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Morris CS, Keen MA, White C, Ingram PB, Mitchell SM, Victor SE. Determining the MMPI-3 SUI scale's cross-sectional and prospective utility in suicide risk assessment. J Clin Psychol 2024; 80:1243-1258. [PMID: 38466342 PMCID: PMC11052672 DOI: 10.1002/jclp.23664] [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] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE In-depth suicide risk assessments are particularly important to long-term suicide prevention. Broadband measures of psychopathology, such as the Minnesota Multiphasic Personality Inventory (MMPI) instruments, assess suicide risk factors and various mental health comorbidities. With the recent release of the MMPI-3, the Suicidal/Death Ideation (SUI) scale underwent revisions to improve its construct validity and detection of suicide risk factors. Thus, we hypothesized the MMPI-3 SUI scale would demonstrate medium to large associations with suicidal experience and behaviors, future ideation, and interpersonal risk factors of suicide. METHODS A sample of 124 college students screened for elevated depressive symptoms completed a brief longitudinal study. Participants completed a baseline session including the MMPI-3 and criterion measures and three brief follow-ups every 2 weeks. RESULTS SUI scores were most robustly associated with increased risk for past suicidal ideation, planning, and perceived burdensomeness. Prospectively assessed suicidal ideation was also meaningfully associated with SUI. SUI scale elevations indicate an increased risk of suicide-related risk factors. CONCLUSION The MMPI-3 is a valuable tool to inform long-term suicide prevention for those experiencing elevated depressive symptoms as the SUI scale can assess past, current, and future suicide-related risk factors, including suicidal ideation and behaviors.
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Affiliation(s)
- Cole S Morris
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Megan A Keen
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Chloe White
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Paul B Ingram
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Sean M Mitchell
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Sarah E Victor
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
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Ndetei DM, Wasserman D, Mutiso V, Shanley JR, Musyimi C, Nyamai P, Munyua T, Swahn MH, Osborn TL, Johnson NE, Memiah P, Bhui K, Gilbert S, Weisz JR, Javed A, Sourander A. Methods and associations of suicidality in Kenyan high school students: clinical and public health implications. BJPsych Open 2024; 10:e112. [PMID: 38738349 DOI: 10.1192/bjo.2024.56] [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: 05/14/2024] Open
Abstract
BACKGROUND Most evidence on suicidal thoughts, plans and attempts comes from Western countries; prevalence rates may differ in other parts of the world. AIMS This study determined the prevalence of suicidal thoughts, plans and attempts in high school students in three different regional settings in Kenya. METHOD This was a cross-sectional study of 2652 high school students. We asked structured questions to determine the prevalence of various types of suicidality, the methods planned or effected, and participants' gender, age and form (grade level). We provided descriptive statistics, testing significant differences by chi-squared and Fisher's exact tests, and used logistic regression to identify relationships among different variables and their associations with suicidality. RESULTS The prevalence rates of suicidal thoughts, plans and attempts were 26.8, 14.9 and 15.7%, respectively. These rates are higher than those reported for Western countries. Some 6.7% of suicide attempts were not associated with plans. The most common method used in suicide attempts was drinking chemicals/poison (18.8%). Rates of suicidal thoughts and plans were higher for older students and students in urban rather than rural locations, and attempts were associated with female gender and higher grade level - especially the final year of high school, when exam performance affects future education and career prospects. CONCLUSION Suicidal thoughts, plans and attempts are prevalent in Kenyan high school students. There is a need for future studies to determine the different starting points to suicidal attempts, particularly for the significant number whose attempts are not preceded by thoughts and plans.
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Affiliation(s)
- David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | | | - Victoria Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | | | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Pascalyne Nyamai
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Timothy Munyua
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Monica H Swahn
- Department of Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, USA
| | | | - Natalie E Johnson
- Shamiri Institute, Nairobi, Kenya; Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland; and University of Basel, Basel, Switzerland
| | | | - Kamaldeep Bhui
- Department of Psychiatry, Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, UK; National Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre; Oxford, UK; and World Psychiatric Association Collaborating Centre, Oxford, UK
| | - Sonja Gilbert
- Research Centre for Child Psychiatry, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; and INVEST Child Psychiatry, INVEST Research Flagship Center, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - John R Weisz
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Afzal Javed
- World Psychiatric Association, Geneva, Switzerland
| | - Andre Sourander
- Research Centre for Child Psychiatry, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; INVEST Child Psychiatry, INVEST Research Flagship Center, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; and Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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Sicotte R, Abdel-Baki A, Mohan G, Rabouin D, Malla A, Padmavati R, Moro L, Joober R, Rangaswamy T, Iyer SN. Similar and different? A cross-cultural comparison of the prevalence, course of and factors associated with suicidal thoughts and behaviors in first-episode psychosis in Chennai, India and Montreal, Canada. Int J Soc Psychiatry 2024; 70:457-469. [PMID: 38174721 PMCID: PMC11067410 DOI: 10.1177/00207640231214979] [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: 01/05/2024]
Abstract
BACKGROUND Data from high-income countries (HICs) show a high risk of suicidal thoughts and behaviors (STBs) in first-episode psychosis (FEP). It is unknown, however, whether rates and associated factors differ in low- and middle-income countries (LMICs). AIMS We therefore aimed to compare the 2-year course of STBs and associated factors in persons with FEP treated in two similarly structured early intervention services in Chennai, India and Montreal, Canada. METHOD To ensure fit to the data that included persons without STBs and with varying STBs' severity, a hurdle model was conducted by site, including known predictors of STBs. The 2-year evolution of STBs was compared by site with mixed-effects ordered logistic regression. RESULTS The study included 333 FEP patients (168 in Chennai, 165 in Montreal). A significant decrease in STBs was observed at both sites (OR = 0.87; 95% CI [0.84, 0.90]), with the greatest decline in the first 2 months of follow-up. Although three Chennai women died by suicide in the first 4 months (none in Montreal), Chennai patients had a lower risk of STBs over follow-up (OR = 0.44; 95% CI [0.23, 0.81]). Some factors (depression, history of suicide attempts) were consistently associated with STBs across contexts, while others (gender, history of suicidal ideation, relationship status) were associated at only one of the two sites. CONCLUSIONS This is the first study to compare STBs in FEP between two distinct geo-sociocultural contexts (an HIC and an LMIC). At both sites, STBs reduced after treatment initiation, suggesting that early intervention reduces STBs across contexts. At both sites, for some patients, STBs persisted or first appeared during follow-up, indicating need for suicide prevention throughout follow-up. Our study demonstrates contextual variations in rates and factors associated with STBs. This has implications for tailoring suicide prevention and makes the case for more research on STBs in FEP in diverse contexts.
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Affiliation(s)
- Roxanne Sicotte
- Research Center of the Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Amal Abdel-Baki
- Research Center of the Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Greeshma Mohan
- Schizophrenia Research Foundation (SCARF), Chennai, Tamil Nadu, India
| | - Daniel Rabouin
- Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montréal, QC, Canada
| | - Ashok Malla
- Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montréal, QC, Canada
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | | | - Laura Moro
- Department of Psychology, Faculty of Arts and Sciences, Université de Montréal, Montréal, QC, Canada
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montréal, QC, Canada
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Thara Rangaswamy
- Schizophrenia Research Foundation (SCARF), Chennai, Tamil Nadu, India
| | - Srividya N. Iyer
- Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Montréal, QC, Canada
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
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Luo Y, Zhou Y, Peng P, Yuan N, Zhang X. Prevalence and clinical correlates of suicide attempts in patients with first-episode drug-naïve major depressive disorder and comorbid autoimmune thyroiditis. BJPsych Open 2024; 10:e95. [PMID: 38686554 PMCID: PMC11060091 DOI: 10.1192/bjo.2024.48] [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: 10/23/2023] [Revised: 01/23/2024] [Accepted: 03/05/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Autoimmune thyroiditis is closely associated with major depressive disorder (MDD) and suicide attempts. However, few studies have examined this relationship. AIMS The study aimed to assess the prevalence and correlates of suicide attempts in patients with first-episode drug-naïve (FEDN) MDD and autoimmune thyroiditis. METHOD We recruited 1718 out-patients with FEDN MDD and assessed depressive, anxiety and psychotic symptoms with the Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety (HRSA) and Positive and Negative Syndrome Subscale positive subscale, respectively. The serum levels of free triiodothyronine, free thyroxine, thyroid stimulating hormone (TSH), antithyroglobulin, thyroid peroxidase antibody (TPOAb) and several other metabolic parameters were assessed. Patients were divided into non-autoimmune thyroiditis, autoimmune thyroiditis only and autoimmune thyroiditis with abnormal TSH groups, based on autoimmune thyroiditis severity. Multiple logistic regression model was applied to identify the correlates of suicide attempts in patients with MDD and autoimmune thyroiditis with abnormal TSH. RESULTS Compared with the non-autoimmune thyroiditis group, the autoimmune thyroiditis with abnormal TSH group had a nearly fourfold higher likelihood of reporting a suicide attempt, whereas no difference was found between the non-autoimmune thyroiditis and autoimmune thyroiditis only groups. HRSA score, lnTPOAb and lnTSH were independently associated with suicide attempts in patients with autoimmune thyroiditis with abnormal TSH. CONCLUSIONS Patients with MDD and autoimmune thyroiditis with abnormal TSH are at higher risk for suicide attempt. TPOAb, TSH and anxiety are all independently associated with suicide attempts in this population, and regular thyroid checks are warranted.
