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Lee SH, Kim J, Han C. Psychological resilience and suicidality in the general population: A cross-sectional study based on data from the National Mental Health Survey of Korea 2021. J Affect Disord 2024; 363:S0165-0327(24)01147-9. [PMID: 39047946 DOI: 10.1016/j.jad.2024.07.088] [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: 04/19/2024] [Revised: 07/08/2024] [Accepted: 07/14/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND The relationship between suicidality and resilience is underexplored among the general population. This study aimed to explore the relationship between lifetime, one-year, and one-month prevalence of suicidality (ideation, plan, attempt) and resilience in the general population. METHODS Data on suicidality, resilience, prevalence of major mental disorders, and other key psychological factors were collected from the National Mental Health Survey of Korea 2021. Interviewees comprised 5511 South Koreans aged 18-79 years. The contribution of resilience to suicidality was evaluated using Rao-Scot logistic regression, adjusting for possible confounders such as mental disorder prevalence and demographic and psychological characteristics. RESULTS Significantly lower resilience levels were noted among participants who reported lifetime, one-year, and one-month suicidal ideation, plan, or attempts. High resilience levels predicted no suicidal ideation, plans, and attempts in the lifetime, and no suicidal ideation and plans in the one-year and one-month time frames. LIMITATIONS First, this study's cross-sectional design has limitations for ascertaining a causal relationship between resilience and suicidality. Second, because the number of participants who had attempted suicide in the past year and reported suicidal thoughts/attempts in the past month was small, there were limitations in the analysis of suicidality in these time frames. Third, it was difficult to rule out the mediating effects of personality and temperament on the relationship between resilience and suicidality. CONCLUSIONS High resilience levels predicted lower lifetime and current suicidal ideation and suicidal planning in the general population. This study shows that psychological resilience is an important factor in evaluating an individual's current suicidality.
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Affiliation(s)
- Seung-Hoon Lee
- Department of Psychiatry, Korea University, Guro Hospital, College of Medicine, Seoul, Republic of Korea
| | - Junhyung Kim
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University, Guro Hospital, College of Medicine, Seoul, Republic of Korea.
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La Sala L, Sabo AV, Lamblin M, Robinson J. Can #chatsafe support parents and carers beyond Australia? A qualitative study. BMC Public Health 2024; 24:1571. [PMID: 38862974 PMCID: PMC11165895 DOI: 10.1186/s12889-024-19040-5] [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: 03/21/2024] [Accepted: 06/03/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Rates of self-harm and suicide are rising for young people globally and many implicate social media in this problem. To address this concern and to increase the confidence of adults to communicate safely about suicide and social media with young people, the #chatsafe Guide for Parents and Carers was developed in Australia. With significant uptake of the resource among Australian adults, the aim of the current study was to update and contextualise the #chatsafe Guide for Parents and Carers for audiences in 15 countries globally. To improve the relevance of this resource for parents and carers in these countries, the present study sought to understand the concerns held by parents, carers and suicide prevention professionals around the world about these topics and to explore the extent to which a resource such as #chatsafe would be helpful within their communities. METHODS Seven focus groups were conducted via Zoom with parents, carers and suicide prevention professionals (n = 40) from 15 countries. Transcribed data were coded and thematically analysed using both inductive and deductive processes. RESULTS Six themes are reported: (1) Two scary 'S' words; (2) Country and culture impact who talks (or is silent) about self-harm and suicide; (3) The need for a protective social ecosystem; (4) #chatsafe is a tool that can help parents, carers and young people worldwide; (5) #chatsafe should consider local context and end users to improve its relevance for parents and carers worldwide; and (6) A range of marketing and dissemination strategies are needed to reach adults with #chatsafe information. Findings of this study informed the update and contextualisation of the #chatsafe Guide for Parents and Carers for adult audiences in 15 countries. CONCLUSIONS The findings from this study underscore a universal need for psychoeducation initiatives that provide adults with the skills and knowledge to support the mental health of young people, both online and offline, and that resources like #chastafe can play an important role in providing reliable information about these topics to adults across a range of cultures and contexts.
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Affiliation(s)
- Louise La Sala
- , 35 Poplar Road, Orygen, Parkville, VIC, 3052, Australia.
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Amanda Vittoria Sabo
- , 35 Poplar Road, Orygen, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michelle Lamblin
- , 35 Poplar Road, Orygen, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jo Robinson
- , 35 Poplar Road, Orygen, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Kim S, Jang KI, Lee HS, Shim SH, Kim JS. Differentiation between suicide attempt and suicidal ideation in patients with major depressive disorder using cortical functional network. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132:110965. [PMID: 38354896 DOI: 10.1016/j.pnpbp.2024.110965] [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: 11/07/2023] [Revised: 02/01/2024] [Accepted: 02/11/2024] [Indexed: 02/16/2024]
Abstract
Studies exploring the neurophysiology of suicide are scarce and the neuropathology of related disorders is poorly understood. This study investigated source-level cortical functional networks using resting-state electroencephalography (EEG) in drug-naïve depressed patients with suicide attempt (SA) and suicidal ideation (SI). EEG was recorded in 55 patients with SA and in 54 patients with SI. Particularly, all patients with SA were evaluated using EEG immediately after their SA (within 7 days). Graph-theory-based source-level weighted functional networks were assessed using strength, clustering coefficient (CC), and path length (PL) in seven frequency bands. Finally, we applied machine learning to differentiate between the two groups using source-level network features. At the global level, patients with SA showed lower strength and CC and higher PL in the high alpha band than those with SI. At the nodal level, compared with patients with SI, patients with SA showed lower high alpha band nodal CCs in most brain regions. The best classification performances for SA and SI showed an accuracy of 73.39%, a sensitivity of 76.36%, and a specificity of 70.37% based on high alpha band network features. Our findings suggest that abnormal high alpha band functional network may reflect the pathophysiological characteristics of suicide and serve as a clinical biomarker for suicide.
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Affiliation(s)
- Sungkean Kim
- Department of Human-Computer Interaction, Hanyang University, Ansan, Republic of Korea
| | - Kuk-In Jang
- Cognitive Science Research Group, Korea Brain Research Institute (KBRI), Daegu, Republic of Korea
| | - Ho Sung Lee
- Department of Pulmonology and Allergy, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
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Sternberg A, Bethge M, Ober J, Weier L, Benninghoven D. [Sensitivity and specificity of the PHQ-9 for identifying suicidality in medical rehabilitation]. DIE REHABILITATION 2024; 63:180-188. [PMID: 38552642 DOI: 10.1055/a-2192-3688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
PURPOSE Suicidality is rarely assessed in patients treated in German rehabilitation centers, although individuals with physical and mental impairments have an increased risk for suicidality. The item 9 of the 9-item depression module of the Patient Health Questionnaire (PHQ-9) asks about the desire to be dead or to harm oneself and could be used as a possible screening for suicidality. The Columbia Suicide Severity Rating Scale (C-SSRS) is a standardized interview to assess suicidality. We assessed the prevalence of suicidality in orthopedic and cardiac rehabilitation using the C-SSRS and the PHQ-9, examined the diagnostic accuracy of the item 9 of the PHQ-9 and of the PHQ-9 total score for identifying suicidality and surveyed the acceptance of the suicidality assessment by the rehabilitants. METHODS Study participants were screened with the PHQ-9 and subsequently interviewed using C-SSRS. Sensitivity and specificity of the item 9 of the PHQ-9 and the PHQ-9 total score were tested for the presence of suicidality assessed with the C-SSRS and in a sensitivity analysis for the presence of nonspecific active suicidal ideation (item 2 of the C-SSRS). We calculated the area under the curve (AUC) to predict the ability of the PHQ-9 to discriminate between individuals with and without acute suicidality. Screening and interview were evaluated by the rehabilitants. RESULTS Among 405 study participants, the prevalence of acute suicidality measured by the C-SSRS was 0.5%. 4% reported nonspecific active suicidal ideation on the C-SSRS. 10.4% reported suicidal ideation on item 9 of the PHQ-9. The sensitivity of item 9 and the PHQ-9 total score for identifying acute suicidality was only 50.0% (95% CI: 1.3% to 98.7%). However, item 9 was sensitive (81.3%, 95% CI: 54.4% to 96.0%) and specific (92.5%, 95% CI: 89.5% to 95.0%) for identifying nonspecific active suicidal ideation. Estimators for sensitivity were highly uncertain because of the low prevalence of acute suicidality. Addressing suicidality was rated as useful and helpful by study participants. CONCLUSION If the response to item 9 is positive, the immediate risk of suicide is low. However, PHQ-9 is suitable for identifying patients with non-specific suicidal thoughts. A conspicuous score on the item 9 of the PHQ-9 should be further clarified by a psychotherapist.
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Affiliation(s)
- Annika Sternberg
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Matthias Bethge
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Jona Ober
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Lisa Weier
- Mühlenbergklinik Holsteinische Schweiz, Malente
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Kwon CY, Lee B. The potential role of Korean medicine doctors in Korea's suicide prevention policy: The first web-based survey. Asian J Psychiatr 2024; 96:104040. [PMID: 38604049 DOI: 10.1016/j.ajp.2024.104040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/29/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-Eui University, 52-57 Yangjeong-ro, Busanjin-gu, Busan 47227, Republic of Korea.
