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Zwar L, König HH, Hajek A. Views of aging and mental health - The role of informal care provision: Longitudinal findings of the health and retirement study in the US. J Affect Disord 2024; 361:472-479. [PMID: 38901694 DOI: 10.1016/j.jad.2024.06.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 06/06/2024] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Informal care is a common form of social support, which can vary greatly in its intensity. While views of aging have shown to be relevant to mental health before, we aim to analyze whether the association between views of aging and depressive symptoms is influenced by the provision of informal care and its intensity. METHODS Data of six waves of the Health and Retirement Study in the United States was used. The sample includes up to 41,058 observations pooled over six waves of community-dwelling adults aged ≥50 years. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CESD) and attitudes towards own aging (ATOA) with the Philadelphia Geriatric Center Morale Scale (higher score indicates positive attitudes); informal caregiving (no/yes) and caregiving intensity (moderate, intense) were surveyed. Adjusted fixed effects regression analysis with robust standard errors, and with caregiving as moderator variable were calculated. RESULTS Informal caregiving did not interact with ATOA. However, transitioning into intense caregiving significantly moderated the association between ATOA and depressive symptoms. Lower depressive symptoms were associated with better ATOA and this association was significantly stronger in the intense caregiving condition than in the non-caregiving condition. No significant interaction effects were found between any form of caregiving and subjective age. LIMITATIONS The possibility of reciprocal effects cannot be excluded. CONCLUSION Internalized ageism and depressive symptoms are more strongly related among caregivers who provide intense care. Thus, interventions to reduce internalized ageism could be helpful in particular among this vulnerable group of informal caregivers.
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Affiliation(s)
- Larissa Zwar
- University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Hamburg, Germany.
| | - Hans-Helmut König
- University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Hamburg, Germany
| | - André Hajek
- University Medical Center Hamburg-Eppendorf, Department of Health Economics and Health Services Research, Hamburg, Germany
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Juan YC, Wang SH, Huang WL, Liao SC, Chien YL, Gau SSF, Hsu CC, Wu CS. Population-attributable fraction of psychiatric and physical disorders for suicide among older adults in Taiwan. J Affect Disord 2024; 360:88-96. [PMID: 38821366 DOI: 10.1016/j.jad.2024.05.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/12/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND This study aimed to estimate the population-attributable fraction (PAF) of psychiatric and physical disorders for suicide among older adults, focusing on sex- and age-specific factors. METHODS Data from Taiwan's National Health Insurance Research Data and National Death Registry included 9136 cases of suicide in individuals aged 65+, with 89,439 matched controls. Physical and psychiatric disorders were identified through diagnostic records. Conditional logistic regression assessed risk factors, and PAF was calculated using disorder prevalence and adjusted odds ratios. RESULTS Major suicide risk factors among older adults were depressive disorders, anxiety disorders, and sleep disorders. Physical disorders like hypertension, peptic ulcers, and cancer also showed significant PAF values. The combined PAF of physical disorders equaled that of psychiatric disorders. Psychiatric disorders had a greater impact on women and the youngest-old adults, while physical disorders had a higher contribution among men, middle-old adults, and oldest-old adults. LIMITATIONS Relying solely on claim data to identify psychiatric and physical disorders may underestimate their prevalence and associations with suicide due to unrecorded cases of individuals not seeking help and the absence of key risk factors like social isolation and family support. CONCLUSIONS This study identifies preventable or treatable risk factors for older adult suicide, emphasizing the need to target specific psychiatric and physical disorders in suicide prevention efforts while taking into account sex- and age-specific considerations. It also underscores the importance of establishing social welfare support systems to address the unique challenges older adults face.
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Affiliation(s)
- Yi-Chen Juan
- National Taiwan University Hospital-integrative Medical Database, Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Shi-Heng Wang
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, College of Medicine, National Taiwan University, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu Hospital, Hsin-Chu City, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, College of Medicine, National Taiwan University, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, College of Medicine, National Taiwan University, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Cheng Hsu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan; Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan.
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Tan MY, Wu S, Zhu SX, Jiang LH. Association between exposure to organophosphorus pesticide and suicidal ideation among U.S. adults: A population-based study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 281:116572. [PMID: 38896903 DOI: 10.1016/j.ecoenv.2024.116572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/27/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE This study aims to investigate the potential link between exposure to organophosphorus pesticides (OPPs) and suicidal ideation (SI) among adults. METHODS This study encompassed four cycles of the National Health and Nutrition Examination Survey (NHANES), involving 5244 participants aged 20 and above. SI was assessed using the Patient Health Questionnaire-9. The levels of exposure to OPPs were estimated by analyzing concentrations of OPP metabolites in urine samples. Multivariate logistic regression models were used to explore the association between exposure to each OPP and SI. Stratified analyses and interaction tests were conducted across various groups, including pairwise combinations of gender and age, as well as body mass index, smoking status, hypertension, and diabetes. Weighted Quantile Sum (WQS) regression and Bayesian Kernel Machine Regression (BKMR) models were applied to assess the cumulative impact of exposure to the four OPPs on SI, along with their respective contributions. Additionally, the potential interactions among these four OPPs were evaluated. RESULTS Multivariate logistic regression revealed that only dimethylthiophosphate (DMTP) among OPPs demonstrated a statistically significant positive association with SI [OR: 1.18; 95 % CI: 1.02-1.37]. Stratified analyses indicated that the influence of OPPs on SI was particularly pronounced in young and older men. The WQS regression analysis revealed a statistically significant association between the mixed metabolites of OPPs and SI [OR = 1.10, 95 % CI: 1.04-1.16], with DMTP (weighted 0.63) contributing the most. Furthermore, the BKMR model supported a positive trend in the overall impact of these OPP metabolites on SI, displaying notable individual exposure-response relationships for DMTP (PIP: 0.77). CONCLUSIONS Our study suggests an association between exposure to DMTP and an increased risk of SI. Specifically, young adult males and older males appear particularly susceptible to the effects of OPP exposure.
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Affiliation(s)
- Mo-Yao Tan
- Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China
| | - Shan Wu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Si-Xuan Zhu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Li-Hai Jiang
- Chengdu Integrated TCM and Western Medicine Hospital, Chengdu, Sichuan, China.
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Grande E, Alicandro G, Vichi M, Pompili M, Frova L. Suicide After Partner's Death in the Elderly Population: Results From a Nationwide Cohort Study in Italy. Am J Geriatr Psychiatry 2024; 32:825-831. [PMID: 38342662 DOI: 10.1016/j.jagp.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVE This study aims to investigate the effect of partner loss on suicide mortality for surviving partners in the elderly Italian population and to explore differences according to sex and time elapsed since the loss. DESIGN This was a historical cohort study. SETTING All Italian residents registered by the 15th Italian Population Census (9 October 2011) were linked to emigration records and death certificates for 2012-2017 to track migration, vital status, and cause of death. PARTICIPANTS 5,068,414 individuals living as a couple, as registered in the census, and aged ≥69 years on January 1, 2012. MEASUREMENTS Mortality rate ratios (MRR) estimated through Poisson regression models were used to compare suicide mortality at age ≥75 years between subjects who experienced partner loss and those who did not. RESULTS Among people who experienced partner loss, there were 383 suicide deaths in men and 90 in women. Suicide mortality was higher in older men and women who experienced the loss compared to those who did not, and the impact of the spouse loss on mortality was stronger in men (age-adjusted MRR=2.83) than in women (1.41). Among men the excess risk was particularly high during the first year following the loss; in women, no substantial differences in the excess risk were observed over the follow-up period. CONCLUSION Study findings provide evidence of the sex differences in the impact of spouse loss based on data from a large national cohort and reinforce the need for monitoring suicide risk in recently widowed older people.
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Affiliation(s)
- Enrico Grande
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics (EG, LF), Rome, Italy.
| | - Gianfranco Alicandro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano (GA), Milano, Italy; Department of Paediatrics, Cystic Fibrosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (GA), Milano, Italy
| | - Monica Vichi
- Statistical Service, Istituto Superiore di Sanità (MV), Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome (MP), Italy
| | - Luisa Frova
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics (EG, LF), Rome, Italy
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Chennapragada L, Osterberg T, Strouse M, Sullivan SR, Silver C, LaMarca M, Boucher C, Fonseca E, Goodman M. A PRISMA Scoping Review to Explore Interventions to Prevent Firearm-Related Injury and Suicide in Older Adults. Clin Gerontol 2024; 47:519-535. [PMID: 38626064 DOI: 10.1080/07317115.2024.2339366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/18/2024]
Abstract
OBJECTIVES This scoping review aims to examine existing research into firearm safety interventions designed to prevent firearm injury and suicide in older adults. METHODS Select databases were searched in 5/2023. Included articles involved an/a 1. aim to develop or investigate firearm safety interventions, 2. focus on adults 50 years and older, and 3. primary analysis. RESULTS The search yielded 10 articles which primarily focused on firearm safety counseling with older adults with suicide risk or emerging impairment. The review found that older adults may be open to receiving firearm safety counseling but that providers feel ill-equipped to have these conversations and to reliably identify suicide risk. Two studies presented promising data on the impact and acceptability of training providers in a firearm safety intervention. The review also identified the importance of building trust between older patients and providers to have helpful discussions regarding firearms, and highlighted specific approaches that facilitate openness to participate in these exchanges. CONCLUSIONS Further research into adapting interventions to meet the clinical needs of older adults and treatment efficacy trials is necessary. CLINICAL IMPLICATIONS Training healthcare providers to conduct firearm safety interventions with older adults may be an acceptable and impactful avenue to prevent suicide.
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Affiliation(s)
- Lakshmi Chennapragada
- VISN 2 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Terra Osterberg
- VISN 2 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Madison Strouse
- VISN 2 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Sarah R Sullivan
- Department of Psychology, The Graduate Center, City University of New York, New York, NY, USA
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA
| | - Chana Silver
- VISN 2 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Mary LaMarca
- Executive Division, National Center for PTSD Department of Veterans Affairs, White River Junction, Vermont, USA
| | - Caroline Boucher
- VISN 2 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Emilia Fonseca
- VISN 2 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
| | - Marianne Goodman
- VISN 2 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Palanbek Yavaş S, Baysan C. A scientometric analysis and visualisation of elderly suicide research from 1951 to 2022. Psychogeriatrics 2024; 24:811-821. [PMID: 38627605 DOI: 10.1111/psyg.13124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/22/2024] [Accepted: 04/01/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND There are still many gaps in both national and international literature on elderly suicide. This study aimed to identify the most influential journals in elderly suicide, the countries and authors that contribute the most to the field, and the trends in the field. MATERIAL AND METHODS Studies published on elderly suicide between 1951 and 2022 were retrieved utilising the Web of Science Core Collection. Co-authorship analysis of countries and authors, as well as co-occurrence analysis of keywords, were conducted using VOSviewer 1.6.18. RESULTS There were 2864 articles retrieved, including 95 countries, 889 academic journals, 9162 authors and 4160 keywords. The number of publications in this field has significantly increased after the 2000s, and the United States is the most productive country (996). The most prolific author is Yeates Conwell, while the journal with the highest number of publications in this field is the International Journal of Geriatric Psychiatry. Other than 'suicide' and 'elderly', the most trending keywords are 'depression', 'primary care', 'treatment', 'antidepressant', 'loneliness', 'quality of life' and 'COVID-19'. CONCLUSION There has been an increase in both the thematic diversity and quantity of studies on elderly suicide over time. However, these publications predominantly originate from socioeconomically affluent countries with relatively low suicide rates. While the increasing numbers of publications from developing countries in recent years are promising, there is a greater need for publications from countries with lower socioeconomic status for the prevention or intervention of elderly suicides.
