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Welty CW, Bingham L, Morales M, Gerald LB, Ellingson KD, Haynes PL. School Connectedness and Suicide Among High School Youth: A Systematic Review. J Sch Health 2024; 94:469-480. [PMID: 38383772 DOI: 10.1111/josh.13445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Suicide is a leading cause of death for adolescents, and school connectedness is a potential, modifiable protective factor for suicide. We sought to examine if school connectedness protected against suicide among high school students and if potential moderators affected the relationship between school connectedness and suicide. METHODS We searched online databases (PubMed, EMBASE, CINAHL, and PsycINFO) on December 12, 2021, for studies that examined the effects of school connectedness on suicide among high school students. RESULTS This systematic review identified 34 studies that examined the effects of school connectedness on adolescent suicidality. Results indicated mixed findings of school connectedness on suicidality. Among studies that assessed a suicide ideation outcome, 73.3% found that school connectedness protected against suicide. Among studies that assessed a suicide attempts outcome, 50% found that school connectedness protected against suicide. Most included studies did not control for notable variables in their final models, such as sleep, impulsivity, substance use, or depression. No studies examined moderators of school connectedness and suicide. CONCLUSIONS School connectedness is somewhat protective of suicidality, and more protective of suicidal ideation than suicide attempts. Researchers should examine the construct of school connectedness among modern youth to better understand school connectedness and suicide.
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Affiliation(s)
- Cody W Welty
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Lindsay Bingham
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Mario Morales
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Lynn B Gerald
- Office of Population Health Sciences, University of Illinois Chicago, 1220 S. Wood Street (MC 619), Chicago, 60608, IL
| | - Katherine D Ellingson
- Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
| | - Patricia L Haynes
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave. Drachman Hall, Tucson, 85724, AZ
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Bozsonyi K, Lester D, Zonda T, Bálint L, Veres E. A Population-Level Study Concerning the Assumed Association Between Suicide Rates and Antidepressant Consumption in Hungary. Omega (Westport) 2024; 89:122-137. [PMID: 35094585 DOI: 10.1177/00302228211067031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND It has been claimed that the advent of modern antidepressants has reduced the suicide rate. AIMS To examine the correlation between the suicide rate and the prescription of antidepressants. METHOD A dynamic regression was employed to analyze a 73-month-long, monthly time series between 2010 and 2016 in Hungary. The independent variable was the Defined Daily Dose value for the number of antidepressant (AD) prescriptions filled each month. RESULTS The models failed to show a significant association between the prescription of antidepressants and age- and sex-specific monthly suicide rates. CONCLUSIONS The prescription of antidepressants in Hungary has had no impact on suicide rates.
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Affiliation(s)
| | | | - Tamás Zonda
- Hungarian Association for Suicide Prevention, Budapest, Hungary
| | - Lajos Bálint
- Népességtudományi Kutatóinézet, Budapest, Hungary
| | - Előd Veres
- Országos Kórházi Főigazgatóság, Budapest, Hungary
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3
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Lamontagne SJ, Gilbert JR, Zabala PK, Waldman LR, Zarate CA, Ballard ED. Clinical, behavioral, and electrophysiological profiles along a continuum of suicide risk: evidence from an implicit association task. Psychol Med 2024; 54:1431-1440. [PMID: 37997749 DOI: 10.1017/s0033291723003331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND An urgent need exists to identify neural correlates associated with differing levels of suicide risk and develop novel, rapid-acting therapeutics to modulate activity within these neural networks. METHODS Electrophysiological correlates of suicide were evaluated using magnetoencephalography (MEG) in 75 adults with differing levels of suicide risk. During MEG scanning, participants completed a modified Life-Death Implicit Association Task. MEG data were source-localized in the gamma (30-58 Hz) frequency, a proxy measure of excitation-inhibition balance. Dynamic causal modeling was used to evaluate differences in connectivity estimates between risk groups. A proof-of-concept, open-label, pilot study of five high risk participants examined changes in gamma power after administration of ketamine (0.5 mg/kg), an NMDAR antagonist with rapid anti-suicide ideation effects. RESULTS Implicit self-associations with death were stronger in the highest suicide risk group relative to all other groups, which did not differ from each other. Higher gamma power for self-death compared to self-life associations was found in the orbitofrontal cortex for the highest risk group and the insula and posterior cingulate cortex for the lowest risk group. Connectivity estimates between these regions differentiated the highest risk group from the full sample. Implicit associations with death were not affected by ketamine, but enhanced gamma power was found for self-death associations in the left insula post-ketamine compared to baseline. CONCLUSIONS Differential implicit cognitive processing of life and death appears to be linked to suicide risk, highlighting the need for objective measures of suicidal states. Pharmacotherapies that modulate gamma activity, particularly in the insula, may help mitigate risk.Clinicaltrials.gov identifier: NCT02543983, NCT00397111.
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Affiliation(s)
- Steven J Lamontagne
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Jessica R Gilbert
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Paloma K Zabala
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Laura R Waldman
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Elizabeth D Ballard
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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Hawke LD, Bastidas-Bilbao H, Cappe V, van Kesteren MR, Stewart DE, Gupta M, Simpson AIF, Campbell BH, Castle D, Stergiopoulos V. Medical Assistance in Dying for Mental Illness as a Sole Underlying Medical Condition and Its Relationship to Suicide: A Qualitative Lived Experience-Engaged Study: Aide Médicale à Mourir Pour Maladie Mentale Comme Seule Condition Médicale Sous-Jacente et Son Lien Avec le Suicide: Une Etude Qualitative Engagée Dans l'Expérience Vécue. Can J Psychiatry 2024; 69:314-325. [PMID: 37885204 PMCID: PMC11032095 DOI: 10.1177/07067437231209658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
OBJECTIVE This lived experience-engaged study aims to understand patient and family perspectives on the relationship between suicidality and medical assistance in dying when the sole underlying medical condition is mental illness (MAiD MI-SUMC). METHOD Thirty individuals with mental illness (age M = 41.8 years, SD = 14.2) and 25 family members (age M = 47.5 years, SD = 16.0) participated in qualitative interviews examining perspectives on MAiD MI-SUMC and its relationship with suicide. Audio recordings were transcribed and analysed using reflexive thematic analysis. People with lived experience were engaged in the research process as team members. RESULTS Four main themes were developed, which were consistent across individuals with mental illness and family members: (a) deciding to die is an individual choice to end the ongoing intolerable suffering of people with mental illness; (b) MAiD MI-SUMC is the same as suicide because the end result is death, although suicide can be more impulsive; (c) MAiD MI-SUMC is a humane, dignified, safe, nonstigmatized alternative to suicide; and (4) suicidality should be considered when MAiD MI-SUMC is requested, but suicidality's role is multifaceted given its diverse manifestations. CONCLUSION For patient-oriented mental health policy and treatment, it is critical that the voices of people with lived experience be heard on the issue of MAiD MI-SUMC. Given the important intersections between MAiD MI-SUMC and suicidality and the context of suicide prevention, the role that suicidality should play in MAiD MI-SUMC is multifaceted. Future research and policy development are required to ensure that patient and family perspectives guide the development and implementation of MAiD MI-SUMC policy and practice.
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Affiliation(s)
- Lisa D. Hawke
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Vivien Cappe
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Donna E. Stewart
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
| | - Mona Gupta
- Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Alexander I. F. Simpson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - David Castle
- Department of Psychiatry, University of Tasmania, Hobart, Tasmania, Australia
- Statewide Mental Health Service, Hobart, Tasmania, Australia
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Zhang J, Lew B, Liu Y, Chistopolskaya K, Zhao S. Religion, Psychological Strain, and Suicidality in China: A Preliminary Study. Omega (Westport) 2024; 89:275-291. [PMID: 35098786 DOI: 10.1177/00302228211072985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND There is a lack of religiosity studies in China especially in relation to mental health and suicidality. In this research, we focus our studies on medical workers of which some studies reported to have higher stress, and to pilot our studies in this adult age-group. DATA AND METHODOLOGY Data were obtained by a questionnaire survey in a large public hospital in a big metropolitan city of China. The final sample consisted of 1012 respondents with 237 (23.4%) being male and 775 (76.6%) being female. The respondents were of three groups: (1) Believers (n = 34; 3.5%); (2) Non-Believers or Atheists (n = 547; 55.8%); and (3) Agnostics or Fence-Sitters (n = 400; 40.8%). Suicidality was measured by the NCS-Suicidality Scale, and standard measures were employed for other major variables. FINDINGS In line with other recent studies in China, the religion rate among the urban adults remained low (3.5%). However, about 40.8% of the respondents chose "don't know" and could be fence-sitters on the issue of religious belief. Many of them are involved in various folk beliefs which may not be considered as religious. The religious believers were at higher risk of suicidality and depression than the atheists and the fence-sitters. However, the fence-sitters were higher than the believers and atheists on psychological strains, and they were higher on depression compared to the atheists. CONCLUSION The religious believers and religious fence-sitters have higher psychopathologic risks and suicidal risk than the atheist group. Religion as of low prevalence in Chinese societies is a social value deviant from the norm and its practitioners are likely to be marginalized or stigmatized. The Strain Theory of Suicide is used for detailed explanations.
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Affiliation(s)
- Jie Zhang
- Central University of Finance and Economics Department of Sociology, Beijing, China
- State University of New York Buffalo State, New York, NY, USA
| | - Bob Lew
- Department of Social Psychology, Putra University of Malaysia, Kuala Lumpur, Malaysia
| | - Yanzheng Liu
- Shandong University Center for Suicide Prevention Research, Shandong University, Shandong, China
| | - Ksenia Chistopolskaya
- Branch of the Federal State Institution "Federal Medical Research Centre of Psychiatry and Narcology" of the Ministry of Health of the Russian Federation, Moscow Research Institute of Psychiatry, Moscow, Russia
| | - Sibo Zhao
- Central University of Finance and Economics Department of Sociology, Beijing, China
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Palbo A, Roed Rasmussen ML, Hansen MS, Subhi Y. Association between visual impairment and suicide: A systematic review and meta-analysis. Acta Ophthalmol 2024; 102:263-273. [PMID: 37395145 DOI: 10.1111/aos.15730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/31/2023] [Accepted: 06/20/2023] [Indexed: 07/04/2023]
Abstract
Visual impairment severely impacts the life of the patients. In this study, we systematically reviewed studies on the potential relationship between visual impairment and suicidal behaviour, and conducted meta-analyses on the risk estimates. We searched 11 literature databases on 20 October 2022 and identified a total of 10 eligible studies with 5.8 million participants. Suicide behaviour was investigated according to three domains: suicide ideation, suicide attempt and suicide death. In the 10 eligible studies, seven reported data on suicide ideation, five reported data on suicide attempt, and three reported data on suicide death. All summary estimates extracted for use in the meta-analyses were adjusted estimates of association since we acknowledged that depression as well as other confounding factors may play an important role. We found that visual impairment was a significant risk factor of suicide ideation (OR 1.83; 95% CI: 1.40-2.40; p = 0.000012), suicide attempt (OR 2.62; 95% CI: 1.29-5.31; p = 0.0077) and suicide death (OR 7.00; 95% CI: 2.30-21.4; p = 0.000063). These high increases in risk of suicide from visual impairment underscore the importance of eye health on the overall mental health, and the potential devastating consequences of insufficient access to eye care, lack of treatment possibilities for any reason or low political priority of eye care.