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
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Almanzar S. Advancing Global Health Through Primary Care Physician Education on Suicide Prevention. Ann Glob Health 2024; 90:32. [PMID: 38800707 PMCID: PMC11122702 DOI: 10.5334/aogh.4410] [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: 01/30/2024] [Accepted: 05/12/2024] [Indexed: 05/29/2024] Open
Abstract
The rising global suicide rate presents a major public health concern, resulting in the loss of over 700,000 lives annually. Discrepancies in the impact of suicide among diverse populations underscore the necessity for targeted prevention strategies. Primary care providers (PCPs) play a crucial role in identifying and managing suicide risk, particularly in underserved areas with limited access to mental health care. Educating PCPs about evidence-based interventions and suicide prevention strategies has demonstrated effectiveness in reducing suicide rates. Landmark initiatives in Australia, Sweden, and Hungary have successfully lowered suicide rates by implementing educational programs for PCPs focused on suicide prevention. Denmark, previously afflicted by some of the highest rates globally in the 1980s, has significantly reduced its figures and now ranks among countries with the lowest rates in high-income nations. Collaborative programs involving PCPs and health workers in low-resource regions have also shown promising outcomes in suicide prevention efforts. Enhancing the expertise of PCPs in suicide prevention can fortify healthcare systems, prioritize mental health, and ultimately save lives, contributing to global health endeavors aimed at addressing the pervasive issue of suicide.
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Sadek J, Diaz-Piedra B, Saleh L, MacDonald L. A narrative review: suicide and suicidal behaviour in older adults. Front Psychiatry 2024; 15:1395462. [PMID: 38800059 PMCID: PMC11117711 DOI: 10.3389/fpsyt.2024.1395462] [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: 03/04/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Globally, suicide is a public health concern that claims the lives of many each year. The complex etiology and factors contributing to the risk of suicide make it hard to predict the likelihood of death by suicide. Suicide rates have been increasing over the past 25 years in patients aged 65 years and older, and with the expected increases in the size of the older adult population and the under-detection of suicide risk, these rates may continue to increase. To mitigate and attempt to limit this expected increase, it is important to understand the risk and protective factors of suicide in older adults. This narrative review focuses on individuals above the age of 65 and encompasses relevant peer-reviewed publications from the past 25 years to cover fatal and non-fatal suicidal behaviour. It summarizes several important risk factors for suicide and suicidal behaviors while considering how risk can be detected, assessed, prevented, and mitigated. Screening methods to detect suicide and depression in older adults were examined based on their effectiveness and suitability for use in this population. Lastly, the impacts of the COVID-19 pandemic on suicide rates in older adults were described.
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Affiliation(s)
- Joseph Sadek
- Professor, Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | | | - Leah Saleh
- Faculty of Science, Dalhousie University, Halifax, NS, Canada
| | - Luke MacDonald
- MD Candidate, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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Bekaroğlu E, Bulut BP, Demirbaş H. Reliability and validity of the Suicide Cognitions Scale-Revised (SCS-R) in emerging adulthood in Turkey. DEATH STUDIES 2024; 48:500-510. [PMID: 37516976 DOI: 10.1080/07481187.2023.2240742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Suicidal thoughts and behaviors (STBs) are a significant public health problem. This study aims to examine the validity and reliability of the Turkish version of the Suicide Cognitions Scale-Revised (SCS-R). Participants (N = 442, age range: 18-29 years) completed the SCS-R, the Beck Depression Inventory, the Inventory of Statements About Self-injury, the Suicide Probability Scale, and the Suicide Rumination Scale. Principal component analysis showed that the SCS-R consisted of a single factor and that the SCS-R could differentiate between participants at high risk and low risk of suicide. High-to-moderate positive associations were found between the measures of depression, suicide probability, suicide rumination, and non-suicidal self-injury and suicide cognition. The Turkish version of the SCS-R has good psychometric properties. This scale can be used to screen for cognitive patterns that are most prone to suicide and to manage such cognitive characteristics, which are important steps for preventive interventions.
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Affiliation(s)
- Ece Bekaroğlu
- Department of Psychology, Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Burcu Pınar Bulut
- Department of Psychology, Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Hatice Demirbaş
- Department of Psychology, Ankara Hacı Bayram Veli University, Ankara, Turkey
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Diaz-Piedra B, Sadek J. ADHD Patients with Suicidal Behaviour: Risk Factors, Comorbidities, and Clinical Profile: A Naturalistic Exploratory Study. Brain Sci 2024; 14:437. [PMID: 38790416 PMCID: PMC11119163 DOI: 10.3390/brainsci14050437] [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: 04/17/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that disrupts brain functioning and is characterized by hyperactivity, impulsivity, and inattention. With varying presentations and complex etiological factors contributing to the development of ADHD, along with its persistence into adulthood, ADHD must be studied. Researchers have taken an interest in the relationship between ADHD and suicide, which is a serious public health concern with increasing prevalence rates in the Americas. The current literature reveals conflicting views on the importance of psychiatric comorbidities in the development of suicidal behaviours in ADHD patients. Therefore, this study aimed to determine whether there were significant differences between adult ADHD patients with suicide risk and adult ADHD patients without suicide risk. This study was a naturalistic retrospective chart review pilot study that used a sample of adults with a confirmed diagnosis of ADHD from January 2023 to August 2023. Using convenience sampling and sets of inclusion and exclusion criteria, patient data were sequentially collected from Med Access electronic medical records. The control and experimental groups each consisted of 50 patients (100) ranging from 19 to 58 years old. Our quantitative data were analyzed using non-parametric statistical tests, including the Chi-Square test and the Mann-Whitney U test. The results showed significant associations between ADHD patients with suicide risk and (1) borderline personality disorder; (2) binge eating disorder; (3) seven specific psychosocial risk factors; and (4) a higher number of antidepressant medication trials. No significant associations were found with other psychiatric disorders; however, there are important sex differences in terms of the risk factors. Our pilot study reveals several significant differences between adult ADHD patients with suicide risk and those without suicide risk. However, given our limited sample size and limitations, we hope our study encourages larger-scale studies to further investigate this relationship to improve its generalizability.
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Affiliation(s)
- Bryan Diaz-Piedra
- Faculty of Science, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Joseph Sadek
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
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De Jonge CJ, Barratt CLR, Aitken RJ, Anderson RA, Baker P, Chan DYL, Connolly MP, Eisenberg ML, Garrido N, Jørgensen N, Kimmins S, Krausz C, McLachlan RI, Niederberger C, O’Bryan MK, Pacey A, Priskorn L, Rautakallio-Hokkanen S, Serour G, Veltman JA, Vogel DL, Vazquez-Levin MH. Current global status of male reproductive health. Hum Reprod Open 2024; 2024:hoae017. [PMID: 38699533 PMCID: PMC11065475 DOI: 10.1093/hropen/hoae017] [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: 09/08/2023] [Revised: 02/22/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The widespread interest in male reproductive health (MRH), fueled by emerging evidence, such as the global decline in sperm counts, has intensified concerns about the status of MRH. Consequently, there is a pressing requirement for a strategic, systematic approach to identifying critical questions, collecting pertinent information, and utilizing these data to develop evidence-based strategies. The methods for addressing these questions and the pathways toward their answers will inevitably vary based on the variations in cultural, geopolitical, and health-related contexts. To address these issues, a conjoint ESHRE and Male Reproductive Health Initiative (MRHI) Campus workshop was convened. OBJECTIVE AND RATIONALE The three objectives were: first, to assess the current state of MRH around the world; second, to identify some of the key gaps in knowledge; and, third, to examine how MRH stakeholders can collaboratively generate intelligent and effective paths forward. SEARCH METHODS Each expert reviewed and summarized the current literature that was subsequently used to provide a comprehensive overview of challenges related to MRH. OUTCOMES This narrative report is an overview of the data, opinions, and arguments presented during the workshop. A number of outcomes are presented and can be summarized by the following overarching themes: MRH is a serious global issue and there is a plethora of gaps in our understanding; there is a need for widespread international collaborative networks to undertake multidisciplinary research into fundamental issues, such as lifestyle/environmental exposure studies, and high-quality clinical trials; and there is an urgent requirement for effective strategies to educate young people and the general public to safeguard and improve MRH across diverse population demographics and resources. LIMITATIONS REASONS FOR CAUTION This was a workshop where worldwide leading experts from a wide range of disciplines presented and discussed the evidence regarding challenges related to MRH. While each expert summarized the current literature and placed it in context, the data in a number of areas are limited and/or sparse. Equally, important areas for consideration may have been missed. Moreover, there are clear gaps in our knowledge base, which makes some conclusions necessarily speculative and warranting of further study. WIDER IMPLICATIONS Poor MRH is a global issue that suffers from low awareness among the public, patients, and heathcare professionals. Addressing this will require a coordinated multidisciplinary approach. Addressing the significant number of knowledge gaps will require policy makers prioritizing MRH and its funding. STUDY FUNDING/COMPETING INTERESTS The authors would like to extend their gratitude to ESHRE for providing financial support for the Budapest Campus Workshop, as well as to Microptic S.L. (Barcelona) for kindly sponsoring the workshop. P.B. is the Director of the not-for-profit organization Global Action on Men's Health and receives fees and expenses for his work, (which includes the preparation of this manuscript). Conflicts of interest: C.J.D.J., C.L.R.B., R.A.A., P.B., M.P.C., M.L.E., N.G., N.J., C.K., AAP, M.K.O., S.R.-H., M.H.V.-L.: ESHRE Campus Workshop 2022 (Travel support-personal). C.J.D.J.: Cambridge University Press (book royalties-personal). ESHRE Annual Meeting 2022 and Yale University Panel Meeting 2023 (Travel support-personal). C.L.R.B.: Ferring and IBSA (Lecture), RBMO editor (Honorarium to support travel, etc.), ExSeed and ExScentia (University of Dundee), Bill & Melinda Gates Foundation (for research on contraception). M.P.C.: Previously received funding from pharmaceutical companies for health economic research. The funding was not in relation to this work and had no bearing on the contents of this work. No funding from other sources has been provided in relation to this work (funding was provided to his company Global Market Access Solutions). M.L.E.: Advisor to Ro, Doveras, Next, Hannah, Sandstone. C.K.: European Academy of Andrology (Past president UNPAID), S.K.: CEO of His Turn, a male fertility Diagnostic and Therapeutic company (No payments or profits to date). R.I.M.: www.healthymale.org.au (Australian Government funded not for profit in men's health sector (Employed as Medical Director 0.2 FET), Monash IVF Pty Ltd (Equity holder)). N.J.: Merck (consulting fees), Gedeon Richter (honoraria). S.R.-H.: ESHRE (Travel reimbursements). C.N.: LLC (Nursing educator); COMMIT (Core Outcomes Measures for Infertility Trials) Advisor, meeting attendee, and co-author; COMMA (Core Outcomes in Menopause) Meeting attendee, and co-author; International Federation of Gynecology and Obstetrics (FIGO) Delegate Letters and Sciences; ReproNovo, Advisory board; American Board of Urology Examiner; American Urological Association Journal subsection editor, committee member, guidelines co-author Ferring Scientific trial NexHand Chief Technology Officer, stock ownership Posterity Health Board member, stock ownership. A.P.: Economic and Social Research Council (A collaborator on research grant number ES/W001381/1). Member of an advisory committee for Merck Serono (November 2022), Member of an advisory board for Exceed Health, Speaker fees for educational events organized by Mealis Group; Chairman of the Cryos External Scientific Advisory Committee: All fees associated with this are paid to his former employer The University of Sheffield. Trustee of the Progress Educational Trust (Unpaid). M.K.O.: National Health and Medical Research Council and Australian Research Council (Funding for research of the topic of male fertility), Bill and Melinda Gates Foundation (Funding aimed at the development of male gamete-based contraception), Medical Research Future Fund (Funding aimed at defining the long-term consequences of male infertility). M.H.V.-L.: Department of Sexual and Reproductive Health and Research (SRH)/Human Reproduction Programme (HRP) Research Project Panel RP2/WHO Review Member; MRHI (Core Group Member), COMMIT (member), EGOI (Member); Human Reproduction (Associate Editor), Fertility and Sterility (Editor), AndroLATAM (Founder and Coordinator).