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Affiliation(s)
- Seher Palanbek Yavaş
- Faculty of Medicine, Department of Public Health, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Caner Baysan
- Faculty of Medicine, Department of Public Health, Izmir Democracy University, Izmir, Turkey
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7
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Cho H, Choi M, Lee H. Mobile Internet Use and Life Satisfaction Among Older Adults: The Moderating Effect of Living Alone. J Appl Gerontol 2024; 43:841-849. [PMID: 37982396 DOI: 10.1177/07334648231216383] [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] [Indexed: 11/21/2023] Open
Abstract
This study, informed by the principle of the Conservation of Resources (COR) theory, evaluated the relationships between mobile internet use frequency, living arrangement, and life satisfaction in older adults. We used data from the 2021 Digital Divide Survey in South Korea, conducting a secondary analysis on 2105 participants aged 65 or above who accessed the internet in the last month. Multiple linear regression models were performed. Compared to the older adults who lived with others, those living alone showed a stronger positive association between their use of the mobile internet for daily services, information production and sharing, social participation, and life satisfaction. These findings align with the principle of the COR theory, suggesting that older adults living alone due to a loss in resources are more likely to benefit from mobile internet use, indicating the potential effectiveness of promoting mobile internet use as a strategy to enhance their life satisfaction.
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Affiliation(s)
- Hyeonmi Cho
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Mona Choi
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Hyangkyu Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
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Keefe B, Beaugard CA, Tripken J. Enhancing behavioral health competencies for senior center staff through workforce development and training. GERONTOLOGY & GERIATRICS EDUCATION 2024; 45:382-397. [PMID: 37272732 DOI: 10.1080/02701960.2023.2219976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Increases in the numbers of older adults with mental health and substance use concerns compel us to identify best practices in training to address these issues. Senior Centers are an ideal location for behavioral health education programs as they are the go-to place for many older adults. This paper describes an online certificate program in Behavioral Health and Aging offered by the Center for Aging and Disability Education and Research at Boston University School of Social Work in collaboration with the National Council on Aging to increase senior center staff knowledge and skills. A total of 228 senior center staff in Illinois, Florida, and Wisconsin completed the online certificate program. There were statistically significant changes in key competencies for all courses based on pre-post assessment. We held key informant interviews to assess the impact of training and participants stated that their knowledge, skills, and behaviors were influenced by the program.
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Affiliation(s)
- Bronwyn Keefe
- School of Social Work, Boston University, Boston, Massachusetts, USA
- Center for Aging & Disability Education & Research (CADER), Boston University, Boston, Massachusetts, USA
| | | | - Jennifer Tripken
- National Council on Aging, Center for Healthy Aging, Arlington, Virginia, USA
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Chan EC, Conlon K, Gagnon L. Risk factors and methods in suicides of elderly patients connected to mental health services from 1999-2024. Front Psychiatry 2024; 15:1425371. [PMID: 38952630 PMCID: PMC11215130 DOI: 10.3389/fpsyt.2024.1425371] [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: 04/29/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024] Open
Abstract
Introduction Suicide prevention is an important aspect of psychiatric care, with older men being a population identified at especially high suicide risk and a recent increase in suicides among older women. Methods Using data collected by the region's quality assurance team, we examined all suicide deaths occurring between March 1999 and February 2024 in patients aged 60 years or older who were connected to the region's Addiction and Mental Health Program at the time of death. Data were analyzed to describe which factors were most commonly identified in suicides in older adults receiving mental healthcare. We also compared male and female cases to determine whether certain factors were more commonly observed in one gender. Results We identified 48 cases of suicide occurring in patients aged 60 or over. 60% of suicides occurred in males. Overdose and hanging were the most common suicide methods used, and all suicides occurring on inpatient units occurred via hanging. Depression was the most common diagnosis, and was diagnosed more frequently in suicides of female older adults. A greater proportion of suicides in older women were associated with previous history of suicide attempts. Discussion Our findings support many current best practices for suicide prevention in psychiatric care, including minimizing ligatures and anchor points on inpatient settings, assessing for and limiting access to means in individuals at-risk, and assessing suicide risk in hospitalized patients prior to passes and discharge. Recognition and treatment of depression remain important aspects in the treatment of older adults to prevent suicide.
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Affiliation(s)
- Eric C. Chan
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada
| | - Kim Conlon
- Alberta Health Services, Calgary, AB, Canada
| | - Lisa Gagnon
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
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Prince JB, Davis HL, Tan J, Muller-Townsend K, Markovic S, Lewis DMG, Hastie B, Thompson MB, Drummond PD, Fujiyama H, Sohrabi HR. Cognitive and neuroscientific perspectives of healthy ageing. Neurosci Biobehav Rev 2024; 161:105649. [PMID: 38579902 DOI: 10.1016/j.neubiorev.2024.105649] [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: 08/21/2023] [Revised: 03/17/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024]
Abstract
With dementia incidence projected to escalate significantly within the next 25 years, the United Nations declared 2021-2030 the Decade of Healthy Ageing, emphasising cognition as a crucial element. As a leading discipline in cognition and ageing research, psychology is well-equipped to offer insights for translational research, clinical practice, and policy-making. In this comprehensive review, we discuss the current state of knowledge on age-related changes in cognition and psychological health. We discuss cognitive changes during ageing, including (a) heterogeneity in the rate, trajectory, and characteristics of decline experienced by older adults, (b) the role of cognitive reserve in age-related cognitive decline, and (c) the potential for cognitive training to slow this decline. We also examine ageing and cognition through multiple theoretical perspectives. We highlight critical unresolved issues, such as the disparate implications of subjective versus objective measures of cognitive decline and the insufficient evaluation of cognitive training programs. We suggest future research directions, and emphasise interdisciplinary collaboration to create a more comprehensive understanding of the factors that modulate cognitive ageing.
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Affiliation(s)
- Jon B Prince
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia.
| | - Helen L Davis
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Jane Tan
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Katrina Muller-Townsend
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Shaun Markovic
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia; Discipline of Psychology, Counselling and Criminology, Edith Cowan University, WA, Australia
| | - David M G Lewis
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | | | - Matthew B Thompson
- School of Psychology, Murdoch University, WA, Australia; Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, WA, Australia
| | - Peter D Drummond
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Hakuei Fujiyama
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, WA, Australia
| | - Hamid R Sohrabi
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, WA, Australia; Department of Biomedical Sciences, Macquarie University, NSW, Australia.
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Smith L, López Sánchez GF, Soysal P, Veronese N, Gibson P, Pizzol D, Jacob L, Butler L, Barnett Y, Oh H, Shin JI, Koyanagi A. Association of handgrip strength with suicidal ideation among adults aged ≥50 years from low- and middle-income countries. Suicide Life Threat Behav 2024; 54:606-614. [PMID: 38469894 DOI: 10.1111/sltb.13071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION This study aimed to investigate the association between handgrip strength and suicidal ideation in representative samples of adults aged ≥50 years from six LMICs (China, Ghana, India, Mexico, Russia, and South Africa). METHODS Cross-sectional, community-based data from the World Health Organization's Study on Global Aging and Adult Health were analyzed. Handgrip strength quintiles by sex were created based on the average value of two handgrip measurements of the dominant hand. Self-reported information on past 12-month suicidal ideation was collected. Multivariable logistic regression analysis was conducted to assess associations. RESULTS Data on 34,129 individuals were analyzed [mean (SD) age 62.4 (16.0) years; age range 50-114 years; 52.1% females]. After adjustment for potential confounders, in the overall sample, compared to the handgrip strength quintile with the highest values [Quintile 1 (Q1)], Q2, Q3, Q4, and Q5 were associated with significant 2.15 (95% CI = 1.05-4.39), 2.78 (95% CI = 1.06-7.32), 3.53 (95% CI = 1.68-7.42), and 6.79 (95% CI = 2.80-16.48) times higher odds for suicidal ideation. CONCLUSIONS Lower handgrip strength was significantly and dose-dependently associated with higher odds for suicidal ideation in adults aged ≥50 years from LMICs. Future longitudinal studies are needed to understand the underlying mechanisms, and whether increasing general muscular strength and physical function may lead to reduction in suicidal ideation.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Poppy Gibson
- Faculty of Arts, Humanities, Education and Social Sciences, Anglia Ruskin University, Chelmsford, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
- AP-HP, Université Paris Cité, Lariboisière-Fernand Widal Hospital, Department of Physical Medicine and Rehabilitation, Paris, France
- Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Université Paris Cité, Inserm U1153, Paris, France
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
- Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
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Kim JM, Kim JW, Kang HJ, Jang H, Kim JC, Chun BJ, Lee JY, Kim SW, Shin IS. Impact of suicidality on delayed-onset post-traumatic stress disorder is modified by age: A two-year longitudinal study. J Affect Disord 2024; 354:51-54. [PMID: 38471635 DOI: 10.1016/j.jad.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/24/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVES This study aimed to investigate the relationship between early suicidality and post-traumatic stress disorder (PTSD) onset in patients with physical injuries, focusing on age as a modifying factor. METHODS At baseline, 1014 patients were evaluated for suicidality, age divided into younger (<60 years) vs. older (≥60 years) groups, and potential covariates. PTSD was diagnosed at follow-up at 3, 6, 12, and 24 months, and then were categorized into early-onset (within the first six months after trauma) and delayed-onset (more than six months after trauma). Logistic regression models were used after adjusting for covariates. RESULTS Presence of suicidality at baseline was significantly associated with delayed-onset PTSD in older but not younger patients with significant interaction terms, whereas it was significantly associated with early-onset PTSD across all age groups. CONCLUSION Age-specific associations were found between suicidality and PTSD onset. The findings highlight the importance of early suicidality assessment, especially in older patients for ongoing monitoring and support, and underscore the critical need for early PTSD identification and intervention for all ages.
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Affiliation(s)
- Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyunseok Jang
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Jung-Chul Kim
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Byung Jo Chun
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
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13
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Werdin S, Wyss K. Advancing suicide prevention in Germany, Austria and Switzerland: a qualitative study. Front Public Health 2024; 12:1378481. [PMID: 38873323 PMCID: PMC11173583 DOI: 10.3389/fpubh.2024.1378481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/10/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction Suicide is a significant public health problem, impacting individuals, families and communities worldwide. Effective suicide prevention requires a comprehensive approach with diverse integrated interventions and collaboration across sectors, stakeholders and professions. This study aims to identify challenges, gaps and success factors in current suicide prevention efforts in Germany, Austria and Switzerland, providing specific recommendations for advancement. Methods We conducted online, semi-structured interviews with 36 suicide prevention experts from Germany, Austria and Switzerland, incorporating perspectives from policy, science and practice. Interviews were conducted between September 2022 and February 2023, audio-recorded, transcribed verbatim and analyzed using the Framework method. Results Despite progress in national strategies and coordinated efforts for suicide prevention, challenges such as resource scarcity, stigma and structural issues in psychiatric and psychotherapeutic care persist. The interviewees identified several areas for advancement, including developing targeted prevention measures for men and older people, strengthening collaboration across sectors, stakeholders and professions, and increasing the involvement of individuals with lived experience. While the COVID-19 pandemic has exacerbated challenges in psychiatric and psychotherapeutic care, it has concurrently strengthened interest in suicide prevention among policymakers and the media. Discussion National suicide prevention strategies play a crucial role in setting priorities, raising public awareness, and guiding action. However, since most suicide prevention efforts are still predominantly health sector-driven, a more comprehensive approach is needed to promote the involvement of all relevant actors and address suicidality as a collective societal responsibility. Tailoring prevention programs for risk groups like older people and men is important, as these populations show high suicide rates and face a lack of targeted interventions. Our study underscores the importance to continuously monitor, refine and strengthen collaborative and evidence-based suicide prevention efforts.