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Affiliation(s)
- Amanda Palbo
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
| | - Marie Louise Roed Rasmussen
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Michael Stormly Hansen
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Yousif Subhi
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Shepard LD, Campbell KA, Byrne KA, Thorn B, Keeshin BR. Screening for and Responding to Suicidality Among Youth Presenting to a Children's Advocacy Center (CAC). Child Maltreat 2024; 29:272-282. [PMID: 36927222 DOI: 10.1177/10775595231163592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Youth presenting to a Children's Advocacy Center (CAC) for a forensic interview are at increased risk for suicidality, but no data exist for suicidality or suicide screening and response at the time of the forensic interview. The current study applied a suicide and traumatic stress screening and response protocol, the Care Process Model for Pediatric Traumatic Stress (CPM-PTS), with youth (11-18 years) presenting for a forensic interview to one of 16 participating CAC locations, 2018-2020.46.2% of youth screened for traumatic stress and suicidality (N = 1651) endorsed thoughts of suicide or self-harm in the past two weeks, and 13.6% were assessed as high risk for suicide. High symptoms of traumatic stress increased the risk of suicidal thinking as well as of high risk suicidality. CAC workers, both clinicians and non-clinicians, facilitated screening and provided prevention response. Suicide screening and response at the CAC at the time of the forensic interview appears important and feasible.
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Affiliation(s)
- Lindsay D Shepard
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Kristine A Campbell
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Kara A Byrne
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Brian Thorn
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Brooks R Keeshin
- School of Medicine, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
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8
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Bolstad CJ, Cui R, Fiske A, Nadorff MR. Age Moderates the Relation between Sleep Problems and Suicide Risk. Clin Gerontol 2024; 47:408-415. [PMID: 35209805 DOI: 10.1080/07317115.2022.2044951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This cross-sectional study examined whether age moderates the relation between sleep problems and suicide risk and investigated whether sleep problems are differentially associated with suicide risk in younger (18-40) and older (60+) adults. METHODS MTurk workers (N = 733) completed the Pittsburgh Sleep Quality Index, Suicidal Behavior Questionnaire-Revised, Patient Health Questionnaire, and demographic questions. Analysis of variance and linear regressions were utilized. RESULTS Older adults scored lower on four PSQI components, symptoms of depression, and suicide risk than younger adults. Age significantly moderated the relation between sleep problems and suicide risk after controlling for gender and depressive symptoms, F(5, 635) = 72.38, p < .001. Sleep problems significantly related to suicide risk in younger adults (t = 6.47, p < .001) but not in older adults (t = 0.57, p = .57). Sleep medication use was related to suicide risk in both groups, whereas daytime dysfunction was related to suicide risk in older adults and sleep disturbances were related to suicide risk in younger adults. CONCLUSIONS The relation between sleep problems and suicide risk differs between younger and older adults. This study adds to the literature suggesting that sleep medications may not be appropriate for older adults. CLINICAL IMPLICATIONS Sleep problems are significantly related to suicide risk in younger adults but not older adults. Sleep medication use is associated with suicide risk regardless of age.
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Affiliation(s)
- Courtney J Bolstad
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi, USA
| | - Ruifeng Cui
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Amy Fiske
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
- Injury Control Research Center, West Virginia University, Morgantown, West Virginia, USA
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
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Sinyor M, Ekstein D, Prabaharan N, Fiksenbaum L, Vandermeer C, Schaffer A, Pirkis J, Heisel MJ, Goldstein BI, Redelmeier DA, Taylor P, Niederkrotenthaler T. Changes in Media Reporting Quality and Suicides Following National Media Engagement on Responsible Reporting of Suicide in Canada: Changements de la Qualité des reportages dans les médias sur les suicides suite à l'engagement des médias nationaux à la déclaration responsable du suicide au Canada. Can J Psychiatry 2024; 69:358-368. [PMID: 38174363 PMCID: PMC11032096 DOI: 10.1177/07067437231223334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
OBJECTIVE Responsible media reporting is an accepted strategy for preventing suicide. In 2015, suicide prevention experts launched a media engagement initiative aimed at improving suicide-related reporting in Canada; its impact on media reporting quality and suicide deaths is unknown. METHOD This pre-post observational study examined changes in reporting characteristics in a random sample of suicide-related articles from major publications in the Greater Toronto Area (GTA) media market. Articles (n = 900) included 450 from the 6-year periods prior to and after the initiative began. We also examined changes in suicide counts in the GTA between these epochs. We used chi-square tests to analyse changes in reporting characteristics and time-series analyses to identify changes in suicide counts. Secondary outcomes focused on guidelines developed by media professionals in Canada and how they may have influenced media reporting quality as well as on the overarching narrative of media articles during the most recent years of available data. RESULTS Across-the-board improvement was observed in suicide-related reporting with substantial reductions in many elements of putatively harmful content and substantial increases in all aspects of putatively protective content. However, overarching article narratives remained potentially harmful with 55.2% of articles telling the story of someone's death and 20.8% presenting an other negative message. Only 3.6% of articles told a story of survival. After controlling for potential confounders, a nonsignificant numeric decrease in suicide counts was identified after initiative implementation (ω = -5.41, SE = 3.43, t = 1.58, p = 0.12). CONCLUSIONS We found evidence that a strategy to engage media in Canada changed the content of reporting, but there was only a nonsignificant trend towards fewer suicides. A more fundamental change in media narratives to focus on survival rather than death appears warranted.
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Affiliation(s)
- Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Daniella Ekstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Nivetha Prabaharan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | | | - Caroline Vandermeer
- Viterbi School of Engineering, University of Southern California, Los Angeles, USA
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Marnin J. Heisel
- Department of Psychiatry, The University of Western Ontario, London, Canada
| | - Benjamin I. Goldstein
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Centre for Youth Bipolar Disorder, Center for Addiction and Mental Health, Toronto, Canada
| | - Donald A. Redelmeier
- Institute for Clinical Evaluative Sciences, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Paul Taylor
- Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Thomas Niederkrotenthaler
- Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
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Abstract
Joiner and colleagues' Interpersonal Theory of Suicide (IPTS), a prominent "desire-capability" model of suicide-based on the common-sense idea that people take their own lives because they want to, and can-is critiqued from a biological perspective. Tinbergen's ethological "four questions" guide the analysis: evolution, survival value, ontogeny, and proximate causation, each addressing a different aspect of biological understanding. Problems for IPTS emerge with all four. As a parsimonious solution, the desire-capability hypothesis is reconceived as an ultimate, instead of proximate, mode of explanation. By this light, desire and capability for suicide combined in our species' ancestral past, thus making suicide a recurrent survival threat, and driving the evolution of special-purpose defensive adaptations. This stance tallies with the pain-brain theory of the evolution of suicide, and with Joiner and colleagues' own investigation into organismic anti-suicide defenses, which appears to conflict conceptually with IPTS. These defenses' evolved algorithm may make suicide an intrinsically aleatory phenomenon, opaque to usefully accurate prediction. Positive implications for prevention and research are proposed.
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Quarshie ENB, Oppong Asante K, Andoh-Arthur J, Akotia CS, Osafo J. To Keep the Law or to Repeal It: Views of Parliamentarians On the Call to Decriminalise Attempted Suicide in Ghana. Omega (Westport) 2024; 89:39-56. [PMID: 34967674 PMCID: PMC11017692 DOI: 10.1177/00302228211066683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We explored the views of members of parliament (MPs) in Ghana on the call to decriminalise attempted suicide. We applied reflexive thematic analysis to Parliamentary Hansards (2017-2020) on calls to decriminalise attempted suicide in Ghana. 11 MPs shared their stance for or against the call. We developed three major themes that entailed, often, opposing views: (1) deterrent effect of the law (against: the law punishes and deters to protect life; for: the law is insensitive and has ironic effects), (2) enforcement of the law (against: leave things as they are, the law is not enforced, anyway; for: crime is not self-inflicted) and (3) prioritisation of suicide prevention (against: focus on more pressing issues, but resource support systems; for: the law and legitimate support systems cannot co-exist). The findings indicate two needs: to extend suicide literacy to Ghanaian MPs, and to initiate a public/private member's bill on attempted suicide decriminalisation.
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Affiliation(s)
- Emmanuel Nii-Boye Quarshie
- School of Psychology, University of Leeds, Leeds, UK
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
| | - Johnny Andoh-Arthur
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
| | - Charity Sylvia Akotia
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana
- Centre for Suicide and Violence Research, Accra, Ghana
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12
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Snowdon J. Recognising inaccuracies in Australian suicide and 'hidden suicide' data. Australas Psychiatry 2024:10398562241245548. [PMID: 38653498 DOI: 10.1177/10398562241245548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To examine the effects of revision of Australian mortality statistics every year since 2007 on numbers and rates of suicide and 'hidden suicide'. METHOD Nine months after the end of each year, the Australian Bureau of Statistics releases preliminary statistics concerning deaths registered in that year, together with revised and finalised data regarding previous years. Numbers and rates of suicide and of deaths coded to selected categories of accidental, undetermined and unknown cause deaths were tabled. RESULTS Upward revision of suicide and accidental drug poisoning death numbers, three years after first release, show that true rates are substantially higher than initially released data suggested. Concomitant downward revision of rates of undetermined and unknown cause deaths supports evidence that at first release some suicides are coded to these categories. CONCLUSIONS Australia's finalised suicide data are likely to be more accurate than equivalent data from nations that do not revise mortality data. More comprehensive investigation (including verbal or psychological autopsy) in doubtful cases in Australia and elsewhere would probably lead to reported suicide rates being higher.
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Affiliation(s)
- John Snowdon
- Department of Psychogeriatrics, Concord Repatriation General Hospital, Concord, NSW, Australia; and
- Speciality of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Waitz-Kudla SN, Brydon C, Alvarez J, Branham J, Witte TK. Suicidality in Veterinarians: Trends at Different Career Stages and a Test of the Interpersonal Theory of Suicide. Arch Suicide Res 2024:1-17. [PMID: 38651894 DOI: 10.1080/13811118.2024.2343741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVE The aim of this study was to investigate sex differences in suicide ideation and attempt at different career stages and test hypotheses derived from the Interpersonal Theory of Suicide (IPTS) in a sample of veterinarians. METHOD The sample of currently practicing veterinarians used for this study (N = 10,319) was derived from a larger sample. Participants completed an online self-report questionnaire. RESULTS As predicted, women generally had a higher prevalence of suicide ideation and attempt across career stages, except men and women showed similar rates of suicide attempt after veterinary school. Contrary to hypotheses, no interaction effects between IPTS variables were observed. However, perceived burdensomeness, thwarted belongingness, and hopelessness exhibited the main effects of suicide ideation, and there were main effects of perceived burdensomeness and hopelessness on suicide attempt. Compared with perceived burdensomeness and thwarted belongingness, hopelessness had a relatively more robust relationship with suicide ideation. We also found a significant relationship between fearlessness about death and suicide attempt, but no relationship between self-reported pain tolerance and suicide attempt. CONCLUSIONS Some of our findings were consistent with the IPTS while others were not. Future research would benefit from a longitudinal examination of suicidality in veterinarians.
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Kursner S, Studer J, Fracasso T, Weber G, Michaud L. The Impact of the COVID-19 Pandemic on Unassisted Suicide and Assisted Suicide Rates in French-Speaking Switzerland: Differences by Gender. Omega (Westport) 2024:302228241248683. [PMID: 38652705 DOI: 10.1177/00302228241248683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Aims: Most studies on the impact of COVID-19 have shown a decrease or no change in unassisted suicide rates, but effects on assisted suicide have not been studied. We aimed to estimate the association between the COVID-19 pandemic and both types of suicide. Methods: Between 2017 and 2021, 1280 assisted suicides and 535 unassisted suicides were recorded in three Swiss cantons. We conducted descriptive and time series analyses on monthly suicide rates, categorized by gender. Results: Among women, a decrease in assisted suicide rates was found during the acute phases of the pandemic. Among men, assisted suicide rates increased gradually from the onset of the pandemic. Regarding unassisted suicide rates, no significant change was observed in women, while in men, there was a decrease, which was larger at the end than at the onset. Conclusions: COVID-19 had contrasting effects on assisted and unassisted men and women suicide rates.