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Affiliation(s)
- Christopher J De Jonge
- Department of Urology, University of Minnesota Medical Center, University of Minnesota, Minneapolis, MN, USA
| | - Christopher L R Barratt
- Division of Systems Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - R John Aitken
- Discipline of Biological Sciences, School of Environment and Life Sciences, College of Engineering, Science and Environment, University of Newcastle, Newcastle, Australia
| | - Richard A Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | | | - David Y L Chan
- Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China
| | - Mark P Connolly
- Health Economics, Global Market Access Solutions LLC, Mooresville, NC, USA
- University Medical Center Groningen, Groningen, The Netherlands
| | - Michael L Eisenberg
- Department of Urology and Obstetrics & Gynecology, Stanford University, Stanford, CA, USA
| | - Nicolas Garrido
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Niels Jørgensen
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sarah Kimmins
- Department of Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada
- Département de Pathologie et Biologie Cellulaire, Université de Montréal, Montréal, QC, Canada
| | - Csilla Krausz
- Department of Experimental and Clinical Biomedical Sciences, ‘Mario Serio’, University of Florence, University Hospital of Careggi (AOUC), Florence, Italy
| | - Robert I McLachlan
- Hudson Institute of Medical Research, Monash University, Melbourne, Australia
- Monash IVF Group, Cremorne, Australia
| | - Craig Niederberger
- Clarence C. Department of Urology, University of Illinois Chicago (UIC), College of Medicine, Department of Bioengineering, UIC College of Engineering, Chicago, IL,USA
| | - Moira K O’Bryan
- School of BioSciences and Bio21 Institute, The University of Melbourne, Parkville, Australia
| | - Allan Pacey
- Faculty of Biology, Medicine and Health, Core Technology Facility, University of Manchester, Manchester, UK
| | - Lærke Priskorn
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Gamal Serour
- The International Islamic Center for Population Studies and Research, Al-Azhar University, Maadi, Cairo, Egypt
- Egyptian IVF Center, Maadi, Cairo, Egypt
| | - Joris A Veltman
- Faculty of Medical Sciences, Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Donna L Vogel
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Mónica H Vazquez-Levin
- Instituto de Biología y Medicina Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina—Fundación IBYME, Buenos Aires, Argentina
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Ryu S, Nam HJ, Lee JY, Kim JM, Kim SW. Understanding the Fluctuations in Korea's Suicide Rates: A Change-Point Analysis and Interrupted Time Series Analysis. J Korean Med Sci 2024; 39:e125. [PMID: 38599599 PMCID: PMC11004772 DOI: 10.3346/jkms.2024.39.e125] [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: 10/01/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Korea has witnessed significant fluctuations in its suicide rates in recent decades, which may be related to modifications in its death registration system. This study aimed to explore the structural shifts in suicide trends, as well as accidental and ill-defined deaths in Korea, and to analyze the patterns of these changes. METHODS We analyzed age-adjusted death rates for suicides, deaths due to transport accidents, falls, drowning, fire-related incidents, poisonings, other external causes, and ill-defined deaths in Korea from 1997 to 2021. We identified change-points using the 'breakpoints' function from the 'strucchange' package and conducted interrupted time series analyses to assess trends before and after these change-points. RESULTS Korea's suicide rates had three change-points in February 2003, September 2008, and June 2012, characterized by stair-step changes, with level jumps at the 2003 and 2008 change-points and a sharp decline at the 2012 change-point. Notably, the 2003 and 2008 spikes roughly coincided with modifications to the death ascertainment process. The trend in suicide rates showed a downward slope within the 2003-2008 and 2008-2012 periods. Furthermore, ill-defined deaths and most accidental deaths decreased rapidly through several change-points in the early and mid-2000s. CONCLUSION The marked fluctuations in Korea's suicide rate during the 2000s may be largely attributed to improvements in suicide classification, with potential implications beyond socio-economic factors. These findings suggest that the actual prevalence of suicides in Korea in the 2000s might have been considerably higher than officially reported.
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Affiliation(s)
- Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Gwangju Metropolitan Mental Health Welfare Center, Gwangju, Korea
| | - Hee Jung Nam
- Department of Psychiatry, Seoul Medical Center, Seoul, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea.
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Tao M, Guo HY, Ji X, Wang W, Yuan H, Peng H. Long-term trends in Alzheimer's disease and other dementias deaths with high body mass index in China from 1990 to 2019, and projections up to 2042. Arch Public Health 2024; 82:42. [PMID: 38528579 DOI: 10.1186/s13690-024-01273-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 03/18/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND In China, the rising prevalence of high Body Mass Index (BMI) is linked to increasing health issues, including Alzheimer's disease (AD). This study analyzes mortality trends related to AD and other dementias associated with high BMI from 1990 to 2019, considering age, period, and birth cohort effects, and forecasts future trends. METHODS We analyzed mortality data for AD and other dementias linked to high BMI in Chinese residents from the Global Burden of Disease 2019 database. Using Joinpoint regression, we examined age-standardized mortality rate (ASMR) trends and calculated annual and average annual percentage changes (APC and AAPC). Age-period-cohort models provided deeper insights, with Bayesian models used to project future ASMR trends to 2042. RESULTS From 1990 to 2019, the ASMR for AD and other dementias associated with high BMI in China showed an overall increasing trend. Females had a lower increase rate than males, yet their overall levels remained higher. Specifically, the ASMR for males increased by an average of 2.70% per year, peaking between 2006 and 2010, while for females, it increased by an average of 2.29% per year, also peaking in the same period. Age-period-cohort analysis revealed increasing mortality relative risk with age and period, but a decrease with birth cohort. Projections suggest a continued rise in ASMR by 2042, with rates for males and females expected to be 2.48/100,000 and 2.94/100,000, respectively. CONCLUSION The increasing mortality trend from AD and other dementias associated with high BMI highlights the urgent need for policy interventions focused on overweight prevention, particularly vital for addressing the health challenges in China's aging population.
