). Sexual minority individuals in deprived areas may face unique challenges and stressors that exacerbate their risk of SRB. This study aims to investigate the association between sexual minority status and clinical SRB, and examine whether the effect of neighbourhood deprivation differs across sexual orientation. METHODS A population-representative survey sample (169,090 respondents weighted to represent 8,778,120 individuals; overall participation rate 75%) was linked to administrative health data in Ontario, Canada to measure SRB-related events (emergency department visits, hospitalizations, and deaths) from 2007 to 2017. Neighbourhood-level deprivation was measured using the Ontario Marginalisation index measure of material deprivation at the dissemination area level. Discrete-time survival analysis models, stratified by sex, tested the effects of neighbourhood deprivation and sexual minority status, while controlling for individual-level covariates. RESULTS Sexual minority men had 2.79 times higher odds of SRB compared to their heterosexual counterparts (95% CI 1.66 to 4.71), while sexual minority women had 2.14 times higher odds (95% CI 1.54 to 2.98). Additionally, neighbourhood deprivation was associated with higher odds of SRB: men in the most deprived neighbourhoods (Q5) had 2.01 times higher odds (95% CI 1.38 to 2.92) of SRB compared to those in the least deprived (Q1), while women had 1.75 times higher odds (95% CI 1.28 to 2.40). No significant interactions were observed between sexual minority status and neighbourhood deprivation levels. CONCLUSION In both men and women, sexual minority status and neighbourhood deprivation are independent risk factors for SRB. Despite the lack of effect modification, sexual minorities living in the most deprived neighbourhoods have the highest chances of SRB. Future investigations should evaluate interventions and policies to improve sexual minority mental health and address neighbourhood deprivation.
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Affiliation(s)
- Karanpreet Kaur Azra
- Department of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Andrew Nielsen
- Department of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Canadian Institute for Health Information, Toronto, Ontario, Canada
| | - Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Antony Chum
- Department of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Adult abuse and poor prognosis in Taiwan, 2000-2015: a cohort study. BMC Public Health 2022; 22:2280. [PMID: 36474217 PMCID: PMC9724336 DOI: 10.1186/s12889-022-14663-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To investigate the risk of poor prognosis regarding schizophrenic disorders, psychotic disorders, suicide, self-inflicted injury, and mortality after adult violence from 2000 to 2015 in Taiwan. METHODS This study used data from National Health Insurance Research Database (NHIRD) on outpatient, emergency, and inpatient visits for two million people enrolled in the National Health Insurance (NHI) from 2000 to 2015. The case study defined ICD-9 diagnosis code N code 995.8 (abused adult) or E code E960-E969 (homicide and intentional injury of another). It analyzed first-time violence in adults aged 18-64 years (study group). 1:4 ratio was matched with injury and non-violent patients (control group). The paired variables were sex, age (± 1 year), pre-exposure to the Charlson comorbidity index, and year of medical treatment. Statistical analysis was conducted using SAS 9.4 and Cox regression for data analysis. RESULTS In total, 8,726 individuals experienced violence (case group) while34,904 did not experienced violence (control group) over 15 years. The prevalence of poor prognosis among victims of violence was 25.4/104, 31.3/104, 10.5/10,4 and 104.6/104 for schizophrenic disorders, psychotic disorders, suicide or self-inflicted injury and mortality, respectively. Among adults, the risks of suicide or self-inflicted injury, schizophrenic disorders, psychotic disorders, and mortality after exposure to violence (average 9 years) were 6.87-, 5.63-, 4.10-, and 2.50-times (p < 0.01), respectively, compared with those without violence. Among males, the risks were 5.66-, 3.85-, 3.59- and 2.51-times higher, respectively, than those without violence (p < 0.01), and they were 21.93-, 5.57-, 4.60- and 2.46-times higher than those without violence (p < 0.01) among females. CONCLUSION The risk of poor prognosis regarding schizophrenic disorders, psychotic disorders, suicide, or self-inflicted injury and mortality after adult violence was higher than in those who have not experienced a violent injury. Adults at the highest risk for violent suicide or self-inflicted injuries due to exposure to violent injuries -males were at risk for schizophrenia and females were at risk for suicide or self-inflicted injuries. Therefore, it is necessary for social workers and medical personnel to pay attention to the psychological status of victims of violence.
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Muacevic A, Adler JR. The Demographic Profile of Suicidal Hanging Deaths in North India. Cureus 2022; 14:e30409. [PMID: 36407218 PMCID: PMC9669517 DOI: 10.7759/cureus.30409] [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: 10/17/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Suicidal hanging is the most prevalent means of suicide worldwide, particularly among young people, and reveals the state of mental health in certain indigenous populations. According to the National Crime Records Bureau, hanging was the most frequent cause of suicide in India in 2019 and 2020, accounting for 53.6% and 57.8% of total suicidal deaths. AIM The current study examines the seasonal distribution of suicide-hanging fatalities in Rishikesh, Uttarakhand, as well as the male and female incidence. METHODS A four-year retrospective examination of autopsy data at the All India Institute of Medical Sciences (AIIMS), Rishikesh, from October 2018 to July 2022. A total of 1720 autopsies were performed during this period with 130 (7.56%) suicidal hangings. RESULTS Males were disproportionately impacted (n=100, 76.92%). The ratio of men to women is 3.33:1. The mean ages of the males and females were 33.09 ± 12.59 and 24.9 ± 7.84 years, respectively. The majority of deaths occur in the third decade of life. The summer months saw the highest number of deaths (April-June). CONCLUSION This data may be used to identify persons with a higher chance of committing suicide by hanging and can be utilized to help people through a nationwide suicidal prevention program that employs a multi-disciplinary team approach. Epidemiological studies should evaluate the psychosocial characteristics of men and women separately to identify the population at risk and develop preventative approaches. LIMITATIONS This is a single-center, retrospective study.
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Contextual fallacy in MLMs with cross-level interaction: A critical review of neighborhood effects on psychiatric resilience. Soc Sci Med 2022; 310:115279. [PMID: 35998424 DOI: 10.1016/j.socscimed.2022.115279] [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: 02/12/2022] [Revised: 08/07/2022] [Accepted: 08/09/2022] [Indexed: 11/22/2022]
Abstract
In the multilevel modeling literature, contextual effect is defined as or identified by the effect of the target group-level variable while controlling for the corresponding individual-level variable. This paper extends the notion of "contextual effects" (or "neighborhood" or "school" effects) to an interaction setting, such that the effect of one explanatory variable Xij on the outcome Yij is modeled as a function of a group-level 'moderating' or predisposing variable Zj* as well as its counterpart at the individual level Zij. Researchers frequently use regression models that only contain a cross-level interaction between Xij and Zj* to test contextual hypotheses in an interaction setting, but this modeling strategy is unable to discriminate the immediate rival hypothesis that attributes a causal role to the corresponding individual-level variable. This paper points out the prevalence of this type of fallacy through a review of past research on contextual determinants of psychiatric resilience. It is argued that the simple step of adding an appropriate individual-level interaction XijZij could help more robustly test substantive hypotheses about how neighborhood context alters the effect of proximal stressors on health outcomes.
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Quality of Media Reporting of Suicide in Nepal. PSYCHIATRY JOURNAL 2022; 2022:5708092. [PMID: 35845252 PMCID: PMC9282984 DOI: 10.1155/2022/5708092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/30/2022] [Indexed: 11/18/2022]
Abstract
Objectives. Suicide is a major public health concern. Sensible media reporting of suicide is one of the important prevention strategies. There has been no report assessing the quality of media reporting of suicide in Nepal. We aimed to assess the quality of newspaper reporting of suicide in Nepal against the World Health Organization (WHO) reporting guidelines. Methods. We undertook a content analysis study of articles from the online archives on reporting of suicide deaths in six English language (daily or weekly) newspapers published in Nepal over the two-year duration from a period between January 1, 2019, and December 31, 2020. Also, we compared them with the World Health Organization (WHO) guidelines. Results. A total of 165 English newspaper articles reporting on suicide were analyzed. 163 (98.8%) of news were published in the main section of the newspaper, and the mean length was 17.6 sentences. The name and age of the person who died of suicide were mentioned in about 69.1% (
) and 53.3% (
) articles, respectively. The most common method of suicide reported in the news articles was hanging (45.5%,
), followed by poisoning (11.5%,
). About 97.6% (
) of news articles violated the recommendation provided in the WHO guidelines. Conclusions. The adherence to the WHO guidelines for media reporting of suicide in Nepal was found to be poor, with a large majority of news reports having at least one potentially harmful media characteristic. Only a small minority of news reports included potentially helpful information to prevent suicide.
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Visualizing the Knowledge Base and Research Hotspot of Public Health Emergency Management: A Science Mapping Analysis-Based Study. SUSTAINABILITY 2022. [DOI: 10.3390/su14127389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Public health emergency management has been one of the main challenges of social sustainable development since the beginning of the 21st century. Research on public health emergency management is becoming a common focus of scholars. In recent years, the literature associated with public health emergency management has grown rapidly, but few studies have used a bibliometric analysis and visualization approach to conduct deep mining and explore the characteristics of the public health emergency management research field. To better understand the present status and development of public health emergency management research, and to explore the knowledge base and research hotspots, the bibliometric method and science mapping technology were adopted to visually evaluate the knowledge structure and research trends in the field of public health emergency management studies. From 2000 to 2020, a total of 3723 papers related to public health emergency management research were collected from the Web of Science Core Collection as research data. The five main research directions formed are child prevention, mortality from public health events, public health emergency preparedness, public health emergency management, and coronavirus disease 2019 (COVID-19). The current research hotspots and frontiers are climate change, COVID-19 and related coronaviruses. Further research is needed to focus on the COVID-19 and related coronaviruses. This study intends to contribute inclusive support to related academia and industry in the aspects of public health emergency management and public safety research, as well as research hotspots and future research directions.