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Affiliation(s)
- Sarah Kursner
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Joseph Studer
- Addiction Medicine and North-West Adult Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Tony Fracasso
- University Center of Legal Medicine, Lausanne, Switzerland
| | - Gerrit Weber
- North-West Adult Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Laurent Michaud
- Liaison Psychiatry Service, Department of Psychiatry, Lausanne University Hospitaland University of Lausanne, Lausanne, Switzerland
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Agudelo-Hernández F, Giraldo Alvarez A, Rojas-Andrade R. Support Groups Versus Primary Mental Healthcare on Disability and Continuity of Care: Community Trial [Support Groups for Recovery]. Psychol Rep 2024:332941241248595. [PMID: 38648517 DOI: 10.1177/00332941241248595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Based on the need to implement strategies to reduce recovery gaps in mental health with the community as axes of recovery, the objective of the present study was to assess the impact on psychosocial disability and care continuity in individuals with suicidal behavior, of the clinical and community components of the Mental Health Gap Action Program (mhGAP), versus exclusive psychiatric care. For this, a controlled community trial carried out in 2023 was conducted, comprising intervention groups: Support Group (SG), mhGAP Group (mhGAPG) and a Control Group (CG). Self-report measurements were collected pretest and posttest, utilizing the Psychosocial Disability Scale and the Alberta Continuity of Care Scale. The study involved the participation of 94 individuals with a history of suicidal behavior, with 30 individuals in the SG, 34 in the mhGAP group, and 30 in the CG. Categorical variables were summarized using frequency distribution tables. Descriptive statistics were used to examine participants' characteristics at the study outcome and estimate treatment compliance. The Mann-Whitney U Test examined differences in sociodemographic variable frequencies. The Jarque-Bera test confirmed a normal distribution for psychological variables, warranting the use of parametric tests. Differences in mean values across groups, each with two measurements per individual, were assessed using a type II repeated measures ANOVA. There were significant differences based on the intervention, with the effect being greater in the SG across all domains. Significant improvement was observed in all domains of the disability and continuity of care scale within the intervention groups. Both groups showed improvement, with better results for the SG. In conclusion, a methodology is proposed for implementing support groups based on core components, which effectively enhances psychosocial disability and the continuity of mental health care, especially in suicidal behavior.
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16
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Richards JA, Kuo E, Stewart C, Shulman L, Parrish R, Whiteside U, Boggs JM, Simon GE, Rowhani-Rahbar A, Betz ME. Reducing Firearm Access for Suicide Prevention: Implementation Evaluation of the Web-Based "Lock to Live" Decision Aid in Routine Health Care Encounters. JMIR Med Inform 2024; 12:e48007. [PMID: 38647319 DOI: 10.2196/48007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 10/12/2023] [Accepted: 02/27/2024] [Indexed: 04/25/2024] Open
Abstract
Background "Lock to Live" (L2L) is a novel web-based decision aid for helping people at risk of suicide reduce access to firearms. Researchers have demonstrated that L2L is feasible to use and acceptable to patients, but little is known about how to implement L2L during web-based mental health care and in-person contact with clinicians. Objective The goal of this project was to support the implementation and evaluation of L2L during routine primary care and mental health specialty web-based and in-person encounters. Methods The L2L implementation and evaluation took place at Kaiser Permanente Washington (KPWA)-a large, regional, nonprofit health care system. Three dimensions from the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) model-Reach, Adoption, and Implementation-were selected to inform and evaluate the implementation of L2L at KPWA (January 1, 2020, to December 31, 2021). Electronic health record (EHR) data were used to purposefully recruit adult patients, including firearm owners and patients reporting suicidality, to participate in semistructured interviews. Interview themes were used to facilitate L2L implementation and inform subsequent semistructured interviews with clinicians responsible for suicide risk mitigation. Audio-recorded interviews were conducted via the web, transcribed, and coded, using a rapid qualitative inquiry approach. A descriptive analysis of EHR data was performed to summarize L2L reach and adoption among patients identified at high risk of suicide. Results The initial implementation consisted of updates for clinicians to add a URL and QR code referencing L2L to the safety planning EHR templates. Recommendations about introducing L2L were subsequently derived from the thematic analysis of semistructured interviews with patients (n=36), which included (1) "have an open conversation," (2) "validate their situation," (3) "share what to expect," (4) "make it accessible and memorable," and (5) "walk through the tool." Clinicians' interviews (n=30) showed a strong preference to have L2L included by default in the EHR-based safety planning template (in contrast to adding it manually). During the 2-year observation period, 2739 patients reported prior-month suicide attempt planning or intent and had a documented safety plan during the study period, including 745 (27.2%) who also received L2L. Over four 6-month subperiods of the observation period, L2L adoption rates increased substantially from 2% to 29% among primary care clinicians and from <1% to 48% among mental health clinicians. Conclusions Understanding the value of L2L from users' perspectives was essential for facilitating implementation and increasing patient reach and clinician adoption. Incorporating L2L into the existing system-level, EHR-based safety plan template reduced the effort to use L2L and was likely the most impactful implementation strategy. As rising suicide rates galvanize the urgency of prevention, the findings from this project, including L2L implementation tools and strategies, will support efforts to promote safety for suicide prevention in health care nationwide.
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Affiliation(s)
- Julie Angerhofer Richards
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Elena Kuo
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Christine Stewart
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Lisa Shulman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Rebecca Parrish
- Department of Mental Health & Wellness, Kaiser Permanente Washington, Seattle, WA, United States
| | - Ursula Whiteside
- NowMattersNow.org, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Jennifer M Boggs
- Kaiser Permanente Colorado Institute for Health Research, Aurora, CO, United States
| | - Gregory E Simon
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
- Department of Mental Health & Wellness, Kaiser Permanente Washington, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States
- Firearm Injury and Policy Research Program, University of Washington, Seattle, WA, United States
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States
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17
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Clary KL, Murley WD, Ortiz RS, Rogers ML. A step forward in conceptualizing psychological closeness/distance to suicide methods: A qualitative approach. Suicide Life Threat Behav 2024. [PMID: 38634715 DOI: 10.1111/sltb.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/04/2024] [Accepted: 03/13/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Suicide is a leading cause of death, making suicide prevention a major public health priority. Increasing understanding of factors influencing suicidal behavior is paramount. Previous research has implicated psychological closeness, characterized by perceptions of how close/distant or attached/detached one feels to a particular object, as a cognitive factor that influences suicidal behavior. However, a better understanding of how psychological closeness to suicide methods is conceptualized by relevant populations is needed to improve its assessment and understand how it may confer risk for suicide. METHODS The goal was to refine the conceptualization of psychological closeness to suicide methods by incorporating feedback from relevant populations. We conducted 30 interviews with those primarily identifying as having lived experience of suicide (n = 10), clinicians who work with suicidal patients (n = 11), and suicide researchers (n = 9). A rigorous thematic approach using NVivo software was used to uncover common themes. RESULTS Primary themes included familiarity, comfort, and attachment, with one emerging theme of symbolism. We define these themes, provide context to their meaning, and share exemplary quotes across diverse participants. CONCLUSION We consider clinical, research, and policy implications from an interdisciplinary lens and discuss the strengths and limitations of this study.
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Affiliation(s)
- Kelly L Clary
- School of Social Work, Texas State University, San Marcos, Texas, USA
| | - William D Murley
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Rachel S Ortiz
- School of Social Work, Texas State University, San Marcos, Texas, USA
| | - Megan L Rogers
- Department of Psychology, Texas State University, San Marcos, Texas, USA
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18
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Pemau A, Marin-Martin C, Diaz-Marsa M, de la Torre-Luque A, Ayad-Ahmed W, Gonzalez-Pinto A, Garrido-Torres N, Garrido-Sanchez L, Roberto N, Lopez-Peña P, Mar-Barrutia L, Grande I, Guinovart M, Hernandez-Calle D, Jimenez-Treviño L, Lopez-Sola C, Mediavilla R, Perez-Aranda A, Ruiz-Veguilla M, Seijo-Zazo E, Toll A, Elices M, Perez-Sola V, Ayuso-Mateos JL. Risk factors for suicide reattempt: a systematic review and meta-analysis. Psychol Med 2024:1-8. [PMID: 38623694 DOI: 10.1017/s0033291724000904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor. METHODS This systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury). RESULTS The initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt. CONCLUSION Most of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.
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Affiliation(s)
- Andres Pemau
- Universidad Complutense de Madrid, Madrid, Spain
| | | | - Marina Diaz-Marsa
- San Carlos University Clinic Hospital, Madrid, Spain
- Araba University Hospital, Vitoria, Spain
| | - Alejandro de la Torre-Luque
- Universidad Complutense de Madrid, Madrid, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | | | - Ana Gonzalez-Pinto
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Bilbao, Spain
| | - Nathalia Garrido-Torres
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Virgen del Rocio University Hospital, Seville, Spain
- Seville Biomedical Research Institute (IBiS), Seville, Spain
| | | | - Natalia Roberto
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Purificación Lopez-Peña
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Bilbao, Spain
- BIOARABA, Vitoria, Spain
| | - Lorea Mar-Barrutia
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Bilbao, Spain
- BIOARABA, Vitoria, Spain
| | - Iria Grande
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
| | - Marti Guinovart
- Institut d'Investigacio i Innovacio ParcTauli (I3PT), Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Daniel Hernandez-Calle
- La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Luis Jimenez-Treviño
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- Principado de Asturias Health Research Institute (ISPA), Oviedo, Spain
- University of Oviedo, Oviedo, Spain
- Principado de Asturias Neuroscience Research Institute (INEUROPA), Oviedo, Spain
| | - Clara Lopez-Sola
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Roberto Mediavilla
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Autonomous University of Madrid, Madrid, Spain
| | | | - Miguel Ruiz-Veguilla
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Virgen del Rocio University Hospital, Seville, Spain
- Seville Biomedical Research Institute (IBiS), Seville, Spain
- University of Seville, Seville, Spain
| | - Elisa Seijo-Zazo
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- Principado de Asturias Health Research Institute (ISPA), Oviedo, Spain
- University of Oviedo, Oviedo, Spain
- Principado de Asturias Neuroscience Research Institute (INEUROPA), Oviedo, Spain
| | - Alba Toll
- Autonomous University of Barcelona, Barcelona, Spain
- Neurosciences Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Matilde Elices
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Neurosciences Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Victor Perez-Sola
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Neurosciences Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Hospital de Mar, Mental Health Institute, Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Jose Luis Ayuso-Mateos
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Autonomous University of Madrid, Madrid, Spain
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19
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Cohen LJ, Liang Y, Peterkin D, McGibbon K, Rappa F, Rogers ML, You S, Chistopolskaya K, Enikolopov S, Barzilay S, Menon V, Husain MI, Dudeck M, Streb J, Çinka E, Yilmaz FK, Kuśmirek O, Valvassori SS, Blum Y, Galynker I. Relationship Between Severity and Length of Exposure to COVID-19 Parameters and Resulting Government Responses and the Suicide Crisis Syndrome (SCS). Disaster Med Public Health Prep 2024; 18:e68. [PMID: 38618875 DOI: 10.1017/dmp.2023.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVE The COVID-19 pandemic has had a globally devastating psychosocial impact. A detailed understanding of the mental health implications of this worldwide crisis is critical for successful mitigation of and preparation for future pandemics. Using a large international sample, we investigated in the present study the relationship between multiple COVID-19 parameters (both disease characteristics and government responses) and the incidence of the suicide crisis syndrome (SCS), an acute negative affect state associated with near-term suicidal behavior. METHODS Data were collected from 5528 adults across 10 different countries in an anonymous web-based survey between June 2020 and January 2021. RESULTS Individuals scoring above the SCS cut-off lived in countries with higher peak daily cases and deaths during the first wave of the pandemic. Additionally, the longer participants had been exposed to markers of pandemic severity (eg, lockdowns), the more likely they were to screen positive for the SCS. Findings reflected both country-to-country comparisons and individual variation within the pooled sample. CONCLUSION Both the pandemic itself and the government interventions utilized to contain the spread appear to be associated with suicide risk. Public policy should include efforts to mitigate the mental health impact of current and future global disasters.