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Affiliation(s)
- Mengjun Tao
- Health management center, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Hao-Yang Guo
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Xincan Ji
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Wei Wang
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China
| | - Hui Yuan
- School of Public Health, Wannan Medical College, Wuhu, Anhui, China.
| | - Hui Peng
- Department of Science and Technology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
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Olgiati P, Pecorino B, Serretti A. Neurological, Metabolic, and Psychopathological Correlates of Lifetime Suicidal Behaviour in Major Depressive Disorder without Current Suicide Ideation. Neuropsychobiology 2024; 83:89-100. [PMID: 38499003 DOI: 10.1159/000537747] [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: 09/11/2023] [Accepted: 01/30/2024] [Indexed: 03/20/2024]
Abstract
INTRODUCTION Suicidal behaviour (SB) has a complex aetiology. Although suicidal ideation (SI) is considered the most important risk factor for future attempts, many people who engage in SB do not report it. METHODS We investigated neurological, metabolic, and psychopathological correlates of lifetime SB in two independent groups of patients with major depression (sample 1: n = 230; age: 18-65 years; sample 2: n = 258; age >60 years) who did not report SI during an index episode. RESULTS Among adults (sample 1), SB was reported by 141 subjects (58.7%) and severe SB by 33 (15%). After controlling for interactions, four risk factors for SB emerged: male gender (OR 2.55; 95% CI: 1.06-6.12), negative self-perception (OR 1.76; 95% CI: 1.08-2.87), subthreshold hypomania (OR 4.50; 95% CI: 1.57-12.85), and sexual abuse (OR 3.09; 95% CI: 1.28-7.48). The presence of at least two of these factors had the best accuracy in predicting SB: sensitivity = 57.6% (39.2-74.5); specificity = 75.1% (68.5-82.0); PPV = 27.9% (20.9-37.2); NPV = 91.4% (87.6-94.1). In older patients (sample 2), 23 subjects (9%) reported previous suicide attempts, which were characterized by earlier onset (25 years: OR 0.95: 0.92-0.98), impaired verbal performance (verbal fluency: OR 0.95: 0.89-0.99), higher HDL cholesterol levels (OR 1.04: 1.00-1.07) and more dyskinesias (OR 2.86: 1.22-6.70). CONCLUSION Our findings suggest that SB is common in major depressive disorder, even when SI is not reported. In these individuals it is feasible and recommended to investigate both psychiatric and organic risk factors. The predictive power of models excluding SI is comparable to that of models including SI.
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Affiliation(s)
- Paolo Olgiati
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
- Mental Health Department, Azienda Sanitaria Locale TO4, Turin, Italy
| | - Basilio Pecorino
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, Kore University of Enna, Enna, Italy
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Medicine and Surgery, Kore University of Enna, Enna, Italy
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Rostami M, Jalilian A, Jalilian M, Mahdavi SA. Years of Life Lost Due to Complete Suicide in Iran: A National Registry-Based Study. J Res Health Sci 2024; 24:e00605. [PMID: 39072541 PMCID: PMC10999103 DOI: 10.34172/jrhs.2024.140] [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: 08/30/2023] [Revised: 10/28/2023] [Accepted: 12/23/2023] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND Suicide was the fourth leading cause of death among individuals aged 15 to 29 years worldwide in 2019, highlighting its significant impact on young people. Iran's suicide-related mortality rate was 5.1 per 100000 population in the same year, which is lower than the global average. This study aimed to estimate the years of life lost (YLLs) due to complete suicide in Iran. Study Design: A registry-based cross-sectional study. METHODS The data on complete suicide cases used in this study were obtained from the national suicide registry of the Iranian Forensic Medicine Organization (FMO) that was registered between March 21, 2016 and March 20, 2020. RESULTS The total number of YLL due to premature death by suicide over the four-year period was 611068 years (15.97 per 1000 persons) in males, 286847 years (7.65 per 1000 persons) in females, and 897915 years (11.86 per 1000 persons) for both genders. Moreover, the age group of 15-29 years experienced the highest YLL attributed to suicide. Furthermore, the study revealed an increasing trend of YLL due to suicide among individuals aged 30-44. CONCLUSION These findings highlight the significant impact of suicide on the loss of potential years of life in Iran. The study indicates that the young and productive age groups of 15-29 and 30-44 years are particularly affected, with the highest YLL due to complete suicide. The study provides valuable insights for designing targeted and evidence-based suicide prevention programs that can reduce the burden of suicide in Iran, particularly among young and middle-aged adults.
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Affiliation(s)
- Mehran Rostami
- Deputy of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Mohammad Jalilian
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Garmsar Branch of Islamic Azad University, Semnan, Iran
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Warren M, O'Connor C, Lee JE, Burton J, Walton D, Keathley J, Wammes M, Osuch E. Predispose, precipitate, perpetuate, and protect: how diet and the gut influence mental health in emerging adulthood. Front Nutr 2024; 11:1339269. [PMID: 38505265 PMCID: PMC10948435 DOI: 10.3389/fnut.2024.1339269] [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: 11/15/2023] [Accepted: 02/02/2024] [Indexed: 03/21/2024] Open
Abstract
Medicine often employs the 4Ps of predisposing, precipitating, perpetuating, and protective factors to identify salient influences on illness states, and to help guide patient care. Mental illness is a significant cause of morbidity and mortality worldwide. Mental health is a complex combination of biological, psychological, environmental, and social factors. There is growing interest in the gut-brain-microbiome (GBM) axis and its impact on mental health. We use the medical model of the 4Ps to explore factors involving the connection between nutrition and the GBM axis and their associated risks with mental health problems in emerging adults (EAs), a life stage when mental illness onset is the most common. We review the impact of current dietary trends on the GBM and on mental health, and the role that gut microbiome-based interventions can have in modulating the GBM axis of EAs. We discuss the implications of gut health on the GBM and areas for clinical intervention.
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Affiliation(s)
- Michael Warren
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Colleen O'Connor
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Ju Eun Lee
- Geriatrics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jeremy Burton
- Department of Surgery, Microbiology and Immunology, Lawson Health Research Institute, Western University, London, ON, Canada
| | - David Walton
- School of Physical Therapy, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Justine Keathley
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, ON, Canada
| | - Michael Wammes
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Elizabeth Osuch
- Department of Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- London Health Sciences Centre, Lawson Health Research Institute, London, ON, Canada
- First Episode Mood and Anxiety Program, London Health Sciences Centre, London, ON, Canada
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Oliveira Alves FJ, Fialho E, Paiva de Araújo JA, Naslund JA, Barreto ML, Patel V, Machado DB. The rising trends of self-harm in Brazil: an ecological analysis of notifications, hospitalisations, and mortality between 2011 and 2022. LANCET REGIONAL HEALTH. AMERICAS 2024; 31:100691. [PMID: 38500959 PMCID: PMC10945432 DOI: 10.1016/j.lana.2024.100691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/16/2024] [Accepted: 01/22/2024] [Indexed: 03/20/2024]
Abstract
Background Self-harm is considered an important public health issue and is comprised by a wide range of definitions and behaviours. It is estimated that suicide affects more than 700,000 individuals every year, although, globally, there is a lack of evidence on other self-harm behaviour, such as attempted suicide. The objective of this study is to report and examine temporal trends of notifications, hospitalisations related to self-harm and suicide rates in Brazil between 2011 and 2022, as well as investigating differences in sociodemographic characteristics, methods, and region. Methods This ecological study used secondary, Brazilian Health Information System data between 2011 and 2022. Self-harm notifications were collected from the Notifiable Diseases Information System (SINAN); self-harm hospitalisations from the Hospital Information System (SIH), and suicide data from the Mortality Information System (SIM). We calculated self-harm notifications, hospitalisations, and suicide rates by sex, age, race, region, and overall. We assessed time-related trends using Joinpoint regression analyses. Findings From 2011 to 2022, 720,480 self-harm notifications, 104,458 self-harm hospitalisations, and 147,698 suicides were recorded in Brazil. In this period, self-harm notifications (AAPC: 21.13 (CI: 17.50, 25.33)) and suicide (AAPC: 3.70 (CI: 3.05, 4.38)) have increased in the country. Male adults (25-59 years old) and the elderly (>60 years old) continue to be the groups most affected by suicide, with respective rates of 9.59 and 8.60/100,000 in 2022. However, the largest percentage increases have been seen in young people (AAPC: 6.14 (CI: 4.57, 7.88)). The Indigenous population had the highest self-harm notification (103.72, 10,000) and suicide (16.58/100,000) rates, but the lowest hospitalisation rates (1.14/100,000) in 2022), compared to the overall population (70.06, 7.27, and 4.69/100,000, respectively, in 2022). Interpretation The observed trend of increased self-harm notifications and suicide rates suggests the need for a greater allocation of resources to strategies to prevent self-harm and suicide. The Indigenous population seems to be the group with less access to healthcare. Funding Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under award number R01MH128911-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Affiliation(s)
- Flávia Jôse Oliveira Alves
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Erika Fialho
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Jacyra Azevedo Paiva de Araújo
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Maurício L. Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Daiane Borges Machado
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Center of Data and Knowledge Integration for Health (CIDACS), Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, Brazil
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Olgiati P, Pecorino B, Serretti A. Suicide ideation and male-female differences in major depressive disorder. Int J Psychiatry Clin Pract 2024; 28:53-62. [PMID: 38587055 DOI: 10.1080/13651501.2024.2335950] [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: 05/16/2023] [Accepted: 03/22/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE This study aimed to explore male-female differences in suicide ideation (SI) and suicide risk factors in major depressive disorder (MDD). METHODS We analysed 482 adults (sample 1) and 438 elderly outpatients (sample 2) with MDD. Sample 1 was treated with different antidepressant combinations (escitalopram; bupropion plus escitalopram; venlafaxine plus mirtazapine) and assessed by means of the Concise Health Risk Tracking (SI), Quick Inventory of Depressive Symptomatology, Altman Mania Rating Scale and Psychiatric Diagnostic Screening Questionnaire. Sample 2 was treated with venlafaxine and assessed using the Hamilton scale for depression, Anxiety Sensitivity Index and Penn State Worry Questionnaire for anxiety, Beck Scale for Suicide Ideation and Repeatable Battery for the Assessment of Neuropsychological Status. RESULTS In sample 1, females had greater depression severity (O.R 0.961 99%CI: 0.929 - 0.995), males reported more alcohol abuse (O.R 1.299 99%CI: 1.118 - 1.509) and active SI (O.R 1.109 99%CI: 1.005 - 1.255). In sample 2 men showed more severe SI (O.R 1.067; 99%CI: 1.014 - 1.122) and weight loss (OR = 5.89 99%CI: 1.01 - 34.19), women more gastrointestinal symptoms. CONCLUSIONS In these selected samples, although women had more severe depression, men had more suicide risk factors. Such differences might contribute to men's increased suicide risk.