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Affiliation(s)
- Yinli Luo
- Department of Psychiatry, Hunan Brain Hospital, Hunan Second People's Hospital, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry, Hunan Brain Hospital, Hunan Second People's Hospital, Changsha, China
| | - Pu Peng
- Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, China
| | - Ning Yuan
- Department of Psychiatry, Hunan Brain Hospital, Hunan Second People's Hospital, Changsha, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; and Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Robison M, Robertson L, Joiner TE. Why did peri-pandemic suicide death rates decrease among non-Hispanic white people while increasing among most people of color? Suicide Life Threat Behav 2024. [PMID: 38676429 DOI: 10.1111/sltb.13088] [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: 04/05/2024] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION While suicides in the United States decreased during the COVID-19 pandemic, statistically significant decreases have been limited to White people throughout a large portion of 2020. METHODS This paper outlines possible explanations for racial/ethnic differences in suicidality in the early pandemic phases. RESULTS We propose both distal (i.e., tele-mental health usage, internet and technology access, employment protections, and economic security) and proximal (cultural beliefs, coping strategies, clustering, pulling together, and embracing life) factors that may have helped build and foster community and mental wellness. However, this paper argues these factors did not extend, or did not extend as much, to many communities of color. CONCLUSIONS We argue that these disparities are due to the myriad effects of discrimination and systemic racism, encapsulated broadly by the minority stress theory, and provide suggestions for relief and research.
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Affiliation(s)
- Morgan Robison
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Lee Robertson
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - T E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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Jewett PI, Taliaferro LA, Borowsky IW, Mathiason MA, Areba EM. Structural adverse childhood experiences associated with suicidal ideation, suicide attempts, and repetitive nonsuicidal self-injury among racially and ethnically minoritized youth. Suicide Life Threat Behav 2024. [PMID: 38651757 DOI: 10.1111/sltb.13084] [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: 01/27/2023] [Revised: 03/14/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION High rates of suicidal ideation (SI), suicide attempts (SA), and repetitive nonsuicidal self-injury (NSSI) among some ethnoracially minoritized United States youth populations may be related to adverse childhood experiences (ACEs) with structural roots. METHODS Using the 2013-2019 Minnesota Student Surveys, we assessed associations of student-reported structural ACEs (parental incarceration, housing instability, food insecurity, and foster care involvement) with SI, SA, and repetitive NSSI within the past 12 months using multilevel logistic regression stratified by ethnoracial group (American Indian/Alaskan Native [AIAN], Hmong, other Asian, Black Latino, other Latino, Somali, other Black/African American [AA], Native Hawaiian/Pacific Islander [NHPI], and multiracial), and adjusted for sex, grade, ACEs experienced within one's household, mental health treatment, and perceived safety. RESULTS Structural ACEs were strongly associated with increasing SI, SA, and NSSI. At ≥2 structural ACEs, repetitive NSSI rates ranged from 7% to 29% (female), 8% to 20% (male); SA rates ranged from 13% to 35% (female), 10% to 22% (male); and SI rates ranged from 31% to 50% (female), 20% to 32% (male). Black Latino, NHPI, AIAN, and Black/AA students most often reported structural ACE exposures. CONCLUSION Reducing structural ACEs may reduce SI, SA, and repetitive NSSI among ethnoracially minoritized youth populations. Disaggregating diverse youth groups revealed variations in these outcomes that remain hidden when subpopulations are aggregated.
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Affiliation(s)
- Patricia I Jewett
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lindsay A Taliaferro
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Iris W Borowsky
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Eunice M Areba
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
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Singh G, Hansen JP, Hulgaard D, Damkjær M, Christiansen E. Impact of COVID-19 restrictions on self-poisoning behaviour with mild analgesics in Danish youth. Nord J Psychiatry 2024:1-9. [PMID: 38625374 DOI: 10.1080/08039488.2024.2339433] [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: 09/27/2023] [Accepted: 03/20/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The COVID-19 pandemic prompted the implementation of precautions to contain the disease, including lockdowns and social isolation. Previous studies have investigated suicide rates among children and adolescents during the pandemic and have found varying results. We speculated how the two lockdowns influenced suicidal behaviour in children and adolescents in Denmark. OBJECTIVE This study aimed to investigate the effect of lockdowns during the COVID-19 pandemic on suicide attempts, as measured by the incidence rate in all self-poisonings with mild analgesics among children and adolescents. METHODS This national Danish registry-based study on children and adolescents used Poisson regression and interrupted time series analysis to examine the incidence rates and trends of self-poisonings with mild analgesics from 2019 to mid-2021. RESULTS For the period of this study, 1655 self-poisonings were registered. During the first lockdown, there was a slight, not statistically significant, decrease in self-poisoning rates (incidence rate ratio [IRR]) 0.98) compared to no lockdown. During the second lockdown, there was a significant increase in self-poisonings for the whole Danish population (IRR 1.85) with girls being slightly higher at risk (IRR 1.87). Being a girl or between the ages of 13-17 years old were risk factors for self-poisoning. CONCLUSION These findings indicate that the restrictions enforced during the second lockdown greatly impacted youth mental health, especially girls, leading to an 85% increase in self-poisonings. We hope for increased awareness of mental health in children and adolescents during possible future lockdowns.
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Affiliation(s)
- Gurbhej Singh
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jonathan Pommer Hansen
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Ditte Hulgaard
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Research Unit Mental Health, Children and Adult, Aabenraa, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Mads Damkjær
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Erik Christiansen
- Research Unit Mental Health, Children and Adult, Aabenraa, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Centre for Suicide Research, Odense, Denmark
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Huntjens A, van den Bosch LMCW, Sizoo B, Kerkhof A, Smit F, van der Gaag M. The effectiveness and safety of dialectical behavior therapy for suicidal ideation and behavior in autistic adults: a pragmatic randomized controlled trial. Psychol Med 2024:1-12. [PMID: 38606582 DOI: 10.1017/s0033291724000825] [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: 04/13/2024]
Abstract
BACKGROUNDS Many autistic people in mental health are suicidal. This study evaluated the effectiveness of dialectical behavior therapy (DBT) v. treatment as usual (TAU) in reducing suicidal ideation and suicide attempts. METHODS At six Dutch mental health centers, 123 outpatients (18-65 years) with DSM-5 diagnosed autism spectrum disorder (ASD) and suicidal behavior were randomly assigned to the DBT intervention group (n = 63) or TAU control group (n = 60). Assessments were conducted at baseline, post-treatment at 6 months and 12-month follow-up. The primary outcomes were severity of suicidal ideation and frequency of suicide attempts. The severity of depression and social anxiety were secondary outcomes. RESULTS At end-of-treatment, DBT significantly reduced both suicidal ideation (z = -2.24; p = 0.025; b = -4.41; s.e. = 197.0) and suicide attempts (z = -3.15; p = 0.002; IRR = 0.046; s.e. = 0.045) compared to TAU, but lost statistical significance at the 12-month follow-up. Depression severity significantly decreased with DBT (z = -1.99; p = 0.046: b = -2.74; s.e. = 1.37) remaining so at 12 months (z = -2.46; p = 0.014; b = -3.37; s.e. = 1.37). No effects were observed on social anxiety. Severe adverse events included two suicides in the TAU condition. CONCLUSIONS DBT is an acceptable, safe, and short-term effective intervention to reduce suicidal ideation and suicide attempts in autistic adults with suicidal behavior.