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Affiliation(s)
- Lisa J Cohen
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Yinan Liang
- Department of Psychology, University of Georgia, GA, USA
| | - Devon Peterkin
- Teachers College, Department of Psychology, Columbia University, NY, USA
| | - Kamryn McGibbon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Frank Rappa
- Department of Psychology, Binghamton University, NY, USA
| | - Megan L Rogers
- Department of Psychology, Texas State University, TX, USA
| | - Sungeun You
- Department of Psychology, Chungbuk National University, Cheongju, Korea
| | - Ksenia Chistopolskaya
- Eramishantsev Moscow, Department of Psychiatry, City Clinical Hospital, Moscow, Russia
| | | | - Shira Barzilay
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Tamil Nadu, India
| | - M Ishrat Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, and Department of Psychiatry, University of Toronto, ON, Canada
| | - Manuela Dudeck
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Judith Streb
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Elif Çinka
- Department of Health Management, University of Health Sciences, İstanbul, Turkey
| | - Fatma Kantas Yilmaz
- Department of Health Management, University of Health Sciences, İstanbul, Turkey
| | | | - Samira S Valvassori
- Program of Health Sciences, Universidade do Extremo Sul Catarinense, Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Criciuma, Brazil
| | - Yarden Blum
- Department of Psychology, The College of Management Academic Studies, Rishon LeZion, Israel
| | - Igor Galynker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA
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20
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Sheehy J, Piel J. Criminal Defense Attorneys and Client Suicide: Survey and Recommendations From Washington State. J Correct Health Care 2024. [PMID: 38608240 DOI: 10.1089/jchc.23.11.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
The connection between suicide and incarceration is well documented, in particular after recent arrest. Criminal defense attorneys may be one of the few people in meaningful contact with this population, and lawyers have a unique window into their clients' well-being. In this Viewpoint, we explore the experiences of attorneys who work with clients with suicidal thoughts and behaviors. We developed and administered a survey to criminal defense attorneys in the State of Washington, ascertaining their experiences with client suicide. A total of 44 responses were collected, with over 95% of respondents having been concerned about a client's risk for suicide. We conclude that client suicide widely impacts criminal defense attorneys, and lawyers' role with justice-involved clients uniquely positions them to be a potential asset in suicide prevention efforts.
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Affiliation(s)
- Joellyn Sheehy
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Jennifer Piel
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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21
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Kirchner S, Till B, Laido Z, Niederkrotenthaler T. Suicide-Related Media Reporting With a Focus on Sexual and Gender Minority Identities. Crisis 2024. [PMID: 38597230 DOI: 10.1027/0227-5910/a000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Background: Little is known about the quality of media reports on suicide and prevention targeting persons with sexual or gender minority identities (LGBTQ+). Aims: To assess the quality of suicide-related media reporting of LGBTQ+ people and its consistency with media guidelines. Method: We conducted a content analysis of 5,652 media items in two US states (Washington and Oregon) published within 1 year. Results: There were only few differences in the reporting about suicide in LGBTQ+ as compared to non-LGBTQ+ reports. LGBTQ+ media items more often portrayed suicide as monocausal [Oregon: OR = 1.75, 95% CI (1.03-2.98), p = .038; Washington: OR = 3.00, 95% CI (1.81-4.97), p < .001] and linked them to adverse life experiences [OR = 2.16, 95% CI (1.38-3.38), p < .001; OR = 2.09, 95% CI (1.30-3.38), p = .002] than non-LGBTQ+ items. They also more often featured mental health experts [OR = 1.79, 95% CI (1.04-3.10), p = .034; OR = 2.12, 95% CI (1.23-3.67), p = .006] and contacts to support services [OR = 2.22, 95% CI (1.41-3.48), p < .001; OR = 2.70, 95% CI (1.64-4.45), p < .001]. Limitations: Aspects possibly influencing the portrayal of LGBTQ+ suicide and prevention beyond the characteristics listed were not investigated. Conclusion: Suicide-related media reporting related to LGBTQ+ issues features potentially beneficial aspects but tends to overlook multifactorial causes of suicide. Diverse factors contributing to LGBTQ+ suicide and prevention warrant greater attention.
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Affiliation(s)
- Stefanie Kirchner
- Public Mental Health Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Benedikt Till
- Public Mental Health Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Zrinka Laido
- Public Mental Health Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Public Mental Health Research Unit, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
- Wiener Werkstaette for Suicide Research, Vienna, Austria
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22
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Hatcher S, Sinyor M, Edgar NE, Schaffer A, MacLean SE, Carleton RN, Colman I, Jayakumar N, Ward B, Zaheer R. A Comparison of Suicides in Public Safety Personnel With Suicides in the General Population in Ontario, 2014 to 2018. Crisis 2024. [PMID: 38597229 DOI: 10.1027/0227-5910/a000953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Background: There is conflicting evidence on the suicide rates of different public safety personnel (PSP). There have been few studies that compare suicides in PSP with the general population and none that have used a detailed comparison of coroner records. Aims: The current study estimates suicide rates among different PSP and compares PSP suicides with the general population. Method: We identified coroner records of PSP suicides from January 2014 to December 2018 and compared each one to two matched general population controls. Results: We identified 36 PSP suicides and 72 general population controls. Police had a higher suicide rate than other PSP groups. PSP were more likely to die by firearm, be separated/divorced or married, die in a motor vehicle, have problems at work, and have a PTSD diagnosis. PSP were less likely to die by jumping. Limitations: The study may have not identified all PSP suicides. Apart from the cause of death, data in coroner records are not systematically collected, so information may be incomplete. Conclusion: PSP suicides appear different than the general population. Death records need to have an occupation identifier to enable monitoring of trends in occupational groups, such as PSP.
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Affiliation(s)
- Simon Hatcher
- Department of Psychiatry, University of Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
| | - Mark Sinyor
- Department of Psychiatry, University of Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Nicole E Edgar
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Sarah E MacLean
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
- School of Journalism and Communication, Carleton University, Ottawa, ON, Canada
| | - R Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, SK, Canada
- Canadian Institute for Public Safety Research and Treatment, University of Regina, SK, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, ON, Canada
| | - Navitha Jayakumar
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Brooklyn Ward
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Rabia Zaheer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Marks RB, Moreira N, O'Connell KL, Hearne A, Law KC. Suicide While Locked Up in Texas: Risk Factors for Death by Suicide in Custody. J Interpers Violence 2024:8862605241243366. [PMID: 38591139 DOI: 10.1177/08862605241243366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
In the United States, suicide is a leading cause of death in prisons and jails, with incarcerated individuals being nine times more likely to die by suicide than the general population. Identifying vulnerabilities at each stage of custody (prebooking, jail, prison) and factors that increase suicide risk can improve prevention efforts. A hierarchical binary logistic regression was conducted on data from the Texas Justice Initiative's Deaths in Custody Report. Variables included race/ethnicity, sex, age at death, days in custody, classification of crime as violent or nonviolent, and custody type of prebooking, jail, or prison. Among main effects, when compared to suicide rates in prison, jail suicide deaths were over three and a half times more likely (OR = 3.61), and the period of prebooking emerged as a period of staggering risk of suicide death, with suicides being over 5,000% more likely than at other stages of custody (OR = 50.86). When interactions were entered, Latinx individuals were at a particularly increased risk of suicide death (OR = 10.46), likelihood of suicide death decreased with each year of age (OR = .89), nonviolent offenders were just under three and a half times more likely to die by suicide when compared to violent offenders (OR = 3.45), and each stage of custody was shown to affect the relationship between age-related rates of suicide in different ways. Results call for further investigation into suicide among understudied populations in corrections, such as Latinx individuals, juveniles in the prison system, and nonviolent offenders, to identify the groups at the highest risk of premature death in correctional systems.
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Affiliation(s)
| | | | | | | | - Keyne C Law
- Seattle Pacific University, Seattle, WA, USA
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24
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Diaz AP, Pinto AB, Araújo MIC, Joaquim RM, Costa DDS, Serpa ALDO, Pisani AR, Conwell Y, Miranda DM, Malloy-Diniz LF, da Silva AG. Social support and suicidality during the COVID-19 pandemic among Brazilian healthcare workers: a longitudinal assessment of an online repeated cross-sectional survey. Braz J Psychiatry 2024. [PMID: 38598451 DOI: 10.47626/1516-4446-2023-3466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/28/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Healthcare workers (HCWs) are at an increased risk of suicide compared to non-healthcare workers. This study aims to investigate the association between social support and suicidal ideation and behavior (SIB) during the COVID-19 pandemic among Brazilian HCWs. METHODS This study utilizes data from 10,885 participants who answered the first (time point 1 - between May and June of 2020) and second (time point 2 - between December 2020 and February 2021) assessments of an online repeated cross-sectional survey for evaluating mental health and quality of life of HCWs during the COVID-19 pandemic in Brazil. Logistic regression analysis was conducted to investigate the relationship between social support as the independent variable (time point 1) and SIB as the outcomes (time point 2). RESULTS Higher social support was associated with a significantly lower chance of reporting SIB in the month prior to follow-up assessment (adjusted odds ratio [AOR]: 0.71, CI 95% 0.66 - 0.76 and AOR 0.61, CI 95% 0.54 - 0.68, respectively). These associations were independent of sex, age, feelings of loneliness, and self-reported psychiatric disorders. CONCLUSION Social support is associated with a lower chance of suicidality among HCWs, a protective role that is probably more evident for suicidal behavior.
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Affiliation(s)
- Alexandre Paim Diaz
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Andre Braule Pinto
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Universidade Federal do Amazonas (UFAM), Faculdade de Psicologia (FAPSI), Programa de Pós-Graduação em Psicologia (PPGPSI), AM, Brazil
| | | | - Rui Mateus Joaquim
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Danielle de Souza Costa
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alexandre Luiz de Oliveira Serpa
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Human Developmental Sciences Graduate Program, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Anthony R Pisani
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Yeates Conwell
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Debora M Miranda
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leandro F Malloy-Diniz
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Department of Psychiatry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Antonio G da Silva
- SAMBE - Saúde Mental Baseada em Evidências, Rio de Janeiro, Brazil. Post Graduation, Department in Molecular Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Associação Brasileira de Psiquiatria, São Paulo, Brazil. Faculdade de Medicina da Universidade do Porto, Portugal
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25
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Martínez-Rives NL, Martín Chaparro MDP, Dhungel B, Gilmour S, Colman RD, Kotera Y. Suicide Interventions in Spain and Japan: A Comparative Systematic Review. Healthcare (Basel) 2024; 12:792. [PMID: 38610214 PMCID: PMC11011319 DOI: 10.3390/healthcare12070792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/24/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: This systematic review presents an overview of psychological interventions in suicide published between 2013 and 2023 in Spain and Japan, sparked by Spain's alarming recent increase in suicide rates and the potential exemplar of Japan's reduction efforts. (2) Methods: Following the PRISMA checklist, the databases Web of Science, Scopus, PubMed, and PsycInfo were searched using the terms [("suicide" OR "suicidal behavior" OR "suicidal attempt" OR "suicidal thought" OR "suicidal intention") AND ("prevention" OR "intervention" OR "psychosocial treatment" OR "Dialectical Behavior Therapy" OR "Cognitive Therapy" OR "psychotherap*")] AND [("Spain" OR "Spanish") OR ("Japan" OR "Japanese")]. We included articles published in peer-reviewed academic journals, written in English, Spanish, and Japanese between 2013 and 2023 that presented, designed, implemented, or assessed psychological interventions focused on suicidal behavior. (3) Results: 46 studies were included, concerning prevention, treatment, and training interventions. The risk of bias was low in both Spanish and Japanese studies, despite the lack of randomization of the samples. We identified common characteristics, such as psychoeducation and coping skills. Assertive case management was only highlighted in Japan, making an emphasis on active patient involvement in his/her care plan. (4) Conclusions: The findings will help professionals to incorporate into their interventions broader, more comprehensive approaches to consider more interpersonal components.