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Affiliation(s)
- Paolo Olgiati
- Department of Sciences of Public Health and Paediatrics, University of Turin, Turin, Italy
- Mental Health Department, Azienda Sanitaria Locale TO4, Turin, Italy
| | - Basilio Pecorino
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, Kore University of Enna, Enna, Italy
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Medicine and Surgery, Kore University of Enna, Enna, Italy
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Raeber F, Haldemann MI, Ray S, Huber J, Firima E, Fernandez LG, Amstutz A, Gerber F, Labhardt ND, Belus JM. Community-based models of care for adolescent and adult depression, suicidal behavior, anxiety, trauma, and substance use in Africa: a scoping review. Front Psychol 2024; 15:1241403. [PMID: 38406302 PMCID: PMC10885163 DOI: 10.3389/fpsyg.2024.1241403] [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: 06/16/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
Background Community-based care (CBC), where care is delivered outside of the traditional health facility setting, has been proposed to narrow the mental health (MH) and substance use (SU) treatment gap in Africa. Objective This scoping review aims to comprehensively summarize CBC models addressing adolescent and adult MH (depression, anxiety, trauma, suicidal behavior) and (non-tobacco) SU problems in Africa. Methods We searched PsycINFO, Embase, Scopus, CINAHL, and Medline Ovid. Studies and protocols were included if they reported on CBC intervention's effects on MH or SU symptoms/ diagnoses, acceptability, feasibility, or patient engagement in care, regardless of whether the intervention itself was designed specifically for MH or SU. Results Among 11,477 screened publications, 217 were eligible. Of the unique intervention studies (n = 206), CBC models were classified into the following approaches (non-mutually exclusive): psychotherapeutic (n = 144), social (n = 81), lifestyle/physical health (n = 55), economic (n = 26), and psychopharmacological (n = 2). While quantitative results suggest possible efficacy of CBC models, description of CBC location was often poor. Fewer interventions addressed suicidal behavior (n = 12), the needs of adolescents (n = 49), or used traditional healers or religious figures as providers (n = 3). Conclusion Many CBC models have been tested on MH and SU in Africa and should be critically appraised and meta-analyzed in subsequent reviews, where possible.
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Affiliation(s)
- Fabian Raeber
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Maria-Inés Haldemann
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Somidha Ray
- Research Consultant, International Center for Research on Women, New Delhi, India
| | - Jacqueline Huber
- Swiss TPH Library, Swiss Tropical and Public Health Institute, Allschwil, Basel, Switzerland
| | - Emmanuel Firima
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Lucia Gonzalez Fernandez
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Alain Amstutz
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Felix Gerber
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
- Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Niklaus D. Labhardt
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
| | - Jennifer M. Belus
- Division of Clinical Epidemiology, Department of Clinical Research, University and University Hospital Basel, Basel, Switzerland
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Moreno X, Monsalves MJ, Rueda S, Dagnino P, Borghero F. Gender differences in life expectancy free of depressive symptoms in Chile between 2003 and 2016. Glob Ment Health (Camb) 2024; 11:e16. [PMID: 38390246 PMCID: PMC10882180 DOI: 10.1017/gmh.2024.9] [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: 08/12/2023] [Revised: 11/26/2023] [Accepted: 01/18/2024] [Indexed: 02/24/2024] Open
Abstract
The aim of the study was to analyze gender differences in life expectancy free of depressive symptoms among the adult population in Chile between 2003 and 2016. The Sullivan method was used to estimate the total and marginal life expectancy, based on prevalence data from the National Health Survey (2003, 2010 and 2016), and abridged life tables for the Chilean population. There was a compression of morbidity among middle-aged men during the first period and among younger and older women during the last one. Men at all ages could expect to live a higher proportion of their lives without depressive symptoms during the whole period. The gender gap in the proportion of life expectancy free of depressive symptoms reached 10 percent points or more, considering almost all ages and periods. Unemployment and lower education increased the probability of depressive symptoms, and these effects were more marked among women. Public policies should have a gender-sensitive approach to address the gap in depression and the disadvantage experienced by women in life expectancy free of depressive symptoms, considering those dimensions that intersect with gender, such as access to education, employment or income.
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Affiliation(s)
- Ximena Moreno
- Facultad de Psicología y Humanidades, Universidad San Sebastián, Santiago, Chile
| | | | - Sarahí Rueda
- Millennium Institute for Care Research (MICARE), Santiago, Chile
| | - Paula Dagnino
- Facultad de Psicología y Humanidades, Universidad San Sebastián, Santiago, Chile
- Millennium Institute for the Study of Personality and Depression (MIDAP), Santiago, Chile
| | - Francesca Borghero
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (IMHAY), Santiago, Chile
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Semaglutide and risk of suicidal ideations. Nat Med 2024; 30:45-46. [PMID: 38182786 DOI: 10.1038/s41591-023-02691-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
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Wang W, Volkow ND, Berger NA, Davis PB, Kaelber DC, Xu R. Association of semaglutide with risk of suicidal ideation in a real-world cohort. Nat Med 2024; 30:168-176. [PMID: 38182782 PMCID: PMC11034947 DOI: 10.1038/s41591-023-02672-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/30/2023] [Indexed: 01/07/2024]
Abstract
Concerns over reports of suicidal ideation associated with semaglutide treatment, a glucagon-like peptide 1 receptor (GLP1R) agonist medication for type 2 diabetes (T2DM) and obesity, has led to investigations by European regulatory agencies. In this retrospective cohort study of electronic health records from the TriNetX Analytics Network, we aimed to assess the associations of semaglutide with suicidal ideation compared to non-GLP1R agonist anti-obesity or anti-diabetes medications. The hazard ratios (HRs) and 95% confidence intervals (CIs) of incident and recurrent suicidal ideation were calculated for the 6-month follow-up by comparing propensity score-matched patient groups. The study population included 240,618 patients with overweight or obesity who were prescribed semaglutide or non-GLP1R agonist anti-obesity medications, with the findings replicated in 1,589,855 patients with T2DM. In patients with overweight or obesity (mean age 50.1 years, 72.6% female), semaglutide compared with non-GLP1R agonist anti-obesity medications was associated with lower risk for incident (HR = 0.27, 95% CI = 0.200.32-0.600.36) and recurrent (HR = 0.44, 95% CI = 0.32-0.60) suicidal ideation, consistent across sex, age and ethnicity stratification. Similar findings were replicated in patients with T2DM (mean age 57.5 years, 49.2% female). Our findings do not support higher risks of suicidal ideation with semaglutide compared with non-GLP1R agonist anti-obesity or anti-diabetes medications.
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Affiliation(s)
- William Wang
- Center for Science, Health, and Society, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nora D Volkow
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
| | - Nathan A Berger
- Center for Science, Health, and Society, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Pamela B Davis
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - David C Kaelber
- Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH, USA
| | - Rong Xu
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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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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Pavarin RM, Lia L, Tugnoli S, Caracciolo S. Suicide Attempts in an Italian Population with Cannabis Use Disorders: Results of a Follow-Up Study. J Psychoactive Drugs 2023:1-8. [PMID: 38009854 DOI: 10.1080/02791072.2023.2287674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
The relationship between cannabis use and suicidal behavior is complex, with no consensus in the literature. We used electronic health records of national health services to identify individuals who received a diagnosis of Cannabis Use Disorder in the Metropolitan area of Bologna from 2009 to 2019. In this cohort we identified accesses to Emergency Departments for suicide attempts from 2009 to 2019. The Crude Suicide Rate for 1,000 Person Years was 2.5, higher in females, in patients with Alcohol Use Disorders, with any psychiatric diagnosis, within one year from the first visit, and during the COVID-19 period. The risk was over 22 times higher than in the general population. Considering the high prevalence of cannabis use in the general population and the consequent risk of Cannabis Use Disorders, these data suggest the importance of a clinical evaluation for suicidal risk.
