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Gunn J, McGrain P, Ördög B, Guerin M. Their final words: An analysis of suicide notes from the United States. DEATH STUDIES 2024:1-11. [PMID: 38709641 DOI: 10.1080/07481187.2024.2348057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
The present study sought to explore motivations (affective, relationships, life events, injury/medical diagnosis) in suicide notes (N = 49) from the U.S. Authors ranged in age from 18 to 74 years and were majority male (73.5%). Four raters analyzed the notes and, through a series of meetings, came to a consensus on the motives behind each note writers' suicide in terms of the broader motivational themes and the narrower second-level themes. All notes were primarily affectional in nature, with some gender and age differences. For example, suicide notes from males frequently refer to financial hardships whereas suicide notes from females were more focused on lowered self-worth and notes written by younger persons focused more on affect and relationships, while notes written by older adults focused on life events and marriage difficulties and separation. Findings illuminate the varied nature of suicide motivations but also highlight important patterns across groups.
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Affiliation(s)
- John Gunn
- Gwynedd Mercy University, Gwynedd Valley, Pennsylvania, USA
| | | | - Brielle Ördög
- Gwynedd Mercy University, Gwynedd Valley, Pennsylvania, USA
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Matsumoto R, Motomura E, Okada M. Impacts of Working Hours, Wages, and Regular Employment Opportunity on Suicide Mortalities of Employed and Unemployed Individuals before and during the COVID-19 Pandemic in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:499. [PMID: 38673410 PMCID: PMC11050676 DOI: 10.3390/ijerph21040499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/08/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
Standardized suicide mortality rates per 100,000 population (SMRs) in Japan consistently decreased from 2009-2019, but these decreasing trends were reversed to increase in 2020. To clarify the mechanisms of recent increasing suicide in Japan, temporal fluctuations of SMRs disaggregated by sex and employment status (employed and unemployed individuals) and labor indices such as working hours, wages, and regular employment opportunity index (REO) from January 2012 to June 2023 were analyzed using interrupted time-series analysis. Additionally, temporal causalities from labor indices to SMRs were analyzed using vector autoregressive and non-linear auto-regressive distributed lag analyses. Decreasing trends among employed SMRs of both sexes were attenuated after the enactment of the "Work Style Reform Program" in 2018, but male SMRs were unaffected by the COVID-19 pandemic. However, female employed SMRs sharply increased, synchronized with the "Work Style Reform Act" and the COVID-19 pandemic outbreak (the COVID-19 impact was greater than the "Work Style Reform Act"). Additionally, unemployed SMRs of both sexes sharply increased with the revision and scale-down of countermeasures against economic deterioration caused by COVID-19 ("revision of economic supportive countermeasures against economic deterioration caused by COVID-19"). Unexpectedly, after enacting the "Work Style Reform Act", wages decreased due to possibly decreasing working hours. Increasing REO, which consistently increased, was a protective factor for male suicides, but unemployed SMRs were not affected by any labor indices. It has been established that controlling a heavy workload plays an important role in suppressing the deterioration of physical and mental conditions, including suicide; however, this study suggested that, at least within appropriate ranges of working hours, decreasing working hours due to excessive management probably contributes to increasing suicides of some vulnerable individuals via de-creasing their wages. Although governmental welfare and economic support measures had to be revised according to rapidly changing situations during the COVID-19 pandemic, this study also suggested that temporal gaps among a part of revisions of several welfare and economic support measures were unexpectedly involved in drastically/sharply increasing suicides of unemployed individuals in 2022.
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Affiliation(s)
| | | | - Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan; (R.M.); (E.M.)