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Affiliation(s)
| | | | - Bibha Dhungel
- School of International Liberal Studies, Waseda University, Tokyo 169-0051, Japan;
- Department of Health Policy, National Centre for Child Health and Development, Tokyo 157-0074, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke’s International University, Tokyo 104-0045, Japan;
| | - Rory D. Colman
- College of Health, Psychology and Social Care, University of Derby, Derby DE22 1GB, UK;
| | - Yasuhiro Kotera
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2TU, UK;
- Center for Infectious Disease Education and Research, Osaka University, Suita 565-0871, Japan
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26
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Andriessen K, Snir J, Krysinska K, Rickwood D, Pirkis J. Supporting Adolescents Bereaved by Suicide or Other Traumatic Death: The Views of Counselors. Omega (Westport) 2024:302228241246031. [PMID: 38581106 DOI: 10.1177/00302228241246031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
Adolescents bereaved by suicide and other traumatic death may experience strong grief reactions and increased risks of mental health problems and suicidal behaviour. As timely access to professional help can be critical, it is essential to understand how counselors perceive suicide bereavement in adolescents and how they work with this population. This study aimed to examine the perspectives of counselors (N = 34). Eleven participated in an individual semi-structured interview and 23 others in group interviews. Thematic analysis yielded three themes: (1) Building a relationship with the bereaved adolescent, (2) Offering support tailored to the needs of the grieving adolescent, and (3) Offering strengths-based and sustainable support. Counselors' skills, attitudes, content-related expertise, and approaching the adolescent's grief within their developmental context were deemed essential for building a therapeutic relationship and offering viable support. The findings may inform good practices in counseling bereaved adolescents to facilitate positive mental health outcomes.
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Affiliation(s)
- Karl Andriessen
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jessica Snir
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Karolina Krysinska
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Jane Pirkis
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Landa-Blanco M, Romero K, Caballero I, Gálvez-Pineda E, Fúnes-Henríquez MJ, Romero R. Exploring suicide ideation in university students: sleep quality, social media, self-esteem, and barriers to seeking psychological help. Front Psychiatry 2024; 15:1352889. [PMID: 38645419 PMCID: PMC11027559 DOI: 10.3389/fpsyt.2024.1352889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
The purpose of the current study is to analyze how variations in suicidal ideation scores can relate to sleep quality, social media consumption, self-esteem, and perceived barriers to seeking psychological help in a sample of university students in Honduras. A quantitative cross-sectional design was used. Self-reported data was collected from a non-random sample of 910 university students in Honduras; their average age was 24.03 years (SD=6.05). Most respondents were women (67%) with men accounting for 33% of the sample. Measurements included item 9 of the Patient Health Questionnaire-9, the Single-Item Sleep Quality Scale, Rosenberg's Self-Esteem Scale, Barriers to Seeking Psychological Help Scale for College Students, and a self-reported questionnaire on social media. In response to the query, "Over the past two weeks, how frequently have you experienced thoughts that you would be better off dead or of hurting yourself?" 54% (n=495) of participants indicated "not at all" 18% (n=168) reported "several days" 14% (n=129) responded "more than half of the days" and 13% (n=118) stated "nearly every day". The results from the ordinal logistic regression model indicate that sleep quality and self-esteem serve as protective factors associated with decreased suicide ideation. At the same time, a higher number of social media platforms used per week and perceived barriers to seeking psychological help increase suicide ideation. Altogether, these variables explained 19% of the variance in suicidal ideation scores. Suicidal ideation is highly prevalent among the sampled university students.
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Affiliation(s)
- Miguel Landa-Blanco
- School of Psychological Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
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28
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Hode Y, Padovani R, Hikmat W, Guillard-Bouhet N, Attal J, Bralet MC, Biotteau M, Chereau Boudet I, Canceil O, Montagne Larmurier A, Roussel C, Lemestré S, Willard D. Family psychoeducation in schizophrenia and schizophrenia related disorder, treatment compliance, and suicidal risk reduction: questions about their relationship from a naturalistic observation. Front Psychiatry 2024; 15:1370566. [PMID: 38638418 PMCID: PMC11024790 DOI: 10.3389/fpsyt.2024.1370566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
Introduction The Profamille V3.2 multi-family psycho-educational program directed at caregivers of relatives with schizophrenia or schizophrenia related disorder has been shown to decrease the annual prevalence of suicide attempts. It has been reported that psychoeducation of families can sometimes improve compliance with treatment. This study investigates whether the Profamille program improves compliance and thus reduces the risk of suicide among patients. Method This is a retrospective study of 179 groups of family caregivers, encompassing 1946 participants enrolled in Module 1 of the Profamille program and followed up one year after completion of the module. Evaluations were conducted using questionnaires filled out by family caregivers at three distinct times: prior to beginning the program, upon its completion, and again one year following its conclusion. The annual prevalence of suicide attempts was measured both before the program began and one year after its conclusion, while compliance to treatment was evaluated at the start and end of the program. Result After the Profamille program, the annual prevalence of suicide attempts fell by a factor of 2 (p-value = 0.00002) and patient compliance improved (p-value <0.000001). This reduction in suicide attempts was observed independently of improved compliance. Compliance seems to have an additional effect, but only after participation in the program. Conclusion The Profamille program reduces patients' risk of suicide even when patients are not taking the treatment. When family psychoeducation is not proposed in schizophrenia or schizophrenia related disorder, this can represent a loss of chance for patients.
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Affiliation(s)
- Yann Hode
- Association Psychoeducation PROFAMILLE, Chatenois, France
| | | | - Wydad Hikmat
- Psychiatric Hospital of Kelaa Sraghna, Ministry of Health, Morocco, Kelâa des Sraghna, Morocco
| | - Nathalie Guillard-Bouhet
- CREATIV Centre de REhabilitation et d'Activités Thérapeutiques Intersectoriel de la Vienne, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Jérome Attal
- La Colombière, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Marie-Cecile Bralet
- CRISALID-HDF (Department Support of cognitive remediation and psychosocial rehabilitation- South Hauts de France area), Etablissement Public de Santé Mentale Oise, Clermont de l Oise, France
- INSERM Unit Research 1247 GRAP, Picardie Jules Vernes University, Amiens, France
- GDR 3557 Research network, Addiction and Psychiatry, Paris, France
- Centre Hospitalier Isarien, Clermont de l’Oise, France
| | | | - Isabelle Chereau Boudet
- Centre Expert Schizophrenie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont Ferrand, France
| | - Olivier Canceil
- Fondation Santé des Etudiants de France, Paris, France
- Sante Mentale France, Paris, France
| | | | - Céline Roussel
- Centre Hospitalier Annecy Genevois (CH Annecy), Metz-Tessy, France
| | - Stéphanie Lemestré
- Association de psychoéducation des Familles Profamille Liège Belgique, Liège, Belgium
| | - Dominique Willard
- Pôle PEPIT (Pôle Hospitalo-Universitaire d’Evaluation Prévention et Innovation Thérapeutique), Groupe Hospitalier Universitaire Paris psychiatrie et neurosciences, Paris, France
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Naguy A, Alhazeem H. Clozapine Prescripers-Dogmatic or Pragmatic? Psychopharmacol Bull 2024; 54:46-50. [PMID: 38601835 PMCID: PMC11003257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
Clozapine, amongst antipsychotics, has a unique composite mode of action that might translate into an expanded therapeutic potential on clinical grounds. Sorely, clozapine remains underutilized.
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Affiliation(s)
- Ahmed Naguy
- Naguy, MBBch, MSc, Child/Adolescent Psychiatrist, Al-Manara CAP Centre, Kuwait Centre for Mental Health (KCMH), Jamal Abdul-Nassir St, Shuwaikh, State of Kuwait
| | - Hessa Alhazeem
- Alhazeem, MD, Faculty of Medicine, Kuwait University, Kuwait
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Bransgrove NJ, Porter JE, Prokopiv V, Wildblood R, Prezioso M, Bradley V, Look B. Local Men Local Communities: A rural placed-based approach to increase men's engagement with mental health training and events. Health Promot J Austr 2024. [PMID: 38566273 DOI: 10.1002/hpja.861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 02/28/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
ISSUE ADDRESSED Suicide is the leading cause of death for Australians aged 15-49 (Department of Health and Aged Care Suicide in Australia, https://www.health.gov.au/health-topics/mental-health-and-suicide-prevention/suicide-in-australia, 2021). With the loss of one community member impacting the individual's family, friends, and wider community. The aim of the article is to showcase a process evaluation of a place-based approach to suicide prevention, exploring the elements of mental health training and events that can be tailored to increase engagement with the men living in a rural Local Government Area in Gippsland, Victoria, Australia. METHODS Participation records and promotional material for the Local Men Local Communities project was utilised to explore similarities and differences between the training and events offered. RESULTS Results indicated that men living in rural areas engaged best with events that included a social element such as food or an activity, highlighting that men may find it easier to talk and connect when they have something to do. CONCLUSION Mental health training and events need to be tailored to meet the needs of the target population. Key details to consider include location, time, promotional material, content, and inclusion of a social element. SO WHAT?: When rural men were provided ownership of their conversations, they were more likely to have them. This challenges the stereotype that men do not talk and creates the opportunity for social connection within the community.
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Affiliation(s)
- Natalie J Bransgrove
- Collaborative Evaluation & Research Group (CERG), Federation University, Churchill, Victoria, Australia
| | - Joanne E Porter
- Collaborative Evaluation & Research Group (CERG), Federation University, Churchill, Victoria, Australia
| | - Valerie Prokopiv
- Collaborative Evaluation & Research Group (CERG), Federation University, Churchill, Victoria, Australia
| | - Robyn Wildblood
- Collaborative Evaluation & Research Group (CERG), Federation University, Churchill, Victoria, Australia
| | - Michelle Prezioso
- Collaborative Evaluation & Research Group (CERG), Federation University, Churchill, Victoria, Australia
| | - Vicki Bradley
- Community Strengthening, South Gippsland Shire Council, Leongatha, Victoria, Australia
| | - Barbara Look
- Community Strengthening, South Gippsland Shire Council, Leongatha, Victoria, Australia
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Valenzuela-García LI, Ayala-García VM, Ramos-Rosales DF, Jacquez-Flores RE, Urtiz-Estrada N, Hernández EMM, Barraza-Salas M. The rs7208505 Polymorphism and Differential Expression of the SKA2 Gene in the Prefrontal Cortex of Suicide Victims from the Mexican Population. Arch Suicide Res 2024; 28:674-685. [PMID: 37204142 DOI: 10.1080/13811118.2023.2209155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE The main aim of the current study was to investigate whether SKA2 gene expression in the postmortem brain of rs7208505 genotype are altered in suicide victims from a Mexican population. METHODS In this study, we report a genetic analysis of expression levels of the SKA2 gene in the prefrontal cortex of the postmortem brain of suicidal subjects (n = 22) compared to subjects who died of causes other than suicide (n = 22) in a Mexican population using RT-qPCR assays. Additionally, we genotyped the rs7208505 polymorphism in suicide victims (n = 98) and controls (n = 88) and we evaluate the association of genotypes for the SNP rs7208505 with expression level of SKA2. RESULTS The results showed that the expression of the SKA2 gene was significantly higher in suicide victims compared to control subjects (p = 0.044). Interestingly, we observed a greater proportion of allele A of the rs7208505 in suicide victims than controls. Even though there was no association between the SNP with suicide in the study population we found a significative association of the expression level from SKA2 with the allele A of the rs7208505 and suicide. CONCLUSION The evidence suggests that the expression of SKA2 in the prefrontal cortex may be a critical factor in the etiology of suicidal behavior.