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Affiliation(s)
- Raimondo Maria Pavarin
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Italian Society of Substance Abuse (SITD), Local Health Unit of Bologna, Bologna, Italy
| | - Loredana Lia
- Mental Health DSM-DP, Azienda USL Bologna, Bologna, Italy
| | - Stefano Tugnoli
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Stefano Caracciolo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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24
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Kwon CY, Lee B. The effectiveness and safety of herbal medicine on suicidal behavior: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34796. [PMID: 37932986 PMCID: PMC10627649 DOI: 10.1097/md.0000000000034796] [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: 05/10/2023] [Accepted: 07/21/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Suicide is the leading cause of death worldwide. Herbal medicine (HM) has been reported to be related to clinical improvement of some risk factors for suicide including depression. This systematic review aimed to comprehensively investigate the effectiveness and safety of HM on suicidal behaviors. METHODS Fifteen electronic databases were searched to search relevant intervention studies, up to September 2022. The methodological quality of the included studies was assessed using the modified Cochrane risk-of-bias tool. In the included studies, outcome on suicidal behavior were analyzed, and the effect sizes were presented as mean differences (MDs) or risk ratios (RRs) with their 95% confidence intervals (CIs) through meta-analysis. The strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS A total of 13 randomized controlled trials (RCTs) were included in this review. Two RCTs of HM in patients with suicidal behavior found significant benefits of HM as an adjunct to fluoxetine or cognitive therapy in improving symptoms of depression. In 11 RCTs of HM in patients with other conditions, there was no statistically significant difference between HM and antidepressants in cognitive disturbance (MD, 0.12; 95% CIs, -0.20 to 0.45), a subscale of the Hamilton Rating Scale for Depression (HAMD), and suicidal ideation (0.18; -0.16 to 0.53), an item of HAMD. The overall quality of the included studies was poor. The strength of evidence assessed by GRADE was low or very low. CONCLUSIONS Though some of the studies reported significant benefits of HM in improving suicidal behavior in patients with depression, further clarification on some unsolved questions is needed in future well-designed clinical trials.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busanjin-gu, Busan, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Republic of Korea
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25
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Ramalle-Gómara E, Palacios-Castaño MI, Martínez-Ochoa E, Quiñones-Rubio C. Trends in suicide mortality in Spain from 1998 to 2021 and its relationship with the COVID-19 pandemic: A joinpoint regression analysis. Psychiatry Res 2023; 329:115520. [PMID: 37797441 DOI: 10.1016/j.psychres.2023.115520] [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: 07/11/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/07/2023]
Abstract
In the European Union, a rate of 11.9 cases per 100,000 was estimated in 2019.In Spain, suicide is the leading cause of external death. Social crises can have an impact on suicide rates. We analyzed changes in suicide mortality trends in Spain following the COVID-19 pandemic. We used statistical data from the National Institute of Statistics of Spain (1998-2021). We calculated age-specific rates, age and sex-adjusted rates, and analyzed trends and changes using joinpoint-regression models. Rates decrease in both sexes at the ages of 65 and older. In women, they increase in the ages of 1-29 years and 45-59 years. In men, they decrease in the ages of 15-39 years. Among women, age-adjusted rates remained stable between 1998 and 2021, with a non-significant annual decrease of 0.4 %. Among men, there was a significant annual decrease of 0.7 %. The years 2020 and 2021 had 8 % higher mortality compared to the two years prior to the COVID-19 pandemic. Suicide mortality in Spain slightly decreased among men and remained stable among women between 1998 and 2021, but there seems to be an increase following the COVID-19 pandemic.
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Affiliation(s)
- Enrique Ramalle-Gómara
- Epidemiology and Health Promotion Department, Directorate General of Public Health, Vara de Rey, 8, 26071 Logroño, La Rioja, Spain.
| | - María-Isabel Palacios-Castaño
- Epidemiology and Health Promotion Department, Directorate General of Public Health, Vara de Rey, 8, 26071 Logroño, La Rioja, Spain
| | - Eva Martínez-Ochoa
- Epidemiology and Health Promotion Department, Directorate General of Public Health, Vara de Rey, 8, 26071 Logroño, La Rioja, Spain
| | - Carmen Quiñones-Rubio
- Epidemiology and Health Promotion Department, Directorate General of Public Health, Vara de Rey, 8, 26071 Logroño, La Rioja, Spain
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Tsai SJ, Chang WH, Cheng CM, Liang CS, Bai YM, Hsu JW, Huang KL, Su TP, Chen TJ, Chen MH. All-cause mortality and suicide mortality in autistic individuals: An entire population longitudinal study in Taiwan. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2496-2506. [PMID: 37161269 DOI: 10.1177/13623613231167287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
LAY ABSTRACT Our study was the first population-based study in an Asian country to investigate the mortality rates among autistic individuals. Among the entire Taiwanese population (N = 29,253,529), between 2003 and 2017, 45,398 autistic individuals were identified and 1:4 age-/sex-matched to 181,592 non-autistic individuals. We found that autistic individuals had increased risks of all-cause mortality, natural-cause mortality, and suicide mortality compared with non-autistic individuals. Furthermore, autistic males were more likely to die by suicide, and autistic females were more likely to die of accident compared with the non-autistic individuals.
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Affiliation(s)
| | | | | | | | - Ya-Mei Bai
- Taipei Veterans General Hospital, Taiwan
| | - Ju-Wei Hsu
- Taipei Veterans General Hospital, Taiwan
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27
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Torales J, Barrios I, Tullo-Gómez JE, Melgarejo O, Gómez N, Riego V, Navarro R, García O, Figueredo P, Almirón-Santacruz J, Caycho-Rodríguez T, Castaldelli-Maia JM, Ventriglio A. Suicides among Children and Adolescents in Paraguay: An 18-year National Exploratory Study (2004-2022). Int J Soc Psychiatry 2023; 69:1649-1657. [PMID: 37092764 DOI: 10.1177/00207640231169656] [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: 04/25/2023]
Abstract
BACKGROUND Suicide and suicide attempts are impacting events for patients and their relatives, and these behaviors are still taboo among adults and may be even more traumatic when involving children and adolescents. AIM In this study we aimed to describe suicide rates among children and adolescents in Paraguay over the last decades as well as associated factors such as sociodemographic characteristics and methods used for suicide. METHODS This was an observational and exploratory study describing the frequency and characteristics of suicide among children and adolescents in Paraguay between 2004 and 2022. Official records of all deaths by suicide were reviewed, and statistical analyses were performed. In addition, an attempt was made to predict the number of suicides in the next 5 years using a mathematical model based on simple linear regression. RESULTS In the 18-year period observed, 940 suicides among children and adolescents were recorded. The mean age was 15.05 ± 1.8 years old. Of these, 51.17% were male, 74.6% were from urban areas, and 22.2% were from the Greater Asunción and Central Department of Paraguay. The most frequently used method of suicide was intentional self-inflicted injury by hanging, strangulation, or suffocation, which all represented 75.3% of the cases. Our mathematical modeling based on simple linear regression determined that the expected yearly number of national suicides in the pediatric population for the following years, from 2023 to 2027, will range between 72 and 81. CONCLUSION This study is the first large national epidemiological report on the emerging issue of suicide among children and adolescents in Paraguay. It may be a relevant source of information for mental health professionals, health authorities, and decision makers to develop national prevention strategies and actions against suicide among youths.
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Affiliation(s)
- Julio Torales
- Department of Child and Adolescent Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
- Department of Medical Psychology, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Iván Barrios
- Department of Statistics, School of Medical Sciences, National University of Asunción, Santa Rosa del Aguaray Campus, Santa Rosa del Aguaray, Paraguay
| | - Juan Edgar Tullo-Gómez
- General Directorate of Strategic Health Information, Ministry of Public Health and Social Welfare, Asunción, Paraguay
| | | | - Nora Gómez
- Department of Child and Adolescent Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Viviana Riego
- Department of Child and Adolescent Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Rodrigo Navarro
- Department of Child and Adolescent Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Oscar García
- Department of Child and Adolescent Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Pamela Figueredo
- Department of Child and Adolescent Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - José Almirón-Santacruz
- Department of Child and Adolescent Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | | | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Fundação do ABC., Santo André, SP, Brazil
- Department of Psychiatry, University of São Paulo. São Paulo, SP, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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28
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Matsumoto R, Motomura E, Okada M. Impacts of Complete Unemployment Rates Disaggregated by Reason and Duration on Suicide Mortality from 2009-2022 in Japan. Healthcare (Basel) 2023; 11:2806. [PMID: 37893880 PMCID: PMC10606519 DOI: 10.3390/healthcare11202806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/11/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023] Open
Abstract
In Japan, suicides had consistently decreased before the COVID-19 pandemic (from 2009-2019), but conversely increased after the pandemic outbreak (from 2020-2022). To identify the features of fluctuations of suicides in Japan, the standardized suicide mortality rates per 100,000 population (SMRP) disaggregated by gender (males/females) and age (10-year cohorts) from 2009-2022 were analyzed using interrupted time-series and joinpoint regression analyses. Temporal causalities from unemployment rate (CUR) disaggregated by unemployment duration and reasons for seeking work to SMRP were analyzed using vector autoregressive modelling with Granger causality analysis. SMRP fluctuations from 2009-2022 were composed of three patterns, such as positive discontinuity (increasing) synchronized with the pandemic outbreak, attenuations of decreasing trends before the pandemic, turning from decreasing before the pandemic to increasing/unchanging after the pandemic outbreak. Dismissal CUR positively related to SMRP of working-age generations, whereas voluntary CUR negatively related to SMRP of younger population (<30 years), which turned to persistently increasing before the pandemic (approximately 2016-2017). CUR shorter than 3 months positively related to SMRP of working-age females, which displayed promptly increasing synchronization with the pandemic outbreak. CUR longer than 12 months positively related to SMRP of working-age males, which contributed to persistently increasing SMRPs during the pandemic. These results suggest that increasing SMRP during 2020-2022 in Japan has been probably at-tributed to interactions among the pandemic-related factors, continuous vulnerabilities from before the pandemic and newly developing risk factors for suicides during the pandemic. Unexpectedly, increasing SMRPs of working-age males in 2022 suggest that either prolongation of the pandemic or the ending of the pandemic might positively affect suicides in Japan.
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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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29
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Rajguru AJ, Balhara YPS. Increasing trend of deaths due to suicide attributable to mental disorders and substance use (disorders) in India. Asian J Psychiatr 2023; 88:103722. [PMID: 37579548 DOI: 10.1016/j.ajp.2023.103722] [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: 06/26/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/16/2023]
Abstract
In this article we aim to assess the change in the deaths due to suicide attributable to mental disorders and substance use (disorders) in India over the past 26 years. We also aim to make projections over the coming years. For the deaths due to suicide attributable to mental disorders there was a biquadratic increasing trend with equations predicting 85.97%, 90.76% and 85.79% variance in the males, females and total deaths, respectively. There was a quadratic increase explaining 94.83% variance in males, 61.79% in females and 95.41% variance in deaths due to suicide attributable to substance use (disorders).