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De Backer K, Pali A, Challacombe FL, Hildersley R, Newburn M, Silverio SA, Sandall J, Howard LM, Easter A. Women's experiences of attempted suicide in the perinatal period (ASPEN-study) - a qualitative study. BMC Psychiatry 2024; 24:255. [PMID: 38570802 PMCID: PMC10988966 DOI: 10.1186/s12888-024-05686-3] [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: 12/22/2023] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Suicide is a leading cause of maternal death during pregnancy and the year after birth (the perinatal period). While maternal suicide is a relatively rare event with a prevalence of 3.84 per 100,000 live births in the UK [1], the impact of maternal suicide is profound and long-lasting. Many more women will attempt suicide during the perinatal period, with a worldwide estimated prevalence of 680 per 100,000 in pregnancy and 210 per 100,000 in the year after birth [2]. Qualitative research into perinatal suicide attempts is crucial to understand the experiences, motives and the circumstances surrounding these events, but this has largely been unexplored. AIM Our study aimed to explore the experiences of women and birthing people who had a perinatal suicide attempt and to understand the context and contributing factors surrounding their perinatal suicide attempt. METHODS Through iterative feedback from a group of women with lived experience of perinatal mental illness and relevant stakeholders, a qualitative study design was developed. We recruited women and birthing people (N = 11) in the UK who self-reported as having undertaken a suicide attempt. Interviews were conducted virtually, recorded and transcribed. Using NVivo software, a critical realist approach to Thematic Analysis was followed, and themes were developed. RESULTS Three key themes were identified that contributed to the perinatal suicide attempt. The first theme 'Trauma and Adversities' captures the traumatic events and life adversities with which participants started their pregnancy journeys. The second theme, 'Disillusionment with Motherhood' brings together a range of sub-themes highlighting various challenges related to pregnancy, birth and motherhood resulting in a decline in women's mental health. The third theme, 'Entrapment and Despair', presents a range of factors that leads to a significant deterioration of women's mental health, marked by feelings of failure, hopelessness and losing control. CONCLUSIONS Feelings of entrapment and despair in women who are struggling with motherhood, alongside a background of traumatic events and life adversities may indicate warning signs of a perinatal suicide. Meaningful enquiry around these factors could lead to timely detection, thus improving care and potentially prevent future maternal suicides.
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Affiliation(s)
- Kaat De Backer
- Department of Women & Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Alexandra Pali
- Department of Women & Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Fiona L Challacombe
- Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Denmark Hill, 16 De Crespigny Park, London, SE5 8AF, England
| | - Rosanna Hildersley
- Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Denmark Hill, 16 De Crespigny Park, London, SE5 8AF, England
| | - Mary Newburn
- Patient and Public Involvement and Engagement Lead for ARC South London, Maternity and Perinatal Mental health theme, Department of Women & Children's Health, School of Life Sciences and Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 6th Floor Addison House, Great Maze Pond, Southwark, London, SE1 1UK, UK
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, Merseyside, L3 3AF, UK
| | - Jane Sandall
- Department of Women & Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK
| | - Louise M Howard
- Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, Denmark Hill, 16 De Crespigny Park, London, SE5 8AF, England
| | - Abigail Easter
- Department of Women & Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, 10th Floor North Wing, St. Thomas' Hospital, Westminster Bridge Road, Lambeth, London, SE1 7EH, UK.
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Ludwig J, Barbek R, von dem Knesebeck O. Education and suicidal ideation in Europe: A systematic review and meta-analysis. J Affect Disord 2024; 349:509-524. [PMID: 38199415 DOI: 10.1016/j.jad.2024.01.040] [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: 07/13/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Understanding predictors of suicidal ideation (SI) is crucial for preventing suicides. Given Europe's high suicide rates and the complex nature of SI, it is essential to also examine social determinants like education as potential risk factors for SI in this region. This systematic review and meta-analysis investigates the association between formal/vocational education and SI in Europe. METHODS Electronic databases (PubMed, Web of Science, PsycINFO, PSYNDEX) were searched until November 2022. Included studies involved European populations examining associations between education and SI. Pooled Odds Ratios (OR) with 95 % confidence intervals (CI) were calculated using random-effects models. Heterogeneity was assessed with the heterogeneity variance τ2 and I2 statistic; subgroup analyses were performed based on study characteristics. Risk of bias was assessed using an adaption of the Newcastle-Ottawa Scale. RESULTS From 20,564 initial studies, 41 were included in the meta-analysis (outlier-adjusted, 96,809 study participants). A negative, insignificant association (OR = 0.86, 95 % CI: 0.75; 1.00) was observed between education and SI, with significant heterogeneity (τ2 = 0.09, I2 = 73 %). Subgroup analyses indicated that population type, age group, categorization of education, timeframe of SI assessment, and study quality significantly moderated the effect size. LIMITATIONS Heterogeneity across studies limits generalizability. The cross-sectional design precludes establishing causal relationships, and social desirability bias may have underestimated the association between education and SI. CONCLUSIONS This systematic review and meta-analysis suggests a trend towards a protective effect of education on the emergence of SI in Europe. Future research, preferably with longitudinal study design examining various covariates, should systematically consider educational inequalities in SI.