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Gibson R, Whealin JM, Dasaro CR, Udasin IG, Crane M, Moline JM, Harrison DJ, Luft BJ, Todd AC, Schechter C, Lowe SM, Feder A, Pietrzak RH. Prevalence and correlates of suicidal ideation in World Trade Center responders: Results from a population-based health monitoring cohort. J Affect Disord 2022; 306:62-70. [PMID: 35283182 DOI: 10.1016/j.jad.2022.03.011] [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: 01/03/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Suicidal ideation (SI) is an early risk factor for suicide among disaster responders. To date, however, no known study has examined the prevalence, and pre-, peri-, and post-disaster risk correlates of SI in World Trade Center (WTC) responders, one of the largest disaster response populations in U.S. METHODS The prevalence, and pre-, peri- and post-event correlates of SI were assessed in a population-based health monitoring cohort of 14,314 police responders and 16,389 non-traditional responders (e.g., construction workers) who engaged in response, recovery, and clean-up efforts following the 9/11/2001 terrorist attacks on the WTC. Multivariable analyses were conducted to identify correlates and individual psychiatric symptoms associated with SI in each group. RESULTS A total 12.5% of non-traditional and 2.2% of police WTC responders reported SI. Depression, functional impairment, alcohol use problems, and lower family support while working at the WTC site were associated with SI in both groups of responders. Symptom-level analyses revealed that three symptoms accounted for approximately half of the variance in SI for both groups-feeling bad about oneself, or that one has let down oneself or family; feeling down, depressed, or hopeless; and sense of foreshortened future (44.7% in non-traditional and 71% in police). LIMITATIONS Use of self-report measures and potentially limited generalizability. CONCLUSIONS SI is prevalent in WTC disaster responders, particularly non-traditional responders. Post-9/11 psychiatric symptoms reflecting guilt, shame, hopelessness, and associated functional impairment are most strongly linked to SI, suggesting that interventions targeting these factors may help mitigate suicide risk in this population.
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Affiliation(s)
- Rachel Gibson
- Department of Psychology, University of the Hawaii at Hilo, HI, USA.
| | - Julia M Whealin
- VA Pacific Islands Health Care Center, Honolulu, HI, USA; Department of Psychiatry, John A. Burns School of Medicine, Manoa, HI, USA
| | - Christopher R Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Iris G Udasin
- Environmental and Occupational Health Sciences Institute (EOHSI) Clinical Center, Rutgers University, Piscataway, NJ, USA
| | - Michael Crane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Jacqueline M Moline
- Department of Occupational Medicine, Epidemiology and Prevention, Northwell Health, Rego Park, NY, USA
| | | | | | - Andrew C Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, NY, USA
| | - Clyde Schechter
- Department of Family and Social Medicine, Albert Einstein College of Medicine at Yeshiva University, Bronx, NY, USA
| | - Sandra M Lowe
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Ivanich JD, O'Keefe V, Waugh E, Tingey L, Tate M, Parker A, Craig M, Cwik M. Social Network Differences Between American Indian Youth Who have Attempted Suicide and Have Suicide Ideation. Community Ment Health J 2022; 58:589-594. [PMID: 34196904 PMCID: PMC8929287 DOI: 10.1007/s10597-021-00857-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/11/2020] [Indexed: 11/26/2022]
Abstract
Suicide is a crucial public health concern for American Indian and Alaska native (AIAN) communities. AIANs have the highest suicide rate compared to all other ethnic groups in the United States. Social relations are a salient fixture of AIAN culture. The primary aims of this study were to describe the personal networks of AI youth that have recently had a suicide attempt or suicidal ideation and to identify key network differences between the two groups. This study uses personal networks collected among AIs living on a reservation in the Southwest. Our sample included 46 American Indians that have recently attempted suicide or had suicidal ideation. We explored social network characteristics of the two groups descriptively as well as comparatively (t-tests). Our findings suggest that AI youth that have attempted suicide nominate more friends in their networks that have used alcohol and drugs compared to the networks of AI youth that have recent suicide ideation. Additionally, AI youth that recently attempted suicide have used alcohol and drugs with their network peers at a higher rate than youth that have had recent suicide ideation. Lastly, AI youth that have attempted suicide recently were significantly more likely to have more nominated friends in their networks that they had reached out to when they were struggling with suicide compared to their peers that have experienced recent suicide ideation. These results indicate a promising method moving forward to identify unique intervention strategies that extend beyond the individual.
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Affiliation(s)
- Jerreed D Ivanich
- Centers for American Indian and Alaska Native Health, Community and Behavioral Health, Colorado School of Public Health, University of Colorado, Aurora, CO, USA.
| | - Victoria O'Keefe
- Department of International Health, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emma Waugh
- Department of International Health, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lauren Tingey
- Department of International Health, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Tate
- White Mountain Apache Tribe, Whiteriver, AZ, USA
| | | | | | - Mary Cwik
- Department of International Health, Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Berardelli I, Innamorati M, Sarubbi S, Rogante E, Erbuto D, Lester D, Pompili M. Demographic and Clinical Correlates of High-lethality Suicide Attempts: A Retrospective Study in Psychiatric Inpatients. J Psychiatr Pract 2021; 27:410-416. [PMID: 34768263 DOI: 10.1097/pra.0000000000000579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Assessment of the lethality of suicide attempts is a neglected topic in the literature in this area. Based on the hypothesis that suicide attempters who choose a highly lethal method differ from those who use less lethal methods, we analyzed the characteristics of suicide attempters who used different suicide methods to determine demographic and clinical risk factors for the lethality of suicide methods. For this purpose, we used the Risk-Rescue Rating Scale to assess the lethality of the suicide method in a consecutive sample of 107 psychiatric inpatients with a recent suicide attempt (in 6 mo before hospitalization). The results demonstrated that patients who used a highly lethal method were younger and more frequently single. A novel finding of this study was that earlier age of onset of psychiatric symptoms and a higher number of previous hospitalizations were associated with the use of more lethal methods. In conclusion, patients who used more lethal methods differed from those who used less lethal methods. Identification of these differences may be necessary to implement specific suicide prevention strategies in patients with psychiatric conditions.
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Perceived Risk Factors for Suicide among Nepalese Migrant Workers in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126368. [PMID: 34208318 PMCID: PMC8296194 DOI: 10.3390/ijerph18126368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/20/2021] [Accepted: 06/08/2021] [Indexed: 12/02/2022]
Abstract
(1) Background: In South Korea, far from their homeland, Nepalese migrant workers often face tremendous challenges. The most severe outcome for migrant workers is death by suicide—a major cause of premature death among migrant workers. Nevertheless, in the literature, key factors associated with suicide among Nepalese migrant workers are not specifically identified. Thus, we aimed to delineate the main suicide risk factors for this group of migrants. (2) Methods: We used qualitative research methodology (sample = 20; male =17, female = 3) and employed nominal group techniques to identify the perceived primary risk factors for suicide. (3) Results: Study participants identified and ranked eight sources of distress and perceived risks for suicide, both from home and in the host country. Perceived risks for suicide include a complex set of socio-cultural, behavioral, occupational, physical, and mental health issues as well as communication barriers. (4) Conclusions: The findings suggest the need to design tailored mental health promotion programs for migrant workers before departure from Nepal as well as after arrival as migrant workers in South Korea.
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Clapperton A, Dwyer J, Millar C, Tolhurst P, Berecki-Gisolf J. Sociodemographic characteristics associated with hospital contact in the year prior to suicide: A data linkage cohort study in Victoria, Australia. PLoS One 2021; 16:e0252682. [PMID: 34081748 PMCID: PMC8174715 DOI: 10.1371/journal.pone.0252682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/19/2021] [Indexed: 11/28/2022] Open
Abstract
Aims The aims of this study were to examine the prevalence of hospital contact in the year prior to suicide in Victoria, Australia, and to compare characteristics among those who did and did not have contact in the year prior to suicide. Methods The study was a data linkage cohort study of 4348 Victorians who died by suicide over the period 2011–2017. Data from the Victorian Suicide Register (VSR) was linked with hospital separations and Emergency Department (ED) presentations datasets by the Centre for Victorian Data Linkages (CVDL). The main outcomes were: (1) hospital contact for any reason, (2) hospital contact for mental-health-related reasons, and (3) hospital contact for intentional self-harm. Unadjusted and adjusted odds ratios were calculated as the measures of association. Results In the year prior to suicide, half of the decedents (50.0%) had hospital contact for any reason (n = 2172), 28.6% had mental-health-related hospital contact (n = 1244) and 9.9% had hospital contact for intentional self-harm (n = 432). In the year prior to suicide, when compared with males aged 25–49 years (the reference group):males aged 75+ years and females of all ages were significantly more likely to have hospital contact for any reason females aged 10–24 years and 25–49 years were significantly more likely to have mental-health-related hospital contact females aged 10–24 years and 25–49 years had 3.5 times and 2.4 times the odds of having hospital contact for intentional self-harm.
Conclusions The comparatively high proportion of female decedents with mental-health related hospital contact in the year prior to suicide suggests improving the quality of care for those seeking help is an essential prevention initiative; this could be explored through programs such as the assertive outreach trials currently being implemented in Victoria and elsewhere in Australia. However, the sizeable proportion of males who do not have contact in the year prior to suicide was a consistent finding and represents a challenge for suicide prevention. Programs to identify males at risk in the community and engage them in the health care system are essential. In addition, promising universal and selective interventions to reduce suicide in the cohort who do not have hospital contact, include restricting access to lethal means and other public health interventions are also needed.