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Affiliation(s)
- Anne Huntjens
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
- Parnassia Psychiatric Institute, The Hague, Netherlands
| | | | | | - Ad Kerkhof
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Filip Smit
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
- Parnassia Psychiatric Institute, The Hague, Netherlands
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Sutcliffe K, Wilson M, Clark TC, Crengle S, Fleming TT. Distinct profiles of mental health need and high need overall among New Zealand adolescents - Cluster analysis of population survey data. Aust N Z J Psychiatry 2024:48674241243262. [PMID: 38600641 DOI: 10.1177/00048674241243262] [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: 04/12/2024]
Abstract
OBJECTIVE The objective was to identify clinically meaningful groups of adolescents based on self-reported mental health and wellbeing data in a population sample of New Zealand secondary school students. METHODS We conducted a cluster analysis of six variables from the Youth19 Rangatahi Smart Survey (n = 7721, ages 13-18 years, 2019): wellbeing (World Health Organization Well-Being Index), possible anxiety symptoms (Generalized Anxiety Disorder 2-item, adapted), depression symptoms (short form of the Reynolds Adolescent Depression Scale) and past-year self-harm, suicide ideation and suicide attempt. Demographic, contextual and behavioural predictors of cluster membership were determined through multiple discriminant function analysis. We performed cross-validation analyses using holdout samples. RESULTS We identified five clusters (n = 7083). The healthy cluster (n = 2855, 40.31%) reported positive mental health across indicators; the anxious cluster (n = 1994, 28.15%) reported high possible anxiety symptoms and otherwise generally positive results; the stressed and hurting cluster (n = 667, 9.42%) reported sub-clinical depression and possible anxiety symptoms and some self-harm; the distressed and ideating cluster (n = 1116, 15.76%) reported above-cutoff depression and possible anxiety symptoms and high suicide ideation; and the severe cluster (n = 451; 6.37%) reported the least positive mental health across indicators. Female, rainbow, Māori and Pacific students and those in higher deprivation areas were overrepresented in higher severity clusters. Factors including exposure to sexual harm and discrimination were associated with increasing cluster severity. CONCLUSION We identified high prevalence of mental health challenges among adolescents, with distinct clusters of need. Youth mental health is not 'one size fits all'. Future research should explore youth behaviour and preferences in accessing support and consider how to best support the mental health of each cluster.
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Affiliation(s)
- Kylie Sutcliffe
- School of Psychology, Faculty of Science, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
- School of Health, Faculty of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Marc Wilson
- School of Psychology, Faculty of Science, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Terryann C Clark
- (Ngāpuhi) School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sue Crengle
- (Kāi Tahu, Kāti Māmoe, Waitaha) Ngāi Tahu Māori Health Research Unit, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Terry Theresa Fleming
- School of Health, Faculty of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
- Department of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand
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Mournet AM, Kellerman JK, Krall HR, Kleiman EM. Investigation into the relationships between Greek life, experiences of violence, and suicidal thoughts and behaviors among undergraduate students. J Am Coll Health 2024:1-9. [PMID: 38592932 DOI: 10.1080/07448481.2024.2337005] [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] [Received: 06/30/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
Introduction: This study aims to examine how involvement in Greek life impacts the relationships between violence and STBs. Methods: This study utilizes data from the American College Health Association-National College Health Assessment (ACHA-NCHA) waves IIb, IIc, and III. Analyses examine the moderating effect of involvement in Greek life on the relationship between violence and presence of STBs in the past year. Results: Main effects revealed consistent patterns across violence types, STBs and waves, with Greek life membership associated with increased odds of experiencing violence and associated with decreased odds of suicidal ideation. The relationship between violence and suicide attempts was stronger for those involved in Greek life. Discussion: Greek life may be an institution where targeted interventions for suicide and violence may be effective. It may be important to identify additional avenues to reduce STBs that are not associated with increased experiences of violence.
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Affiliation(s)
- Annabelle M Mournet
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - John K Kellerman
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Hannah R Krall
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Evan M Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
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Sourander A, Silwal S, Osokina O, Hinkka-Yli-Salomäki S, Hodes M, Skokauskas N. Suicidality and Self-Harm Behavior of Adolescents During the Early Phase of the War in Ukraine. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00177-1. [PMID: 38575059 DOI: 10.1016/j.jaac.2024.03.015] [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: 07/25/2023] [Revised: 03/13/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE War profoundly impacts people's lives, causing death, displacement, and psychological trauma, but research investigating suicidality of adolescents in this context has been limited. We compared suicidality or self-harm behavior among adolescents in regions that were, and were not, affected by Russia's initial invasion of Ukraine in 2014. METHOD This cross-sectional study comprised 2,752 school students aged 11 to 17 years from the war-affected Donetsk region and non-war Kirovograd region. Data collection occurred in 2016 and 2017 using self-report tools to assess suicidality or self-harm behavior; psychopathology including posttraumatic stress disorder (PTSD), depression, and anxiety; and war trauma exposure. RESULTS Adolescent girls in the war-affected region reported more suicide attempts (9.5% vs 5.1%; adjusted odds ratio [aOR] 1.8, 95% CI 1.2-2.8), suicidal ideation (39.3% vs 19.6%; aOR 2.6, 95% CI 2.01-3.3), or self-harm behavior (19.6% vs 13.1%; aOR 1.6, 95% CI 1.2-2.1), and boys reported more suicidal ideation (17.0% vs 9.8%; aOR 1.7, 95% CI 1.2-2.4). Boys and girls with PTSD, depression, or anxiety showed increased risks for any suicidality or self-harm. A dose-effect relation was observed between war trauma exposure and suicidality or self-harm. The association was strongest for adolescents who had experienced 5 or more different war trauma exposures (aOR 3.2, 95% CI 2.2-4.8). CONCLUSION War trauma exposure and psychopathology were strongly associated with suicidality or self-harm behavior, with a greater impact in girls than boys. The high prevalence of suicidality found in this study emphasizes the need for intervention on a large scale for adolescents living in war situations.
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Affiliation(s)
- Andre Sourander
- Research Centre for Child Psychiatry, INVEST Flagship, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland.
| | - Sanju Silwal
- Research Centre for Child Psychiatry, INVEST Flagship, University of Turku, Turku, Finland
| | - Olga Osokina
- Donetsk National Medical University, Kropyvnitskyi, Ukraine; Kyiv Medical University, Kyiv, Ukraine
| | | | | | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare, IPH, Norwegian University of Science and Technology, Trondheim, Norway
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12
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Schafer KM, Joiner TE. A Comparison of Patients Presenting with Suicide Attempts, Psychopathology Symptoms, or Pain within Emergency Departments. Arch Suicide Res 2024; 28:512-522. [PMID: 36994500 DOI: 10.1080/13811118.2023.2192765] [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: 03/31/2023]
Abstract
Previous suicide attempts, psychopathology symptoms, and pain significantly increase risk of suicide, a leading cause of death. It is possible that patients across these three groups exhibit key differences that could provide insights into unique interventions for suicide-related outcomes. Data were collected using a standardized form at 432 emergency departments (EDs; 14,018 participants [females, n = 8,042; 57.4%; males, n = 5,976; 42.6%]). We conducted a series of ANOVAs to investigate if patients presenting for (1) suicide attempts (n = 33; 0.2%), (2) psychopathology symptoms (n = 1,104; 7.9%), or (3) pain (n = 12,881; 91.9%) varied across a variety of healthcare-relevant variables. Findings indicated that patients presenting with suicide attempts were seen with more urgency (F[2,12054] = 66.41, p < .001) and were more likely to be admitted to hospitalization (F[2,14015] = 187.296, p < .001), observation unit overall (F[2,14015] = 78.572, p < .001), or transferred to another hospital (F[2,14015] = 406.568, p < .001); they also required longer visits (F [2, 12054] = 66.41, p < .001) as compared to patients with psychopathology symptoms or pain. Notably, potentially important similarities between groups emerged: groups did not differ across leaving without medical screening, leaving against medical advice, or contact with healthcare providers in the long-term (i.e., twelve months) or short-term (i.e., 72 hours) preceding ED admission. These findings in particular indicate that there could be ample time (1) prior to admission to intervene and (2) during care in EDs to connect patients to goal-oriented, time-limited evidence based psychotherapies at a time when they may be particularly willing to engage in care.
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Cheng J, Peng C, Rong F, Wang Y, Tan Y, Yu Y. Mobile phone addiction and suicide behaviors among Chinese adolescents: The mediation of poor sleep quality. J Behav Addict 2024; 13:88-101. [PMID: 38224348 PMCID: PMC10988414 DOI: 10.1556/2006.2023.00078] [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] [Received: 02/08/2023] [Revised: 07/18/2023] [Accepted: 12/03/2023] [Indexed: 01/16/2024] Open
Abstract
Background and aims Mobile phone addiction (MPA) is emerging among adolescents, especially during the COVID-19 pandemic. Nevertheless, there is a dearth of knowledge regarding the correlation between MPA and suicide behaviors and its mechanism. The objective of the current study is exploring the direct effect of MPA on suicide behaviors and the indirect effect through poor sleep quality. Methods A total of 18,900 Chinese adolescents aged 12 to 18 were recruited via a multi-stage cluster sampling method. Results The prevalence of MPA and poor sleep quality was 26.2 and 23.1%, respectively. During the past year, 24.4% participants were involved in suicide behaviors. Specifically, suicide ideators, suicide planners, and suicide attempters were 10.7, 8.4, and 5.3%, respectively. Particularly, rural females had the highest prevalence of suicide behaviors, MPA, and poor sleep quality. Logistic regression analysis showed that MPA was significantly associated with suicide ideators (OR = 1.22, 95% CI: 1.09-1.37, p < 0.001) and planners (OR = 1.18, 95% CI: 1.04-1.34, p < 0.05), but not for suicide attempters (p > 0.05). Structural equation modelling demonstrated that MPA had direct effect on suicide behaviors (β = 0.145, 95% CI = 0.127-0.160), and poor sleep quality partially mediated the relationship (the mediating ratio was 46.7%). The mediating ratio of poor sleep quality was the highest in urban males. Conclusions MPA has both direct and indirect effects on suicide behaviors. For suicide prevention, limited mobile phone use and improvement sleep quality may be practical for adolescents. Additionally, more efforts of intervention could give priority to rural girls.