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Affiliation(s)
- Julia Ludwig
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rieke Barbek
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kim C, Bai Y, Dusing GJ, Nielsen A, Chum A. The impact of minimum wage increase on suicidal ideation in South Korea: a difference-in-differences analysis using nationally representative panel data. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02646-w. [PMID: 38429540 DOI: 10.1007/s00127-024-02646-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND South Korea had the highest suicide rates in the OECD and one of the largest (16.4%) increases in the minimum wage in 2018. Prior studies have provided evidence that increases in minimum wage reduce suicide rates in the population, but no study examined the effects of the policy change on individual-level suicidal behaviour. METHODS Our study sample was built using the 2015-2019 waves of the Korean Welfare Panel Survey, a population-representative longitudinal survey. The sample consisted of 5146 participants, including those earning above minimum wage (control) and minimum wage earners (treatment) based on their 2018/19 earnings. The outcome of the study was suicidal ideation, which is an important precursor to other suicidal behaviours, and was captured using self-reported measures. We examined the impact of the 2018 minimum wage hike in Korea on suicidal ideation, using a difference-in-differences design. RESULTS The minimum wage increase was associated with a 1.6% points reduction (95% CI: -2.8% to -0.5%) in self-reported suicidal ideation. Stronger policy effects were shown among women and older age groups. CONCLUSIONS Our study demonstrates that public policies employing a population-based approach, such as increasing minimum wages, could serve as an effective intervention to mitigate suicidal ideation among low-income workers.
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Affiliation(s)
- Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Yihong Bai
- Department of Economics, McMaster University, Hamilton, ON, Canada
- Western University Ontario, London, Canada
| | - Gabriel John Dusing
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Andrew Nielsen
- Canadian Institute for Health Information, Ottawa, ON, Canada
| | - Antony Chum
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada.
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Jeremic JV, Mihaljevic JM, Radosavljevic ILJ, Jurisic MM, Suđecki BJ, Stojicic MT, Jovanović MD, Pavlovic Z, Radenovic KG, Milic NV, Pavlovic V, Milic NM, Jovic MS. Trend of suicide by self-immolation in a 13-year timeline: was the COVID-19 pandemic a potentially important stressor? Front Public Health 2024; 12:1234584. [PMID: 38450141 PMCID: PMC10914977 DOI: 10.3389/fpubh.2024.1234584] [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: 06/04/2023] [Accepted: 01/31/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Self-immolation is an uncommon way of attempting and committing a suicide, with a fatality rate of 80%. The risk factors in self-immolation victims vary depending on demographic characteristics, socio-economic and cultural factors as well as religious beliefs. Whether the COVID-19 pandemic was a potentially important stressor for self-immolation is still unknown, with insufficient studies examining this issue. Therefore, in this study, we aimed to examine the trend of self-immolation in a 13-year timeline, and the potential association of COVID-19 pandemic with the increase in the incidence and severity of self-immolation injuries in Serbia in 2021. Materials and methods The study included hospitalized patients due to intentional burns caused by self-immolation in the period from January 1, 2008 to December 31, 2021. Joinpoint regression analysis was used for the analysis of continuous linear trends of self-immolation cases with change points. Results While a rising trend was observed in the 2008-2013 time segment, followed by a decline in the upcoming 2013-2016 time segment, a significant increase reached its maximum during COVID-19 pandemic (2021), with annual percent change of 37.1% (p = 0.001). A significant increase in the median number of cases per year was observed during 2021 compared to the previous periods (7.5 vs. 2). Frequency of patients with a psychiatric diagnosis vs. those without a psychiatric diagnosis was significantly higher during than before the COVID-19 period (66.7 vs. 36.1%, p = 0.046). Conclusion In our study, a significant increase in the frequency of suicide attempts by self-immolation during COVID-19 pandemic was noticed. There was also an increased frequency of pre-existing psychiatric illness among patients during the pandemic period. With limited high-quality data available, the study adds to a rising body of evidence for assessment of outcomes of the pandemic on mental health and recognition of stressors for self-immolation.