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Affiliation(s)
- Angela Clapperton
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Monash University Accident Research Centre, Monash University, Melbourne, Victoria, Australia
- * E-mail:
| | - Jeremy Dwyer
- Coroners Prevention Unit, Coroners Court of Victoria, Melbourne, Victoria, Australia
| | - Ciara Millar
- Coroners Prevention Unit, Coroners Court of Victoria, Melbourne, Victoria, Australia
| | - Penny Tolhurst
- Mental Health and Drugs Branch, Victorian Department of Health, Melbourne, Victoria, Australia
| | - Janneke Berecki-Gisolf
- Monash University Accident Research Centre, Monash University, Melbourne, Victoria, Australia
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15
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Chen X, Wang M, Hu Y, Zhan Y, Zhou Y, Zheng W, Liu W, Wang C, Zhong X, Li H, Lan X, Ning Y, Zhang B. Working memory associated with anti-suicidal ideation effect of repeated-dose intravenous ketamine in depressed patients. Eur Arch Psychiatry Clin Neurosci 2021; 271:431-438. [PMID: 33386430 DOI: 10.1007/s00406-020-01221-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
Suicide is a tremendous threat to global public health, and a large number of people who committed suicide suffered the pain of mental diseases, especially major depressive disorder (MDD). Previous study showed that ketamine could reduce suicidal ideation (SI), potentially by improving the impaired working memory (WM). The objective of current study was to illuminate the relationship between WM and SI in MDD with repeated ketamine treatment. MDD patients with SI (n = 59) and without SI (n = 37) completed six intravenous infusions of ketamine (0.5 mg/kg over 40 min) over 12 days (Day 1, 3, 5, 8, 10 and 12). The severity of depressive symptoms, SI and WM were assessed at baseline, day 13 and day 26. We found that WM was significantly improved after 6 ketamine infusions (F = 161.284, p = 0.009) in a linear mixed model. Correlation analysis showed that the improvement of depressive symptom was significantly associated with WM at baseline (r = - 0.265, p = 0.042) and the reduction in SSI-part I was related to the change of WM (r = 0.276, p = 0.034) in the MDD patients with SI. Furthermore, Logistic regression analysis showed that improvement in WM might predict the anti-SI response of ketamine. Our findings suggest that the improvement of working memory may partly account for the anti-SI effect of ketamine, and intervention of improving working memory function may be capable of reducing suicidal ideation.
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Affiliation(s)
- Xiaoyu Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Mingqia Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yiru Hu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yanni Zhan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Weijian Liu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Chengyu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Xiaomei Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Hanqiu Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Xiaofeng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China. .,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China.
| | - Bin Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Mingxin Rd.36, Guangzhou, 510370, Guangdong, China
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16
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Ordóñez-Monak I, Arroyave I, Cardona D. Educational inequalities in suicide in a middle-income country: A socioeconomic approach of mental health. Suicide Life Threat Behav 2021; 51:289-300. [PMID: 33373083 DOI: 10.1111/sltb.12704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This research aims to describe trends in inequalities in suicide mortality by educational level in Colombia between 1998 and 2015. METHOD Standardized suicide mortality rates (SMR) were calculated by educational level, sex, and age in adult men and women over 25 years of age. Poisson regression models were used to calculate the RR (rate ratio) with those highly educated as a reference, and the RII (relative index of inequality). RESULTS The number of reported deaths by suicide between 1998 and 2015 was 24,654, of which 84.7% were men. By age-group, 48.5% of suicides were among young adult men and women (25-44). Men had higher suicide rates than women (SMR men = 10.44/100,000; SMR women = 1.72/100,000). The age-standardized mortality rates (SMR) were higher in the groups with the lowest educational level in both sexes and all age-groups, except for senior adult women (65+). Broadly, while SMR reduced throughout most of the period, inequalities grew. CONCLUSIONS We found that the educational inequities associated with suicide in Colombia grew slightly. This suggests the need to work on suicide prevention strategies that go beyond the individual risk factors. Socioeconomic issues need to be considered as a key tool to prevent suicide by improving peoples' quality of life and their mental health.
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Affiliation(s)
- Ivonne Ordóñez-Monak
- Health Equity Research Group- Faculty of Medicine, Universidad Nacional de Colombia, Bogotá D.C., Colombia
| | - Ivan Arroyave
- National School of Public Health, University of Antioquia, Medellin, Colombia
| | - Doris Cardona
- School of Graduates, CES University, Medellin, Colombia
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17
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Johnson LL, Muehler T, Stacy MA. Veterans' satisfaction and perspectives on helpfulness of the Veterans Crisis Line. Suicide Life Threat Behav 2021; 51:263-273. [PMID: 33876480 DOI: 10.1111/sltb.12702] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Crisis hotlines are an important part of a public health approach to suicide prevention. The Veterans Crisis Line (VCL) provides hotline services to Veterans. There is a paucity of research concerning the effectiveness of the VCL. The current work describes efforts to establish groundwork for VCL effectiveness research. METHODS 155 VCL users who were referred to a Veterans Affairs Medical Center Suicide Prevention Team completed interviews including open-ended and closed-ended questions. Outcomes are reported for suicidal participants, non-suicidal participants, and those who had emergency intervention. Thematic analysis was used for open-ended questions. RESULTS Eighty-seven percent of interviewees expressed satisfaction with the VCL, 81.9% reported that the VCL was helpful, and 72.9% said that the VCL helped keep them safe. Of those with suicidal thoughts, 82.6% said the contact helped stop them from killing themselves. Themes are described concerning user identified reasons for VCL contact, most and least helpful aspects of the contact, and suggestions for improvement. DISCUSSION This project demonstrates that this group of people who used the VCL overwhelmingly finds the service to be helpful and a barrier to suicide. Further, implications of user feedback for application to VCL operations and future research are discussed.
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Affiliation(s)
- Lora L Johnson
- Department of Veterans Affairs, Robley Rex VA Medical Center, Louisville, KY, USA
| | - Tanner Muehler
- Department of Veterans Affairs, Robley Rex VA Medical Center, Louisville, KY, USA.,Eastern Kentucky University, Richmond, KY, USA
| | - Meaghan A Stacy
- Department of Veterans Affairs, Veterans Crisis Line, National Care Coordination and Field Operations Team, Canandaigua, NY, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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18
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Blosnich JR, De Luca S, Lytle MC, Brownson C. Questions of faith: Religious affiliations and suicidal ideation among sexual minority young adults. Suicide Life Threat Behav 2020; 50:1158-1166. [PMID: 32744388 PMCID: PMC10334798 DOI: 10.1111/sltb.12679] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/18/2020] [Accepted: 05/05/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine how the associations of specific religious affiliations with recent suicidal ideation vary by sexual orientation among young adults. METHOD This project was a cross-sectional secondary analysis of data from the 2006 and 2011 surveys of the National Research Consortium of Counseling Centers in Higher Education. The analytic sample was restricted to persons between the ages of 18-29 (n = 40,150). Multiple logistic regression analyses were used to examine associations of religious affiliations with recent suicidal ideation between heterosexual and sexual minority (e.g., gay, lesbian, bisexual, questioning) young adults. RESULTS Approximately 6.7% of the sample self-identified as sexual minority. Compared to heterosexuals, sexual minorities were more likely to report recent suicidal ideation (aOR = 4.52, 95% CI = 3.97-5.16). Among heterosexuals, Unspecified Christian and Catholic denominations were associated with 24% and 37% reduced odds of recent suicidal ideation compared to agnostic/atheist heterosexuals. However, among sexual minorities, Unspecified Christian and Catholic denominations were associated with 68% and 77% increased odds of recent suicidal ideation compared to agnostic/atheist sexual minorities. Unspecified Christian and Catholic sexual minorities had 184% and 198% increased odds of recent suicidal ideation compared to Unitarian/Universalist sexual minorities. CONCLUSIONS Although protective for heterosexuals, religious affiliation may not be globally protective against suicidal ideation among sexual minorities.
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Affiliation(s)
- John R. Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Susan De Luca
- School of Social Work, University of Texas at Austin, Austin, Texas
- Population Research Center, University of Texas at Austin, Austin, Texas
| | - Megan C. Lytle
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - Chris Brownson
- Department of Educational Psychology, College of Education, University of Texas at Austin, Austin, Texas
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19
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Elbogen EB, Lanier M, Montgomery AE, Strickland S, Wagner HR, Tsai J. Financial Strain and Suicide Attempts in a Nationally Representative Sample of US Adults. Am J Epidemiol 2020; 189:1266-1274. [PMID: 32696055 DOI: 10.1093/aje/kwaa146] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/29/2020] [Accepted: 06/13/2020] [Indexed: 02/01/2023] Open
Abstract
Although research has identified many suicide risk factors, the relationship between financial strain and suicide has received less attention. Using data representative of the US adult population (n = 34,653) from wave 1 (2001-2002) and wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions, we investigated the association between financial strain-financial debt/crisis, unemployment, past homelessness, and lower income-and subsequent suicide attempts and suicidal ideation. Multivariable logistic regression controlling for demographic and clinical covariates showed that cumulative financial strain was predictive of suicide attempts between waves 1 and 2 (odds ratio (OR) = 1.53, 95% confidence interval (CI): 1.32, 1.77). Wave 1 financial debt/crisis (OR = 1.58, 95% CI: 1.06, 2.34), unemployment (OR = 1.52, 95% CI: 1.10, 2.10), past homelessness (OR = 1.50, 95% CI: 1.03, 2.17), and lower income (OR = 1.51, 95% CI: 1.01, 2.25) were each associated with subsequent suicide attempts. Respondents endorsing these 4 financial-strain variables had 20 times higher predicted probability of attempting suicide compared with respondents endorsing none of these variables. Analyses yielded similar results examining suicidal ideation. Financial strain accumulated from multiple sources (debt, housing instability, unemployment, and low income) should be considered for optimal assessment, management, and prevention of suicide.