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Affiliation(s)
- Sophia Werdin
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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14
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Choi NG, Marti CN. Depression in older women who died by suicide: associations with other suicide contributors and suicide methods. J Women Aging 2024; 36:210-224. [PMID: 38090746 PMCID: PMC11062817 DOI: 10.1080/08952841.2023.2292164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/02/2023] [Indexed: 05/02/2024]
Abstract
Suicides among older women have received little research attention. In this study based on the 2017-2019 National Violent Death Reporting System data, we examined the prevalence of depression in older female suicide decedents (N = 3,061), associations between depression and other suicide precipitants, and the associations between suicide methods and depression. Descriptive statistics and generalized linear models (GLM) for a Poisson distribution with a log link were used to examine the research questions. Of the decedents, 15.0% had depressed mood without a reported diagnosis and 41.8% had a depression diagnosis. Nearly one-half of the decedents with reported depression were receiving mental health/substance use treatment at the time of injury. The likelihood of depression was lower among those who were age 85 and older compared to those were age 65-74, but higher among those who had anxiety disorder (IRR = 1.50, 95% CI = 1.33-1.69), history of suicidal ideation (IRR = 1.22, 95% CI = 1.10-1.35), history of suicide attempt (IRR = 1.27, 95% CI = 1.14-1.41), and bereavement problems (IRR = 1.45, 95% CI = 1.27-1.65). Those who had depression were less likely to have used firearms (IRR = 0.85, 95% CI = 0.75-0.97) but more likely to have used hanging/suffocation (IRR = 1.37, 95% CI = 1.13-1.67). The findings show that gun ownership was likely an important factor for firearm use. The high prevalence of depressed mood and/or depression diagnosis among older female suicide decedents at the time of their fatal injury underscores the importance of assessing depression and providing evidence-based depression treatment as an essential suicide prevention approach.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX 78712, USA
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX 78712, USA
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15
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Ki M, Lapierre S, Gim B, Hwang M, Kang M, Dargis L, Jung M, Koh EJ, Mishara B. A systematic review of psychosocial protective factors against suicide and suicidality among older adults. Int Psychogeriatr 2024; 36:346-370. [PMID: 38305360 DOI: 10.1017/s104161022300443x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Research on suicide rarely focuses on protective factors. The goal of this systematic review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults. METHOD First, a scoping review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience, coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis. RESULTS A total of 70 studies were retained for the review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures. CONCLUSION Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.
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Affiliation(s)
- Myung Ki
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Brain Korea 21 Four Research and Education Center, Korea University, Seoul, South Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Sylvie Lapierre
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
| | - Boeun Gim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Minji Hwang
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Brain Korea 21 Four Research and Education Center, Korea University, Seoul, South Korea
| | - Minku Kang
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Luc Dargis
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
| | - Myoungjee Jung
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Emily Jiali Koh
- Department of Public Health, Korea University Graduate School, Seoul, South Korea
| | - Brian Mishara
- Centre for Research and Intervention on Suicide, Ethical Issues and End of Life Practices, Université du Québec à Montréal, Montréal, Canada
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16
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Liu XQ, Wang X. Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs. World J Psychiatry 2024; 14:494-506. [PMID: 38659598 PMCID: PMC11036461 DOI: 10.5498/wjp.v14.i4.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/24/2024] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
Adolescents are considered one of the most vulnerable groups affected by suicide. Rapid changes in adolescents' physical and mental states, as well as in their lives, significantly and undeniably increase the risk of suicide. Psychological, social, family, individual, and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct, indirect, or combined pathways. Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide. When deliberately cultivated, fostered, and enhanced, self-awareness, self-management, social awareness, interpersonal skills, and responsible decision-making, as the five core competencies of social-emotional learning, can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support. Among numerous suicide intervention methods, school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents. The characteristics of school-based interventions based on social-emotional competence, including their appropriateness, necessity, cost-effectiveness, comprehensiveness, and effectiveness, make these interventions an important means of addressing the crisis of adolescent suicide. To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide, additional financial support should be provided, the combination of social-emotional learning and other suicide prevention programs within schools should be fully leveraged, and cooperation between schools and families, society, and other environments should be maximized. These efforts should be considered future research directions.
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Affiliation(s)
- Xin-Qiao Liu
- School of Education, Tianjin University, Tianjin 300350, China
| | - Xin Wang
- School of Education, Tianjin University, Tianjin 300350, China
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17
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Moya-Salazar J, Damián DY, Goicochea-Palomino EA, Cañari B, Moya-Salazar B, Contreras-Pulache H. There is no association between anxiety and lifestyle in older adults during the COVID-19 pandemic: A cross-sectional study. SAGE Open Med 2024; 12:20503121241242394. [PMID: 38595829 PMCID: PMC11003340 DOI: 10.1177/20503121241242394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction and objective The COVID-19 pandemic has caused mental health problems worldwide. Older people have been particularly affected by the lockdown as their health conditions have changed, although they have been kept in isolation to avoid exposure to contagion. We sought to determine the association between lifestyles and anxiety in older adults during the COVID-19 pandemic. Materials and methods This study was cross-sectional. We enrolled 150 older adults of both sexes and with a history of chronic diseases from the municipality of El Agustino (Lima, Peru). The 20-item Geriatric Anxiety Scale and the 25-item Lifestyle Questionnaire on eating, physical activity, rest, and sleep were administered in Spanish during July-August 2021. Results The mean age was 70.8 ± 8.1 years, 54.7% were male, and 75.3% practiced exercise. During the COVID-19 pandemic, 99.3% of the elderly had healthy lifestyles and 40% presented anxiety (mild, moderate, and severe anxiety in 26.7%, 8.7%, and 4.7%, respectively). We found no association between anxiety and lifestyle (p = 0.189), physical exercise was a predictor of lifestyle (p < 0.001) and we did not find predictors of anxiety symptoms (p > 0.05). Conclusions Our results suggest that there was no link between anxiety symptoms and lifestyle in older adults during the lockdown. It is important to conduct in-depth research on factors associated with anxiety symptoms among older residents in other regions, focusing on population groups with the highest rates of infection and death from COVID-19.
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Affiliation(s)
- Jeel Moya-Salazar
- Faculty of Health Sciences, Universidad Privada del Norte, Lima, Peru
| | | | | | - Betsy Cañari
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
| | - Belén Moya-Salazar
- Digital Transformation Center, Universidad Norbert Wiener, Lima, Peru
- Qualitative Unit, Nesh Hubbs, Lima, Peru
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18
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Guo G, Li J, Zheng Y, Liu ZX, Lin H. Breast-conserving surgery is associated with a lower incidence of suicide among females with breast cancer in the United States: a population-based retrospective cohort study. Int J Surg 2024; 110:1392-1401. [PMID: 38215250 PMCID: PMC10942248 DOI: 10.1097/js9.0000000000001060] [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: 09/29/2023] [Accepted: 12/20/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND With comparable overall survival and local recurrence rates with mastectomy, breast-conserving surgery (BCS) has become the cornerstone of therapy for breast cancer; however, the difference in the incidence of suicide between BCS and mastectomy among breast cancer survivors remains unclear. This study evaluated the mortality risk from suicide among breast cancer survivors and compared suicide risk between BCS and mastectomy using a population-based cohort. MATERIALS AND METHODS Female patients newly diagnosed with first primary breast cancer, recorded in the Surveillance, Epidemiology and End Results database, were included. Standardized mortality ratio (SMR) and cumulative mortality rate from suicide among those who underwent BCS and mastectomy were compared. RESULTS A total of 1 190 991 patients with newly diagnosed first primary breast cancer were included in the study, of whom 56.5% underwent BCS and 36.1% underwent mastectomy. During the follow-up period, 667 suicides were recorded. Patients who underwent mastectomy exhibited significantly higher suicide mortality than the general population [mortality rate, 8.16 per 100 000 person-years; SMR 1.18 (95% CI 1.05-1.33)], while there was no significant difference in suicide rate between patients who underwent BCS and the general population [SMR 0.92 (95% CI 0.83-1.02)]. Multivariate Cox analysis revealed that BCS, compared with mastectomy, was associated with a significantly decreased risk of suicide among females with breast cancer [hazard ratio 0.80 (95% CI 0.68-0.95); P = 0.009]. CONCLUSION BCS was associated with a significantly lower incidence of suicide among females with breast cancer. BCS offers a compelling option for improving the quality of life and self-esteem of patients with cancer and provides a novel perspective on cancer management.
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Affiliation(s)
- Guiping Guo
- Department of Breast Surgery, The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University
| | - Junteng Li
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Yongqiang Zheng
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Ze-Xian Liu
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Huan Lin
- Department of Breast Surgery, The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University
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19
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Klein H, Washington TA. Evidence of syndemic effects influencing older transgender persons' likelihood of contemplating suicide: results from a large national study. Aging Ment Health 2024; 28:557-567. [PMID: 37981680 DOI: 10.1080/13607863.2023.2275153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/19/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES Very little research has examined suicidal ideation or the factors associated with contemplating suicide among older transgender adults. This paper examines whether or not there is evidence of syndemic effects influencing suicidal ideation among transgender persons aged 50 or older. METHODS Data from the 2015 U.S. National Transgender Survey were used to examine five domains of potentially-syndemic effects (workplace issues, interactions with professionals, using public services, personal safety, and socioeconomic disadvantages) in a sample of 3,724 transgender Americans aged 50 or older. A dichotomous measure of suicidal ideation during the past year was the main outcome measure. RESULTS The odds of contemplating suicide increased anywhere from 96% to 121% among people experiencing any of the problems under study, and anywhere from 258% to 1,552% (depending upon the syndemic effect domain in question) when they were faced by all of the experiences included in any particular domain. When all items were combined, exposure to any of the domains' problems elevated the risk of contemplating suicide by 276% and exposure to all of the problems examined increased the risk by 861%. The syndemic effects measure remained significant in multivariate analysis controlling for the influence of other potentially-relevant factors. CONCLUSIONS Considerable evidence for the presence of syndemic effects was found, demonstrating that the more different types of adverse conditions that older transgender person's face, the more likely they are to experience to contemplate suicide. There is evidence that these effects diminish with advancing age.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Silver Spring, MD, USA
- School of Social Work, California State University-Long Beach, Long Beach, CA, USA
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20
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Werdin S. Suicide in the Elderly - A Prevalent Phenomenon With Low Societal Awareness. Int J Public Health 2024; 69:1606482. [PMID: 38464907 PMCID: PMC10922918 DOI: 10.3389/ijph.2024.1606482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/01/2024] [Indexed: 03/12/2024] Open
Affiliation(s)
- Sophia Werdin
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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21
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Kidd G, Marston L, Nazareth I, Osborn D, Pitman A. Suicidal thoughts, suicide attempt and non-suicidal self-harm amongst lesbian, gay and bisexual adults compared with heterosexual adults: analysis of data from two nationally representative English household surveys. Soc Psychiatry Psychiatr Epidemiol 2024; 59:273-283. [PMID: 37291332 PMCID: PMC10838834 DOI: 10.1007/s00127-023-02490-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/30/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE We aimed to compare differences in suicidality and self-harm between specific lesbian, gay and bisexual (LGB) groups, and investigate whether minority stress factors might contribute to any associations, addressing methodological limitations of previous research. METHODS We analysed data combined from two population-based representative household surveys of English adults (N = 10,443) sampled in 2007 and 2014. Using multivariable logistic regression models adjusted for age, gender, educational attainment, area-level deprivation, and common mental disorder, we tested the association between sexuality and three suicide-related outcomes: past-year suicidal thoughts, past-year suicide attempt, and lifetime non-suicidal self-harm (NSSH). We added bullying and discrimination (separately) to final models to explore whether these variables might mediate the associations. We tested for interactions with gender and survey year. RESULTS Lesbian/gay people were more likely to report past-year suicidal thoughts [adjusted odds ratio (AOR) = 2.20; 95% CI 1.08-4.50] than heterosexuals. No minority group had an increased probability of suicide attempt. Bisexual (AOR = 3.02; 95% CI = 1.78-5.11) and lesbian/gay (AOR = 3.19; 95% CI = 1.73-5.88) individuals were more likely to report lifetime NSSH than heterosexuals. There was some evidence to support a contribution of bullying in the association between lesbian/gay identity and past-year suicidal thoughts, and of each minority stress variable in the associations with NSSH. There was no interaction with gender or survey year. CONCLUSION Specific LGB groups are at elevated risk of suicidal thoughts and NSSH, with a possible contribution of lifetime bullying and homophobic discrimination. These disparities show no temporal shift despite apparent increasing societal tolerance towards sexual minorities.