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Affiliation(s)
- Junhan Cheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chang Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fajuan Rong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yafei Tan
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yizhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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14
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Bond AE, Houtsma C, Bryan CJ, Anestis MD. Self-Reported Likelihood of a Future Suicide Attempt: The Role of Plans for Suicide. Arch Suicide Res 2024:1-11. [PMID: 38526309 DOI: 10.1080/13811118.2024.2332249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
OBJECTIVE The present study seeks to add to the existing literature by determining if having a plan for suicide, is associated with an individual's self-reported likelihood of attempting suicide in the future. METHOD Data came from a sample of 97 United States Army personnel with past week ideation or lifetime attempt history. Assessments were collected at baseline, 1-month, 3-month, and 6-months. RESULTS Self-reported likelihood of attempting suicide in the future was not associated with the presence of a plan for suicide overall or a plan with a specific method (i.e., firearm, cutting/scratching, and medication). DISCUSSION Although a plan for suicide is commonly thought to indicate elevated risk our findings suggest that presence or absence of suicide plans is not associated with more self-reported likelihood of a future suicide attempt.
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15
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Cho D, Shim EJ. Profiles of Decision-Making and Suicidal Behaviors. Arch Suicide Res 2024:1-15. [PMID: 38451149 DOI: 10.1080/13811118.2024.2324974] [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: 03/08/2024]
Abstract
OBJECTIVE Deficits in decision-making (DM) are a significant risk factor for suicidal behaviors. However, specific patterns of DM aspects have rarely been examined. This study examined the profiles of DM and their relationship with suicide ideation and attempts. METHODS A total of 175 young adults participated in an online survey and the Cambridge Gambling Task between October and November 2021. RESULTS Based on the latent profile analysis with four aspects of DM-risk DM, risk adjustment, DM speed, and delay-discounting-as indicators, three profiles were identified: (1) no deficit class, (2) high risk DM class, and (3) slow DM speed class. Higher use of an avoidant and dependent DM styles was associated with a greater likelihood of being in the slow DM speed class. Younger age and psychache was associated with a greater likelihood of being in the high risk DM class. The rates of lifetime suicide ideation (i.e., wish for death, suicide intent, and suicide plan) and lifetime suicide attempt were higher in the high risk DM class than in the no deficit class. The rate of lifetime wish for death was higher in the slow DM speed class than in the no deficit class. CONCLUSIONS Suicide prevention may benefit from addressing DM, which is characterized by high risk and slow speed.
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Wang Q, Wen M, Fan S, Liu J, Wang X, Guo W, Hu J, Zhang J, Li B, Zhang L, Zhang Y, Li K. Attention-Dominated Cognitive Dysfunction May Be a Biological Marker for Distinguishing SA from SI in Adolescents: A Network Analysis Study Based on Adolescent Depression. Psychol Res Behav Manag 2024; 17:945-956. [PMID: 38464812 PMCID: PMC10924855 DOI: 10.2147/prbm.s448904] [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: 11/08/2023] [Accepted: 02/27/2024] [Indexed: 03/12/2024] Open
Abstract
Objective Suicidal behavior is strongly correlated with depressive symptoms and the degree of suicidal ideation. Cognitive impairment may have varying degrees of influence on suicidal ideation (SI) and suicidal attempts (SA). The aim of this study was to identify the cognitive biomarkers that distinguish suicidal ideation from suicidal attempts in adolescents. Methods The cross-sectional sample comprised 54 adolescents with major depressive disorder (MDD) and 32 healthy controls (HC). The THINC-it was utilized to assess cognitive function of all the samples. Suicidal ideation was examined by the Positive and Negative Suicide Ideation Scale (PANSI). Based on the type of data, one-way ANOVA or Kruskal-Wallis was performed to investigate group differences. Bonferroni post-hoc analysis was employed for regulating type I error for pairwise comparisons. Network analysis was used to compare the networks associated with suicidal ideation, depression symptoms, and cognitive function between SA and SI. Results The depression symptoms (HAMD-17) (F=72.515, P<0.001) and suicidal ideation (PANSI) (F=267.952, P<0.001) in the SA were higher than those in the SI. Analysis of between-group differences showed SA performed worse in THINC-it, especially in "Spotter (SP)" (P=0.033), "Objective cognition score (OS)" (P=0.027) and "Composite score (CS)" (P=0.017). Compared with SI, network analysis revealed that SA had a unique network of cognitive function, depressive symptoms, and suicidal ideation. Nevertheless, both networks exhibit comparable performance concerning the node strength of cognitive function. Within their separate networks, the aspects of CS, OS, and SP have emerged as the three most crucial elements. Conclusion Adolescents with SI or SA exhibit a broad spectrum of cognitive impairments. Attention impairment can be beneficial in discerning between SI and SA. Future interventions for adolescent suicide can center on attention and the comprehensive cognitive ability that it represents.
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Affiliation(s)
- Qi Wang
- Clinical Medicine College, Hebei University, Hebei, People's Republic of China
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
| | - Min Wen
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China
| | - Shaohang Fan
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, People's Republic of China
| | - Jinning Liu
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
| | - Xiaowen Wang
- Psychosomatic Medicine Department, Jiangxi Provincial People's Hospital, Nanchang, People's Republic of China
| | - Wentao Guo
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
| | - Jinyun Hu
- Psychiatric Department, The Second People's Hospital of Yuxi, Yunnan, People's Republic of China
| | - Jialan Zhang
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
| | - Bing Li
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
- Hebei Provincial Key Laboratory of Major Mental and Behavioral Disorders, Hebei, People's Republic of China
| | - Lili Zhang
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
- Hebei Provincial Key Laboratory of Major Mental and Behavioral Disorders, Hebei, People's Republic of China
| | - Yunshu Zhang
- Clinical Medicine College, Hebei University, Hebei, People's Republic of China
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
- Hebei Provincial Key Laboratory of Major Mental and Behavioral Disorders, Hebei, People's Republic of China
| | - Keqing Li
- Hebei Provincial Mental Health Center, Hebei, People's Republic of China
- Hebei Provincial Key Laboratory of Major Mental and Behavioral Disorders, Hebei, People's Republic of China
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Kimbrel NA, Aho NA, Neal LC, Bernes SA, Beaver TA, Hertzberg JA, Lutrey A, Leto F, Ostiguy W, Cammarata C, Meyer EC, Wilson SM, Dennis MF, Calhoun PS, Beckham JC, Stanley B, Gulliver SB. Development and Implementation of Web-Based Safety Planning Intervention Training for Firefighter Peer Support Specialists. Crisis 2024; 45:108-117. [PMID: 37727969 DOI: 10.1027/0227-5910/a000924] [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: 09/21/2023]
Abstract
Background: Recent findings indicate that firefighters may be at increased risk for death by suicide; however, there has been only limited suicide prevention work in fire service to date. Aim: The objective of this program evaluation project was to develop and evaluate a web-based Safety Planning Intervention (SPI) training course for firefighter peer support specialists. Method: Peer support specialists who completed the web-based SPI training were administered evaluation questionnaires before the training and then again at a 3-month follow-up assessment. Results: A total of 213 peer support specialists completed the SPI training. Most participants took 2-3 h to complete the training. Participants generally reported high levels of satisfaction with the course, with the vast majority (94.4%) indicating they would recommend it to their peers. Course completers also demonstrated significant gains in SPI knowledge and self-efficacy from baseline to 3-month follow-up (all p's < .001). Moreover, the percentage of participants who reported completing a safety plan with someone they suspected at being of risk for suicide increased approximately 7-fold from baseline (3.5%) to 3-month follow-up (25.2%; p < .001). Participants further reported that 97.6% of the safety plans that they completed resulted in a positive outcome. Limitations: This was a program evaluation project that did not include a control group. Thus, causality cannot be inferred. Conclusions: The present findings suggest that web-based SPI training is a feasible and scalable approach for training peer support specialists to deliver the SPI to at-risk individuals.