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20
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Mortier P, Vilagut G, Puértolas Gracia B, De Inés Trujillo A, Alayo Bueno I, Ballester Coma L, Blasco Cubedo MJ, Cardoner N, Colls C, Elices M, Garcia-Altes A, Gené Badia M, Gómez Sánchez J, Martín Sánchez M, Morros R, Prat Pubill B, Qin P, Mehlum L, Kessler RC, Palao D, Pérez Sola V, Alonso J. Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study: protocol for a population-representative nested case-control study of suicide attempts in Catalonia, Spain. BMJ Open 2020; 10:e037365. [PMID: 32660952 PMCID: PMC7359191 DOI: 10.1136/bmjopen-2020-037365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/02/2020] [Accepted: 05/29/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Suicide attempts represent an important public health burden. Centralised electronic health record (EHR) systems have high potential to provide suicide attempt surveillance, to inform public health action aimed at reducing risk for suicide attempt in the population, and to provide data-driven clinical decision support for suicide risk assessment across healthcare settings. To exploit this potential, we designed the Catalonia Suicide Risk Code Epidemiology (CSRC-Epi) study. Using centralised EHR data from the entire public healthcare system of Catalonia, Spain, the CSRC-Epi study aims to estimate reliable suicide attempt incidence rates, identify suicide attempt risk factors and develop validated suicide attempt risk prediction tools. METHODS AND ANALYSIS The CSRC-Epi study is registry-based study, specifically, a two-stage exposure-enriched nested case-control study of suicide attempts during the period 2014-2019 in Catalonia, Spain. The primary study outcome consists of first and repeat attempts during the observation period. Cases will come from a case register linked to a suicide attempt surveillance programme, which offers in-depth psychiatric evaluations to all Catalan residents who present to clinical care with any suspected risk for suicide. Predictor variables will come from centralised EHR systems representing all relevant healthcare settings. The study's sampling frame will be constructed using population-representative administrative lists of Catalan residents. Inverse probability weights will restore representativeness of the original population. Analysis will include the calculation of age-standardised and sex-standardised suicide attempt incidence rates. Logistic regression will identify suicide attempt risk factors on the individual level (ie, relative risk) and the population level (ie, population attributable risk proportions). Machine learning techniques will be used to develop suicide attempt risk prediction tools. ETHICS AND DISSEMINATION This protocol is approved by the Parc de Salut Mar Clinical Research Ethics Committee (2017/7431/I). Dissemination will include peer-reviewed scientific publications, scientific reports for hospital and government authorities, and updated clinical guidelines. TRIAL REGISTRATION NUMBER NCT04235127.
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Affiliation(s)
- Philippe Mortier
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Vilagut
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Beatriz Puértolas Gracia
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ana De Inés Trujillo
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Social Psychology, Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain
| | - Itxaso Alayo Bueno
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Laura Ballester Coma
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Psychology, University of Girona (UdG), Girona, Spain
| | - María Jesús Blasco Cubedo
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
| | - Narcís Cardoner
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Barcelona, Spain
| | - Cristina Colls
- Agència de Qualitat i Avaluació Sanitàries de Catalunya - Health Evaluation and Quality Agency of Catalonia (AQuAS), Catalan Health Department, Barcelona, Spain
| | - Matilde Elices
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Neurosciences Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Anna Garcia-Altes
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Agència de Qualitat i Avaluació Sanitàries de Catalunya - Health Evaluation and Quality Agency of Catalonia (AQuAS), Catalan Health Department, Barcelona, Spain
- Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Manel Gené Badia
- Legal Medicine Unit, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Javier Gómez Sánchez
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Mario Martín Sánchez
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, Pompeu Fabra University, Barcelona, Spain
| | - Rosa Morros
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Departament de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut Català de la Salut (ICS), Metropolitana Nord, Barcelona, Spain
| | - Bibiana Prat Pubill
- Master Plan on Mental Health and Addictions, Ministry of Health, Catalan Government, Barcelona, Spain
| | - Ping Qin
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars Mehlum
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Diego Palao
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Institut d'Investigació i Innovació Parc Taulí (I3PT), Sabadell, Barcelona, Spain
| | - Víctor Pérez Sola
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola Del Vallès, Barcelona, Spain
- Centro de Investigación en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Neurosciences Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain
| | - Jordi Alonso
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health & Experimental Sciences, Pompeu Fabra University (UPF), Barcelona, Spain
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21
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Fishburn KE, Alfred L. Consider opportunities to build resilience with individuals who experience suicidal ideas and behaviours following stressful life events. Evid Based Nurs 2020; 24:ebnurs-2020-103301. [PMID: 32471833 DOI: 10.1136/ebnurs-2020-103301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Kirsty E Fishburn
- Department of Psychological Health Wellbeing and Social Work, University of Hull, Hull, Kingston upon Hull, UK
| | - Lolita Alfred
- Department of Psychological Health Wellbeing and Social Work, University of Hull, Hull, Kingston upon Hull, UK
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22
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Cabrera-Mendoza B, Fresno C, Monroy-Jaramillo N, Fries GR, Walss-Bass C, Glahn DC, Ostrosky-Wegman P, Mendoza-Morales RC, García-Dolores F, Díaz-Otañez CE, González-Sáenz EE, Genis-Mendoza AD, Martínez-Magaña JJ, Romero-Pimentel AL, Flores G, Vázquez-Roque RA, Nicolini H. Sex differences in brain gene expression among suicide completers. J Affect Disord 2020; 267:67-77. [PMID: 32063575 DOI: 10.1016/j.jad.2020.01.167] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 12/23/2019] [Accepted: 01/28/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Suicide rates vary substantially by sex. Suicides committed by males significantly outnumber female suicides. Disparities in community and social factors provide a partial explanation for this phenomenon. Thus, the evaluation of sex differences at a biological level might contribute to the elucidation of the factors involved in this imbalance. The aim of the present study was to evaluate sex-specific gene expression patterns in the suicidal brain. METHODS postmortem samples from the dorsolateral prefrontal cortex (DLPFC) of 75 Latino individuals were analyzed. We considered the following groups: i) male suicides (n = 38), ii) female suicides (n = 10), iii) male controls (n = 20), and iv) female controls (n = 7). Gene expression profiles were evaluated by microarrays. Differentially expressed genes among the groups were identified with a linear model. Similarities and differences in the gene sets between the sexes were identified. RESULTS Differentially expressed genes were identified between suicides and controls of each sex: 1,729 genes in females and 1,997 genes in males. Female-exclusive suicide genes were related to cell proliferation and immune response. Meanwhile, male-exclusive suicide genes were associated to DNA binding and ribonucleic protein complex. Sex-independent suicide genes showed enrichment in mitochondrial and vesicular functions. LIMITATIONS Relatively small sample size. Our diagnosis approach was limited to information found on coroner's records. The analysis was limited to a single brain area (DLPFC) and we used microarrays. CONCLUSION Previously unexplored sex differences in the brain gene expression of suicide completers were identified, providing valuable foundation for the evaluation of sex-specific factors in suicide.
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Affiliation(s)
- Brenda Cabrera-Mendoza
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico; PECEM, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Cristóbal Fresno
- Technological Development Department, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | - Nancy Monroy-Jaramillo
- Department of Genetics, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Gabriel Rodrigo Fries
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, United States
| | - Consuelo Walss-Bass
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, TX, United States
| | - David C Glahn
- Tommy Fuss Center for Neuropsychiatric Disease Research, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | | | | | | | | | | | - Alma Delia Genis-Mendoza
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | - José Jaime Martínez-Magaña
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | - Ana Luisa Romero-Pimentel
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
| | - Gonzalo Flores
- Neuropsychiatry Laboratory, Institute of Physiology, Meritorious Autonomous University of Puebla, Mexico City, Mexico
| | - Rubén Antonio Vázquez-Roque
- Neuropsychiatry Laboratory, Institute of Physiology, Meritorious Autonomous University of Puebla, Mexico City, Mexico
| | - Humberto Nicolini
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico.
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23
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Black J, Bond MA, Hawkins R, Black E. Test of a clinical model of poor physical health and suicide: The role of depression, psychosocial stress, interpersonal conflict, and panic. J Affect Disord 2019; 257:404-411. [PMID: 31306991 DOI: 10.1016/j.jad.2019.05.079] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/08/2019] [Accepted: 05/31/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study employed a structural equation model to examine the relationships between poor physical health, suicide, depression, psychosocial stress, interpersonal conflict, and panic. METHODS The sample consisted of a large, archived set of mental health treatment-seeking adults who completed a behavioral outcome questionnaire prior to beginning treatment. RESULTS Results supported the extant literature indicating that poor physical health, depression, psychosocial stress, interpersonal conflict, and panic impose increased risk for suicidal ideation, with depression demonstrating the highest risk for increased suicidal ideation. The results also supported the hypotheses that depression, psychosocial stress, interpersonal conflict, and panic would mediate the association between poor physical health and suicidal ideation. Although no a priori hypotheses were made regarding relationships among the 15 physical illnesses examined, results indicated that HIV/AIDS had the strongest correlation with depression and the weakest correlation with interpersonal conflict. LIMITATIONS Firstly, the study sample was primarily Caucasian, limiting its generalizability. Secondly, causal inferences should be interpreted with caution, due to the quasi-experimental design. Thirdly, these data were self-reported, which create response biases since suicidal ideation is stigmatized. CONCLUSIONS These findings highlight the importance of considering interpersonal factors as potential mediators in the relationship between poor physical health, mental illness, and suicide. Clinically, the impact of an active major depressive episode on an individual who is struggling with a serious physical illness may be strongly predictive of suicidal ideation.
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Affiliation(s)
- Janie Black
- Department of Educational Psychology, The University of Texas at Austin, United States (BOND).
| | - Mark A Bond
- Department of Educational Psychology, The University of Texas at Austin, United States (BOND)
| | - Raymond Hawkins
- Department of Psychology, the University of Texas at Austin, United States
| | - Elizabeth Black
- Elizabeth A. Black: MSN Candidate, School of Nursing, University of Texas at Austin, United States
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Fitzpatrick SJ, Brew BK, Read DMY, Inder KJ, Hayes A, Perkins D. Rethinking Suicide in Rural Australia: A study Protocol for Examining and Applying Knowledge of the Social Determinants to Improve Prevention in Non-Indigenous Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162944. [PMID: 31426302 PMCID: PMC6719075 DOI: 10.3390/ijerph16162944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 01/26/2023]
Abstract
Disproportionate rates of suicide in rural Australia in comparison to metropolitan areas pose a significant public health challenge. The dynamic interrelationship between mental and physical health, social determinants, and suicide in rural Australia is widely acknowledged. Advancement of this knowledge, however, remains hampered by a lack of adequate theory and methods to understand how these factors interact, and the translation of this knowledge into constructive strategies and solutions. This paper presents a protocol for generating a comprehensive dataset of suicide deaths and factors related to suicide in rural Australia, and for building a program of research to improve suicide prevention policy and practice to better address the social determinants of suicide in non-indigenous populations. The two-phased study will use a mixed-methods design informed by intersectionality theory. Phase One will extract, code, and analyse quantitative and qualitative data on suicide in regional and remote Australia from the National Coronial Information System (NCIS). Phase Two will analyse suicide prevention at three interrelated domains: policy, practice, and research, to examine alignment with evidence generated in Phase One. Findings from Phase One and Two will then be integrated to identify key points in suicide prevention policy and practice where action can be initiated.