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Affiliation(s)
- Garrett Kidd
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Louise Marston
- UCL Research Department of Primary Care and Population Health, Upper Third Floor, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK
| | - Irwin Nazareth
- UCL Research Department of Primary Care and Population Health, Upper Third Floor, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK
| | - David Osborn
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE, UK
| | - Alexandra Pitman
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE, UK.
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Ahmed A, Patil PS. Navigating the Shadows: A Comprehensive Review of Suicide in the Geriatric Population. Cureus 2024; 16:e53352. [PMID: 38435868 PMCID: PMC10907885 DOI: 10.7759/cureus.53352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
This review critically examines the complex landscape of suicide within the geriatric population, defined as individuals aged 65 and older. By synthesizing existing research, we elucidate critical findings related to the prevalence, risk factors, and challenges associated with suicide in this demographic. Social isolation, mental health issues, and the intricate psychosocial dimensions of ageing emerge as pivotal factors contributing to the vulnerability of older individuals. The conclusion underscores a compelling call to action, urging collaborative efforts from healthcare professionals, policymakers, and communities to implement targeted prevention strategies. Our vision for the future involves building a supportive and resilient community for the geriatric population, emphasizing age-friendly policies, robust social support networks, and destigmatizing mental health discussions. Through this comprehensive exploration, we aim to contribute to a deeper understanding of suicide in the geriatric population and inspire effective interventions that prioritize the well-being and dignity of older individuals.
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Affiliation(s)
- Ateeba Ahmed
- Psychiatry, Jawaharlal Nehru Medical College, Wardha, IND
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23
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Bagheri S, Taridashti S, Farahani H, Watson P, Rezvani E. Multilayer perceptron modeling for social dysfunction prediction based on general health factors in an Iranian women sample. Front Psychiatry 2023; 14:1283095. [PMID: 38161726 PMCID: PMC10756140 DOI: 10.3389/fpsyt.2023.1283095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/15/2023] [Indexed: 01/03/2024] Open
Abstract
In the year 2022, this research conducted an in-person study involving 780 single or widowed women, aged between 20 and 70, falling within the bottom three economic deciles and possessing varying levels of education. All participants held educational qualifications below a high school diploma and were beneficiaries of charitable financial support in Khorasan province, Iran. The study aimed to investigate the predictive factors of social dysfunction in this specific demographic. Data collection spanned a 12-month period throughout 2022, with participants completing the GHQ-28 questionnaire during their visits to the charity office. Clinical in-person interviews were also conducted to gather comprehensive data. Data analysis was carried out using IBM SPSS version 27. The research employed a Multilayer Perceptron (MLP) neural network model, considering an extensive set of input factors and covariates. These factors included cognitive functioning, anxiety, depression, age, and education levels. The MLP model exhibited robust performance, achieving high overall accuracy and sensitivity in identifying cases of high social dysfunction. The findings emphasized the significance of cognitive functioning, anxiety, and depression as pivotal predictors of social dysfunction within this specific demographic, while education and age displayed relatively lower importance. The normalized importance scores provided a relative measure of each covariate's impact on the model's predictions. These results furnish valuable insights for the development of targeted interventions and evidence-based policies aimed at addressing social dysfunction and promoting societal well-being among economically disadvantaged, single or widowed women. Notably, the research underscores the potential of MLP modeling in social science research and suggests avenues for further research and refinement to enhance the model's predictive accuracy, particularly for cases of low social dysfunction.
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Affiliation(s)
- Sajjad Bagheri
- Clinical Psychology, Department of Psychology, Hakim-Toos Institute of Higher Education, Mashhad, Iran
| | - Sarvenaz Taridashti
- Industrial and Organizational Psychology, Department of Psychology, Montclair State University, Montclair, NJ, United States
| | | | - Peter Watson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Elham Rezvani
- Clinical Psychology, Department of Psychology, Hakim-Toos Institute of Higher Education, Mashhad, Iran
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Encina-Zúñiga E, Rodante D, Agrest M, Tapia-Munoz T, Vidal-Zamora I, Ardila-Gómez S, Alvarado R, Leiderman EA, Reavley N. Development of mental health first-aid guidelines for suicide risk: a Delphi expert consensus study in Argentina and Chile. BMC Psychiatry 2023; 23:928. [PMID: 38082256 PMCID: PMC10712185 DOI: 10.1186/s12888-023-05417-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Suicide continues to pose a significant global public health challenge and ranks as one of the leading causes of death worldwide. Given the prevalence of suicide risk in the community, there is a significant likelihood of encountering individuals who may be experiencing suicidal thoughts or plans, creating an opening for non-health professionals to offer support. This study aims to culturally adapt the original Australian Mental Health First Aid Guidelines for suicide risk to the Chilean and Argentine context. METHODS A two-round Delphi expert consensus study was conducted involving two panels, one comprising individuals with personal experience in suicide thoughts/attempts or caregiving for those with such experiences (n = 18), and the other consisting of professionals specialized in suicide assessment and support for individuals at risk (n = 25). They rated a total of 179 items mainly derived from guidelines developed by Australian experts and translated into Spanish (168), and new items included by the research team (11). The panel members were requested to assess each item utilizing a five-point Likert scale. During the second round, items that received moderate approval in the initial round were re-evaluated, and new items suggested by the local experts in the first round were also subjected to evaluation in the next round. Inclusion in the final guidelines required an 80% endorsement as "essential" or "important" from both panels. RESULTS Consensus of approval was reached for 189 statements. Among these, 139 statements were derived from the English-language guidelines, while 50 locally generated statements were accepted during the second round. A significant difference from the original guideline was identified concerning the local experts' reluctance to discuss actions collaboratively with adolescents. Furthermore, the local experts proposed the inclusion of an entirely new section addressing suicide risk in older individuals, particularly focusing on suicide methods and warning signs. CONCLUSIONS A Delphi expert consensus study was conducted to culturally adapt mental health first aid guidelines for assessing suicide risk in Chile and Argentina. This study involved professionals and individuals with lived experience. While many items were endorsed, some related to inquiring about suicide risk and autonomy, particularly for adolescents, were not. An additional section for older individuals was introduced. Future research should explore the implementation and impact of these adapted guidelines in training courses. This is vital for enhancing mental health support and implementing effective suicide prevention strategies in Chile and Argentina.
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Affiliation(s)
- Esteban Encina-Zúñiga
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile.
| | - Demián Rodante
- Facultad de Medicina, Instituto de Farmacología, Universidad de Buenos Aires, Buenos Aires, Argentina
- Fundación Foro para la salud mental, Buenos Aires, Argentina
| | - Martín Agrest
- Proyecto Suma, Güemes 4130 (1425), Ciudad Autónoma de Buenos Aires, Argentina
- Facultad de Psicología, Universidad de Buenos Aires, Instituto de Investigaciones, Buenos Aires, Argentina
| | - Thamara Tapia-Munoz
- Department of Behavioural Science and Health, University College London, London, UK
| | - Isidora Vidal-Zamora
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile
| | - Sara Ardila-Gómez
- Facultad de Psicología, Universidad de Buenos Aires, Instituto de Investigaciones, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Rosario, Santa Fe, Argentina
| | - Rubén Alvarado
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Departamento de Salud Pública, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Eduardo A Leiderman
- Departamento de Neurociencias, Facultad de Ciencias Sociales, Universidad de Palermo, Buenos Aires, Argentina
| | - Nicola Reavley
- Melbourne School of Population and Global Health, Centre for Mental Health, University of Melbourne, Victoria, Australia
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Raittila S, Kouvonen A, Koskinen A, Väänänen A. Occupational class differences in male suicide risk in Finland from 1970 to 2019. Eur J Public Health 2023; 33:1014-1019. [PMID: 37802915 PMCID: PMC10710325 DOI: 10.1093/eurpub/ckad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND In the last few decades, suicide rates have decreased in most European countries. However, periodic changes in risk by occupational class have not been studied as much in detail. METHODS Representative cohorts of Finnish working-age men were followed for nine years on suicide mortality starting from five different census years (1970, 1980, 1990, 2000, 2010). Each cohort included between 300 970 and 332 318 men. Cox regression modelling was used to estimate hazard ratios by census year, occupational class and their interactions. Further models adjusted for age and its interactions with census year and occupational class. RESULTS The risk of male suicide has more than halved between 1991 and 2019. The relative hazard ratio of suicide in manual workers compared to managers and professionals was around 1.6 to 1.8 times higher. The period when the suicide risk started to decline differed by occupational class: a significant decrease compared to 1970s' levels was seen for managers and professionals already in the 1990s and for lower non-manual employees around 10 years later (in the 2000s). Manual workers only reached the 1970s suicide risk of managers and professionals in the 2000s and 2010s. CONCLUSION A delayed reduction of suicide rates among lower occupational classes suggests that the impact of social changes can occur at different speed in different population groups.
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Affiliation(s)
- Simo Raittila
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ari Väänänen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Cations M, Lang C, Draper B, Caughey GE, Evans K, Wesselingh S, Crotty M, Whitehead C, Inacio MC. Death by suicide among aged care recipients in Australia 2008-2017. Int Psychogeriatr 2023; 35:724-735. [PMID: 36803904 DOI: 10.1017/s104161022300008x] [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] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To characterize the features of aged care users who died by suicide and examine the use of mental health services and psychopharmacotherapy in the year before death. DESIGN Population-based, retrospective exploratory study. SETTING AND PARTICIPANTS Individuals who died while accessing or waiting for permanent residential aged care (PRAC) or home care packages in Australia between 2008 and 2017. MEASUREMENTS Linked datasets describing aged care use, date and cause of death, health care use, medication use, and state-based hospital data collections. RESULTS Of 532,507 people who died, 354 (0.07%) died by suicide, including 81 receiving a home care package (0.17% of all home care package deaths), 129 in PRAC (0.03% of all deaths in PRAC), and 144 approved for but awaiting care (0.23% of all deaths while awaiting care). Factors associated with death by suicide compared to death by another cause were male sex, having a mental health condition, not having dementia, less frailty, and a hospitalization for self-injury in the year before death. Among those who were awaiting care, being born outside Australia, living alone, and not having a carer were associated with death by suicide. Those who died by suicide more often accessed Government-subsidized mental health services in the year before their death than those who died by another cause. CONCLUSIONS Older men, those with diagnosed mental health conditions, those living alone and without an informal carer, and those hospitalized for self-injury are key targets for suicide prevention efforts.