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Affiliation(s)
- Akanksha Jayant Rajguru
- National Drug Dependence Treatment Center and Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Yatan Pal Singh Balhara
- Behavioral Addictions Clinic (BAC), National Drug Dependence Treatment Center and Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
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30
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Thornton J, Tandon R. Does machine-learning-based prediction of suicide risk actually reduce rates of suicide: A critical examination. Asian J Psychiatr 2023; 88:103769. [PMID: 37741111 DOI: 10.1016/j.ajp.2023.103769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Affiliation(s)
- Joseph Thornton
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL 32608, USA.
| | - Rajiv Tandon
- Department of Psychiatry, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49048, USA
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31
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Kwon CY, Lee B. Prevalence of suicidal behavior in patients with chronic pain: a systematic review and meta-analysis of observational studies. Front Psychol 2023; 14:1217299. [PMID: 37842717 PMCID: PMC10576560 DOI: 10.3389/fpsyg.2023.1217299] [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: 05/09/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Objective Chronic pain is a leading cause of disability, severely impairing an individual's daily activity and quality of life. In addition, this condition may contribute to suicidal thoughts by leading to neuropsychological impairments, a perceived lack of meaning in life, and pain-related catastrophizing. This systematic review aimed to comprehensively investigate the prevalence and associated factors of suicidal behaviors (SBs) including suicidal ideation (SI) and suicide attempt (SA) or its complete, in individuals with chronic pain. Methods Five electronic databases were searched up to October 4, 2022. Only observational studies investigating the prevalence of SB in individuals with chronic pain were included. The methodological quality of the included studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. A meta-analysis was conducted to quantify the prevalence of SB in the population, and the command "Metaprop" was used in STATA/MP 16. In addition, factors explaining the association between chronic pain and SB identified through regression analysis were investigated. Results A total of 19 studies were included in this review (N = 3,312,343). The pooled lifetime prevalence of SI and SA was 28.90% (95% confidence interval, 17.95 to 41.26%) and 10.83% (5.72 to 17.30%), respectively, in a mixed sample comprising various chronic pain conditions. Importantly, the pooled prevalence of past 2-week SI was as high as 25.87% (18.09 to 34.50%). The methodological quality of the included studies was not optimal, and studies using validated SB assessment tools were lacking. Potential protective factors against SB in this population included pain coping and self-efficacy, older age, certain race/ethnicity groups, and marriage. Conclusion This systematic review and meta-analysis demonstrated the high prevalence of SB in individuals with chronic pain. Specifically, around 1 in 4 individuals with chronic pain had SI within the last 2 weeks. However, there was considerable heterogeneity in the pooled prevalence of SB in this population.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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32
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Sasaki T, Shinozaki M, Nemoto A, Nagao Y, Yasuda M, Shimoda K, Suda S, Yasui‐Furukori N. Effects of age on suicide attempts by medication in patients transferred to the emergency rooms of two advanced medical centers: A retrospective chart review of the DJ project. Neuropsychopharmacol Rep 2023; 43:453-456. [PMID: 37433639 PMCID: PMC10496036 DOI: 10.1002/npr2.12367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/22/2023] [Accepted: 06/25/2023] [Indexed: 07/13/2023] Open
Abstract
AIMS The means of suicide vary, but in cases of impaired consciousness, it is often difficult to determine the initial treatment because it is not known whether a patient has overdosed or used pesticides or poisons. Therefore, we investigated the clinical characteristics of suicide by medication in patients with suicide attempts who were brought to the emergency department, especially the influence of age. METHODS Patients with suicide attempts were transported to the two hospitals. There were 96 males (38.4%) and 154 females (61.6%). The mean age was 43.5 ± 20 years, and both males and females were most often in their 20s. Data on sex, age, motive for suicide, means of suicide attempt, psychiatric diagnosis, length of hospital stay, and place of discharge were retrospectively analyzed. RESULTS The average age of the patients by means of suicide attempt was 40.5 years for "prescription drugs," 30.2 years for "over-the-counter drugs," and 63.5 years for "pesticide/poison." For each means of suicide attempt, there was a significant difference in age among patients with suicide attempts using "prescription drugs," "over-the-counter drugs" and "pesticides/poisons." There was a statistical bias in the means and reasons for each suicide attempt. CONCLUSION The results showed that the age of patients who used over-the-counter medicines and pesticides and poisons varied significantly. It was thought that pesticide use should be considered first, especially when patients aged 50 years and over are brought to the hospital with impaired consciousness due to suicide attempts.
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Affiliation(s)
- Taro Sasaki
- Department of PsychiatryDokkyo Medical University School of MedicineMibuJapan
| | - Masataka Shinozaki
- Department of PsychiatryDokkyo Medical University School of MedicineMibuJapan
| | - Aki Nemoto
- Department of PsychiatryDokkyo Medical University School of MedicineMibuJapan
| | - Yukiko Nagao
- Department of PsychiatryJichi Medical UniversityShimotukeJapan
| | - Manabu Yasuda
- Department of PsychiatryJichi Medical UniversityShimotukeJapan
| | - Kazutaka Shimoda
- Department of PsychiatryDokkyo Medical University School of MedicineMibuJapan
| | - Shiro Suda
- Department of PsychiatryJichi Medical UniversityShimotukeJapan
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Park GWV, Cho SI. Monday peak is unique to suicide? Comparison of weekly distribution by causes of death using national representative cohort database. Suicide Life Threat Behav 2023; 53:613-627. [PMID: 37166224 DOI: 10.1111/sltb.12968] [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: 12/02/2022] [Revised: 03/16/2023] [Accepted: 04/15/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION The excess suicide mortality on Monday was reported in numerous studies. However, it is uncertain that the uneven weekly distribution of deaths is observed among suicide, or common among various causes of death. METHODS Weekly distributions of suicide and other causes of death from 2012 to 2017 in South Korea were compared. Logistic regression models were fitted to investigate the association between causes of death and day-of-the-week effects. We also fitted conditional logistic regression models after age and gender matching. RESULTS A total of 1,622,213 deaths, including 80,492 suicide decedents, were analyzed. A total of 16.0% of suicide deaths occurred on Monday, whereas 12.4% on Saturday and 13.0% on Sunday. Suicide decedents were more likely to die on Monday than other causes of deaths after controlling sociodemographic factors in unmatched data. However, there was no evidence of excess suicide deaths on Mondays than other days in contrast to matched death controls. CONCLUSION While the increase in mortality on Mondays was not unique to suicide, our findings have suicide prevention implications. Mental health practitioners should consider providing additional mental health resources on earlier working days. Workplace mental health programs to reduce psychological burdens of employees could help to prevent suicide during working days.
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Affiliation(s)
- Gun Woo Victor Park
- Division of Public Health, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Sung-Il Cho
- Division of Public Health, Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
- Institute for Health and Environment, Seoul National University, Seoul, South Korea
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34
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Bhatia G, Thapa P, Mathur R. The Top 100 Most Cited Publications on Suicide: A Citation Analysis. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231189642. [PMID: 37436419 DOI: 10.1177/00302228231189642] [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: 07/13/2023]
Abstract
Suicide is one of the leading causes of death globally and a matter of public health concern. Biomedical research on suicide has grown exponentially over the past few decades. Although numerous articles are published on suicide, only some exert significant influence in the evolution of scientific understanding. The number of citations a publication receives are a proxy marker of its impact on the field. Hence we aimed to analyze 100 top-cited articles on suicide till May, 2023, using Google scholar as the search database. These citation classics provide important insights into the historical development and trends in suicide research.
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Affiliation(s)
| | - Priyanka Thapa
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Mathur
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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35
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Schuerkamp R, Liang L, Rice KL, Giabbanelli PJ. Simulation Models for Suicide Prevention: A Survey of the State-of-the-Art. COMPUTERS (BASEL, SWITZERLAND) 2023; 12:10.3390/computers12070132. [PMID: 37869477 PMCID: PMC10588059 DOI: 10.3390/computers12070132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Suicide is a leading cause of death and a global public health problem, representing more than one in every 100 deaths in 2019. Modeling and Simulation (M&S) is widely used to address public health problems, and numerous simulation models have investigated the complex, dependent, and dynamic risk factors contributing to suicide. However, no review has been dedicated to these models, which prevents modelers from effectively learning from each other and raises the risk of redundant efforts. To guide the development of future models, in this paper we perform the first scoping review of simulation models for suicide prevention. Examining ten articles, we focus on three practical questions. First, which interventions are supported by previous models? We found that four groups of models collectively support 53 interventions. We examined these interventions through the lens of global recommendations for suicide prevention, highlighting future areas for model development. Second, what are the obstacles preventing model application? We noted the absence of cost effectiveness in all models reviewed, meaning that certain simulated interventions may be infeasible. Moreover, we found that most models do not account for different effects of suicide prevention interventions across demographic groups. Third, how much confidence can we place in the models? We evaluated models according to four best practices for simulation, leading to nuanced findings that, despite their current limitations, the current simulation models are powerful tools for understanding the complexity of suicide and evaluating suicide prevention interventions.