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Affiliation(s)
- Scott J Fitzpatrick
- Centre for Rural and Remote Mental Health, The University of Newcastle, PO Box 8043, Orange East, NSW 2800, Australia.
| | - Bronwyn K Brew
- Centre for Big Data Research in Health and National Perinatal Epidemiology and Statistics Unit, School of Women and Children's Health, University of New South Wales, Level 4, Lowy Cancer Research Centre, Cnr High & Botany St, Kensington, NSW 2052, Australia
| | - Donna M Y Read
- Centre for Rural and Remote Mental Health, The University of Newcastle, PO Box 8043, Orange East, NSW 2800, Australia
| | - Kerry J Inder
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Alan Hayes
- Family Action Centre, University of Newcastle, Callaghan, NSW 2308, Australia
| | - David Perkins
- Centre for Rural and Remote Mental Health, The University of Newcastle, PO Box 8043, Orange East, NSW 2800, Australia
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Osafo J, Akotia CS, Quarshie ENB, Andoh-Arthur J, Boakye KE. Community leaders' attitudes towards and perceptions of suicide and suicide prevention in Ghana. Transcult Psychiatry 2019; 56:529-551. [PMID: 30907246 DOI: 10.1177/1363461518824434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Community leaders can play an important role in suicide prevention because they are potential gatekeepers in resource-poor settings. To investigate their attitudes towards suicide and the role they play when people are in suicidal crisis, 10 community leaders were interviewed in a rural community in Ghana. Thematic Analysis of the interviews showed that leaders held two conflicting views about suicide: health crisis and moral taboo. They also viewed the reasons for suicide as psychosocial strains more than psychiatric factors. Though they viewed suicide as a moral taboo, they maintained a more neutral position in their gatekeeping role: providing support for persons in suicidal crisis more often than exerting a condemnatory attitude. Implications for gatekeeper training are discussed.
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Kopacz MS, Nieuwsma JA, Wortmann JH, Reyes ILB, Meador KG. Examining faith-based collaboration in U.S. States' suicide prevention guidelines. J Prev Interv Community 2019; 48:81-93. [PMID: 31140954 DOI: 10.1080/10852352.2019.1617524] [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: 10/26/2022]
Abstract
Faith-based communities (FBCs) are recognized by most states as key players within systematic suicide prevention efforts. The aim of the present study was to conduct a thematic analysis of documents that detail the suicide prevention efforts of individual states with respect to the role(s) delegated to FBCs. Thematic analysis is recognized as a useful methodology for identifying implications for policy and practice. Documents were procured from all states, with the exception of New Mexico (n = 49). The findings suggest six areas relevant to collaboration with FBCs: suicide prevention training for the FBC, suicide prevention training for individual faith leaders, community engagement, faith leaders as gatekeepers, culturally sensitive suicide prevention, and postvention support. These state guideline documents consistently affirm the importance of engaging FBCs in suicide prevention efforts and cover a range of recommendations, though generally lack specifics with respect to how FBCs can optimally engage.
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Affiliation(s)
- Marek S Kopacz
- US Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York, USA.,US Department of Veterans Affairs, Mid-Atlantic Mental Illness Research, Education and Clinical Center, Mental Health and Chaplaincy, Durham, North Carolina, USA
| | - Jason A Nieuwsma
- US Department of Veterans Affairs, Mid-Atlantic Mental Illness Research, Education and Clinical Center, Mental Health and Chaplaincy, Durham, North Carolina, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Jennifer H Wortmann
- US Department of Veterans Affairs, Mid-Atlantic Mental Illness Research, Education and Clinical Center, Mental Health and Chaplaincy, Durham, North Carolina, USA
| | - Iza L B Reyes
- US Department of Veterans Affairs, Mid-Atlantic Mental Illness Research, Education and Clinical Center, Mental Health and Chaplaincy, Durham, North Carolina, USA
| | - Keith G Meador
- US Department of Veterans Affairs, Mid-Atlantic Mental Illness Research, Education and Clinical Center, Mental Health and Chaplaincy, Durham, North Carolina, USA.,Departments of Psychiatry and Health Policy, Center for Biomedical Ethics and Society, Vanderbilt University, Nashville, Tennessee, USA.,Graduate Department of Religion, Vanderbilt University, Nashville, Tennessee, USA
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27
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Affiliation(s)
- Leo Sher
- 1 James J. Peters VA Medical Center, Bronx, NY, USA
- 2 Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Suicidal Ideation, Attempt, and Associated Factors among Patients with Tuberculosis in Ethiopia: A Cross-Sectional Study. PSYCHIATRY JOURNAL 2019; 2019:4149806. [PMID: 31001549 PMCID: PMC6436369 DOI: 10.1155/2019/4149806] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/21/2018] [Accepted: 01/13/2019] [Indexed: 02/07/2023]
Abstract
Background Suicidal behaviors among people with tuberculosis are one of the commonest psychiatric emergencies that need a major public health concern. People with tuberculosis show suicidal ideation and attempt, which are problems to end life. In Ethiopia large numbers of people are affected by tuberculosis. Therefore, assessing suicide among patients with tuberculosis is important in implementing further interventions. Methods An institutional based cross-sectional study was conducted among systematic random samples of 415 and face-to-face interview was used. Suicidal ideation and attempt were assessed by using suicidality module World Health Organization (WHO) composite International diagnostic interview (CIDI). Data was analyzed by using SPSS version 20. Bivariate and multivariate binary logistic analyses were done to identify associated factors to both suicidal ideation and attempt. P values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% C.I. Results The prevalence of suicidal ideation and attempt among tuberculosis patients was 17.3% (95%CI, 13.7-20.6) and 7.5 %( 95%CI, 4.8-10.4), respectively. Being female (AOR=2.7, 95% CI 1.39, 5.23), no formal education (AOR=3.35, 95%CI 1.26, 9.91), extra-pulmonary tuberculosis (AOR=2.35, 95%CI 1.1, 4.98), depression (AOR=4.9, 95%CI, 2.56, 9.4), and perceived TB stigma (AOR=3.24, 95%CI, 1.64, 6.45) were statistically associated with suicidal ideation. Factors like being female (AOR=4.57, 95%CI, 1.7, 12.27), MDR-TB (AOR=3.06, 95%CI, 1.23, 7.57), comorbid HIV illness (AOR=6.67, 95%CI, 2.24, 19.94), and depression (AOR=4.75, 95%CI, 1.89, 11.91) were associated with suicidal attempt. Conclusion Developing guidelines and training of health workers in TB clinics is important to screen and treat suicide among patients with tuberculosis.
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Khezeli M, Hazavehei SMM, Ariapooran S, Ahmadi A, Soltanian A, Rezapur-Shahkolai F. Individual and social factors related to attempted suicide among women: A qualitative study from Iran. Health Care Women Int 2019; 40:295-313. [PMID: 30856070 DOI: 10.1080/07399332.2018.1545773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The researchers conducted this study as a phenomenological research to understand the individual and social factors related to attempted suicide phenomenon among women of Gilan-e Gharb. Participants of the study are comprised of 17 women survivors of attempted suicide selected by purposive sampling or snowball method. To gather the data, we conducted semi-structured interviews in face-to-face and audio-recorded methods from February to April 2017. Researchers transcribed verbatim and analyzed the content of the interviews thematically. The main issues in this study were three main themes including the "personal factors", "social factors", and "other issues related to attempted suicide" with seven sub-themes. We concluded that both personal and social factors contribute to the suicide attempts in female subjects. Also, we found that the majority of participants did not want to die by the attempted suicide.
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Affiliation(s)
- Mehdi Khezeli
- a Department of Public Health, School of Public Health , Hamadan University of Medical Sciences , Hamadan , Iran
| | - Seyyed-Mohammad-Mahdi Hazavehei
- a Department of Public Health, School of Public Health , Hamadan University of Medical Sciences , Hamadan , Iran.,b Research Center for Health Sciences, School of Public Health , Hamadan University of Medical Sciences , Hamadan , Iran
| | - Saeed Ariapooran
- c Department of Psychology , Malayer University , Malayer , Iran
| | - Alireza Ahmadi
- d Department of Anesthesiology, Critical Care and Pain Management , Imam Reza Hospital, Kermanshah University of Medical Sciences , Kermanshah , Iran
| | - Alireza Soltanian
- e Modeling of Non-communicable Diseases Research Center, Hamadan University of Medical Sciences , Hamadan , Iran.,f Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences , Hamadan , Iran
| | - Forouzan Rezapur-Shahkolai
- a Department of Public Health, School of Public Health , Hamadan University of Medical Sciences , Hamadan , Iran.,g Social Determinants of Health Research Center, School of Public Health , Hamadan University of Medical Sciences , Hamadan , Iran
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Law YW, Yeung TL, Ip FWL, Yip PSF. Evidence-Based Suicide Prevention: Collective Impact of Engagement with Community Stakeholders. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2019; 16:211-227. [PMID: 30784376 DOI: 10.1080/23761407.2019.1578318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Purpose: In response to the rising suicide trend in Hong Kong, the Centre for Suicide Research and Prevention ("CSRP") was established in 2002, with the aim to capitalize on the collective impact of research-support practices to prevent suicides.Method: The CSRP has since become an international knowledge hub that applies a public health approach and innovative strategies to address suicide-related problems at multiple levels.Results: The CSRP actively engages in research, teaching, and knowledge exchange with community stakeholders. These effort are associated with Hong Kong's more than 30% reduction in suicide rates between 2003 and 2016.Discussion: The rationale for and examples of the CSRP's practices in face of the suicide prevention challenges lay ahead were also discussed.Conclusion: The outcomes of these practices, which hold great potential for suicide prevention worldwide, have contributed to important academic debates in the field of suicidology.