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Affiliation(s)
- Monica Cations
- Registry of Senior Australians, South Australian Health and Medical Research Institute, AdelaideSA, Australia
- College of Education, Psychology and Social Work, Flinders University, AdelaideSA, Australia
| | - Catherine Lang
- Registry of Senior Australians, South Australian Health and Medical Research Institute, AdelaideSA, Australia
| | - Brian Draper
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, UNSW Sydney, SydneyAustralia
| | - Gillian E Caughey
- Registry of Senior Australians, South Australian Health and Medical Research Institute, AdelaideSA, Australia
- UniSA Allied Health and Human Performance, University of South Australia, AdelaideSA, Australia
| | - Keith Evans
- Registry of Senior Australians, South Australian Health and Medical Research Institute, AdelaideSA, Australia
| | - Steve Wesselingh
- Registry of Senior Australians, South Australian Health and Medical Research Institute, AdelaideSA, Australia
| | - Maria Crotty
- College of Medicine and Public Health, Flinders University, AdelaideSA, Australia
| | - Craig Whitehead
- College of Medicine and Public Health, Flinders University, AdelaideSA, Australia
| | - Maria C Inacio
- Registry of Senior Australians, South Australian Health and Medical Research Institute, AdelaideSA, Australia
- UniSA Allied Health and Human Performance, University of South Australia, AdelaideSA, Australia
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Villarreal RI, Stanley IH, Anestis MD, Buck-Atkinson J, Betz ME. Older Adults' Preferences Regarding Firearm Locking Device Use: Results of a National Survey. Clin Gerontol 2023:1-11. [PMID: 37994864 DOI: 10.1080/07317115.2023.2285994] [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] [Indexed: 11/24/2023]
Abstract
OBJECTIVES Use of firearm locking devices may reduce the risk of suicide and injury among older adults. This study describes older adults' preferences when choosing a firearm locking device. METHODS We conducted a secondary analysis of a nationally representative survey of US adult firearm owners (N = 2,152). We compared older adults (≥65y) with relatively younger adults (<65y), stratified by self-reported gender. RESULTS The top three factors cited as impacting firearm locking device selection included speed (53.6%) and ease of firearm access from device (52.4%), and cost of the device (28.7%). These top factors were comparable for all adults across genders. A larger proportion of older vs younger males reported that a primary preference was whether the device allows the firearm to remain loaded with ammunition; smaller proportions of older vs younger males reported strength of device (device durability) and costs. CONCLUSIONS Preference among older adults, particularly older males, for locking devices that maintain the firearms easy to access - especially, loaded with ammunition - might impact firearm injury prevention efforts for this high-risk group. CLINICAL IMPLICATIONS For harm reduction, use of any firearm locking device may reduce the risk of firearm injury or death. Clinicians are encouraged to explore reasons for locking device selection within motivational interviewing frameworks.
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Affiliation(s)
- Ricardo I Villarreal
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Center for COMBAT Research, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ian H Stanley
- Center for COMBAT Research, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Firearm Injury Prevention Initiative, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Michael D Anestis
- New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- School of Public Health, Rutgers, the State University of New Jersey, Piscataway, New Jersey, USA
| | - Jessica Buck-Atkinson
- Firearm Injury Prevention Initiative, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Marian E Betz
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Firearm Injury Prevention Initiative, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
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Liao SJ, Fang YW, Liu TT. Exploration of related factors of suicide ideation in hospitalized older adults. BMC Geriatr 2023; 23:749. [PMID: 37974110 PMCID: PMC10655411 DOI: 10.1186/s12877-023-04478-w] [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: 05/10/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND With the rapid aging of the population structure, and the suicide ideation rate also increasing year by year, the ratio of people over 65 to the total number of deaths is increasing yearly. The study provides a reference for researchers interested in older adults' care to explore SI further affecting older adults in the future and provide a reference for qualitative research methods or interventional measures. OBJECTIVE The objective of this study is to explore the influence of mental health status, life satisfaction, and depression status on suicidal ideation (SI) among hospitalized older adults. METHODS In a cross-sectional correlation study, taking inpatients over 65 years old in a regional teaching hospital in eastern Taiwan, and the BSRS-5 ≧ 5 points of the screening cases, a total of 228 older adults agree to conduct data analysis in this study. Mainly explore the influence of personal characteristics, mental health status, life satisfaction, and depressed mood on SI among the hospitalized older adults. The basic attributes of the cases used in the data, mental health status, cognitive function, quality of life, depression, and suicide ideation, the data obtained were statistically analyzed with SPSS 20/Windows, and the descriptive statistics were average, standard deviation, percentage, median, etc. In the part of inference statistics, independent sample t-test, single-factor analysis of variance, Pearson performance difference correlation, and logistic regression analysis were used to detect important predictors of SI. RESULTS Research results in (1) 89.5% of hospitalized older adults have a tendency to depression. 2.26.3% of the older adults had SI. (2) Here are significant differences in the scores of SI among hospitalized older adults in different economic status groups and marital status groups. (3) The age, marital status, and quality of life of the hospitalized older adults were negatively correlated with SI; economic status, self-conscious health, mental health, and depression were positively correlated with SI. (4) The results of the mental health status and SI is (r = .345, p < .001), higher the score on the BSRS-5 scale, the higher the SI. The correlation between the depression scale score (SDS-SF) and SI was (r = .150, p < .05), the higher the depression scale score, the higher the SI. CONCLUSION The results of the study found that there was a statistically significant correlation between SI in older adults and age, marital status, economic status, mental health, quality of life, and depression, and also showed that they might interact with each other; the older adults in BSRS-5, GDS-SF, quality of life scale scores have statistically significant differences as essential predictors of SI. The results of this study suggest that medical staff can use the BSRS-5 scale to quickly screen and evaluate the mental health status of older adults, hoping to detect early and provide preventive measures, thereby improving the quality of life of older adults.
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Affiliation(s)
- Su-Jung Liao
- Department of Nursing, College of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Yu-Wen Fang
- Department of Nursing, College of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan.
| | - Tse-Tsung Liu
- Department of Family Physician and Geriatrician, Mennonite Christian Hospital, Hualien, Taiwan.
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Kim SH, Park S. Modeling suicidal ideation in Korean older adults based on their social relationships and mental health: a meta-analytic path analysis. Aging Ment Health 2023; 27:2193-2201. [PMID: 37132465 DOI: 10.1080/13607863.2023.2207483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 04/13/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES Elder suicide is a serious concern in many countries, including South Korea. Various policies and programs to prevent elder suicide are essential; however, further understanding of this phenomenon is necessary. The current study, therefore, developed a model for understanding the underlying mechanism of suicidal ideation in older adults in South Korea. The model was based on Andersen's theory (2021), which explains the path from social relationships to mental health. METHODS This study was conducted utilizing meta-analytic structural equation modeling in accordance with a pooled correlation matrix. We used data from 93 existing studies systematically identified in nine academic databases. RESULTS The fit statistics show that our model fits the data well. The results demonstrated that suicidal ideation was directly affected by abuse, depression, and self-esteem but not by family relationships. Depression significantly mediated the relationship between abuse and suicidal ideation and between family relationships and suicidal ideation. CONCLUSION Social relationships play an important role in determining mental health among Korean older adults, consistent with Andersen's theory. Prevention of elder abuse and depression is essential in preventing suicide among older adults in South Korea.
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Affiliation(s)
- Sin-Hyang Kim
- Department of Nursing, Shinsung University, Dangjin-Si, South Korea
| | - Sihyun Park
- Department of Nursing, Chung-Ang University, Seoul, South Korea
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Jeong H, Noh H. Resilience as a Protective Factor in Older Adult Suicide: A Rapid Review. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:1005-1018. [PMID: 37129535 DOI: 10.1080/01634372.2023.2202729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
Nearly 700,000 suicide deaths occur each year. One in every five suicide death occurs among adults over 60 years of age or older. As the aging population increases rapidly, there is a need to understand protective factors to prevent older adult suicide. This study used the rapid review methodology to search literature from 1997 to 2022, examining whether resilience was a protective factor. The literature search was conducted over the following six databases for peer-reviewed journals and gray literature including Abstracts in Social Gerontology, Academic Search Premier, APA PsycInfo, CINAHL Complete, MEDLINE, and SocINDEX with Full Text. A total of six peer-reviewed journal articles met the inclusion criteria. The conclusion of the articles suggested resilience may be a protective factor in older adult suicide. Despite its underpinning, resilience in suicide prevention literature is lacking. More studies should examine resilience and its constructs as part of the effort to prevent older adult suicide.
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Affiliation(s)
- Haelim Jeong
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Hyunjin Noh
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
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Lin G, Chen B, Yang M, Wu Z, Qiu K, Zhang M, Wang Q, Zhang S, Lao J, Zeng Y, Ning Y, Zhong X. Lower Dorsal Lateral Prefrontal Cortex Functional Connectivity in Late-Life Depression With Suicidal Ideation. Am J Geriatr Psychiatry 2023; 31:905-915. [PMID: 37271652 DOI: 10.1016/j.jagp.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The dorsal lateral prefrontal cortex (DLPFC) has been identified as a neuromodulation target for alleviating suicidal ideation. Dysfunctional DLPFC has been implicated in suicidality in depression. This study aimed to investigate the functional connectivity (FC) of the DLPFC in late-life depression (LLD) with suicidal ideation. METHODS Resting-state functional magnetic resonance imaging (fMRI) data from 32 LLD patients with suicidal ideation (LLD-S), 41 LLD patients without suicidal ideation (LLD-NS), and 54 healthy older adults (HOA) were analyzed using DLPFC seed-based FC analyses. Group differences in FC were examined, and machine learning was applied to explore the potential of DLPFC-FC for classifying LLD-S from LLD-NS. RESULTS Abnormal DLPFC-FC patterns were observed in LLD-S, characterized by lower connectivity with the angular gyrus, precuneus, and superior frontal gyrus compared to LLD-NS and healthy controls. A classification model based on the identified DLPFC-FC achieved an accuracy of 75%. CONCLUSION The lower FC of DLPFC networks may contribute to the neurobiological mechanism of suicidal ideation in late-life depression. These findings may facilitate suicide prevention for LLD by providing potential neuroimaging markers and network-based neuromodulation targets. However, further confirmation with larger sample sizes and experimental designs is warranted.
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Affiliation(s)
- Gaohong Lin
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ben Chen
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mingfeng Yang
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhangying Wu
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kaijie Qiu
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Min Zhang
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Wang
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Si Zhang
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jingyi Lao
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yijie Zeng
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuping Ning
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; The First School of Clinical Medicine (YN), Southern Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders (YN), Guangzhou, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China (YN), The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xiaomei Zhong
- Geriatric Neuroscience Center (GL, BC, MY, ZW, KQ, MZ, QW, SZ, JL, YZ, YN, XZ), The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
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Kim Y, Nam E, Yun Y. Factors associated with depression and suicidal ideation among oldest-old adults aged 85 years or older based on gender, using the survey data of South Korea. Psychogeriatrics 2023; 23:996-1006. [PMID: 37646325 DOI: 10.1111/psyg.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/08/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND South Korea is predicted to become a superaged society around 2025. Depression in older adults is a major factor influencing suicide. South Korea exhibits the highest suicide rate among the Organization for Economic Co-operation and Development countries. METHODS This study aimed to examine the factors associated with depression and suicidal ideation among individuals aged 85 years or older based on gender. Data were obtained from the Korea Institute for Health and Social Affairs, 2017. Overall, 768 individuals aged ≥85 years were included in the final analysis. The participants' general, health-related, and social characteristics were analyzed as factors influencing depression and suicidal ideation. RESULTS Among male oldest-old adults, living arrangements and the number of chronic diseases were factors affecting depression, while activities of daily living restrictions and the number of chronic diseases were factors affecting suicidal ideation. Among female oldest-old adults, only the number of chronic diseases affected depression, while financial status and the number of chronic diseases were the factors affecting suicidal ideation. CONCLUSIONS The healthcare and welfare services for older adults must be expanded to cater to oldest-old adults who live alone, have activities of daily living restrictions, and have lower financial status. Additionally, the oldest age group's psychological health must be monitored regularly for depression and suicidal ideation to implement active interventions for this high-risk group.