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Affiliation(s)
- Jelena V. Jeremic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Jovan M. Mihaljevic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ivan L. J. Radosavljevic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milana M. Jurisic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Branko J. Suđecki
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan T. Stojicic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan D. Jovanović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Zorana Pavlovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia
| | - Kristina G. Radenovic
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Nikola V. Milic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vedrana Pavlovic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Natasa M. Milic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Marko S. Jovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Burns, Plastic and Reconstructive Surgery, University Clinical Center of Serbia, Belgrade, Serbia
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Norström T, Ramstedt M. The impact of the COVID-19 pandemic on mortality in Sweden-Did it differ across socioeconomic groups? Eur J Epidemiol 2024; 39:137-145. [PMID: 38177570 PMCID: PMC10904510 DOI: 10.1007/s10654-023-01068-3] [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: 07/18/2023] [Accepted: 10/23/2023] [Indexed: 01/06/2024]
Abstract
The characterization of the socioeconomic profile of COVID-19 mortality is limited. Likewise, the mapping of potential indirect adverse outcomes of the pandemic, such as suicide and alcohol abuse, along socioeconomic lines is still meagre. The main aim of this paper is to (i) depict SES-differences in COVID-19 mortality, and (ii) to assess the impact of the COVID-19 pandemic on suicide and alcohol mortality across socioeconomic groups. We used Swedish monthly data spanning the period January 2016-December 2021. We chose education as indicator of socioeconomic status (SES). The following causes of deaths were included in the analysis: COVID-19, all-cause mortality excluding COVID-19, suicide and a composite index of alcohol-specific deaths. SARIMA-modelling was used to assess the impact of the pandemic on suicide and alcohol-specific mortality. Two alternative measures of the pandemic were used: (1) a dummy that was coded 1 during the pandemic (March 2020 and onwards), and 0 otherwise, and (2) the Oxford COVID-19 Government Response Tracker's Stringency Index. There was a marked SES-gradient in COVID-19 mortality in the working-age population (25-64) which was larger than for other causes of death. A SES-gradient was also found in the old-age population, but this gradient did not differ from the gradient for other causes of death. The outcome from the SARIMA time-series analyses suggested that the pandemic did not have any impact on suicide or alcohol-specific mortality in any of the educational and gender groups.
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Affiliation(s)
- Thor Norström
- Swedish Institute for Social Research (SOFI), Stockholm University, 106 91, Stockholm, Sweden.