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Affiliation(s)
- Yik Wa Law
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PRC
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, PRC
| | - Tsz Long Yeung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PRC
| | - Flora Wai Lam Ip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PRC
| | - Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PRC
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, PRC
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31
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Brown S, Seals J. Intimate partner problems and suicide: are we missing the violence? J Inj Violence Res 2019; 11:53-64. [PMID: 30636256 PMCID: PMC6420923 DOI: 10.5249/jivr.v11i1.997] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 08/12/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Suicide consistently ranks in the top ten causes of death nationally. The purpose of this study was to develop a novel coding scheme to determine what percentage of suicide cases from 2005-2015 in Kentucky involved violence when intimate partner problems were identified. Currently, researchers using the national dataset, containing these data, only have the option to identify intimate partner problems unless each case is reviewed individually. METHODS Data from the Kentucky Violent Death Reporting System from 2005-2015 were used to create a subset of cases where intimate partner problems were identified and qualitative and quantitative analysis of the death scene investigation incident narratives was conducted to identify cases where intimate partner violence also contributed to the suicide. RESULTS Intimate partner problems were identified in 1,327 (26%) of all suicide cases where circumstances were known and intimate partner violence in 575 (43%) cases identified as having intimate partner problems. There was an argument or fight in 30% of cases where intimate partner problems were identified and most were immediately followed by the suicide. CONCLUSIONS We did find supporting evidence of our hypothesis that there is a great deal of underlying and outright violence in intimate relationships, which is exacerbating the risk of suicide. This detailed coding schema guided abstractors to better identify intimate partner violence in suicides, which could be easily replicated.
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Affiliation(s)
- Sabrina Brown
- Department of Epidemiology, University of Kentucky, Kentucky Violent Death Reporting System, Kentucky, USA.
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32
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Osafo J, Akotia CS, Andoh-Arthur J, Boakye KE, N-B Quarshie E. "We Now Have a Patient and Not a Criminal": An Exploratory Study of Judges and Lawyers' Views on Suicide Attempters and the Law in Ghana. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:1488-1508. [PMID: 29237314 DOI: 10.1177/0306624x17692059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study explored the views of judges and lawyers of the superior courts of Ghana on the law criminalizing attempted suicide. Qualitative data were collected from 12 experienced legal practitioners of the superior courts (five judges and seven lawyers) using a semi-structured interview schedule. Thematic analysis of the data yielded three main perspectives: In defence of the Law, Advocating a Repeal, and Pro-Health Orientation. Although exploratory, the findings of this study offer cues for stepping up suicide literacy and advocacy programmes toward either a repeal of the law or a reform.
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Abstract
PURPOSE Suicide is a significant health problem internationally. Those who complete suicide may have different behaviors and risk factors than those who attempt a non-fatal suicide. The purpose of this article is to analyze the concept of suicide lethality and propose a clear definition of the concept through the identification of antecedents, attributes, and consequences. METHODS A literature search for articles published in the English language between 1970 and 2016 was conducted using MEDLINE, the Cochrane Library, Pubmed, Psychlit, Ovid, PsycINFO, and Proquest. The bibliographies of all included studies were also reviewed to identify additional relevant citations. A concept analysis was conducted on the literature findings using six stages of Walker and Avant's method. FINDINGS The concept analysis differentiated between suicide, lethality, suicidal behavior, and suicide lethality. Presence of a suicide plan or a written suicide note was not found to be associated with the majority of completed suicides included in the definition of suicide lethality. There are a few scales that measure the lethality of a suicide attempt, but none that attempt to measure the concept of suicide lethality as described in this analysis. CONCLUSIONS Clarifying the concept of suicide lethality encourages awareness of the possibility of different suicidal behaviors associated with different suicide outcomes and will inform the development of future nursing interventions. A clearer definition of the concept of suicide lethality will guide clinical practice, research, and policy development aimed at suicide prevention.
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Affiliation(s)
- Summer DeBastiani
- a University of Miami, School of Nursing and Health Studies , Coral Gables , USA
| | - Joseph P De Santis
- a University of Miami, School of Nursing and Health Studies , Coral Gables , USA
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Hunt T, Wilson CJ, Woodward A, Caputi P, Wilson I. Intervention among Suicidal Men: Future Directions for Telephone Crisis Support Research. Front Public Health 2018; 6:1. [PMID: 29404319 PMCID: PMC5780337 DOI: 10.3389/fpubh.2018.00001] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/03/2018] [Indexed: 11/13/2022] Open
Abstract
Telephone crisis support is a confidential, accessible, and immediate service that is uniquely set up to reduce male suicide deaths through crisis intervention. However, research focusing on telephone crisis support with suicidal men is currently limited. To highlight the need to address service delivery for men experiencing suicidal crisis, this perspective article identifies key challenges facing current telephone crisis support research and proposes that understanding of the role of telephone crisis helplines in supporting suicidal men may be strengthened by careful examination of the context of telephone crisis support, together with the impact this has on help-provision for male suicidal callers. In particular, the impact of the time- and information-poor context of telephone crisis support on crisis-line staff's identification of, and response to, male callers with thoughts of suicide is examined. Future directions for research in the provision of telephone crisis support for suicidal men are discussed.
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Affiliation(s)
- Tara Hunt
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.,Centre for Mental Illness in Nowra District: Goals and Prevention (MINDtheGaP), Nowra, NSW, Australia
| | - Coralie J Wilson
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.,Centre for Mental Illness in Nowra District: Goals and Prevention (MINDtheGaP), Nowra, NSW, Australia.,Centre for Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Alan Woodward
- Centre for Mental Illness in Nowra District: Goals and Prevention (MINDtheGaP), Nowra, NSW, Australia.,Centre for Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Lifeline Research Foundation, Lifeline Australia, Canberra, ACT, Australia.,Suicide Prevention Australia, Sydney, NSW, Australia
| | - Peter Caputi
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Ian Wilson
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
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Mental disorders and the risk for the subsequent first suicide attempt: results of a community study on adolescents and young adults. Eur Child Adolesc Psychiatry 2018; 27:839-848. [PMID: 29027588 PMCID: PMC6013520 DOI: 10.1007/s00787-017-1060-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/25/2017] [Indexed: 10/29/2022]
Abstract
Adolescents and young adults represent the high-risk group for first onset of both DSM-IV mental disorders and lifetime suicide attempt (SA). Yet few studies have evaluated the temporal association of prior mental disorders and subsequent first SA in a young community sample. We examined (a) such associations using a broad range of specific DSM-IV mental disorders, (b) the risk of experiencing the outcome due to prior comorbidity, and (c) the proportion of SAs that could be attributed to prior disorders. During a 10-year prospective study, data were gathered from 3021 community subjects, 14-24 years of age at baseline. DSM-IV disorders and SA were assessed with the Munich-Composite International Diagnostic Interview. Cox models with time-dependent covariates were used to estimate the temporal associations of prior mental disorders with subsequent first SA. Most prior mental disorders showed elevated risk for subsequent first SA. Highest risks were associated with posttraumatic stress disorder (PTSD), dysthymia, and nicotine dependence. Comorbidity elevated the risk for subsequent first SA, and the more disorders a subject had, the higher the risk for first SA. More than 90% of SAs in the exposed group could be attributed to PTSD, and over 30% of SAs in the total sample could be attributed to specific phobia. Several DSM-IV disorders increase the risk for first SA in adolescents and young adults. Several promising early intervention targets were observed, e.g., specific phobia, nicotine dependence, dysthymia, and whether a young person is burdened with comorbid mental disorders.
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Caine ED, Reed J, Hindman J, Quinlan K. Comprehensive, integrated approaches to suicide prevention: practical guidance. Inj Prev 2017; 24:i38-i45. [PMID: 29263088 DOI: 10.1136/injuryprev-2017-042366] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/13/2017] [Accepted: 11/19/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND Efforts in the USA during the 21st century to stem the ever-rising tide of suicide and risk-related premature deaths, such as those caused by drug intoxications, have failed. Based primarily on identifying individuals with heightened risk nearing the precipice of death, these initiatives face fundamental obstacles that cannot be overcome readily. OBJECTIVE This paper describes the step-by-step development of a comprehensive public health approach that seeks to integrate at the community level an array of programmatic efforts, which address upstream (distal) risk factors to alter life trajectories while also involving health systems and clinical providers who care for vulnerable, distressed individuals, many of whom have attempted suicide. CONCLUSION Preventing suicide and related self-injury morbidity and mortality, and their antecedents, will require a systemic approach that builds on a societal commitment to save lives and collective actions that bring together diverse communities, service organisations, healthcare providers and governmental agencies and political leaders. This will require frank, data-based appraisals of burden that drive planning, programme development and implementation, rigorous evaluation and a willingness to try-fail-and-try-again until the tide has been turned.
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Affiliation(s)
- Eric D Caine
- Department of Psychiatry, Injury Control Research Center for Suicide Prevention, University of Rochester Medical Center, Rochester, New York, USA
| | - Jerry Reed
- Injury Control Research Center for Suicide Prevention, Education Development Center, Washington, USA
| | - Jarrod Hindman
- Department of Public Health and Environment, Violence and Injury Prevention - Mental Health Promotion Branch Colorado, Denver, Colorado, USA
| | - Kristen Quinlan
- Injury Control Research Center for Suicide Prevention, Education Development Center, Waltham, Massachusetts, USA
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37
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Yip P. Learning from a negative trial of lockable pesticide storage. Lancet 2017; 390:1817-1819. [PMID: 28807537 DOI: 10.1016/s0140-6736(17)32207-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 08/01/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Paul Yip
- Hong Kong Jockey Club Center for Suicide Research and Prevention, University of Hong Kong, Hong Kong.
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38
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Stulz N, Hepp U, Gosoniu DG, Grize L, Muheim F, Weiss MG, Riecher-Rössler A. Patient-Identified Priorities Leading to Attempted Suicide. CRISIS 2017; 39:37-46. [PMID: 28793817 DOI: 10.1027/0227-5910/a000473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Attempted suicide is a major public health problem. AIM The aim of this study was to identify patient-identified problems and triggers typically leading to attempted suicide. METHOD A representative sample of 66 adult patients was recruited from all clinical sites and psychiatrists who treat patients after attempted suicide in the Canton of Basel-City (Switzerland). Patients were diagnosed using the Structured Clinical Interview for DSM-IV (SCID) and interviewed with a local adaptation of the Explanatory Model Interview Catalogue (EMIC) to study underlying problems and triggers of attempted suicide. RESULTS Of the patients, 92.4% had at least one DSM-IV disorder, with depressive disorders being the most prevalent disorder. Although half (50.0%) of the patients identified a health problem, 71.2% identified an interpersonal conflict as underlying problem leading to the suicide attempt. Furthermore, an interpersonal conflict was identified as the trigger of the suicide attempt by more than half of the patients (54.5%). LIMITATIONS The study included German-speaking patients only. CONCLUSION According to patients, interpersonal problems often amplify underlying psychiatric problems, leading to suicide attempts. Social and interpersonal stressors should be acknowledged with integrated clinical and social interventions to prevent suicidal behavior in patients and populations.