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Affiliation(s)
- Yujeong Kim
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, South Korea
| | - Eunhee Nam
- Health Insurance Review and Assessment Service, Wonju, South Korea
| | - Younghee Yun
- School of Nursing, University of California, San Francisco, USA
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Dhole AR, Petkar P, Choudhari SG, Mendhe H. Understanding the Factors Contributing to Suicide Among the Geriatric Population: A Narrative Review. Cureus 2023; 15:e46387. [PMID: 37927668 PMCID: PMC10620465 DOI: 10.7759/cureus.46387] [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: 05/29/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
A critical health concern for older adults is suicide, particularly for those above the age of 60 years. Despite this, research on suicide in this age group is relatively scarce compared to studies on younger populations. This article is intended to summarize the existing literature on etiological/risk factors, including problems with one's physical and mental health, social isolation, money, and life changes like retirement and the death of a spouse and methods for preventing suicide specific to the geriatric population. We conducted a comprehensive literature search to identify the original reports and reviewed publications through various databases, including Google Scholar, PubMed, and the CDC. We gathered information on Google from reputable sources such as the WHO and the National Crime Records Bureau (NCRB). Our review found that the risk factor of suicide in the geriatric population includes physical illness, familial issues, financial issues, and hopelessness. The suicide rate for older adults declined, dropping from 16.17 per 100,000 individuals to 14.25 per 100,000 individuals aged 50 to 69 years and from 27.45 per 100,000 individuals to 24.53 per 100,000 individuals for those over 70 years. A more significant proportion of elderly suicide attempters come from rural than urban locations. Young individuals have better professional opportunities in urban areas, but older people are dispersed to underdeveloped or rural areas, where they are more likely to experience social isolation. By systematically identifying these risk factors, we can develop prevention and intervention strategies to decrease the suicide rates among the geriatric population.
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Affiliation(s)
- Akshay R Dhole
- Department of Community Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
| | - Prithvi Petkar
- Department of Community Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
| | - Sonali G Choudhari
- Department of Community Medicine, Datta Meghe Institute of Higher Education and Research (DU), Wardha, IND
| | - Harshal Mendhe
- Department of Community Medicine, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research (DU), Nagpur, IND
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Aharon ON, Aisenberg-Shafran D, Levi-Belz Y. The effect of suicide severity and patient's age on mental health professionals' willingness to treat: The moderating effect of ageism. DEATH STUDIES 2023; 48:652-662. [PMID: 37695242 DOI: 10.1080/07481187.2023.2255854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Understanding mental health professionals' (MHPs) willingness to treat suicidal older adults is critical in preventative psychotherapy. We examined the effect of a hypothetical patient's age and suicide severity on MHPs' willingness to treat or refer them to another therapist. Vignettes of hypothetical patients were presented to 368 MHPs aged 24-72 years. The vignettes had two age conditions (young/old) and three suicidality severity conditions. MHPs completed measures of their levels of willingness to treat/likeliness to refer and their levels of ageism. As suicide severity intensified, MHPs were less willing to treat and more likely to refer. Willingness to treat was the lowest for the old/suicide attempt condition. Ageism moderated the relationships between patient age and willingness to treat: MHPs with higher ageism were less willing to treat older than younger patients, regardless of suicidality severity. Findings indicate that MHPs with higher ageism levels are more reluctant to treat older suicidal patients and highlight the need for training MHPs to reduce ageism and enhance competence in suicide interventions.
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Affiliation(s)
- Ofir Neomi Aharon
- Clinical Psychology of Adulthood and Aging Department, Ruppin Academic Center, Emek Hefer, Israel
| | | | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Emek Hefer, Israel
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Hein P, Chávez-Hernández AM, Padilla GM, Valadez Figueroa I. Suicide in Later Life in Uruguay: A Suicide Note Analysis. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231196928. [PMID: 37607567 DOI: 10.1177/00302228231196928] [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: 08/24/2023]
Abstract
Suicide is a significant public health challenge worldwide, with inconsistent behavioral patterns. This study examined the psychological processes underlying 191 suicide notes left by older adults in Uruguay, a country doubling global and regional suicide rates, with the highest prevalence among those aged 60+. Uruguay highlights in the region as a high-income country. Through content analysis with an inter-judge strategy, the notes revealed that loneliness, loss of interest, and loss of meaning for life, were prevalent. Financial hardship was not a primary reason for suicide. Social connectedness was highlighted as a factor for reducing suicide risk in older adults, particularly those with ill health and physical impairment. The study sheds light on the need to expand social services aimed at reducing loneliness and the need to combat ageism and social prejudice towards suicide in Uruguay, providing valuable insights into suicide prevention strategies for older adults in diverse social settings.
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Affiliation(s)
- Pablo Hein
- Department of Sociology, Universidad de La República, Montevideo, Uruguay
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Chochinov HM. Fractured Personhood, Suicide, and Lessons from Those Nearing Death. J Palliat Med 2023; 26:1037-1039. [PMID: 37262136 DOI: 10.1089/jpm.2023.0299] [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] [Indexed: 06/03/2023] Open
Abstract
Sometimes dying patients teach us things that apply across the entirety of the life cycle. There is a significant literature indicating that some patients toward end of life covet an earlier, or hastened, death. Many of the things that move patients toward a wish to die can be subsumed under the rubric of fractured personhood. This idea describes a state of brokenness, causing people to feel they are no longer the person they once were, and that the person they have become is no longer worthy of living. This article explores the idea of fractioned personhood, and how this concept might inform our understanding of self-harm and suicide within the general population.
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Affiliation(s)
- Harvey Max Chochinov
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
- CancerCare Manitoba Research Institute, CancerCare Manitoba, Winnipeg, Manitoba, Canada
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Zangeneh A, Khademi N, Farahmandmoghadam N, Ziapour A, Naderlou R, Oghli SS, Teimouri R, Yenneti K, Moghadam S. Spatiotemporal clustering of suicide attempt in Kermanshah, West-Iran. Front Psychiatry 2023; 14:1174071. [PMID: 37583840 PMCID: PMC10425239 DOI: 10.3389/fpsyt.2023.1174071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/18/2023] [Indexed: 08/17/2023] Open
Abstract
Background A suicide attempt is a major societal problem because it imposes high costs on societies worldwide. This paper analyses the spatiotemporal clustering of suicide attempt in Kermanshah, Iran from 2006-14. Methods This study draws on 18,333 individuals (7,234 males and 11,097 females) who attempted suicide across the Kermanshah province. Data was collected from the records of individuals registered in hospitals across the Kermanshah province between 2006 and 2014. Mean Center, Standard Deviational Ellipse (SDE), Moran's I and Kernel Density Estimation (KDE) in Arc/GIS10.6 software were used for the analysis of the spatial distribution of suicide attempt, while the chi-squared test in SPSS was used to examine the different demographic variables between groups within/outside spatial clusters of suicide. Results The results show that a total of 18,331 suicide attempts (39.46% male and 60.53% female) were reported between 2006 and 2014 in the Kermanshah province. The spatial pattern of suicide attempts was clustered in 16 clusters (6 high clusters and 10 low clusters) and statistically significant differences were found within and outside the hotspots of suicide attempts. Most hot spots were formed in and around cities. Younger people were at a greater risk. The rate of suicide attempts reduced in illiterate people and increased in people with university degrees. Unmarried people were associated with a higher risk of suicide attempt than was married status for both males and females. Conclusion The results of this study could help public health practitioners and policymakers in Iran prioritize resources and target efforts for suicide attempt prevention.
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Affiliation(s)
- Alireza Zangeneh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nahid Khademi
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Farahmandmoghadam
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reyhane Naderlou
- Geography and Urban Planning, University of Zanjan, Zanjan, Iran
| | - Somayyeh Shalchi Oghli
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Raziyeh Teimouri
- UniSA Creative, University of South Australia, Adelaide, SA, Australia
| | - Komali Yenneti
- School of Architecture and the Built Environment, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, United Kingdom
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Hassan S, Bhatti MI, Habib S, Fatima S, Bhader S, Khan NH, Jiang E. How fear of intimacy affects infertile men's neuropsychological functioning through mental toughness. Front Psychiatry 2023; 14:1049008. [PMID: 37555007 PMCID: PMC10406444 DOI: 10.3389/fpsyt.2023.1049008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 05/03/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE There is a significant need in Pakistan to investigate the psychological effects of infertility on the mental health of infertile men. The current study examined how fear of intimacy affects neuropsychological impairment and evaluated its relationship to other variables including quality of life and mental toughness. METHOD An analytical cross-sectional study was carried out on infertile male patients in various healthcare settings in Punjab, Pakistan. The participants were recruited using a non-probability (purposive) sampling strategy. The sample size was 120 infertile. SPSS 26 was used to analyze the data. RESULTS Fear of intimacy was found significant impact on neuropsychological impairment (r = 0.40; ***p < 0.001), as well as fear of intimacy, significantly associated with emotional problems (r = 0.48; **p < 0.01), learning problems (r = 0.33; **p < 0.01), sensory and motor problem (r = 0.55; **p < 0.01), concentration problem (r = 0.21; **p < 0.01), mental & physical in coordination (r = 0.37; **p < 0.01) and depression (r = 0.22; **p < 0.01). Fear of intimacy has negative impact on QoL (r = -0.25; *p > 0.05). Similarly, neuropsychological impairment was found to be negatively associated with QoL (r = -0.52; **p > 0.01). The relationship between fear of intimacy and neuropsychological impairment was found to be significantly mediated by QoL. Furthermore, the findings revealed that mental toughness significantly moderated the relationship between fear of intimacy and neuropsychological impairment. CONCLUSION Overall, infertile men in Pakistan had relatively high levels of fear of intimacy, which largely caused neuropsychological impairment. This study can help neuropsychological researchers, mental health professionals, as well as policymakers in improving clinical mental health practices for infertile patients.
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Affiliation(s)
- Sajid Hassan
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Mazhar Iqbal Bhatti
- Department of Psychology, International Islamic University, Islamabad, Pakistan
| | - Shazia Habib
- Department of Applied Psychology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sidra Fatima
- University Gillani Law College, Bahauddin Zakariya University, Multan, Pakistan
| | - Sher Bhader
- Department of Psychology, International Islamic University, Islamabad, Pakistan
| | - Nazeer Hussain Khan
- Institute of Nursing and Health, Henan University, Kaifeng, China
- Department of Animal Sciences, Quaid I Azam University, Islamabad, Pakistan
| | - Enshe Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, China
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Choi NG, Choi BY, Marti CN. Physical Health Problems as a Suicide Precipitant: Associations With Other Risk Factors and Suicide Methods in Three Age Groups of Older Decedents. Innov Aging 2023; 7:igad073. [PMID: 37554949 PMCID: PMC10406434 DOI: 10.1093/geroni/igad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Indexed: 08/10/2023] Open
Abstract
Background and Objectives Physical health problems are a significant late-life suicide precipitant. This study's purpose was to examine differences in (i) other suicide precipitants and psychiatric/substance use problems, and (ii) suicide methods (firearms, hanging/suffocation, and poisoning) in 3 age groups (55-64, 65-74, and 75+) of older suicide decedents who had physical health problems as a suicide precipitant. Research Design and Methods Data came from the 2017-2019 U.S. National Violent Death Reporting System (N = 34,912; 27,761 males [79.5%] and 7,151 females [20.5%]). Generalized linear models for a Poisson distribution with a log link were used to examine the study questions. Results Physical health problems were a suicide precipitant for 25.8%, 41.9%, and 57.7% of the 55-64, 65-74, and 75+ age groups, respectively, and were associated with a higher likelihood of having had depressed mood (IRR = 1.38, 95% CI: 1.33-1.43) and other substance use problems (IRR = 1.22, 95% CI: 1.13-1.31). Interaction effects showed that when job/finance/housing problems, depressed mood, or any psychiatric disorders were co-present with physical health problems, the age group differences in the predicted rates of physical health problems were diminished. Physical health problems were also positively associated with firearm and poisoning use, but negatively associated with hanging/suffocation. Interaction effects indicated that the predicted rates of firearm and poisoning use significantly increased among those aged 55-64 with than without physical health problems. Discussion and Implications In all 3 age groups of older suicide decedents, physical health problems were the predominant suicide precipitant, and those with physical health problems had elevated depressed mood. Assessment of suicide risk, affordable and accessible health, and mental health services, restriction of access to lethal suicide methods, and policy-based suicide prevention approaches for older adults with physical health problems are needed.