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Sönmez İ. How Does Sexual Identity-Attraction Discordance Influence Suicide Risk? A Study on Male and Female Adults in the U.S. Arch Suicide Res 2024; 28:686-700. [PMID: 37303190 DOI: 10.1080/13811118.2023.2220757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Suicide continues to be one of the main causes of death among adults in the U.S. Research showed an association between sexual identity-attraction discordance (IAD) and adverse health outcomes, including suicidal ideation. METHODS We sought to determine whether sexual IAD is associated with self-injurious thoughts and behaviors (SITBs), namely suicidal thoughts, plans, and suicide attempts, in the past year. We examined data from adults participating in the most recent six waves (2015-2020) of the National Survey on Drug Use and Health. RESULTS Men who report sexual identity-attraction discordance were at greater risk of reporting suicidal thoughts (aOR = 3.67, 95% CI: 2.24-6.00) and plans (aOR = 5.71, 95% CI: 3.32-9.81) in the past year. Stratified by sexual identity, results showed that gay (aOR = 5.92, 95% CI: 1.54-22.7) and bisexual men (aOR = 4.38, 95% CI: 2.17-8.83) had higher odds of reporting suicide plans and heterosexual (aOR = 2.66, 95% CI: 1.06-6.68), gay (aOR = 7.05, 95% CI: 1.88-26.4), and bisexual men (aOR = 5.30, 95% CI: 4.37-22.9) had higher odds of suicide attempts when compared to men with concordant sexual identity-attraction. We found that bisexual women who report sexual identity-attraction discordance had less odds of reporting suicidal thoughts (aOR = 0.36, 95% CI: 0.21-0.63) and suicide plans (aOR = 0.43, 95% CI: 0.20-0.89) than women with concordant sexual identity-attraction. Among bisexual-identified males, those who experience sexual identity-attraction discordance were at greater risk for past-year suicidal thoughts (aOR = 3.82, 95% CI: 2.12-6.91) and suicide attempts (aOR = 5.30, 95% CI: 2.13-13.1) when compared to bisexual men with concordant sexual identity-attraction. CONCLUSION Sexual IAD is associated with SITB and particularly concerning results emerged concerning bisexual-identified men.
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Coleman TA, Chee K, Chin-See R, Salama R, Sajan M, Narbonne M, Travers R, Coulombe S. Minority Stressors, Social Provisions, and Past-Year Suicidal Ideation and Suicide Attempts in a Sample of Sexual Orientation and Gender Identity/Expression Minority People in Canada. LGBT Health 2024. [PMID: 38557210 DOI: 10.1089/lgbt.2022.0344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Purpose: Mental health disparities in sexual orientation and/or gender identity and/or expression (SOGIE) minority groups are well-documented, with research consistently showing higher levels of suicidality, even in Canada, considered one of the world's most accepting countries of SOGIE minority groups. Adverse outcomes in these groups are often framed using minority stress theory, with social support frequently studied as an integral buffer to these outcomes. This analysis explores facets of minority stress and social support associated with past-year suicidal ideation and suicide attempts. Methods: A cross-sectional internet survey of SOGIE diverse people in Canada (n = 1542) was conducted. Binary logistic regression calculated bivariate and multivariate factors associated with past-year suicidal ideation and suicide attempts. Backward elimination (retaining sociodemographic factors and self-rated mental health) identified salient minority stress and social support (provisions) factors. Results: Over half (56.72%) of participants had ever thought of dying by suicide, with 24.84% having attempted suicide. During the past year, 26.80% had thought of dying by suicide, with 5.32% having attempted suicide. Victimization events, and guidance (e.g., someone to talk to about important decisions) and attachment (e.g., close relationships providing emotional security) social provision subscales remained salient after backward elimination procedures. Conclusion: Our findings emphasize that a fulsome, multilevel approach considering structural, community, and individual strategies to address overt discrimination, integrating social connections and guidance, is necessary to prevent dying by suicide.
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Affiliation(s)
- Todd A Coleman
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Kenny Chee
- Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Robert Chin-See
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Ramez Salama
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Maria Sajan
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Macie Narbonne
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Simon Coulombe
- Département des relations industrielles, Université Laval, Québec, Québec, Canada
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Moskow DM, Lipson SK, Tompson MC. Anxiety and suicidality in the college student population. J Am Coll Health 2024; 72:881-888. [PMID: 35427461 PMCID: PMC9568619 DOI: 10.1080/07448481.2022.2060042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 12/14/2021] [Accepted: 03/27/2022] [Indexed: 06/14/2023]
Abstract
Objective: This study examined symptoms of anxiety, depression and suicidality in a national sample of college students. Participants: Using national survey data from the Healthy Minds Study (HMS), a random sample from 184 U.S. campuses from fall 2016 to spring 2019 was analyzed (N = 119,875). Methods: Prevalence rates were examined with the Generalized Anxiety Disorder 7-Item scale, Patient Health Questionnaire-9 and suicidality questions. Relationships between anxiety, depression and suicidality were assessed through Spearman's correlations, the Kruskal-Wallis H test and logistic regressions. Results: Findings revealed that screening only for depression would pick up 23% of suicidal ideation, increasing to 35% when also screening for anxiety. Those with anxiety and no to minimal depression had the second highest likelihood of suicide attempt, following those with anxiety and depression. The symptom "feeling afraid something awful might happen" doubled the odds of suicidal ideation. Conclusions: College campuses may benefit from assessing particular anxiety symptoms in relation to suicide.
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Affiliation(s)
- Danielle M. Moskow
- 900 Commonwealth Ave, Boston University, Department of Psychological and Brain Sciences, Boston, MA 02215
| | - Sarah K. Lipson
- 715 Albany St, Boston University, School of Public Health, Department of Health Law Policy and Management, Boston, MA 02118
| | - Martha C. Tompson
- 900 Commonwealth Ave, Boston University, Department of Psychological and Brain Sciences, Boston, MA 02215
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Oya Y, Ishihara K, Shiko Y, Kawasaki Y, Iwase H. A Descriptive Study of the Characteristics of Homicide- Suicide in Forensic Autopsy Cases. J Interpers Violence 2024; 39:1473-1495. [PMID: 37887432 DOI: 10.1177/08862605231207616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Homicide followed by suicide (HS) is a tragic event with varied characteristics across countries and regions. Compared to Western countries, there are limited studies on HS in Asian countries. Therefore, this study aimed to clarify the characteristics of recent HS cases by examining forensic autopsy records from 2008 to 2020 collected from the Department of Legal Medicine, Chiba University, in Japan. A total of 77 HS cases were identified, involving 77 perpetrators (52 completed suicides, 25 attempted suicides), with 28 perpetrator and 89 victim autopsies. Our findings showed that older adults accounted for nearly half of the victims; victims were mostly females, whereas most perpetrators were male. The most common HS relationship was that between a parent and a child. Autopsy findings showed that the most common cause of death was strangulation, and illegal drugs were detected only in a few cases; however, psychotropic drugs were detected in child victims. No obvious evidence of past child physical abuse by caregivers was found. In contrast, intimate partner violence (IPV) was present, with a history of IPV found in half of HS cases involving adult intimate partner relationships. Notably, gender differences in age and relationship to the victim were identified. Likewise, some perpetrators may have expressed their plans and intentions for HS before the event, which may represent an important sign for HS prevention. However, to accurately reveal the course of HS, nationwide integrated statistics, forensic autopsies, including toxicological analyses of the deceased; and forensic psychiatric perspectives, including psychological autopsy, are required.
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Affiliation(s)
| | | | | | - Yohei Kawasaki
- Japanese Red Cross College of Nursing, Shibuya-ku, Tokyo, Japan
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Ringering S, Gracy L, Sass D. Male Farm and Agricultural Worker Suicides in Kansas, 2016-2020. J Agromedicine 2024; 29:136-143. [PMID: 38250797 DOI: 10.1080/1059924x.2024.2305332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
OBJECTIVES There is limited research on the factors that contribute to suicides among farm and agriculture workers. The purpose of this analysis was to examine the socio-demographic characteristics and circumstances that may increase risk of suicide for a farm worker by using the detailed data from the Kansas Violent Death Reporting System (KS-VDRS). METHODS KS-VDRS is a state-based system and was used to look at suicides among farm and agricultural workers that occurred in Kansas from 2016 to 2020. Frequencies, percentages, and age-adjusted rates were calculated to compare trends between farm/agriculture workers and other major occupational groups (non-farm/agriculture). Females were not included in this analysis due to low counts in the occupational group. RESULTS In Kansas, male farm and agriculture workers die by suicide at a rate of 147.5 per 100,000 population, which is 3 times that of the average male workers (45.2 per 100,000 population). Male suicide decedents in farming and agriculture-related occupations were older with a mean age of 54 years and less educated (73% had a high school diploma or less) than their non-agriculture counterparts (mean age 44 years, and 57% had a high school diploma or less). Common circumstances around time of death were current depressed mood (58.6%), current mental health problem (41.4%), and physical health problem (31.4%). CONCLUSION KSVDRS provides valuable information on the circumstances surrounding suicides, and this can inform prevention efforts within and across states. Numerous factors may contribute to the increased risk of suicide among farmers and those who work in agriculture. Physical health problems, family relationship problems, and financial problems are more commonly reported among this population compared to other male workers. Findings from this report highlight the complexity of suicide risk within the farm and agriculture industry in Kansas and reinforce the need for state-specific data and tailored prevention efforts.
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Affiliation(s)
| | - Lauren Gracy
- Kansas Department of Health and Environment, Topeka, KS, USA
| | - Danielle Sass
- Kansas Department of Health and Environment, Topeka, KS, USA
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Geulayov G, Casey D, Bale L, Brand F, Clements C, Kapur N, Ness J, Waters K, White S, Hawton K. Variation in the clinical management of self-harm by area-level socio-economic deprivation: findings from the multicenter study of self-harm in England. Psychol Med 2024; 54:1004-1015. [PMID: 37905705 DOI: 10.1017/s0033291723002799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
BACKGROUND We investigated disparities in the clinical management of self-harm following hospital presentation with self-harm according to level of socio-economic deprivation (SED) in England. METHODS 108 092 presentations to hospitals (by 57 306 individuals) after self-harm in the Multicenter Study of Self-harm spanning 17 years. Area-level SED was based on the English Index of Multiple Deprivation. Information about indicators of clinical care was obtained from each hospital's self-harm monitoring systems. We assessed the associations of SED with indicators of care using mixed effect models. RESULTS Controlling for confounders, psychosocial assessment and admission to a general medical ward were less likely for presentations by patients living in more deprived areas relative to presentations by patients from the least deprived areas. Referral for outpatient mental health care was less likely for presentations by patients from the two most deprived localities (most deprived: adjusted odd ratio [aOR] 0.77, 95% CI 0.71-0.83, p < 0.0001; 2nd most deprived: aOR 0.80, 95% CI 0.74-0.87, p < 0.0001). Referral to substance use services and 'other' services increased with increased SED. Overall, referral for aftercare was less likely following presentations by patients living in the two most deprived areas (most deprived: aOR 0.85, 95% CI 0.78-0.92, p < 0.0001; 2nd most deprived: aOR 0.86, 95% CI 0.79-0.94, p = 0.001). CONCLUSIONS SED is associated with differential care for patients who self-harm in England. Inequalities in care may exacerbate the risk of adverse outcomes in this disadvantaged population. Further work is needed to understand the reasons for these differences and ways of providing more equitable care.