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Affiliation(s)
- Niklaus Stulz
- 1 Psychiatric Services Aargau, Brugg, Switzerland.,2 University of Bern, Department of Psychology, Bern, Switzerland
| | - Urs Hepp
- 3 Integrated Psychiatric Services of Winterthur and Zurich Unterland (ipw), Switzerland
| | - Dominic G Gosoniu
- 4 Swiss Tropical and Public Health Institute, Basel, Switzerland.,5 University of Basel, Switzerland
| | - Leticia Grize
- 4 Swiss Tropical and Public Health Institute, Basel, Switzerland.,5 University of Basel, Switzerland
| | - Flavio Muheim
- 6 University of Basel Psychiatric Clinics, Department of Forensic Psychiatry, Basel, Switzerland
| | - Mitchell G Weiss
- 4 Swiss Tropical and Public Health Institute, Basel, Switzerland.,5 University of Basel, Switzerland
| | - Anita Riecher-Rössler
- 7 University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
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39
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Chu C, Walker KL, Stanley IH, Hirsch JK, Greenberg JH, Rudd MD, Joiner TE. Perceived problem-solving deficits and suicidal ideation: Evidence for the explanatory roles of thwarted belongingness and perceived burdensomeness in five samples. J Pers Soc Psychol 2017. [PMID: 28650191 DOI: 10.1037/pspp0000152] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Perceived social problem-solving deficits are associated with suicide risk; however, little research has examined the mechanisms underlying this relationship. The interpersonal theory of suicide proposes 2 mechanisms in the pathogenesis of suicidal desire: intractable feelings of thwarted belongingness (TB) and perceived burdensomeness (PB). This study tested whether TB and PB serve as explanatory links in the relationship between perceived social problem-solving (SPS) deficits and suicidal thoughts and behaviors cross-sectionally and longitudinally. The specificity of TB and PB was evaluated by testing depression as a rival mediator. Self-report measures of perceived SPS deficits, TB, PB, suicidal ideation, and depression were administered in 5 adult samples: 336 and 105 undergraduates from 2 universities, 53 homeless individuals, 222 primary care patients, and 329 military members. Bias-corrected bootstrap mediation and meta-analyses were conducted to examine the magnitude of the direct and indirect effects, and the proposed mediation paths were tested using zero-inflated negative binomial regressions. Cross-sectionally, TB and PB were significant parallel mediators of the relationship between perceived SPS deficits and ideation, beyond depression. Longitudinally and beyond depression, in 1 study, both TB and PB emerged as significant explanatory factors, and in the other, only PB was a significant mediator. Findings supported the specificity of TB and PB: Depression and SPS deficits were not significant mediators. The relationship between perceived SPS deficits and ideation was explained by interpersonal theory variables, particularly PB. Findings support a novel application of the interpersonal theory, and bolster a growing compendium of literature implicating perceived SPS deficits in suicide risk. (PsycINFO Database Record
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Affiliation(s)
- Carol Chu
- Department of Psychology, Florida State University
| | - Kristin L Walker
- Semel Institute for Neuroscience, University of California at Los Angeles
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Cutcliffe JR. Ecological mental health promotion - The case of suicide prevention: 21st century mental health analogues for 'clean water', 'improved sanitation', and 'vaccines'. Int J Ment Health Nurs 2017; 26:211-214. [PMID: 28548348 DOI: 10.1111/inm.12348] [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: 11/29/2022]
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Drum DJ, Brownson C, Hess EA, Burton Denmark A, Talley AE. College Students' Sense of Coherence and Connectedness as Predictors of Suicidal Thoughts and Behaviors. Arch Suicide Res 2017; 21:169-184. [PMID: 27049588 DOI: 10.1080/13811118.2016.1166088] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to explore the relationship between college students' sense of coherence and connectedness and their development of suicidal thoughts and behaviors. Using archival data from a larger survey with responses from 26,742 undergraduate and graduate students at 74 colleges and universities, we applied Exploratory Factor Analysis to derive these protective factors (coherence and connectedness) as well as hypothesized distal and proximal risk factors (pre-existing vulnerabilities and distress). Structural Equation Modeling was used to explore latent variable interactions among these factors with regards to outcomes on a continuum of suicidal thinking and behavior. Sense of coherence mitigated the impact of pre-existing vulnerabilities on movement along the continuum, while connectedness mitigated the impact of distress. Findings suggest that including both connectedness and coherence in suicide prevention frameworks will increase the impact of suicide prevention programming.
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Keller SN, Wilkinson T. Preventing Suicide in Montana: A Community-Based Theatre Intervention. JOURNAL OF SOCIAL MARKETING 2017; 7:423-440. [PMID: 29255588 PMCID: PMC5731785 DOI: 10.1108/jsocm-12-2016-0086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
PURPOSE This study examined whether a community-based suicide prevention project could increase willingness to seek professional help for suicidal ideation among eastern Montana youth. DESIGN Online surveys were administered at baseline (N = 224) and six months post-test (N = 217) consisting of the Risk Behavior Diagnosis Scale (RBD), self-report questions on suicidality, willingness to engage with suicide prevention resources, and willingness to communicate with peers, family members, teachers or counselors about suicide. FINDINGS A comparison of means within groups from pre- to post-test showed increases in self-efficacy for communicating about suicidal concerns with a teacher, school counselor or social worker; increases in self-efficacy for helping others; and increases in response-efficacy of interpersonal communication about suicide with a teacher, school counselor or social worker. PRACTICAL IMPLICATIONS Young adults need to be willing and able to intervene in life-threatening situations affecting their peers. In step with narrative empowerment education, personal experiences can be used to communicatively reduce peer resistance to behavior change. ORIGINALITY Health communicators tend to rely on overly didactic education and awareness-raising when addressing suicide prevention. This research shows the importance of direct and personal forms of influence advocated by social marketing professionals.
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Affiliation(s)
- Sarah N Keller
- Department of Communication & Theater, Montana State University Billings, 1500 University Drive, Billings, MT 59101, (406) 896-5824,
| | - Tim Wilkinson
- Professor and Charles L. Boppell Dean, School of Business, Whitworth University, 300 W. Hawthorne Road, Spokane, WA 99251, (509) 777-4567,
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Shrivastava A, De Sousa A, Rao GP. Brain-Derived Neurotrophic Factor and Suicide in Schizophrenia: Critical Role of Neuroprotective Mechanisms as an Emerging Hypothesis. Indian J Psychol Med 2016; 38:499-504. [PMID: 28031582 PMCID: PMC5178030 DOI: 10.4103/0253-7176.194913] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Suicide is a common occurrence in psychiatric disorders and is a cause of increased healthcare utilization worldwide. Schizophrenia is one of the most common psychiatric disorders worldwide and posited to be seen in 1% of the population worldwide. Suicide is a common occurrence in schizophrenia with 25%-30% patients with schizophrenia attempting suicide and 8%-10% completing it. There is a need for valid biological markers to help clinicians identify patients with schizophrenia that may be at a risk of suicide and thus help in them receiving better care and interventions at the earliest even before a suicide attempt occurring. There are clear neurobiological changes at a genetic, neuroimaging, and neurochemical level that occurs in patients with schizophrenia that attempt suicide. There is a new theory that postulates neuronal plasticity and neuroprotection to have a role in the biological changes that ensue when suicidal thoughts and feelings occur in patients with schizophrenia. Neurotrophic growth factors like brain-derived neurotrophic factor (BDNF) have been documented to play a role in the protection of neurons and in the prevention of neurobiological changes that may lead to suicide both in schizophrenia and depression. The present paper presents a commentary that looks at the role of BDNF as a protective factor and neurobiological marker for suicide in schizophrenia.
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Affiliation(s)
- Amresh Shrivastava
- Department of Psychiatry, Parkwood Institute of Mental Health Care and Associate Scientist, Lawson Health Research Institute, London, Ontario, Canada
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - G Prasad Rao
- Department of Psychiatry, Asha Hospital, Hyderabad, Telangana, India
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Stanley IH, Hom MA, Joiner TE. Suicide mortality among firefighters: Results from a large, urban fire department. Am J Ind Med 2016; 59:942-947. [PMID: 27219513 DOI: 10.1002/ajim.22587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Research regarding suicide mortality among firefighters within the U.S. has been sparse and has yielded inconsistent findings. This study aimed to: (i) describe suicide rates within a large, urban fire department; and (ii) compare firefighter suicide rates with demographically adjusted general population suicide rates. METHODS Rosters were obtained from the Philadelphia Fire Department (PFD) for all members employed by or separated from the department between 1993 and 2014 (N = 4,395). Vital statistics for each member were obtained from the CDC's National Death Index. RESULTS Overall, 272 deaths were recorded; 11 (4.0%) were certified as suicides. The overall suicide rate among firefighter affiliates of the PFD between 1993 and 2014 was 11.61 per 100,000 person-years. CONCLUSIONS The suicide rate among firefighters appears comparable to, and perhaps lower than, demographically adjusted general population estimates. Infrastructure to triangulate and monitor suicide rates from multiple departments, both career and volunteer, is needed to derive a more representative and informative estimate of firefighter suicide rates. Am. J. Ind. Med. 59:942-947, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ian H. Stanley
- Department of Psychology; Florida State University; Tallahassee Florida
| | - Melanie A. Hom
- Department of Psychology; Florida State University; Tallahassee Florida
| | - Thomas E. Joiner
- Department of Psychology; Florida State University; Tallahassee Florida
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Burrage RL, Gone JP, Momper SL. Urban American Indian Community Perspectives on Resources and Challenges for Youth Suicide Prevention. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2016; 58:136-149. [PMID: 27576308 DOI: 10.1002/ajcp.12080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
American Indian (AI) youth have some of the highest rates of suicide of any group in the United States, and the majority of AI youth live in urban areas away from tribal communities. As such, understanding the resources available for suicide prevention among urban AI youth is critical, as is understanding the challenges involved in accessing such resources. Pre-existing interview data from 15 self-identified AI community members and staff from an Urban Indian Health Organization were examined to understand existing resources for urban AI youth suicide prevention, as well as related challenges. A thematic analysis was undertaken, resulting in three principal themes around suicide prevention: formal resources, informal resources, and community values and beliefs. Formal resources that meet the needs of AI youth were viewed as largely inaccessible or nonexistent, and youth were seen as more likely to seek help from informal sources. Community values of mutual support were thought to reinforce available informal supports. However, challenges arose in terms of the community's knowledge of and views on discussing suicide, as well as the perceived fit between community values and beliefs and formal prevention models.