| | - Mats Ramstedt
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
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Mendez I, Strassle PD, Rodriquez EJ, Ponce S, Le R, Green A, Martinez E, Pérez-Stable EJ, Nápoles AM. Racial and ethnic disparities in the association between financial hardship and self-reported weight change during the first year of the pandemic in the U.S. Int J Equity Health 2024; 23:12. [PMID: 38254081 PMCID: PMC10804602 DOI: 10.1186/s12939-023-02093-0] [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: 08/15/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Studies have shown that financial hardship can impact weight change; however, it is unclear what the economic impact of the COVID-19 pandemic has had on weight change in U.S. adults, or whether racial-ethnic groups were impacted differentially. We estimated the association between financial hardship and self-reported weight change using data from the cross-sectional COVID-19's Unequal Racial Burden (CURB) survey, a nationally representative online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults conducted from 12/2020 to 2/2021. Financial hardship was measured over six domains (lost income, debt, unmet general expenses, unmet healthcare expenses, housing insecurity, and food insecurity). The association between each financial hardship domain and self-reported 3-level weight change variable were estimated using multinomial logistic regression, adjusting for sociodemographic and self-reported health. After adjustment, food insecurity was strongly associated with weight loss among American Indian/Alaska Native (aOR = 2.18, 95% CI = 1.05-4.77), Black/African American (aOR = 1.77, 95% CI = 1.02-3.11), and Spanish-speaking Latino adults (aOR = 2.32, 95% CI = 1.01-5.35). Unmet healthcare expenses were also strongly associated with weight loss among Black/African American, English-speaking Latino, Spanish-speaking Latino, and Native Hawaiian/Pacific Islander adults (aORs = 2.00-2.14). Other domains were associated with weight loss and/or weight gain, but associations were not as strong and less consistent across race-ethnicity. In conclusion, food insecurity and unmet healthcare expenses during the pandemic were strongly associated with weight loss among racial-ethnic minority groups. Using multi-dimensional measures of financial hardship provides a comprehensive assessment of the effects of specific financial hardship domains on weight change among diverse racial-ethnic groups.
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Affiliation(s)
- Izabelle Mendez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA.
| | - Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Erik J Rodriquez
- Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland), USA
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Stephanie Ponce
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Randy Le
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Alexis Green
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Emma Martinez
- Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland), USA
| | - Eliseo J Pérez-Stable
- Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland), USA
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Anna M Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
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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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Hollederer A, Jahn HJ. Results from a Nationwide Evaluation Study of Labor Market-Integrative Health Promotion for the Unemployed: Impact of the JOBS Program Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6835. [PMID: 37835105 PMCID: PMC10572609 DOI: 10.3390/ijerph20196835] [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: 06/16/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023]
Abstract
Compared to the employed, the unemployed suffer from poorer health, especially in terms of mental health. At the same time, health promotion rarely reaches unemployed people. The "JOBS Program" is an intervention to promote health and labor market integration and has shown positive effects in the USA and Finland. In this confirmatory study, we investigated whether the JOBS Program achieves similar effects in Germany. We applied a randomized controlled trial to compare an intervention group (IVG) with a waiting control group (WCG) before (T0; N = 94) and shortly after (T1; n = 65) the intervention. Concerning our primary outcomes, the JOBS Program Germany was beneficial: Compared to the WCG, the regression estimated that the IVG had (1) a 2.736 scale point higher level of life satisfaction (p = 0.049), (2) a 0.337 scale point higher level of general health (p = 0.025), and (3) a 14.524 scale point higher level of mental well-being (p = 0.004). Although not statistically significant, job search-specific self-efficacy also appeared to be positively associated with the intervention. This study provides evidence of the effectiveness of JOBS Program on the abovementioned outcomes, including for older and long-term unemployed people, supporting the benefits of regular implementation of this program for a wide range of unemployed people in Germany.