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Affiliation(s)
- G Geulayov
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - D Casey
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - L Bale
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - F Brand
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - C Clements
- Centre for Mental Health and Safety, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - N Kapur
- Centre for Mental Health and Safety, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - J Ness
- Centre for Self-harm and Suicide Prevention Research, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - K Waters
- Centre for Self-harm and Suicide Prevention Research, Derbyshire Healthcare NHS Foundation Trust, Derby, UK
| | - S White
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - K Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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Wilner JG, Ronzio B, Gillen C, Aguirre B. Self-Hatred: The Unaddressed Symptom of Borderline Personality Disorder. J Pers Disord 2024; 38:157-170. [PMID: 38592908 DOI: 10.1521/pedi.2024.38.2.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Individuals with borderline personality disorder (BPD) often report chronic, severe self-hatred. It is frequently experienced as immutable, seen as a barrier to recovery, and is associated with risk for self-injury and suicide attempts. Yet self-hatred remains a poorly understood, underdiagnosed, and undertreated presentation of BPD. In this concept article and review, we describe the nature of self-hatred in BPD and related disorders, propose a theory as to the development of self-hatred in BPD, review the assessments of and interventions for self-hatred, and consider next steps in the research, assessment, and treatment of self-hatred in BPD. Through increased awareness, understanding, and measures of self-hatred in BPD, new treatment paradigms can be developed to ensure more comprehensive recovery.
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Affiliation(s)
- Julianne G Wilner
- From Division of Child and Adolescent Psychiatry, McLean Hospital/Harvard Medical School, Belmont, Massachusetts
| | - Blake Ronzio
- From Division of Child and Adolescent Psychiatry, McLean Hospital/Harvard Medical School, Belmont, Massachusetts
| | - Carly Gillen
- From Division of Child and Adolescent Psychiatry, McLean Hospital/Harvard Medical School, Belmont, Massachusetts
| | - Blaise Aguirre
- From Division of Child and Adolescent Psychiatry, McLean Hospital/Harvard Medical School, Belmont, Massachusetts
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Susukida R, Nestadt PS, Kharrazi H, Wilcox HC. Prevalence and Correlates of Opioid-Involved Suicides in Maryland. Arch Suicide Res 2024; 28:660-673. [PMID: 37143364 PMCID: PMC10624645 DOI: 10.1080/13811118.2023.2207612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Involvement of opioids in suicides has doubled during the past two decades, worsening a major public health concern. This study examined the characteristics of opioid-involved suicides. METHODS The sample of decedents (N = 12,038) in Maryland between 2006 and 2020 was used to compare the characteristics of opioid-involved suicides (n = 947) with suicides not involving opioids (n = 6,896) and accidental opioid deaths (n = 4,125). Direct comparisons were then made between opioid-involved suicides with and without the additional presence of non-opioid substances. RESULTS Opioid-involved suicides were significantly more likely than suicides not involving opioids to occur among those aged 18-64 years, non-Hispanic Whites, and unemployed or disabled individuals. Opioid-involved suicides were more likely than accidental opioid deaths to occur among females, those aged <18 years, non-Hispanic Whites, and employed individuals. Of all suicides involved opioids, 45% involved other non-opioid substances. Polysubstance opioid suicides were significantly more likely than suicides involving opioids only to occur among non-Hispanic Whites. CONCLUSIONS Significant differences were observed in the demographic groups most at risk for opioid-involved suicide than other suicide or accidental opioid death. Among opioid-involved suicides, polysubstance involvement also represents a distinct group. These findings may enhance the targeting of prevention efforts.
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Affiliation(s)
- Ryoko Susukida
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA
| | - Paul S. Nestadt
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe St. Baltimore, MD 21287
| | - Hadi Kharrazi
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA
- Division of Health Sciences Informatics, Johns Hopkins School of Medicine, 600 N. Wolfe St. Baltimore, MD 21287
| | - Holly C. Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe St. Baltimore, MD 21287
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD, 21205, USA
- Johns Hopkins University School of Education, Education Building, 2800 N. Charles St. Baltimore, MD 21218
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Zisook S, Moutier CY, Rush AJ, Johnson GR, Tal I, Chen PJ, Davis LL, Hicks PB, Wilcox J, Planeta B, Lauro KW, Scrymgeour AA, Kasckow J, Mohamed S. Effect of next-step antidepressant treatment on suicidal ideation: findings from the VAST-D trial. Psychol Med 2024; 54:1172-1183. [PMID: 37859623 DOI: 10.1017/s0033291723003008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) contributes to suicide risk. Treating MDD effectively is considered a key suicide prevention intervention. Yet many patients with MDD do not respond to their initial medication and require a 'next-step'. The relationship between next-step treatments and suicidal thoughts and behaviors is uncharted. METHOD The VA Augmentation and Switching Treatments for Depression trial randomized 1522 participants to one of three next-step treatments: Switching to Bupropion, combining with Bupropion, and augmenting with Aripiprazole. In this secondary analysis, features associated with lifetime suicidal ideation (SI) and attempts (SA) at baseline and current SI during treatment were explored. RESULTS Compared to those with SI only, those with lifetime SI + SA were more likely to be female, divorced, or separated, unemployed; and to have experienced more childhood adversity. They had a more severe depressive episode and were more likely to respond to 'next-step' treatment. The prevalence of SI decreased from 46.5% (694/1492) at baseline to 21.1% (315/1492) at end-of-treatment. SI during treatment was associated with baseline SI; low positive mental health, more anxiety, greater severity and longer duration of current MDD episode; being male and White; and treatment with S-BUP or C-BUP as compared to A-ARI. CONCLUSION SI declines for most patients during next-step medication treatments. But about 1 in 5 experienced emergent or worsening SI during treatment, so vigilance for suicide risk through the entire 12-week acute treatment period is necessary. Treatment selection may affect the risk of SI.
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Affiliation(s)
- Sidney Zisook
- University of California San Diego, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| | | | - A John Rush
- Duke Medical School, Durham, NC, USA
- Duke-National University of Singapore, Singapore
| | - Gary R Johnson
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ilanit Tal
- VA San Diego Healthcare System, San Diego, CA, USA
| | - P J Chen
- Department of Psychiatry, VA Northeast Ohio Healthcare System, and Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Lori L Davis
- Tuscaloosa VA Medical Center, Tuscaloosa, AL, USA
| | - Paul B Hicks
- Department of Psychiatry, Texas A&M College of Medicine, Temple, TX, USA
| | - James Wilcox
- Department of Veterans Affairs, Phoenix, AZ, USA
| | - Beata Planeta
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | | | - Alexandra A Scrymgeour
- Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, Albuquerque, NM, USA
| | - John Kasckow
- University of Pittsburgh Physicians, Pittsburgh, PA, USA
| | - Somaia Mohamed
- Veterans Affairs (VA) New England Mental Illness Research, Education, and Clinical Center, VA Connecticut Healthcare System, West Haven, CT, USA
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Reinbergs EJ, Rogers ML, Anderson JR, Pryor SM. Firearm carrying and adolescent suicide risk outcomes between 2015 and 2021 across nationally representative samples. Suicide Life Threat Behav 2024; 54:302-309. [PMID: 38223934 DOI: 10.1111/sltb.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 01/02/2024] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Firearms are the most frequent means of youth suicide for the 14-18-year-old age group, and adolescent firearm access confers substantial increases in the risk of suicidal behaviors. There have been significant increases in firearm purchases and firearm violence in the United States since the onset of the COVID-19 pandemic. METHODS This study uses four time points of nationally representative data from the Youth Risk Behavior Survey (YRBS) from 2015 to 2021 to examine the differential associations of reporting having carried a firearm and suicide-related outcomes, after controlling for relevant demographic factors. As a sensitivity analysis, we examined whether a similar risk pattern was seen for the probability of reporting depressed mood. RESULTS Results reveal significant increases in suicide-related outcomes among students who reported carrying a firearm and no significant increases among those who did not. Unlike the suicide-related outcomes, increases in depressed mood overtime were not limited to students who carried firearms, suggesting that the risk associated with firearms may be specific to suicide-related outcomes. CONCLUSIONS Carrying a firearm is associated with significant increases in the risk of suicidal ideation and behaviors among youth and this risk has increased between 2015 and 2021. Implications for youth suicide prevention and directions for future research are discussed.
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Affiliation(s)
- Erik J Reinbergs
- Department of Clinical Health and Applied Sciences, University of Houston Clear Lake, Houston, Texas, USA
| | - Megan L Rogers
- Department of Psychology, Texas State University, College Station, Texas, USA
| | - Jacqueline R Anderson
- Department of School Psychology, University of Northern Colorado, Greeley, Colorado, USA
| | - Sarah M Pryor
- Department of School Psychology, University of Northern Colorado, Greeley, Colorado, USA
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Matsumoto T, Kitada S, Suda S. The association between exposure to hate speech or perceived discrimination and mental health problems among Korean residents in Japan. Transcult Psychiatry 2024; 61:133-141. [PMID: 38297813 DOI: 10.1177/13634615231225127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
This study evaluated the effect of perceived discrimination and racism on the mental health state of Korean residents in Japan, with a particular focus on the risk of post-traumatic stress disorder (PTSD), depression, and psychological distress. Surveys were sent to Korean residents in Japan and a total of 240 valid responses were received. The valid response rate was 27.1%. The participants answered several questionnaire items, including demographic information and questions pertaining to their experiences of perceived discrimination, along with three self-reported measures of mental health, i.e., the Japanese version of Impact of Event Scale-Revised, the Zung Self-rating Depression Scale (SDS), and the 12-item General Health Questionnaire (GHQ-12). The results indicated that Korean residents in Japan experience hate speech and discrimination with a markedly high frequency (92.9% and 100%, respectively), and that factors such as employment discrimination and exposure to hate speech via social networking services were significant predictors of probable PTSD and psychological distress.
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Affiliation(s)
- Takuya Matsumoto
- Graduate School of Human and Environmental Studies, Kyoto University, Japan
| | - Shiro Kitada
- Department of Nursing, Faculty of Sports & Health Science, Daito Bunka University, Japan
| | - Shiro Suda
- Department of Psychiatry, Jichi Medical University, Japan
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Gorraiz G, Porta G, McMakin DL, Kennard BD, Douaihy AB, Biernesser C, Foxwell AA, Wolfe K, Goldstein T, Brent DA. Factors Associated With Reasons for Living Among Suicidal Adolescents. Arch Suicide Res 2024; 28:471-481. [PMID: 37013700 PMCID: PMC10548347 DOI: 10.1080/13811118.2023.2190367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
OBJECTIVE The objective of this study was to identify baseline demographic and clinical factors associated with higher scores on the Reasons for Living Inventory for Adolescents (RFL-A) at baseline and over follow-up. METHOD Using data from a pilot clinical trial of a brief intervention for suicidal youth transitioning from inpatient to outpatient, we identified univariate associations of baseline characteristics with RFL-A and used regression to identify the most parsimonious subset of these variables. Finally, we examined to what extent changes in these characteristics over time were related to changes in RFL-A. RESULTS Univariate analyses found that better external functional emotion regulation and social support were associated with higher RFL-A scores; more self-reported depression, internal dysfunctional emotion regulation, sleep disturbance, anxiety, and distress tolerance were associated with lower RFL-A scores. Multiple linear regression identified internal dysfunctional emotion regulation and external functional emotion regulation as the most parsimonious set of characteristics associated with RFL-A. Improvement in internal emotion regulation, sleep, and depression were related to improvements in RFL-A over time. CONCLUSION Our findings indicate that emotion regulation-specifically maladaptive internal strategies and use of external resources-is strongly associated with RFL-A. Improvements in internal emotion regulation (r = 0.57), sleep (r = -0.45), and depression (r = -0.34) were related to increases in RFL-A.