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Affiliation(s)
- Rachel L Burrage
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
- School of Social Work, University of Michigan, Ann Arbor, MI, USA.
| | - Joseph P Gone
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Sandra L Momper
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
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Gutierrez PM, Davidson CL, Friese AH, Forster JE. Physical Activity, Suicide Risk Factors, and Suicidal Ideation in a Veteran Sample. Suicide Life Threat Behav 2016; 46:284-92. [PMID: 26404757 DOI: 10.1111/sltb.12190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 07/10/2015] [Indexed: 11/28/2022]
Abstract
The association between current level of suicidal ideation and physical activity was tested in a broad sample of veterans seeking care from the Veterans Health Administration. It was hypothesized that the two variables would be significantly inversely related. It was further hypothesized that the relationship would be mediated by depressive symptoms, disturbed sleep, and a measure of heart rate variability based on existing research regarding physical activity and sleep. Due to the first hypothesis not being supported, the second could not be tested. Post hoc correlation analyses did find associations between physical activity and depressive symptoms, in expected directions, and are discussed. Possible explanations for the negative findings along with recommendations for future research to continue exploring links between suicide risk and physical activity are presented. We conclude by suggesting that physical activity may have promise as a risk reduction intervention and that prospective data are more likely to yield significant results than the cross-sectional methodology employed in the current study.
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Affiliation(s)
- Peter M Gutierrez
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA.,Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Collin L Davidson
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA
| | - Ariel H Friese
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA
| | - Jeri E Forster
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver VA Medical Center, Denver, CO, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA.,Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA
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Huffman JC, Boehm JK, Beach SR, Beale EE, DuBois CM, Healy BC. Relationship of optimism and suicidal ideation in three groups of patients at varying levels of suicide risk. J Psychiatr Res 2016; 77:76-84. [PMID: 26994340 PMCID: PMC4841259 DOI: 10.1016/j.jpsychires.2016.02.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 02/19/2016] [Accepted: 02/25/2016] [Indexed: 12/12/2022]
Abstract
Optimism has been associated with reduced suicidal ideation, but there have been few studies in patients at high suicide risk. We analyzed data from three study populations (total N = 319) with elevated risk of suicide: (1) patients with a recent acute cardiovascular event, (2) patients hospitalized for heart disease who had depression or an anxiety disorder, and (3) patients psychiatrically hospitalized for suicidal ideation or following a suicide attempt. For each study we analyzed the association between optimism (measured by the Life-Orientation Test-Revised) and suicidal ideation, and then completed an exploratory random effects meta-analysis of the findings to synthesize this data. The meta-analysis of the three studies showed that higher levels of self-reported optimism were associated with a lower likelihood of suicidal ideation (odds ratio [OR] = .89, 95% confidence interval [CI] = .85-.95, z = 3.94, p < .001), independent of age, gender, and depressive symptoms. This association held when using the subscales of the Life Orientation Test-Revised scale that measured higher optimism (OR = .84, 95% CI = .76-.92, z = 3.57, p < .001) and lower pessimism (OR = .83, 95% CI = .75-.92], z = 3.61, p < .001). These results also held when suicidal ideation was analyzed as an ordinal variable. Our findings suggest that optimism may be associated with a lower risk of suicidal ideation, above and beyond the effects of depressive symptoms, for a wide range of patients with clinical conditions that place them at elevated risk for suicide.
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Affiliation(s)
- Jeff C. Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Julia K. Boehm
- Department of Psychology, Chapman University, Orange, CA, USA
| | - Scott R. Beach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Eleanor E. Beale
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | - Brian C. Healy
- Department of Neurology, Harvard Medical School, Boston, MA, USA,Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
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Law CK, Kõlves K, De Leo D. Influences of population-level factors on suicides in older adults: a national ecological study from Australia. Int J Geriatr Psychiatry 2016; 31:384-91. [PMID: 26343391 DOI: 10.1002/gps.4343] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/20/2015] [Accepted: 07/17/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The relationship between older adult suicide rates and population-level variables has been examined in a few studies. Therefore, the objective of the present study is to analyse the extent to which population-level factors are associated with suicide by older persons in Australia, from an ecological perspective. METHODS Suicide rates for older adults aged 65 years and over were calculated for 68 observation units at Statistical Areas Level 4 in Australia for 2002-2011. The 2011 Census of Population and Housing was used for population-level variables. Analysis on standardised suicide mortality ratios and Poisson regression were performed to examine geographical and gender differences. RESULTS Between 2002 and 2011, a total of 3133 suicides of persons aged 65 years and above (men: n = 2418, 77.1%) was identified with an average annual rate of 10.1 per 100,000 persons. Suicide rates in older adults vary widely between different geographical regions in Australia. The multivariate estimates of contextual factors showed that the risk of suicide was positively associated with the sex ratio (incidence risk ratio (IRR) = 1.053, 95%CI = 1.016-1.092), the proportion of those in tenant household (IRR = 1.120, 95%CI = 1.081-1.160) and Australian residents born in North-West Europe (IRR = 1.058, 95%CI = 1.022-1.095). Significant gender variations were found. CONCLUSIONS Specific factors increasing risk of suicide for older adults on SA4 level in Australia were living in areas with a higher proportion of male population, a higher proportion of tenant household dwellers and a higher proportion of immigrants from North-West Europe. The different influences of population-level factor on suicide between older men and women indicate the need for targeted suicide prevention activities.
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Affiliation(s)
- Chi-Kin Law
- Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Brisbane, Queensland, Australia.,The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Brisbane, Queensland, Australia
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, National Centre of Excellence in Suicide Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Brisbane, Queensland, Australia
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Examination of the population attributable risk of different risk factor domains for suicidal thoughts and behaviors. J Affect Disord 2015; 187:66-72. [PMID: 26321257 DOI: 10.1016/j.jad.2015.07.042] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/22/2015] [Accepted: 07/29/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Despite the fact that suicide is an important public health problem, the etiology is still not well understood. Especially lacking is a societal-level approach that takes into account the extent to which several risk factor domains are attributable to new onset of suicidal thoughts and behaviors (STB). METHODS Data stem from a cross-sectional population study of the non-institutionalized adult (18+) population from Belgium (N=2419). The third version of the Composite International Diagnostic Interview (CIDI-3.0) was administered to assess lifetime STB and risk factor domains. Multivariate approaches, expressed in population attributable risk proportions, were used to estimate the proportion of new onset cases of STB related to the occurrence of different risk factors. RESULTS Approximately 38% of cases of suicidal ideation onset were attributable to mental disorders, 20% to chronic physical conditions, and another 13% to parental psychopathology. Suicide attempts in the general population were attributable to mental disorders (PARP=48%), but attempts among persons with suicidal ideation were unrelated to mental disorders, but rather to trauma (PARP=17%) and childhood adversities (PARP=12%). LIMITATIONS This is an explorative study using multivariate additive general models that generates specific hypotheses on the development of STB onset rather than testing specific pathways in the process of STB. CONCLUSIONS New onset STB is mostly attributable to proximal risk factors such as mental disorders. However, distal risk factors like childhood adversities or trauma also play a considerable role in the new onset of STB, especially in the transition from suicide ideation to suicide attempt.
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Abstract
IMPORTANCE Suicide is one of the top 10 leading causes of mortality among middle-aged women. Most work in the field emphasizes the psychiatric, psychological, or biological determinants of suicide. OBJECTIVE To estimate the association between social integration and suicide. DESIGN, SETTING, AND PARTICIPANTS We used data from the Nurses' Health Study, an ongoing nationwide prospective cohort study of nurses in the United States. Beginning in 1992, a population-based sample of 72 607 nurses 46 to 71 years of age were surveyed about their social relationships. The vital status of study participants was ascertained through June 1, 2010. EXPOSURES Social integration was measured with a 7-item index that included marital status, social network size, frequency of contact with social ties, and participation in religious or other social groups. MAIN OUTCOMES AND MEASURES The primary outcome of interest was suicide, defined as deaths classified using the codes E950 to E959 from the International Classification of Diseases, Eighth Revision. RESULTS During more than 1.2 million person-years of follow-up (1992-2010), there were 43 suicide events. The incidence of suicide decreased with increasing social integration. In a multivariable Cox proportional hazards regression model, the relative hazard of suicide was lowest among participants in the highest category of social integration (adjusted hazard ratio, 0.23 [95% CI, 0.09-0.58]) and second-highest category of social integration (adjusted hazard ratio, 0.26 [95% CI, 0.09-0.74]). Increasing or consistently high levels of social integration were associated with a lower risk of suicide. These findings were robust to sensitivity analyses that accounted for poor mental health and serious physical illness. CONCLUSIONS AND RELEVANCE Women who were socially well integrated had a more than 3-fold lower risk for suicide over 18 years of follow-up.
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Affiliation(s)
- Alexander C Tsai
- Center for Global Health, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Michel Lucas
- Department of Social and Preventive Medicine, Université Laval, Québec City, Québec G1V 2M2, Canada
- Population Health and Optimal Health Practices Research Unit, Centre Hospitalier Universitaire de Québec Research Centre, Québec City, Québec G1V 2M2, Canada
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
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