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Affiliation(s)
- Namkee G Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Bryan Y Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
- Department of Emergency Medicine, BayHealth, Dover, Delware, USA
| | - C Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
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Nascimento C, Kyunghee Kim H, Villela Nunes P, Paraiso Leite RE, Katia Cristina DO, Barbosa A, Bernardi Bertonha F, Moreira-Filho CA, Jacob-Filho W, Nitrini R, Pasqualucci CA, Tenenholz Grinberg L, Kimie Suemoto C, Brentani HP, Lafer B. Gene expression alterations in the postmortem hippocampus from older patients with bipolar disorder - A hypothesis generating study. J Psychiatr Res 2023; 164:329-334. [PMID: 37393798 DOI: 10.1016/j.jpsychires.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/23/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023]
Abstract
Bipolar disorder (BD) presents with a progressive course in a subset of patients. However, our knowledge of molecular changes in older BD is limited. In this study, we examined gene expression changes in the hippocampus of BD from the Biobank of Aging Studies to identify genes of interest that warrant further exploration. RNA was extracted from the hippocampus from 11 subjects with BD and 11 age and sex-matched controls. Gene expression data was generated using the SurePrint G3 Human Gene Expression v3 microarray. Rank feature selection was performed to identify a subset of features that can optimally differentiate BD and controls. Genes ranked in the top 0.1% with log2 fold change >1.2 were identified as genes of interest. Average age of the subjects was 64 years old; duration of disease was 21 years and 82% were female. Twenty-five genes were identified, of which all but one was downregulated in BD. Of these, CNTNAP4, MAP4, SLC4A1, COBL, and NEURL4 had been associated with BD and other psychiatric conditions in previous studies. We believe our findings have identified promising targets to inform future studies aiming to understand the pathophysiology of BD in later life.
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Affiliation(s)
- Camila Nascimento
- Bipolar Disorder Program, Department of Psychiatry, University of Sao Paulo Medical School, SP, Brazil; Department of Psychiatry, University of Sao Paulo Medical School, SP, Brazil.
| | | | - Paula Villela Nunes
- Bipolar Disorder Program, Department of Psychiatry, University of Sao Paulo Medical School, SP, Brazil; Department of Psychiatry, University of Sao Paulo Medical School, SP, Brazil.
| | | | | | - André Barbosa
- Department of Psychiatry, University of Sao Paulo Medical School, SP, Brazil.
| | | | | | - Wilson Jacob-Filho
- Division of Geriatrics, University of Sao Paulo Medical School, SP, Brazil.
| | - Ricardo Nitrini
- Department of Neurology, University of Sao Paulo Medical School, SP, Brazil.
| | | | - Lea Tenenholz Grinberg
- Department of Pathology, University of Sao Paulo Medical School, SP, Brazil; Memory and Aging Center University of California, San Francisco, USA.
| | | | | | - Beny Lafer
- Bipolar Disorder Program, Department of Psychiatry, University of Sao Paulo Medical School, SP, Brazil; Department of Psychiatry, University of Sao Paulo Medical School, SP, Brazil.
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O'Brien E, Whitman K, Buerke M, Galfalvy H, Szanto K. Life-Satisfaction, Engagement, Mindfulness, Flourishing, and Social Support: Do they Predict Depression, Suicide Ideation, and History of Suicide Attempt in Late Life? Am J Geriatr Psychiatry 2023; 31:415-424. [PMID: 36682987 PMCID: PMC10164675 DOI: 10.1016/j.jagp.2022.12.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/12/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Suicide is an outcome arising from a combination of risk and protective factors. Examining psychological resilience traits associated with successful aging may help to better understand late-life suicide and depression. We examined self-reported protective factors including mindfulness, life satisfaction and engagement, flourishing, and subjective and objective social support in a high suicide-risk sample of depressed older adults. METHODS Participants were 297 individuals aged 55+ (mean age: 64.2): 92 depressed suicide attempters, 138 depressed individuals who never attempted suicide, and 67 non-psychiatric comparisons. Using linear and binomial logistic regression, we examined the effects of a combined Protective Factor value on presence and severity of depression and suicidal ideation, and history of suicide attempt. RESULTS Relative to the non-psychiatric comparison group, all depressed participants had significantly lower Protective Factor values. Higher Protective Factor value was associated with lower likelihood of depression, depression severity, and likelihood of ideation, but was not associated with ideation severity or history of suicide attempt. Participants with one standard deviation higher Protective Factor had lower odds of ideation incidence by a factor of OR=0.68 (95%CI=0.48-0.96). CONCLUSION Resiliency characteristics relevant to psychological wellbeing and successful aging may mitigate the emergence of depression and suicidal ideation, as well as the severity of depression in late-life. The Resilience Factor used in this study can help clinicians nuance their appraisal of depression and suicide risk.
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Affiliation(s)
- Emma O'Brien
- Department of Psychiatry (OBE, WK, SK), University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Kathrine Whitman
- Department of Psychiatry (OBE, WK, SK), University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Morgan Buerke
- Department of Psychology (BM), University of Southern Mississippi, Hattiesburg, MS
| | - Hanga Galfalvy
- Department of Psychiatry (GH), Columbia University College of Physicians and Surgeons, New York, NY; Department of Molecular Imaging and Neuropathology (GH), New York State Psychiatric Institute, New York, NY
| | - Katalin Szanto
- Department of Psychiatry (OBE, WK, SK), University of Pittsburgh School of Medicine, Pittsburgh, PA.
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Shin H, Park C. Social network typologies moderate the association of loneliness with depressive symptomatology in middle-aged and older adults. Front Psychiatry 2023; 14:1141370. [PMID: 37215658 PMCID: PMC10198616 DOI: 10.3389/fpsyt.2023.1141370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/14/2023] [Indexed: 05/24/2023] Open
Abstract
Background Depression remains among the most prevalent mental disorders, and it severely affects daily functioning and quality of life. There has been extensive research reporting on the impact of social relationships on depression, but much of this research has only considered isolated aspects of relationships. This study derived social network types based on the multiple components of social relationships, and then investigated their effects on depressive symptoms. Methods Using samples of 620 adults (Mage = 53.52), Latent Profile Analysis (LPA) was conducted to uncover network types based on the structural (network size, contact frequency, marital status, and social engagement), functional (levels of support and conflict), and qualitative (satisfaction with relationships) aspects of social relationships. Multiple regressions were used to test if distinct network types directly impact on depressive symptoms and whether network types moderate the association of loneliness (perceived social isolation) with depressive symptoms. Results LPA identified four distinct network types (diverse, family-focused, friend-focused, and restricted) and there were significant differences in depressive symptoms among four network types. Analysis using the BCH method showed that individuals in the restricted network type had the highest depressive symptoms, followed in order by individuals in the friend-focused, family-focused, and diverse network types. Regression results further indicated that an individual's network network type membership was significantly associated with depressive symptoms, and being in the diverse and family-focused network types alleviated the negative effect of loneliness on depressive symptoms. Conclusion The results suggest that both quantitative and qualitative aspects of social relationships are important in buffering against the adverse effect of loneliness on depressive symptoms. These findings underscore the utility of taking a multi-dimensional approach to uncover heterogeneity in the social networks of adults and their implications on depression.
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Beaudreau SA, Lutz J, Wetherell JL, Nezu AM, Nezu CM, O'Hara R, Gould CE, Roelk B, Jo B, Hernandez B, Samarina V, Otero MC, Gallagher A, Hirsch J, Funderburk J, Pigeon WR. Beyond maintaining safety: Examining the benefit of emotion-centered problem solving therapy added to safety planning for reducing late life suicide risk. Contemp Clin Trials 2023; 128:107147. [PMID: 36921689 PMCID: PMC10164054 DOI: 10.1016/j.cct.2023.107147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Few clinical trials have examined brief non-pharmacological treatments for reducing suicide risk in older Veterans, a high-risk group. Problem Solving Therapy (PST) is a promising psychosocial intervention for reducing late life suicide risk by increasing adaptive coping to problems through effective problem solving and related coping skills. The current randomized clinical trial will compare the efficacy of six telephone-delivered sessions of Safety Planning (enhanced usual care; EUC) only or an updated version of PST (emotion-centered PST [EC-PST]) + EUC to determine the added clinical benefit of EC-PST for reducing severity of suicidal ideation and for increasing reasons for living, a critical protective factor. Participants randomized to EC-PST + EUC or EUC only will be 150 Veterans (75 each) with active suicidal ideation who are aged 60 or older; have a current DSM-5 anxiety, depressive, and/or trauma-related disorder; and without significant cognitive impairment. Primary outcomes (Geriatric Suicide Ideation Scale and Reasons for Living-Older Adults scale) will be assessed at 11 timepoints: baseline, after each of 6 treatment sessions, posttreatment, and at follow-up at 1, 3, and 6 months posttreatment, and analyzed using mixed effects modeling. Additionally, moderators and mediators of primary outcomes will be examined-functional disability, executive dysfunction, and problem-solving ability. Qualitative feedback from participants will identify potential Veteran-centric changes to the EC-PST protocol and to EUC. Ultimately, the goal of this study is to inform the evidence-based clinical practice guidelines for treatments to reduce suicide risk in older Veterans and specifically to inform clinical decision-making regarding the merit of adding EC-PST to EUC.
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Affiliation(s)
- Sherry A Beaudreau
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5717, USA.
| | - Julie Lutz
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
| | - Julie Loebach Wetherell
- Mental Health Service, Veterans Affairs San Diego Health Care System, 3350 La Jolla Village Drive, San Diego, CA 92161-0002, USA; Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
| | - Arthur M Nezu
- Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Philadelphia, PA 19104, USA
| | - Christine Maguth Nezu
- Department of Psychological and Brain Sciences, Drexel University, 3141 Chestnut Street, Philadelphia, PA 19104, USA
| | - Ruth O'Hara
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5717, USA
| | - Christine E Gould
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5717, USA; Geriatric Research Education and Clinical Center (GRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
| | - Brandi Roelk
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, 800 Irving Ave, Syracuse, NY 13210, USA
| | - Booil Jo
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5717, USA
| | - Beatriz Hernandez
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5717, USA
| | - Viktoriya Samarina
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
| | - Marcela C Otero
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5717, USA
| | - Alana Gallagher
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA; Psychology Department, Palo Alto University, 1791 Arastradero Rd, Palo Alto, CA 94304, USA
| | - James Hirsch
- Sierra Pacific Mental Illness Research Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
| | - Jennifer Funderburk
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, 800 Irving Ave, Syracuse, NY 13210, USA; Department of Psychiatry, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA
| | - Wilfred R Pigeon
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, 800 Irving Ave, Syracuse, NY 13210, USA; Department of Psychiatry, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA; VA Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, 400 Fort Hill Ave, Canandaigua, NY 14624, USA
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Kahlbaugh P, Budnick CJ. Benefits of Intergenerational Contact: Ageism, Subjective Well-Being, and Psychosocial Developmental Strengths of Wisdom and Identity. Int J Aging Hum Dev 2023; 96:135-159. [PMID: 34839730 DOI: 10.1177/00914150211050881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The present study examines the benefits of an in-person intergenerational contact program called SAGE (Successful Aging and Inter-Generational Experiences). The SAGE Program pairs older adults (M age 85 years) and younger adults (M age 23 years) for 2 to 3-hour weekly meetings over a 7-week period, where participants can share memories, skills, and values, and foster new perspectives and friendships. We expected the SAGE Program to benefit both older and younger participants with respect to identity processes, subjective well-being, positive mood, and wisdom while reducing ageist beliefs compared to old and young participants serving as their matched controls. Overall, participants in the SAGE Program reported greater identity synthesis,subjective well-being, and positive mood. Exploratory analyses suggested that identity synthesis is a likely mediator of that effect. The SAGE Program did not reduce ageist beliefs, but age differences in ageism were found. We address additional results,limitations, and future research directions.