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Affiliation(s)
- Nathan A Kimbrel
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Natalie A Aho
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Lydia C Neal
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Sarah A Bernes
- International Association of Fire Fighters, Washington, DC, USA
| | - Tiffany A Beaver
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Jeffrey A Hertzberg
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
| | - Alice Lutrey
- International Association of Fire Fighters, Washington, DC, USA
| | - Frank Leto
- International Association of Fire Fighters, Washington, DC, USA
- Fire Department of the City of New York, NY, USA
| | - Willy Ostiguy
- International Association of Fire Fighters, Washington, DC, USA
- Boston Fire Department, Boston, MA, USA
| | - Claire Cammarata
- New York City Office of Labor Relations Employee Assistance Program, New York, NY, USA
| | - Eric C Meyer
- Department of Counseling and Behavioral Health, University of Pittsburgh, PA, USA
| | - Sarah M Wilson
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Michelle F Dennis
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Patrick S Calhoun
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Jean C Beckham
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Durham Veterans Affairs Healthcare System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Barbara Stanley
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Suzy B Gulliver
- International Association of Fire Fighters, Washington, DC, USA
- Warriors Research Institute, Waco, TX, USA
- Department of Psychiatry and Human Behavior, Texas A&M Health Science Center, Bryan, TX, USA
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Nassar M, Misra A, Bloomgarden Z. Impact of treatment with GLP-1RAs on suicide attempts in adults persons with type 2 diabetes: A retrospective comparative effectiveness study based on a global TriNetX health research database. J Diabetes 2024; 16:e13547. [PMID: 38501220 PMCID: PMC10949079 DOI: 10.1111/1753-0407.13547] [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: 01/11/2024] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE To assess the association between glucagon-like peptide-1 receptor agonists (GLP-1RA) treatment and the risk of suicide attempts in people with type 2 diabetes (T2D), with a focus on subgroups with and without a history of depression or suicide attempts. METHODS This retrospective cohort study utilized TriNetX, a federated network of real-world data. Using the Global Collaborative Network data, we collected electronic medical records from 113 health care organizations with 135 million patient records with 8 million with T2D, 83% from the United States. The four cohorts were identified based on age, medication, diagnosis, and presence of depression or suicide attempts. Analytic methods included measures of association and number of Instances, with propensity score matching employed to mitigate potential confounders. The primary outcome was the incidence of suicide attempts among people with T2D with GLP-1RA treatment in comparison with dipeptidyl peptidase-4 inhibitor (DPP-4i) treatment. RESULTS People with T2D treated with GLP-1RA consistently exhibited a lower risk of suicide attempts compared to those treated with DPP-4i. This was particularly significant in people with a history of depression or suicide attempts. The risk and odds ratios were significantly lower in the GLP-1RA-treated cohorts than in DPP-4i across all analyses. CONCLUSION As compared with DPP-4i, our analysis shows a protective effect associated with GLP-1RA treatment on the risk of suicide attempts among people with T2D. However, further research, particularly prospective and randomized studies, is necessary to confirm these observations and understand the underlying mechanisms.
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Affiliation(s)
- Mahmoud Nassar
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical SciencesUniversity at BuffaloBuffaloNew YorkUSA
| | - Anoop Misra
- Fortis‐C‐DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Diabetes Foundation (India), and National Diabetes Obesity and Cholesterol Foundation (NDOC)New DelhiIndia
| | - Zachary Bloomgarden
- Department of Medicine, Division of Endocrinology, Diabetes and Bone DiseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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Huntjens A, Landlust A, Wissenburg S, van der Gaag M. The Prevalence of Suicidal Behavior in Autism Spectrum Disorder. Crisis 2024; 45:144-153. [PMID: 37668055 DOI: 10.1027/0227-5910/a000922] [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: 09/06/2023]
Abstract
Background: Suicidal ideation (SI) and suicide attempts (SA) are common in autistic individuals, but prevalence rates have not yet been estimated with meta-analysis. Aims: This meta-analysis aims to estimate SI and SA prevalence rates in autistic individuals and identify subgroup differences based on sample characteristics and study quality. Methods: A systematic search identified 52 studies with 88,509 autistic participants reporting SI and SA. Pooled prevalence estimates were calculated using a random-effects model. Results: Pooled prevalence estimates of lifetime SI and SA were 37.2% [95% CI 25.3-50.8] and 15.3% [95% CI 9.5-23.6], respectively. For 12-month prevalence, this was 25.4% [95% CI 19.0-33.2] and 14.1% [95% CI 7.4-25.2], respectively. Subgroup analyses revealed significant differences based on age (SI), region (SI), data collection (SI), measurement scales used to define autism and suicidality (SA), and representation of the study sample (SI and SA). Heterogeneity measures were high for all outcomes (I2 = 60.3-99.1%). Limitations: The heterogeneity of the included studies may limit the generalizability of our findings. Conclusion: The high rates of suicidal problems in autistic individuals call for a systematic evaluation of suicidality in clinical practice and adequate therapeutic interventions to improve this condition.
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Affiliation(s)
- Anne Huntjens
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Academy, The Hague, The Netherlands
| | - Annemiek Landlust
- Autism Team Northern-Netherlands, Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, The Netherlands
- Department of Genetics, University Medical Center Groningen, The Netherlands
| | - Sophie Wissenburg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Academy, The Hague, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Academy, The Hague, The Netherlands
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20
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Fu Z, Zhang X, Xiao J. Prevalence and risk factors of suicide attempts among Chinese elderly patients over 50 years with schizophrenia. Suicide Life Threat Behav 2024. [PMID: 38363017 DOI: 10.1111/sltb.13057] [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: 01/03/2024] [Revised: 01/04/2024] [Accepted: 01/30/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Several research efforts have found that older schizophrenia patients are at higher risk for suicide. Related risk factors for suicide attempts in the elderly with schizophrenia are poorly understood. This study sought to assess the prevalence of suicide attempts and related risk variables in schizophrenia patients over the age of 50. METHODS We recruited 591 elderly patients over the age of 50. Demographic, clinical and blood parameters of all patients were collected. Patients with schizophrenia were evaluated for psychopathological symptoms using the Positive and Negative Syndrome Scale (PANSS). RESULTS The rate of suicide attempts among elderly Chinese schizophrenia patients was 15.2%. In these elderly schizophrenia patients, those who with suicide attempts had significantly higher scores for insomnia, depression and smoking addiction, and higher levels of red blood cells, Hc1 glycosylated hemoglobin and free T3, but significantly lower levels of hypersensitive C-reactive protein and -globulin. Binary logistic regression analysis showed that higher depression scores and smoking addiction were risk factors for suicide attempts in these patients. Additionally, multiple regression analyses showed that higher BMI and insomnia scores were associated with suicide risk scores in elderly schizophrenia patients. CONCLUSIONS Our research shows that there is a high incidence of suicide attempts in people over 50 years of age with schizophrenia. A number of clinically relevant factors and metabolic markers are associated with suicide attempts among elderly patients with schizophrenia.
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Affiliation(s)
- Zejin Fu
- Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jing Xiao
- Beijing Key Laboratory of Learning and Cognition and Department of Psychology, Capital Normal University, Beijing, China
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21
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Fujikane D, Ohi K, Kuramitsu A, Takai K, Muto Y, Sugiyama S, Shioiri T. Genetic correlations between suicide attempts and psychiatric and intermediate phenotypes adjusting for mental disorders. Psychol Med 2024; 54:488-494. [PMID: 37559484 DOI: 10.1017/s0033291723002015] [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: 08/11/2023]
Abstract
BACKGROUND Suicide attempts are a moderately heritable trait, and genetic correlations with psychiatric and related intermediate phenotypes have been reported. However, as several mental disorders as well as major depressive disorder (MDD) are strongly associated with suicide attempts, these genetic correlations could be mediated by psychiatric disorders. Here, we investigated genetic correlations of suicide attempts with psychiatric and related intermediate phenotypes, with and without adjusting for mental disorders. METHODS To investigate the genetic correlations, we utilized large-scale genome-wide association study summary statistics for suicide attempts (with and without adjusting for mental disorders), nine psychiatric disorders, and 15 intermediate phenotypes. RESULTS Without adjusting for mental disorders, suicide attempts had significant positive genetic correlations with risks of attention-deficit/hyperactivity disorder, schizophrenia, bipolar disorder, MDD, anxiety disorders and posttraumatic stress disorder; higher risk tolerance; earlier age at first sexual intercourse, at first birth and at menopause; higher parity; lower childhood IQ, educational attainment and cognitive ability; and lower smoking cessation. After adjusting for mental disorders, suicide attempts had significant positive genetic correlations with the risk of MDD; earlier age at first sexual intercourse, at first birth and at menopause; and lower educational attainment. After adjusting for mental disorders, most of the genetic correlations with psychiatric disorders were decreased, while several genetic correlations with intermediate phenotypes were increased. CONCLUSIONS These findings highlight the importance of considering mental disorders in the analysis of genetic correlations related to suicide attempts and suggest that susceptibility to MDD, reproductive behaviors, and lower educational levels share a genetic basis with suicide attempts after adjusting for mental disorders.