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Affiliation(s)
- Alfons Hollederer
- Section of Theory and Empirics of Health, Department of Social Work and Social Welfare, The Faculty of Human Sciences, University of Kassel, D-34109 Kassel, Germany;
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Oh TK, Park HY, Song IA. Suicidal Thinking Among Patients With Spinal Conditions in South Korea: A Population-Based Cross-Sectional Study. Psychiatry Investig 2023; 20:834-842. [PMID: 37794665 PMCID: PMC10555517 DOI: 10.30773/pi.2023.0072] [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: 03/02/2023] [Revised: 04/15/2023] [Accepted: 06/28/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE Chronic pain increases the risk of suicide because it is often accompanied by depressive symptoms. However, the existing information regarding suicidal thinking in patients with chronic pain such as spinal conditions is insufficient. We aimed to examine the prevalence of suicidal thinking and the factors associated with it among patients with spinal conditions. METHODS Data from the National Health Insurance Service database in South Korea were used in this population-based, cross-sectional study, and 2.5% of adult patients diagnosed with spinal conditions (low back pain and/or neck pain) between 2018 and 2019 were selected using a stratified random sampling technique. Patient Health Questionnaire-9 was used to determine the presence of suicidal thoughts and depressive symptoms. RESULTS 33,171 patients with spinal conditions were included in this study. Among them, 5.9% had suicidal thinking and 20.7% had depressive symptoms. In the multivariable logistic regression model, old age, male sex, and employment were associated with a decreased prevalence of suicidal thinking. Current smokers, previous smokers, medical aid program recipients, and patients with mild-to-moderate or severe disability showed increased suicidal thinking. Underlying depression, bipolar disorder, insomnia disorder, and substance abuse were also associated with increased suicidal thinking. CONCLUSION In South Korea, 5.9% and 20.7% of patients with spinal conditions had suicidal thoughts and depressive symptoms, respectively. Some factors were associated with an increased prevalence of suicidal thoughts among patients with spinal conditions. Our results suggest that screening for these factors can help prevent suicide in patients with spinal conditions.
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Affiliation(s)
- Tak Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Hye Yoon Park
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
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12
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Di Quirico R. Uncertainty, Anxiety and the Post-Pandemic Economic Environment. CLINICAL NEUROPSYCHIATRY 2023; 20:227-232. [PMID: 37791078 PMCID: PMC10544235 DOI: 10.36131/cnfioritieditore20230401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
There is ample evidence from medical and social sciences that economic crises impact on individual mental health. This makes neuro-psychiatric dynamics and individual mental health, particularly that of entrepreneurs, relevant for economic policy designers. At the same time, economic policies can have an impact on mental health, reducing or increasing economic uncertainty and, consequently, changing the level of anxiety in individuals. The COVID-19 pandemic resulted in a severe economic crisis and a drastic transformation of the European economic environment. However, the severity and impact of this crisis differ from many other economic and financial setbacks of the past, including the one resulting from the 2008 crisis. Moreover, the consequences of the pandemic on mental health will add to the long-term consequences of the 2010s crisis and the effects of the war at Europe's Eastern borders. Together, the three crises may increase economic uncertainty in the post-pandemic World and its impact on mental health. This essay examines the connections between economic uncertainty, anxiety, and mental health. It suggests considering some relevant elements to estimate the impact of economic uncertainty on individual mental health. Also, hypotheses about the consequences of the "three crises shock" on mental health in the post-pandemic World are advanced. Finally, the essay helps anticipate how the EU anti-crisis economic policies may generate needs and opportunities for mental health care in national health systems.
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Affiliation(s)
- Roberto Di Quirico
- Dipartimento di Ingegneria meccanica, chimica e dei materiali Università degli studi di Cagliari (Dept. Of Mechanical, Chemical, and Materials Engineering, University of Cagliari) via Marengo, 2 - 09123 Cagliari, Italy
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13
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S Y, Vaibhav V, Chandran S, Navlani LL, Bhute AR, Meshram R. Icy Intrigue: A Case Report of an Unusual Encounter With an Ice Pick Injury. Cureus 2023; 15:e40805. [PMID: 37485086 PMCID: PMC10362887 DOI: 10.7759/cureus.40805] [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] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
An ice pick is rarely observed as a weapon of offense in homicide or suicide. The severity of injuries produced by an ice pick ranges from circular contused abrasions to punctured wounds with clean-cut margins. We present a case of a self-inflicted ice pick injury to the chest autopsied at the AIIMS Rishikesh morgue. During this study, we noticed and analyzed the unusual presentation of injury by an ice pick, contrary to the injuries generally observed in ice pick cases. We highlight a peculiar case of a homicidal ice pick injury observed during the autopsy. The presentation deviated from typical patterns, with the weapon penetrating the victim's body in an unconventional manner. The findings challenge traditional assumptions regarding ice pick injuries and underscore the importance of comprehensive forensic analysis. Understanding and documenting atypical presentations of such injuries can aid forensic experts in accurately determining the cause and manner of death, facilitating the pursuit of justice in criminal investigations.