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An S, Lim S, Kim HW, Kim HS, Lee D, Son E, Kim TW, Goh TS, Kim K, Kim YH. Global prevalence of suicide by latitude: A systematic review and meta-analysis. Asian J Psychiatr 2023; 81:103454. [PMID: 36634498 PMCID: PMC9822839 DOI: 10.1016/j.ajp.2023.103454] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 12/29/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Affiliation(s)
- Seongjun An
- School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Sungju Lim
- School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Hyun-Woo Kim
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Hyung-Sik Kim
- Department of Oral Biochemistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Dongjun Lee
- Department of Convergence Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Eunjeong Son
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Tae Woo Kim
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Tae Sik Goh
- Department of Orthopaedic Surgery, Pusan National University, Busan, Republic of Korea
| | - Kihun Kim
- Department of Occupational and Environmental Medicine, Kosin University Gospel Hospital, Busan, Republic of Korea.
| | - Yun Hak Kim
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of Korea; Department of Anatomy, School of Medicine, Pusan National University, Yangsan, Republic of Korea.
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Zhang X, Clarke C, Ding R. Living with dementia: Why I am thinking of 'death'. DEMENTIA 2023; 22:807-819. [PMID: 36809154 PMCID: PMC10088338 DOI: 10.1177/14713012231158859] [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: 02/23/2023]
Abstract
BACKGROUND AND AIMS Dementia is recognized globally as a massive burden on public health and wider society. It is a major cause of disability and mortality amongst older people. China has the largest population of people with dementia worldwide, accounting for approximately 25% of the entire global population of people with dementia. The study investigated the perceived experiences of care giving and care receiving in China, with one area identified in the data concerning the extent to which the participants discussed death. The research also explored the meaning of living with dementia in modern China, where the economy, demography and culture are rapidly changing. METHOD The qualitative approach of interpretative phenomenological analysis was used for this study. Semi-structured interviews were used for data collection. FINDING The paper reports on one specific finding concerning death as a way out of the situation that participants found themselves in. CONCLUSION The study described and interpreted one of the specific issues, 'death', in the participants' narratives. This finding reflects how psychological and social factors, such as stress, social support, healthcare cost, caring burden and medical practice have created the participants' thoughts of 'wishing to die' and the reasons why they believe 'death is a way to reduce burden'. It calls for an understanding, supportive social environment and a reconsideration of a culturally and economically appropriate family-based care system.
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Affiliation(s)
- Xiubin Zhang
- National Heart and Lung Institute, 4615Imperial College London, London, UK
| | | | - Rong Ding
- School of Heath in Social Science, The University of Edinburgh, Edinburgh, UK
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Cations M, Cook JM, Nichter B, Esterlis I, Pietrzak RH. Subjective cognitive difficulties and posttraumatic stress disorder interact to increase suicide risk among middle-aged and older US military veterans. Int Psychogeriatr 2023:1-9. [PMID: 36756753 DOI: 10.1017/s1041610222001053] [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] [Indexed: 02/10/2023]
Abstract
OBJECTIVES To examine the role of subjective cognitive difficulties (SCD), posttraumatic stress disorder (PTSD), and their interaction in predicting suicidal ideation and current suicidal intent in middle-aged and older United States (US) military veterans. DESIGN Population-based cross-sectional study. SETTING AND PARTICIPANTS Data were analyzed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 3602 US veterans aged 50 years and older (mean age = 69.0). MEASUREMENTS Questionnaires including the Medical Outcomes Study Cognitive Functioning Scale (SCD), PTSD Checklist for DSM-5 (PTSD), Patient Health Questionnaire-9 (suicidal ideation in the previous two weeks), and the Suicide Behaviors Questionnaire-Revised (current suicidal intent). RESULTS A total of 154 (4.4%) veterans screened positive for current PTSD, 239 (6.7%) reported past two-week suicidal ideation, and 37 (1.0%) reported current suicidal intent. The probability of suicidal ideation among veterans with both SCD and PTSD was more than six times higher than that observed in the full sample (44.5% vs. 6.7%) and more than 2.5 times higher than that observed in veterans with SCD and no PTSD (44.5% vs. 17.5%). Veterans with both subjective memory and concentration difficulties were more likely to report suicidal intent, though the interaction between SCD and PTSD was not significantly associated with suicidal intent. CONCLUSION Middle-aged and older U.S. veterans with subjective cognitive impairment and PTSD report higher rates of suicidal ideation than those with SCD alone. Interventions targeting SCD and PTSD may mitigate suicide risk among middle-aged and older veterans.
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Affiliation(s)
- Monica Cations
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Joan M Cook
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Brandon Nichter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 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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Kato H, Nakazawa E, Mori K, Akabayashi A. Disclosure of Spousal Death to Patients with Dementia: Attitude and Actual Behavior of Care Managers. Eur J Investig Health Psychol Educ 2023; 13:419-428. [PMID: 36826215 PMCID: PMC9955679 DOI: 10.3390/ejihpe13020031] [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: 12/15/2022] [Revised: 01/18/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
As the number of dementia patients increases, there is a need to protect patients' right to know. However, in reality, there are cases in Japan where spouses' deaths are concealed from patients. We conducted a questionnaire survey of care managers (CMs) to obtain their attitude and actual behavior regarding the disclosure of a spouse's death to patients with dementia. A self-administered, anonymous questionnaire survey was implemented at academic meetings attended by CMs from March to December 2019, inquiring about experiences with spousal deaths of patients with dementia, disclosure rates, behavioral and psychological symptoms of dementia, and depression. Over 80% had experienced the spousal death of a patient with dementia; the percentage of CMs who had implemented the disclosures varied widely. About 18% had experienced worsening behavioral and psychological symptoms of dementia (BPSD), and 26% had worsening depression as a result of the disclosure. About 83% of respondents were positive about disclosure, but about 44% did so less than 50% of the time. This study is the first to reveal the current state of CMs' policies and behaviors regarding the disclosure of spousal death to patients with dementia in Japan. Family members' wishes and the possibility of BPSD put a relatively large number of caregivers in a dilemma regarding disclosure.
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Affiliation(s)
- Hisashi Kato
- Department of Biomedical Ethics, Faculty of Medicine, University of Tokyo, Tokyo 1130033, Japan
- General Practice Department, Chichibu Municipal Hospital, Chichibu 3680025, Japan
| | - Eisuke Nakazawa
- Department of Biomedical Ethics, Faculty of Medicine, University of Tokyo, Tokyo 1130033, Japan
- Correspondence:
| | - Katsumi Mori
- Department of Biomedical Ethics, Faculty of Medicine, University of Tokyo, Tokyo 1130033, Japan
| | - Akira Akabayashi
- Department of Biomedical Ethics, Faculty of Medicine, University of Tokyo, Tokyo 1130033, Japan
- Division of Medical Ethics, School of Medicine, New York University, New York, NY 10016, USA
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Dieudonné Rahm N, Pautex S. Determinants of suicidal history before assisted versus self-initiated suicide late in life: an observational study. Swiss Med Wkly 2023; 153:40042. [PMID: 36787459 DOI: 10.57187/smw.2023.40042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Older adults are at risk of assisted and self-initiated suicide. The links between prior attempts and assisted suicide in the elderly have not been investigated. Hence, we aimed to investigate and describe the occurrence, timing and determinants of suicide attempts prior to assisted and self-initiated suicide. METHODS We developed a retrospective study of all assisted and self-initiated suicides among people over 65 years in the canton of Geneva, Switzerland, for a 10-year period (2010-2019). Cases were identified by cross-referencing hospitals' routinely collected electronic data and a forensic report database. Cases were characterised in terms of sociodemographic factors, mental health disorders, main comorbidities, temporal sequence, methods of injury, medical complications and disclosure rates of previous attempts. The study used descriptive statistics. RESULTS A total of 26 of 497 (5.2%) and 20 of 149 (13.4%) older adults had made previous attempts before assisted and self-initiated suicide, respectively. More than half of them had made a single attempt, mostly by medication poisoning, sometimes more than 10 years before dying. Individuals who made two attempts were significantly more represented among the assisted suicide decedents. One self-initiated suicide decedent and half of the assisted suicide cases had disclosed that they had considered suicide. Individual characteristics were similar, except for assisted suicide decedents, who were eight years older than self-initiated suicide decedents. Almost all the individuals had mental disorders. Depression, anxiety and chronic pain were particularly prevalent among decedents of assisted suicide. The substantial representation of women in both groups may be an indication of their vulnerability, possibly related to chronic pain and life stressors. CONCLUSIONS Our results show commonalities between older assisted and self-initiated suicide decedents who made an attempt (s) before suicide. Further research is needed to demonstrate the overlap between the determinants of assisted suicide and other forms of suicidality and to support a suicide prevention strategy applicable to both types of suicide.
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Affiliation(s)
- Nathalie Dieudonné Rahm
- Department of Rehabilitation and Geriatrics, Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sophie Pautex
- Department of Rehabilitation and Geriatrics, Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland
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Kim J, Gwak D, Kim S, Gang M. Identifying the suicidal ideation risk group among older adults in rural areas: Developing a predictive model using machine learning methods. J Adv Nurs 2023; 79:641-651. [PMID: 36534434 DOI: 10.1111/jan.15549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 10/10/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
AIMS The aim of this study was to develop a predictive model that can identify the suicidal ideation risk group among older adults in rural areas using machine learning methods. DESIGN This study applied an exploratory, descriptive and cross-sectional design. METHODS The participants were older adults (N = 650) aged over 65 living in rural areas of South Korea. Self-report questionnaires were used to collect the demographics, suicidal ideation, depression, socioeconomic information and basic health information from September to October 2020. The collected data were analysed using machine learning methods with R statistical software 4.1.0. RESULTS The predictive models indicated that depression, pain, age and loneliness were significant factors of suicidal ideation. Good performance was observed based on the area under the receiver operating characteristic curve in the decision tree, random forest and logistic regression. Finally, the evaluation of model performance indicated moderate to high sensitivity and specificity. CONCLUSION The predictive models using machine learning methods may be useful to predict the risk of suicidal ideation. Furthermore, depression with pain, age and feelings of loneliness should be included in the initial screening to assess suicide risk among older adults in rural areas. IMPACT Identifying suicidal risk among older adults is challenging. Thus, employing predictive models that can assess depression, pain, age and loneliness can enable public healthcare providers to detect suicidal risk groups. Particularly, the presented models from this study can facilitate healthcare providers with initiating early interventions to prevent suicide among older adults in clinical and community nursing care settings. REPORTING METHOD The reporting of this study (Observational, cross-sectional study) conforms to the STROBE statement. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. IMPLICATION FOR THE PROFESSION AND/OR PATIENTS CARE Applying this model may help to prevent geriatric suicide because the nursing staff will have a greater awareness regarding the suicide ideation risk of older adults, thereby reducing the possibility of their suicide.
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Affiliation(s)
- Junglyun Kim
- College of Nursing, Chungnam National University, Daejeon, South Korea.,Department of Biobehavioral Nursing Science, University of Florida, Gainesville, Florida, USA
| | - DongHyeon Gwak
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - Seonhee Kim
- Nursing Department, Songwon University, Gwangju, South Korea
| | - Moonhee Gang
- College of Nursing, Chungnam National University, Daejeon, South Korea
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