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Affiliation(s)
- Daisuke Fujikane
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazutaka Ohi
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
- Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, Japan
| | - Ayumi Kuramitsu
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kentaro Takai
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yukimasa Muto
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Shunsuke Sugiyama
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Toshiki Shioiri
- Department of Psychiatry, Gifu University Graduate School of Medicine, Gifu, Japan
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Kılıçarslan Ş, Çelik S, Güngör AY, Alkan Ö. The role of effective factors on suicidal tendency of women in Turkey. Front Public Health 2024; 11:1332937. [PMID: 38274522 PMCID: PMC10809711 DOI: 10.3389/fpubh.2023.1332937] [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: 11/09/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Background/Aim This study aims to identify the variables that influence the suicidal tendency of women who are married, have had a relationship or are currently in a relationship in Turkey. Methods This study uses cross-sectional data from the 2014 Hacettepe University Institute of Population Studies National Research on Domestic Violence Against Women in Turkey. Data from 6,458 women between the ages of 15 and 49 were analyzed in this dataset. Binary logistic regression was used to determine the factors influencing women's suicidal tendencies. Results Based on the analysis's findings, age, education level, health status, number of children, the sector in which the spouse/partner works, the drinking status of the spouse/partner, the situation where the spouse/partner fights with another man in a way that involves physical violence, the cheating status of the spouse/partner, the controlling behaviour of the spouse/partner, exposure to various types of violence by both the spouse/partner and someone other than the partner, and the household income level variables were found to be associated with the suicidal tendency of women. Conclusion Prioritizing women who are, in particular, between the ages of 15 and 24, live in the south of Turkey, have a high school education, are in poor health, are childless, have low household incomes, live with an unemployed spouse or partner, and are exposed to various forms of violence from their partner or other sources can be achieved more effective results in reducing and preventing women's suicidal behaviors.
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Affiliation(s)
- Şerife Kılıçarslan
- Oltu Faculty of Humanities and Social Sciences, Department of Finance and Banking, Ataturk University, Erzurum, Türkiye
| | - Sefa Çelik
- Faculty of Economics and Administrative Sciences, Department of Business Administration, Ataturk University, Erzurum, Türkiye
| | - Abdullah Y. Güngör
- Oltu Faculty of Humanities and Social Sciences, Department of Business Administration, Ataturk University, Erzurum, Türkiye
| | - Ömer Alkan
- Faculty of Economics and Administrative Sciences, Department of Econometrics, Ataturk University, Erzurum, Türkiye
- Master Araştırma Eğitim ve Danışmanlık Hizmetleri Ltd. Şti., Erzurum, Türkiye
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Zhu Q, Lang X, Zhang XY. Gender differences in prevalence and clinical risk factors of suicide attempts in young adults with first-episode drug-naive major depressive disorder. BJPsych Open 2024; 10:e19. [PMID: 38179592 PMCID: PMC10790225 DOI: 10.1192/bjo.2023.635] [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: 01/06/2024] Open
Abstract
BACKGROUND Suicide rates in adolescents with major depressive disorder (MDD) change with age and gender. Early adulthood is an important transitional stage between late adolescence and adulthood, in which an individual's mind gradually matures. However, there are fewer studies on prevalence and variables linked to the suicide attempts of young adults with MDD. AIMS To explore gender differences in the prevalence and risk factors associated with suicide attempts in young adults with first-episode drug-naive MDD. METHOD The Hamilton Rating Scale for Depression (HRSD), Hamilton Rating Scale for Anxiety (HRSA) and Positive Subscale of the Positive and Negative Syndrome Scale (PANSS) were used to assess depression, anxiety and psychotic symptoms respectively and various biochemical indicators were assessed. RESULTS Among 293 young adults with first-episode drug-naive MDD, the prevalence of suicide attempts was 15.45% (19/123) for males and 14.12% (24/170) for females. Males with suicide attempts had higher levels of thyroid-stimulating hormone (TSH) and higher PANSS Positive Subscale scores, whereas females with suicide attempts had higher TSH, serum total cholesterol, fasting blood glucose and diastolic blood pressure levels and higher scores on the HRSD, HRSA, PANSS Positive Subscale (all Bonferroni corrected P < 0.05). In males, PANSS Positive Subscale score (B = 0.17, P = 0.03, OR = 1.19, 95% CI 1.02-1.38) was a risk factor for suicide attempts. CONCLUSIONS There were significant gender differences in the risk factors for suicide attempts in young adults with first-episode drug-naive MDD.
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Affiliation(s)
- Quanfeng Zhu
- Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Xiaoe Lang
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China; and Department of Psychology, University of the Chinese Academy of Sciences, Beijing, China
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Núñez D, Gaete J, Guajardo V, Libuy N, Araneda AM, Contreras L, Donoso P, Ibañez C, Mundt AP. Brief Report: The Association of Adverse Childhood Experiences and Suicide-Related Behaviors Among 10th-Grade Secondary School Students. Arch Suicide Res 2024; 28:399-410. [PMID: 36330838 DOI: 10.1080/13811118.2022.2134067] [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: 11/06/2022]
Abstract
The association between adverse childhood experiences and suicide-related behaviors (SRB) of adolescents has been widely studied in Western high-income countries, but not yet in Latin America. The aim of this study was to determine this association and to explore a dose-response relationship between adverse childhood experiences and SRB in Chile. We conducted a cross-sectional survey to assess adverse childhood experiences up to 1 year prior to the survey and SRB (suicide ideation and attempts) in a sample of secondary school students. Multilevel and multivariable logistic regressions were run with SRB as dependent and adverse childhood experiences as independent variables, adjusted by self-esteem, general mental health, friend and parental support, and the age at onset of cannabis and alcohol use. We included 7,458 adolescents (48.7% girls), mean age = 16.0 (SD = 0.7), and found a prevalence of 78.1% for at least one adverse childhood experience. The 6-month prevalence of suicidal ideation was 18.1% (95% confidence interval [CI]: 17.2%-19.0%), and the prevalence of suicide attempts was 5.0% (95% CI: 4.6-5.6). Among all adverse childhood experiences, only sexual abuse was a risk factor for both SRB. We also found an independent effect of the total number of adverse childhood experiences on suicidal ideation (p < .001) and on suicide attempts (p < .001). Additionally, ages at onset of alcohol and cannabis use were associated with suicidal ideation and suicidal attempts, respectively. This is the first study exploring the influence of adverse childhood experiences on suicide-related behaviors in adolescents from Latin America.HIGHLIGHTSSexual abuse is associated with suicidal ideation and suicide attempts in 10th-grade secondary school studentsThere is a dose-response effect between adverse childhood experiences and suicide-related behaviorAges at onset of alcohol and cannabis use were associated with suicidal ideation and suicidal attempts, respectively.
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Ganson KT, Pang N, Testa A, Nagata JM. Muscle dysmorphia symptomatology is prospectively associated with suicidal thoughts, suicidal behaviors, and non-suicidal self-injury among a sample of Canadian adolescents and young adults. Suicide Life Threat Behav 2023; 53:1076-1085. [PMID: 37855328 DOI: 10.1111/sltb.13008] [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] [Received: 07/24/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Limited, primarily cross-sectional research has identified associations between muscle dysmorphia and suicidal thoughts suicidal behaviors, and non-suicidal self-injury (NSSI). This study aimed to investigate the associations between muscle dysmorphia and suicidal thoughts, suicidal behaviors, and NSSI prospectively over a 1-year period among a large, diverse sample of Canadian adolescents and young adults. METHODS Data from wave one (2021) and wave two (2022) of the Canadian Study of Adolescent Health Behaviors were analyzed (N = 912). Multiple modified Poisson regression analyses were used to determine the associations between muscle dysmorphia symptomatology at wave one and three items of suicidal thoughts and behaviors and one item of NSSI at wave two. Unadjusted models and adjusted models were estimated. RESULTS Total muscle dysmorphia symptomatology and symptoms of Appearance Intolerance were prospectively associated with suicidal ideation and suicide planning at 12-month follow-up. These findings were significant across unadjusted and adjusted models. CONCLUSIONS Findings from this study expand prior research and underscore the clinical complexity of muscle dysmorphia. Future research should investigate mechanisms explaining the association between muscle dysmorphia and suicide and develop interventions to prevent suicide among people with muscle dysmorphia.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Nelson Pang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, California, USA
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Graham CE, Frisco ML. The Mental "Weight" of Discrimination: The Relationship between Perceived Interpersonal Weight Discrimination and Suicidality in the United States. J Health Soc Behav 2023; 64:610-625. [PMID: 37776190 PMCID: PMC10683344 DOI: 10.1177/00221465231200634] [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: 10/02/2023]
Abstract
Extant research has investigated the relationship between body weight and suicidality because obesity is highly stigmatized, leading to social marginalization and discrimination, yet has produced mixed results. Scholars have speculated that factors associated with body weight, such as weight discrimination, may better predict suicidality than body weight itself. We consider this possibility among a sample of 12,057 adult participants ages 33 to 43 in Wave V of the National Longitudinal Study of Adolescent to Adult Health through investigation of the relationships between weight discrimination and two dimensions of suicidality-suicide ideation and attempts. We also examine gender as a moderator of these relationships. We find that weight discrimination is positively associated with both suicide ideation and attempts, and this relationship is similar among men and women. Our findings underscore the need to address issues of weight discrimination in our society to better promote mental well-being.