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Affiliation(s)
- Yashpal S
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Vikas Vaibhav
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Salu Chandran
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Lakhan Lal Navlani
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Ashish R Bhute
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Raviprakash Meshram
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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14
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Affiliation(s)
- Kaat De Backer
- Department of Women and Children's Health, School of Life Science and Medicine, King's College London, St Thomas Hospital, London, UK
| | - Claire A Wilson
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Clare Dolman
- Section of Women's Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Zoe Vowles
- Department of Women and Children's Health, School of Life Science and Medicine, King's College London, St Thomas Hospital, London, UK
| | - Abigail Easter
- Department of Women and Children's Health, School of Life Science and Medicine, King's College London, St Thomas Hospital, London, UK
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15
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Reyes S, Jabouley A, Alili N, De Sanctis MH, Machado C, Taleb A, Herve D, Dias-Gastellier N, Chabriat H. Psychological impact of COVID-19 containment on CADASIL patients. J Neurol 2023; 270:2370-2379. [PMID: 36869886 PMCID: PMC9985090 DOI: 10.1007/s00415-023-11648-8] [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: 01/16/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/05/2023]
Abstract
INTRODUCTION COVID-19 restrictive containment was responsible for major psychological distress and alteration of quality of life (QoL) in the general population. Their impact in a group of patients having cerebral small vessel disease (SVD) and at high risk of stroke and disability was unknown. OBJECTIVE We aimed to determine the potential psychological impact of strict containment during the COVID-19 pandemic in a sample of CADASIL patients, a rare SVD caused by NOTCH3 gene mutations. METHODS Interviews of 135 CADASIL patients were obtained just after the end of the strict containment in France. Depression, QoL and negative subjective experience of the containment were analysed, as well as predictors of posttraumatic and stressor-related manifestations, defined as an Impact Event Scale-Revised score ≥ 24, using multivariable logistic analysis. RESULTS Only 9% of patients showed a depressive episode. A similar proportion had significant posttraumatic and stressor-related disorder manifestations independently associated only with socio-environment factors, rather than clinical ones: living alone outside a couple (OR 7.86 (1.87-38.32), unemployment (OR 4.73 (1.17-18.70)) and the presence of 2 or more children at home (OR 6.34 (1.35-38.34). CONCLUSION Psychological impact of the containment was limited in CADASIL patients and did not appear related to the disease status. About 9% of patients presented with significant posttraumatic and stressor-related disorder manifestations which were predicted by living alone, unemployment, or exhaustion related to parental burden.
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Affiliation(s)
- S Reyes
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - A Jabouley
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - N Alili
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - M H De Sanctis
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - C Machado
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - A Taleb
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - D Herve
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - N Dias-Gastellier
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France
| | - H Chabriat
- CNVT and Department of Neurology and Referral Center for Rare Vascular Diseases of the Brain and Retina (CERVCO), Hopital Universitaire Lariboisière, Assistance Publique des Hôpitaux de Paris, GHU-Paris-Nord, APHP, 2 Rue Ambroise Paré, 75010, Paris, France. .,INSERM U1141-FHU-NeuroVasc, Paris, France.