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Affiliation(s)
- G. Gorraiz
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - G. Porta
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - D. L. McMakin
- Department of Psychology, Florida International University, Miami, FL, United States
| | - B. D. Kennard
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - A. B. Douaihy
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - C. Biernesser
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - A. A. Foxwell
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Children’s Health Medical Center, Dallas, TX, United States
| | - K. Wolfe
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
- Children’s Health Medical Center, Dallas, TX, United States
| | - T. Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
| | - D. A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- UPMC Western Psychiatric Hospital, Pittsburgh, PA, United States
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Keefner T, Minton M, Antonen K. Embracing Emotional Pain: A Case Study of Adolescent Suicidality and Spirituality. J Am Psychiatr Nurses Assoc 2024; 30:397-408. [PMID: 36016492 DOI: 10.1177/10783903221118932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Suicidality continues to be the second leading cause of adolescent death. Nurses are in a prime position to address the emotional pain associated with adolescent suicidality but report skepticism and discomfort. Moreover, spirituality is identified as a protective factor against suicidality, yet a gap exists related to exploring spirituality within the context of the emotional pain associated with adolescent suicidality. Building awareness of adolescents' spirituality and emotional pain associated with suicidality is essential to address nurse skepticism and discomfort. AIMS The purpose of this study was to explore young adults' experiences of suicide attempt(s) during adolescence in the context of spirituality using a case study application of participant narratives to Minton and Antonen's B.L.E.S.S. acronym. METHOD A multiple-case study design was used to provide an alternative perspective for understanding adolescent suicidality from a spiritual context. Reed's theory of self-transcendence and the B.L.E.S.S. acronym guided the analysis and interpretation. Convenience online sampling resulted in six adult participants who provided email narratives of their adolescent experiences. Email data collection was guided by Fritz and Vandermause. Analysis of participant narratives followed the protocol of Baxter and Jack. RESULTS Participant's narratives revealed self-transcendence that paralleled the five truths about emotional pain and spirituality inherent in the B.L.E.S.S. acronym. CONCLUSION This case study provides nurses a guide for counteracting the barriers of skepticism and stigma to promote help-seeking behavior associated with adolescent suicidality. Further research is needed for the application of the B.L.E.S.S. acronym with other population samples.
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Affiliation(s)
- Tamara Keefner
- Tamara Keefner, PhD, RN, CNE, University of South Dakota, Vermillion, SD, USA
| | - Mary Minton
- Mary Minton, PhD, RN, CHPN, South Dakota State University, Brookings, SD, USA
| | - Kathy Antonen
- Kathy Antonen, PhD, South Dakota School of Mines and Technology, Rapid City, SD, USA
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Zemestani M, Abdolmaleki S, McGrew SJ, Vujanovic A. Associations between Sleep Disturbance and Suicidal Ideation Severity in Iranian University Students: Evaluating Emotion Regulation Difficulties and Distress Tolerance. Arch Suicide Res 2024; 28:454-470. [PMID: 36927369 DOI: 10.1080/13811118.2023.2190366] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
AIM Although sleep disturbance is associated with suicide ideation, underlying cognitive-affective mechanisms that may explain this association are not well understood. The aim of the present study was to concurrently evaluate whether emotion regulation difficulties and distress tolerance explain this association among Iranian university students. METHOD A total of 679 Iranian university students (66.42% females; Mage = 24.34 years, SD = 4.86) completed a battery of online self-report questionnaire. Structural equation modeling was used to empirically explore the relations among variables. RESULTS Sleep disturbance was positively associated with suicide ideation. Higher sleep disturbance symptoms were associated with higher levels of suicide ideation. Sleep disturbance was indirectly related to suicide ideation through both emotion regulation difficulties and distress tolerance. CONCLUSION Findings expand knowledge of cognitive-emotional processes that may explain the sleep disturbance-suicide ideation association among Iranian university students. Iranian students experiencing sleep disturbance may benefit from intervention strategies targeting emotion regulation skills and distress tolerance to reduce suicide ideation.
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Anestis MD. Firearm Access and Suicide Rates: An Unambiguously Robust Association. Arch Suicide Res 2024; 28:701-705. [PMID: 36987987 DOI: 10.1080/13811118.2023.2192753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Firearms account for approximately half of all suicide deaths within the United States each year. Recently, Lane and Kleck published pieces reporting conflicting results regarding the relationship between firearm access and suicide rates. In this commentary, I aim to contextualize the findings within the broader literature and to provide clarity for readers aiming to navigate the findings of the two studies. Ultimately, I conclude that the results of Lane more accurately represent the nature of the relationship and align with the extant literature on the topic.
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Hill RM, McCray CL. Suicide-Related Stigma and Social Responsibility Moderate the Effects of an Online Suicide Prevention Gatekeeper Training Program. Arch Suicide Res 2024; 28:706-715. [PMID: 37209132 DOI: 10.1080/13811118.2023.2199802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
AIM Gatekeeper interventions are universal programs designed for use by the general public that provide brief training sessions in responding to suicidal risk. To date, the evidence base for the efficacy of gatekeeper intervention training programs has been mixed. However, little attention has been paid to potential psychological moderators of the efficacy of suicide gatekeeper interventions. We explore the potential moderating effects of suicide-related stigma and social responsibility on the efficacy of a suicide prevention gatekeeper training program. METHODS Participants were 179 college students with a mean age of 19.05 years (SD = 1.82, range 18-31). Participants were 71.5% women, 48.6% Hispanic, and 19.6% non-Hispanic White. RESULTS Results indicated that higher scores on suicide-related stigma were associated with smaller intervention effects on gatekeeper self-efficacy. In contrast, higher scores on social responsibility were associated with greater intervention effects with regard to gatekeeper preparedness and gatekeeper likelihood. CONCLUSION An improved understanding of the factors associated with efficacy of gatekeeper intervention programs may lead to the development of improved gatekeeper interventions. These findings may also contribute to the development of targeted gatekeeper interventions for specific cultural or occupational groups.
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Gomes KD, Collette TL, Schlenk M, Judkins J, Sanchez-Cardona I, Channer B, Ross P, Fredrick G, Moore BA. Posttraumatic Stress Disorder, Suicidal ideation, and Stress: The Moderating Role of Dysfunctional and Recovery Cognitions. Arch Suicide Res 2024; 28:569-584. [PMID: 37073774 DOI: 10.1080/13811118.2023.2199798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Trauma and stressor-related behavioral health conditions are prevalent in military populations and have become a major public health concern in recent years. Individuals who commonly report suicidal ideation often have comorbid mental health diagnoses (i.e., posttraumatic stress disorder; PTSD). However, the mechanisms associated with stress, suicidal ideation, and PTSD are unclear. METHOD The present study examined the moderating role of dysfunctional and recovery cognitions between (i) PTSD and suicidal ideation, and (ii) stress and suicidal ideation in two distinct samples. Sample 1 was composed of civilians and military personnel (N = 322). Sample 2 was composed of (N = 377) student service members and veterans (SSM/Vs). RESULTS In Study 1, we found that low recovery cognitions at higher and moderate levels of PTSD symptoms were significantly associated with increased suicidal ideation. High dysfunctional cognitions were significantly associated with suicidal ideation at higher levels of PTSD symptoms. In Study 2, we found no differences in any level of recovery cognitions at low and moderate stress levels with suicidal ideation. Higher levels of stress were associated with high dysfunctional cognitions and suicidal ideation. CONCLUSION Promoting higher levels of recovery cognitions and reducing dysfunctional cognitions are important in addressing stress, suicidal ideation, and comorbid conditions such as PTSD. Future research should focus on examining the clinical utility of the Dispositional Recovery and Dysfunction Inventory (DRDI) in other populations (i.e., firefighters and paramedics). This could contribute to efforts of suicide prevention and the promotion of the well-being of individuals experiencing suicidal ideation.
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Mason A, Riordan BC, Morley K, Winter T, Haber P, Scarf D. High Risk or Risky Highs: Understanding the Links Between Alcohol and Cannabis Use on the Transition From Suicidal Ideation to Attempts in Australian Men. Arch Suicide Res 2024; 28:600-609. [PMID: 37151101 DOI: 10.1080/13811118.2023.2199801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Alcohol and cannabis use are consistently associated with greater risk of suicide, particularly among men and in higher-income countries (e.g., Australia). Adult data (n = 7,464) from waves 1 and 2 of Ten to Men: The Australian Longitudinal Study on Male Health were used to explore whether alcohol and/or cannabis use increased the longitudinal risk of a suicide attempt among suicidal ideators. Cannabis use was associated with increased risk of transitioning from suicidal ideation to making a suicide attempt; no association was found for alcohol. Broadly, these findings indicate that greater cannabis but not alcohol use may increase risk of transitioning to making a suicide attempt among those who are thinking about suicide.
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Santillanes G, Foster AA, Ishimine P, Berg K, Cheng T, Deitrich A, Heniff M, Hooley G, Pulcini C, Ruttan T, Sorrentino A, Waseem M, Saidinejad M. Management of youth with suicidal ideation: Challenges and best practices for emergency departments. J Am Coll Emerg Physicians Open 2024; 5:e13141. [PMID: 38571489 PMCID: PMC10989674 DOI: 10.1002/emp2.13141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/09/2024] [Accepted: 02/22/2024] [Indexed: 04/05/2024] Open
Abstract
Suicide is a leading cause of death among youth, and emergency departments (EDs) play an important role in caring for youth with suicidality. Shortages in outpatient and inpatient mental and behavioral health capacity combined with a surge in ED visits for youth with suicidal ideation (SI) and self-harm challenge many EDs in the United States. This review highlights currently identified best practices that all EDs can implement in suicide screening, assessment of youth with self-harm and SI, care for patients awaiting inpatient psychiatric care, and discharge planning for youth determined not to require inpatient treatment. We will also highlight several controversies and challenges in implementation of these best practices in the ED. An enhanced continuum of care model recommended for youth with mental and behavioral health crises utilizes crisis lines, mobile crisis units, crisis receiving and stabilization units, and also maximizes interventions in home- and community-based settings. However, while local systems work to enhance continuum capacity, EDs remain a critical part of crisis care. Currently, EDs face barriers to providing optimal treatment for youth in crisis due to inadequate resources including the ability to obtain emergent mental health consultations via on-site professionals, telepsychiatry, and ED transfer agreements. To reduce ED utilization and better facilitate safe dispositions from EDs, the expansion of community- and home-based services, pediatric-receiving crisis stabilization units, inpatient psychiatric services, among other innovative solutions, is necessary.
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Affiliation(s)
- Genevieve Santillanes
- Department of Emergency Medicine, Keck School of Medicine of USCLos Angeles General Medical CenterLos AngelesCaliforniaUSA
| | - Ashley A. Foster
- Department of Emergency MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Paul Ishimine
- Departments of Emergency Medicine and PediatricsUniversity of California, San Diego School of Medicine, UC San Diego Health and Rady Children's HospitalSan DiegoCaliforniaUSA
| | - Kathleen Berg
- Department of Pediatrics, Dell Medical SchoolThe University of TexasAustinTexasUSA
| | - Tabitha Cheng
- Department of Emergency MedicineHarbor UCLA Medical CenterDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Ann Deitrich
- Division Chief Pediatric Emergency MedicineDepartment of Emergency MedicinePrisma HealthUniversity of South Carolina School of MedicineGreenvilleSouth CarolinaUSA
| | - Melanie Heniff
- Departments of Emergency Medicine and PediatricsIndiana University School of MedicineIndianapolisIndianaUSA
| | - Gwen Hooley
- Division of Emergency and Transport MedicineChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
| | - Christian Pulcini
- Department of Emergency Medicine and PediatricsUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Timothy Ruttan
- Department of PediatricsDell Medical SchoolThe University of Texas at Austin. US Acute Care SolutionsCantonOhioUSA
| | - Annalise Sorrentino
- Department of Pediatrics, Division of Emergency MedicineUniversity of AlabamaBirminghamAlabamaUSA
| | - Muhammad Waseem
- Lincoln Medical Center, Bronx New York; Weill Cornell MedicineNew YorkUSA
| | - Mohsen Saidinejad
- Departments of Emergency Medicine and PediatricsDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
- The Lundquist Institute for Biomedical Innovation at Harbor UCLATorranceCaliforniaUSA
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