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Torrents R, Reynoard J, Glaizal M, Schmitt C, Fabeck KV, Boulamery A, de Haro L, Simon N. Deliberate Self-Poisoning with Plants in Southeastern France, a Poison Center 20-Year Report. Toxins (Basel) 2023; 15:671. [PMID: 38133175 PMCID: PMC10747985 DOI: 10.3390/toxins15120671] [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: 10/07/2023] [Revised: 11/09/2023] [Accepted: 11/18/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION In a few regions of the globe, deliberate botanical intoxication may induce significant rates of toxicity and fatality. The objective of this report was to describe plant self-intoxication using the experiences of the southeastern France poison control center (PCC) between 2002 and 2021. RESULTS During those 20 years, 262 deliberate plants poisonings were reported involving 35 various plants. In most of the cases, poisoning was caused by Nerium oleander (n = 186, 71%), followed by the Datura genus (4.2%), Ricinus communis (3.8%), Taxus baccata (1.9%), Digitalis purpurea (1.2%), Aconitum nape (1.9%), Myristica fragans (1.5%), and Pyracantha coccine (1.2%). Through the 262 plants poisonings, 19 patients among the 186 Nerium oleander poisonings received Digifab as an antidote and 1 patient received physostigmine among the 11 Datura poisonings. Only four deaths were reported for this review, each involving Nerium oleander. DISCUSSION The first involved species was Nerium oleander (71% of all plants poisonings), then Datura sp and Ricinus communis. It is explained by this native local species' important repartition. Most patients must be admitted to an emergency department for adapted medical care; however, only 41 of them described severe poisonings symptoms. Even fewer needed an antidote, only 20 patients. There is no protocol for the use of a specific treatment, and it might be interesting to develop one for this purpose. MATERIAL AND METHODS This retrospective review was realized with files managed by the southeastern France PCC based in Marseille from 2002 to 2021. Our department covers the complete French Mediterranean coast, Corsica, and tropical islands (Reunion Island, Mayotte). For every patient, toxicity was evaluated using the Poison Severity Score (PSS).
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Affiliation(s)
- Romain Torrents
- Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Hôpital Sainte Marguerite, Clinical Pharmacology and Poison Control Centre, 13009 Marseille, France;
| | - Julien Reynoard
- APHM, Hôpital Sainte Marguerite, Clinical Pharmacology and Poison Control Centre, 13009 Marseille, France; (J.R.); (M.G.); (K.V.F.); (A.B.); (L.d.H.)
| | - Mathieu Glaizal
- APHM, Hôpital Sainte Marguerite, Clinical Pharmacology and Poison Control Centre, 13009 Marseille, France; (J.R.); (M.G.); (K.V.F.); (A.B.); (L.d.H.)
| | - Corinne Schmitt
- APHM, Hôpital Sainte Marguerite, Clinical Pharmacology and Poison Control Centre, 13009 Marseille, France; (J.R.); (M.G.); (K.V.F.); (A.B.); (L.d.H.)
| | - Katharina Von Fabeck
- APHM, Hôpital Sainte Marguerite, Clinical Pharmacology and Poison Control Centre, 13009 Marseille, France; (J.R.); (M.G.); (K.V.F.); (A.B.); (L.d.H.)
| | - Audrey Boulamery
- APHM, Hôpital Sainte Marguerite, Clinical Pharmacology and Poison Control Centre, 13009 Marseille, France; (J.R.); (M.G.); (K.V.F.); (A.B.); (L.d.H.)
| | - Luc de Haro
- APHM, Hôpital Sainte Marguerite, Clinical Pharmacology and Poison Control Centre, 13009 Marseille, France; (J.R.); (M.G.); (K.V.F.); (A.B.); (L.d.H.)
| | - Nicolas Simon
- Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Hôpital Sainte Marguerite, Clinical Pharmacology and Poison Control Centre, 13009 Marseille, France;
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French Á, Gaynor K, Nearchou F, Raftery S, O'Dwyer B, Hennessy E. Parents' Information Needs in Relation to Adolescent Self-Harm: Perspectives of Parents and Professionals. Arch Suicide Res 2023:1-16. [PMID: 37950673 DOI: 10.1080/13811118.2023.2279524] [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: 11/13/2023]
Abstract
OBJECTIVE Discovering that an adolescent is self-harming is extremely distressing for parents and this distress can be compounded by lack of easily accessible and well targeted information on what they can do to help. Some research has even suggested that parental distress can be an obstacle to seeking professional help. This paper describes two studies that sought to identify the information needs of parents in the immediacy of discovering self-harm and in ongoing efforts to support their child. METHOD Study 1: on-line survey of 128 parents who had experienced their child's self-harm; study 2: two-round Delphi method with 29 professionals who provide therapeutic interventions to adolescents who self-harm. The primary aim of both studies was to elicit views on parents' information needs in relation to supporting adolescents who self-harm. RESULTS There was a high level of agreement between parents and professionals on the needs for information on topics such as: communication, psychoeducation, managing emotional responses, parenting strategies and interventions. The professionals also emphasized the need for parents to practice self-care and the value of teaching alternative coping strategies to adolescents. Parents placed greater emphasis than professionals on the need for information on future therapeutic needs. CONCLUSION Despite the agreement between parents and professionals on most of the information needed, there were sufficient differences in emphasis to confirm the importance of consulting with both groups. The findings can be used to develop information sources that are specifically tailored to the needs of parents at all stages of adolescent self-harm.
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Sicotte R, Iyer SN, Lacourse É, Séguin JR, Abdel-Baki A. Heterogeneity in the Course of Suicidal Ideation and its Relation to Suicide Attempts in First-Episode Psychosis: A 5-Year Prospective Study. Can J Psychiatry 2023; 68:850-859. [PMID: 37071553 PMCID: PMC10590090 DOI: 10.1177/07067437231167387] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 04/19/2023]
Abstract
OBJECTIVES Although the risk of suicide is high in first-episode psychosis (FEP), little is known about the course of suicidal ideation and its relation to suicide attempts. Therefore, we aimed to identify 5-year trajectories of suicidal ideation and associated factors in FEP and compare how suicide attempts were distributed across these identified trajectories. METHOD This 5-year prospective study assessed suicidal ideation, suicide attempts and potentially associated factors through research interviews, chart review and coroners' reports in 382 FEP patients [mean age = 23.53 (SD = 3.61)] admitted to 2 5-year early psychosis services in Montreal, Canada. Trajectories were identified using a semiparametric mixture model, and associated factors with multinomial logistic regression. RESULTS Three suicidal ideation trajectories were identified: low and decreasing (n = 325, 85.08%); early decline, then increasing (n = 30, 7.85%), and persistent suicidal ideation (n = 27, 7.07%). Suicidal ideation prior to admission (OR = 2.85, 95% CI, 1.23 to 6.63, P < 0.05) and cocaine use disorder (OR = 6.78, 95% CI, 1.08 to 42.75, P < 0.05) were associated with the early decline, then increasing suicidal ideation trajectory. Persons with prior suicide ideation (OR = 4.33, 95% CI, 1.66 to 11.29, P < 0.05) and attempts (OR = 8.18, 95% CI, 2.39 to 27.97, P < 0.001) and alcohol use disorder (OR = 3.63, 95% CI, 1.4 to 9.42, P < 0.05) were more likely to belong to the persistent suicidal ideation trajectory, and to attempt suicide during follow-up. CONCLUSIONS Our study highlights heterogeneity in the course of suicidal ideation over 5 years and the importance of ongoing assessment of suicidal risk in FEP patients, particularly for patients who persistently report suicidal ideation, as they are likelier to engage in suicide attempts. Patients with factors associated with increasing or persistent suicidal ideation trajectories should be targeted for suicide prevention interventions from the early phase of follow-up. Given the small number of persons in these trajectories and the wide CIs for some factors, larger studies are however needed to further characterize who belongs in each group.
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Affiliation(s)
- Roxanne Sicotte
- Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Srividya N. Iyer
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
- Prevention and Early Intervention Program for Psychosis (PEPP), Douglas Mental Health University Institute, Verdun, Québec, Canada
| | - Éric Lacourse
- Department of Sociology, Faculty of Arts and Sciences, Université de Montréal, Montréal, Québec, Canada
| | - Jean R. Séguin
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
- Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, Montréal, Québec, Canada
| | - Amal Abdel-Baki
- Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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Xi W, Banerjee S, Zima BT, Alexopoulos GS, Olfson M, Xiao Y, Pathak J. Effects of Geography on Risk for Future Suicidal Ideation and Attempts Among Children and Youth. JAACAP Open 2023; 1:206-217. [PMID: 37946932 PMCID: PMC10635419 DOI: 10.1016/j.jaacop.2023.07.002] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Objective Geography may influence the relationships of predictors for suicidal ideation (SI) and suicide attempts (SA) in children and youth. Method This is a nationwide retrospective cohort study of 124,424 individuals less than 25 years of age using commercial claims data (2011-2015) from the Health Care Cost Institute. Outcomes were time to SI or SA within 3 months after the indexed mental health or substance use disorder (MH/SUD) outpatient visit. Predictors included sociodemographic and clinical characteristics up to 3 years before the index event. Results At each follow-up time period, rates of SI and SA varied by the US geographic division (p < .001), and the Mountain Division consistently had the highest rates for both SI and SA (5.44%-10.26% for SI; 0.70%-2.82% for SA). Having MH emergency department (ED) visits in the past year increased the risk of SI by 28% to 65% for individuals residing in the New England, Mid-Atlantic, East North Central, West North Central, and East South Central Divisions. The main effects of geographic divisions were significant for SA (p<0.001). Risk of SA was lower in New England, Mid-Atlantic, South Atlantic, and Pacific (hazard ratios = 0.57, 0.51, 0.67, and 0.79, respectively) and higher in the Mountain Division (hazard ratio = 1.46). Conclusion To understand the underlying mechanisms driving the high prevalence of SI and SA in the Mountain Division and the elevated risk of SI after having MH ED visits, future research examining regional differences in risks for SI and SA should include indicators of access to MH ED care and other social determinants of health.