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16
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Turner BJ, Switzer AC, Welch BE, Legg NK, Gregory MA, Phiri P, Rathod S, Paterson TS. Psychological mediators of the associations between pandemic-related stressors and suicidal ideation across three periods of the COVID-19 pandemic in Canada. J Affect Disord 2023; 324:566-575. [PMID: 36584705 PMCID: PMC9794401 DOI: 10.1016/j.jad.2022.12.074] [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: 08/02/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND The COVID-19 pandemic's mental health impact is well-established. While early evidence suggested suicide deaths remained stable or declined, suicidal ideation (SI) became more prevalent than before the pandemic. Our study: (1) examined the prevalence and distribution of SI among Canadian adults, (2) compared SI among those with and without pre-existing mental illnesses, and (3) evaluated associations between pandemic-related stressors (i.e., unemployment, insecure employment, loss of income, medical vulnerability, COVID-19 exposure) with SI, and whether such associations were mediated by depression, thwarted belongingness, perceived burdensomeness, or perceived discrimination. METHODS The sample was comprised of data gathered at three timepoints (Wave 1 08/18/2020-10/01/2020, n = 6629; Wave 2 12/21/2020-03/31/2021, n = 5920; Wave 3 09/07/2021-12/07/2021, n = 7354). Quota-based responses from survey research panels which matched the geographic, age, and sex distribution of the Canadian population were supplemented with convenience-sampled responses. RESULTS The prevalence of SI was 4.1 % (Wave 1), 5.3 % (Wave 2), and 5.8 % (Wave 3). Odds of SI were higher for respondents under the age of 35 years and with pre-existing mental illnesses. SI was associated with quarantining due to suspected or confirmed COVID-19 exposure, potential COVID-19 exposure at work, medical vulnerability toward COVID-19, insecure employment or unemployment, and income loss. These associations were mediated by psychological experiences, particularly depression and thwarted belongingness. LIMITATIONS This cross-sectional, observational study cannot establish temporality or causality. CONCLUSION Results highlight groups who may benefit from enhanced screening for depression and suicide risk. Reducing depression and increasing sense of belonging should be prioritized.
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Affiliation(s)
- Brianna J. Turner
- Department of Psychology, University of Victoria, Victoria, BC, Canada,Corresponding author at: Department of Psychology, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada
| | - Andrew C. Switzer
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Brooke E. Welch
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Nicole K. Legg
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | | | - Peter Phiri
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK,School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Shanaya Rathod
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK,Faculty of Science, University of Portsmouth, UK
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17
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Abstract
Two years ago, in the early stages of the COVID-19 pandemic, there were widespread and grim predictions of an ensuing suicide epidemic. Not only has this not happened but also by the end of 2021 in the majority of countries and regions with available data, the suicide rates had, if anything, declined. We discuss four reasons why the predictions of suicide models were exaggerated: (1) government intervention reduced the economic and mental costs of lockdowns, (2) the pandemic itself and lockdowns had less of an effect on mental health than assumed, (3) the evidence for a link between economic downturns, distress and suicide is weaker and less consistent than the models assumed and (4) predicting suicide is generally hard. Predictive models have an important place, but their strong modelling assumptions need to acknowledge the inherent high degree of uncertainty which has been further augmented by behavioural responses of pandemic management.
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Affiliation(s)
- Nick Glozier
- Central Clinical School, Faculty of
Medicine and Health, The University of Sydney, Sydney, NSW, Australia,ARC Centre of Excellence for Children
and Families over the Life Course, Indooroopilly, QLD, Australia,Nick Glozier, Central Clinical School,
Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006,
Australia.
| | - Richard Morris
- Central Clinical School, Faculty of
Medicine and Health, The University of Sydney, Sydney, NSW, Australia,ARC Centre of Excellence for Children
and Families over the Life Course, Indooroopilly, QLD, Australia,School of Psychology, Faculty of
Science, The University of Sydney, Sydney, NSW, Australia
| | - Stefanie Schurer
- ARC Centre of Excellence for Children
and Families over the Life Course, Indooroopilly, QLD, Australia,School of Economics, The University of
Sydney, Sydney, NSW, Australia
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