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Affiliation(s)
- Ryan Schuerkamp
- Department of Computer Science & Software Engineering, Miami University, Oxford, OH 45056, USA
| | - Luke Liang
- Department of Computer Science & Software Engineering, Miami University, Oxford, OH 45056, USA
| | - Ketra L. Rice
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30341, USA
| | - Philippe J. Giabbanelli
- Department of Computer Science & Software Engineering, Miami University, Oxford, OH 45056, USA
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Kwon CY, Lee B. The Effect of Herbal Medicine on Suicidal Behavior: A Protocol for Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:healthcare11101387. [PMID: 37239673 DOI: 10.3390/healthcare11101387] [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: 03/29/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Suicide is an important social and medical problem worldwide, including in countries that use traditional East Asian medicine (TEAM). Herbal medicine (HM) has been reported to be effective against several suicide-related conditions. This systematic review aimed to investigate the efficacy and safety of HM in reducing suicidal behavior including suicidal ideation, attempts, or completed suicide. We conduct a comprehensive search in 15 electronic bibliographic databases from inception to September 2022. All types of prospective clinical studies-including randomized controlled clinical trials (RCTs)-involving HM without or with routine care are included. The primary outcomes of this review are validated measures of suicidal ideation including the Beck scale for suicidal ideation. The revised Cochrane's risk of bias tool and other tools including the ROBANS-II tool are used to assess the methodological quality of RCTs and non-RCTs, respectively. A meta-analysis is performed using RevMan 5.4 in cases of homogeneous data from controlled studies. The results of the systematic review provide high-quality evidence to determine the efficacy and safety of HM for suicidal behavior. Our findings are informative for clinicians, policymakers, and researchers, aimed at reducing suicide rates, especially in countries that use TEAM.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Dong-Eui University, 52-57 Yangjeong-ro, Busanjin-gu, Busan 47227, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon 34054, Republic of Korea
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37
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Kwon CY, Lee B. The Effectiveness and Safety of Acupuncture on Suicidal Behavior: A Systematic Review. Healthcare (Basel) 2023; 11:healthcare11070955. [PMID: 37046882 PMCID: PMC10094566 DOI: 10.3390/healthcare11070955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/07/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
In situations where death by suicide is a major global issue and effective prevention and management approaches are lacking, acupuncture improves some risk factors for suicide, including depression, and it has been used for a long time in clinical settings. Herein, we aimed to assess the effectiveness and safety of acupuncture in the treatment of suicidal behaviors. Fourteen electronic databases were searched for studies published up to 7 September 2022. Original interventional studies of acupuncture in suicide prevention were included. The primary outcome was the validated measure of suicidal ideation. The risk of bias in the included studies was assessed using an appropriate assessment tool. Due to the heterogeneity of the included studies, only qualitative analyses were conducted. Eight studies on manual acupuncture (50%), electro-acupuncture (37.5%), and acupressure (12.5%) were included. In particular, three studies (37.5%) used the National Acupuncture Detoxification Association protocol to stimulate the bilateral sympathetic, Shenmen, kidney, liver, and lung auricular points. Acupuncture was effective in direct and indirect outcomes related to suicidal behavior, not only for participants with suicidal behavior, but also for those with other conditions, including depression. A decrease in salivary cortisol was the only biological indicator of acupuncture in patients with suicidal ideation. However, the methodological quality of the included studies was not optimal. In conclusion, acupuncture may reduce the risk of suicidal behavior in clinical and non-clinical populations. Owing to clinical heterogeneity, low methodological quality, and the small number of included studies, further high-quality studies should assess the effectiveness of acupuncture.
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Kasal A, Táborská R, Juríková L, Grabenhofer-Eggerth A, Pichler M, Gruber B, Tomášková H, Niederkrotenthaler T. Facilitators and barriers to implementation of suicide prevention interventions: Scoping review. Glob Ment Health (Camb) 2023; 10:e15. [PMID: 37854412 PMCID: PMC10579684 DOI: 10.1017/gmh.2023.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/12/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023] Open
Abstract
We know that suicide is preventable, yet hundreds of thousands of people still die due to suicide every year. Many interventions were proven to be effective, and dozens of others showed promising results. However, translating these interventions into new settings brings several challenges. One of the crucial obstacles to success is not anticipating possible barriers to implementation nor enhancing possible benefits of factors facilitating the implementation. While we witnessed great support for suicide prevention activities globally in the past years, implementation barriers and facilitating factors are yet to be comprehensively mapped to help implementation activities worldwide. This scoping review maps current knowledge on facilitators and barriers to the implementation of suicide prevention interventions while using the Consolidated Framework for Implementation Research (CFIR) for classification. We included 64 studies. Barriers and facilitators were most commonly identified in the outer setting CFIR domain, namely in the sub-domain of patient needs and resources, which refers to the way in which these needs and resources are reflected by the reviewed interventions. The second most saturated CFIR domain for facilitators was intervention characteristics, where relative advantage, adaptability and cost of intervention sub-domains were equally represented. These sub-domains refer mostly to how the intervention is perceived by key stakeholders, to what extent it can be tailored to the implementation context and how much it costs. While intervention characteristics domain was the second most common also for barriers, the complexity sub-domain referring to high perceived difficulty of implementation was the most frequently represented. With reference to the results, we recommend adapting interventions to the needs of the target groups. Furthermore, carefully selecting the intervention to suit the target context concerning their adaptability, costs and complexity is vital for a successful implementation. Further implications for practice and research are discussed.
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Affiliation(s)
- Alexandr Kasal
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Social Sciences, Charles University, Prague, Czech Republic
| | - Roksana Táborská
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
| | - Laura Juríková
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | | | - Michaela Pichler
- Department of Psychosocial Health, Gesundheit Österreich GmbH, Wien, Austria
| | - Beate Gruber
- Department of Psychosocial Health, Gesundheit Österreich GmbH, Wien, Austria
| | - Hana Tomášková
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
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Olgiati P, Fanelli G, Serretti A. Clinical correlates and prognostic implications of severe suicidal ideation in major depressive disorder. Int Clin Psychopharmacol 2023:00004850-990000000-00051. [PMID: 36853754 DOI: 10.1097/yic.0000000000000461] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Suicidal ideation (SI) is a risk factor for suicidal behaviour. To ascertain the clinical correlates and prognostic impact of severe SI, we analysed 249 outpatients with major depressive disorder (MDD) and suicidal thoughts included in the COmbining Medications to Enhance Depression outcome (CO-MED) trial. Patients with severe SI (36%) were younger at disease onset (P = 0.0033), more severely depressed (P = 0.0029), had more lifetime suicidal behaviour (P < 0.0001) and psychiatric comorbidities (panic disorder: P = 0.0025; post-traumatic stress disorder: P = 0.0216), and a history of childhood maltreatment (neglect: P = 0.0054; emotional abuse: P = 0.0230; physical abuse: P = 0.0076; sexual abuse: P = 0.0016) than those experiencing low-moderate SI. After controlling for depression score, severe SI was positively correlated with lifetime suicidal behaviour (OR [95% CI]: 1.26 [1.12-1.41]), panic disorder (1.05 [1.00-1.12]), and childhood maltreatment (neglect: 1.93 [1.13-3.30]; physical abuse: 2.00 [1.11-3.69]; sexual abuse: 2.13 [1.17-3.88]), and inversely correlated with age of onset (0.97 [0.95-0.99]) and sleep-onset insomnia (0.76 [0.61-0.96]). Finally, the occurrence of serious lifetime suicidal behaviour was predicted by SI severity (2.18 [1.11-4.27]), bipolar score (1.36 [1.02-1.81]), and childhood sexual abuse (2.35 [1.09-5.05]). These results emphasise the importance of assessing childhood maltreatment and bipolar liability in MDD to estimate suicidal behaviour risk.
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Affiliation(s)
- Paolo Olgiati
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Castillo-Avila RG, Genis-Mendoza AD, Juárez-Rojop IE, López-Narváez ML, Dionisio-García DM, Nolasco-Rosales GA, Ramos-Méndez MÁ, Hernández-Díaz Y, Tovilla-Zárate CA, González-Castro TB, Nicolini H. High Serum Levels of IL-6 Are Associated with Suicide Attempt but Not with High Lethality Suicide Attempts: A Preliminary Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14735. [PMID: 36429454 PMCID: PMC9690459 DOI: 10.3390/ijerph192214735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Suicide attempts are an emerging health problem around the world. Increased levels of IL-6 have been associated with suicidal behavior. Therefore, the aims of this study were to evaluate the serum levels of IL-6 in individuals with suicide attempts and a comparison group and to associate the IL-6 levels with the lethality of the suicide attempt. Additionally, we associated the rs2228145 polymorphism of the IL6R gene with suicide attempts or with the IL-6 serum levels. Suicide attempts and their lethality were evaluated using the Columbia Suicide Severity Rating Scale. The serum concentrations of IL-6 were measured by the ELISA technique in individuals with suicide attempts and then compared to a control group. The rs2228145 polymorphism of the IL6R gene was analyzed by real-time polymerase chain reaction. We found elevated serum levels of IL-6 in the suicide attempt group when compared to the control group (F = 10.37, p = 0.002). However, we found no differences of the IL-6 levels between high and low lethality. The IL6R gene polymorphism rs2479409 was not associated with suicide attempts. Our data suggest that IL-6 serum is increased in individuals with suicide attempts.
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Affiliation(s)
| | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de Mexico 14610, Mexico
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Mexico
| | - María Lilia López-Narváez
- Hospital Chiapas Nos Une “Dr. Gilberto Gómez Maza”, Secretaría de Salud, Tuxtla Gutierrez 29045, Mexico
| | - Diana María Dionisio-García
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Mexico
| | | | - Miguel Ángel Ramos-Méndez
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Mexico
| | - Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Mendez 86040, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86040, Mexico
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Mendez 86040, Mexico
| | - Humberto Nicolini
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de Mexico 14610, Mexico
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