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Affiliation(s)
- Wenna Xi
- Weill Cornell Medicine, New York
| | | | - Bonnie T Zima
- Center for Health Services and Society, UCLA-Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
| | | | - Mark Olfson
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York
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Khoso AB, Noureen A, Un Nisa Z, Hodkinson A, Elahi A, Arshad U, Naz A, Bhatti MM, Asif M, Husain MO, Husain MI, Chaudhry N, Husain N, Chaudhry IB, Panagioti M. Prevalence of suicidal ideation and suicide attempts in individuals with psychosis and bipolar disorder in South Asia: systematic review and meta-analysis. BJPsych Open 2023; 9:e179. [PMID: 37814419 PMCID: PMC10594255 DOI: 10.1192/bjo.2023.570] [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: 04/29/2023] [Revised: 08/01/2023] [Accepted: 08/17/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Suicidal ideation and attempts are growing public health concerns globally. Evidence from high-income countries suggests that individuals with psychosis and bipolar disorder are at increased risk of suicidal ideation and attempts, but there is a scarcity of evidence from South Asia. AIMS To estimate the prevalence of suicidal ideation and attempts in individuals with psychosis and bipolar disorder in South Asia. METHOD In this systematic review and meta-analysis, four databases (PsycINFO, Web of Science, EMBASE and Medline) were searched until December 2022. Pooled prevalence was estimated with random-effects models. Heterogeneity was quantified with the I2-statistic. RESULTS The pooled sample size across the 21 studies was 3745 participants, 1941 (51.8%) of which were male. The pooled prevalence of suicide attempts in South Asian people with either psychosis or bipolar disorder was 22% (95% CI 17-27; n = 15). The pooled prevalence of suicidal ideation with psychosis or bipolar disorder combined was 38% (95% CI 27-51; n = 10). Meta-regression, subgroup and sensitivity analysis showed that the pooled prevalence estimates for both suicide attempt and ideation remained unaffected by variations in critical appraisal ratings and study designs. Only one study reported data on suicide-related deaths. CONCLUSIONS One in four individuals diagnosed with psychosis or bipolar disorder have reported suicide attempts, whereas up to one in three have experienced suicidal ideation. These findings underscore the urgent need for clinicians to regularly assess and monitor suicidal ideation and attempts among individuals with these disorders in South Asia.
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Affiliation(s)
- Ameer B. Khoso
- Division of At-Risk Mental State, Schizophrenia Spectrum, and other Psychotic Disorders, Pakistan Institute of Living and Learning, Karachi, Pakistan; and Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Amna Noureen
- Division of Child and Adolescent Mental Health, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Zaib Un Nisa
- Division of At-Risk Mental State, Schizophrenia Spectrum, and other Psychotic Disorders, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Alexander Hodkinson
- National Institute for Health and Care Research (NIHR) School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK; and National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK
| | - Anam Elahi
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, UK
| | - Usman Arshad
- Division of Child and Adolescent Mental Health, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Anum Naz
- Division of At-Risk Mental State, Schizophrenia Spectrum, and other Psychotic Disorders, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | | | - Muqaddas Asif
- Division of Substance-Related and Addiction Disorders, Pakistan Institute of Living and Learning, Lahore, Pakistan; and Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Muhammad Omair Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Muhammad Ishrat Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Nasim Chaudhry
- Division of Neurodevelopmental Disorders, Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Nusrat Husain
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK; and Mersey Care NHS Foundation Trust, Prescot, UK
| | - Imran B. Chaudhry
- Division of At-Risk Mental State, Schizophrenia Spectrum, and other Psychotic Disorders, Pakistan Institute of Living and Learning, Karachi, Pakistan; Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK; and Department of Psychiatry, Ziauddin University, Karachi, Pakistan
| | - Maria Panagioti
- National Institute for Health and Care Research (NIHR) School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, UK; and National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK
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Feluse A, Mevorach T, Horesh N, Asherov J, Briskman I, Apter A. Comparative Epidemiology of Attempted and Fatal Suicide in a Defined Catchment Area in Israel. Arch Suicide Res 2023; 27:1180-1190. [PMID: 36005156 DOI: 10.1080/13811118.2022.2110547] [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: 11/02/2022]
Abstract
BACKGROUND Both attempted and fatal suicides are important public health issues and the relationship between these behaviors has great relevance to clinical practice. AIMS To determine how the epidemiology of attempted and fatal suicide relate to each other over time. METHOD In an 18-year period consecutive admissions for suicide attempts (n = 4,645) to the emergency room of the central hospital of a well-defined catchment area were assessed using a structured interview. Data were compared with records of 425 fatal suicides from the same catchment area. RESULTS The relative rates of attempted and fatal suicide changed over time independent of both age and gender up to age 64. Rates of suicide and attempted suicide did not correlate over time in this age group. This was not true for the over 65 age group where attempted suicide and fatal suicide were significantly correlated over time in both men and women. CONCLUSIONS In subjects over 65 attempted suicide is highly associated with eventual suicide. This relationship is much less clear in younger age groups. Thus age of attempt is of great importance when considering the prognostic import of a suicide attempt.
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Meza JI, Zullo L, Vargas SM, Ougrin D, Asarnow JR. Practitioner Review: Common elements in treatments for youth suicide attempts and self-harm - a practitioner review based on review of treatment elements associated with intervention benefits. J Child Psychol Psychiatry 2023; 64:1409-1421. [PMID: 36878853 DOI: 10.1111/jcpp.13780] [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] [Accepted: 01/20/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Adopting a common elements approach, this practitioner review aims to highlight specific treatment elements that are common to interventions with demonstrated benefits in randomized controlled trials (RCTs) for reducing suicide attempts and self-harm in youth. Identification of common treatment elements among effective interventions offers a key strategy for clarifying the most robust features of effective interventions and improving our ability to implement effective treatment and decrease the lag between scientific advances and clinical care. METHODS A systematic search of RCTs evaluating interventions targeting suicide/self-harm in youth (ages 12-18) yielded a total of 18 RCTs assessing 16 different manualized interventions. An open coding process was used to identify common elements present within each intervention trial. Twenty-seven common elements were identified and classified into format, process, and content categories. All trials were coded for the inclusion of these common elements by two independent raters. RCTs were also classified into those where trial results supported improvements in suicide/self-harm behavior (n = 11 supported trials) and those without supported evidence (n = 7 unsupported trials). RESULTS Compared with unsupported trials, the 11 supported trials shared the following elements: (a) inclusion of therapy for both the youth and family/caregivers; (b) an emphasis on relationship-building and the therapeutic alliance; (c) utilization of an individualized case conceptualization to guide treatment; (d) provided skills training (e.g. emotion regulation skills) to both youth and their parents/caregivers; and (e) lethal means restriction counseling as part of self-harm monitoring and safety planning. CONCLUSIONS This review highlights key treatment elements associated with efficacy that community practitioners can incorporate in their treatments for youth presenting with suicide/self-harm behaviors.
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Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
- Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lucas Zullo
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sylvanna M Vargas
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
- Departments of Psychology and Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Dennis Ougrin
- Department of Child and Adolescent Psychiatry and Global Mental Health, Queen Mary University of London, London, UK
| | - Joan R Asarnow
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
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Abstract
OBJECTIVE In a large multisite cohort of Veterans who underwent Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy, we compared the 5-year suicidal ideation and attempt rates with matched nonsurgical controls. BACKGROUND Bariatric surgery has significant health benefits but has also been associated with adverse mental health outcomes. METHODS Five-year rates of suicidal ideation and suicide attempts of Veterans who underwent Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy from the fiscal year 2000-2016 to matched nonsurgical controls using sequential stratification using cumulative incidence functions (ideation cohort: n=38,199; attempt cohort: n=38,661 after excluding patients with past-year outcome events). Adjusted differences in suicidal ideation and suicide attempts were estimated using a Cox regression with a robust sandwich variance estimator. RESULTS In the matched cohorts for suicidal ideation analyses, the mean age was 53.47 years and the majority were males (78.7%) and White (77.7%). Over 40% were treated for depression (41.8%), had a nonrecent depression diagnosis (40.9%), and 4.1% had past suicidal ideation or suicide attempts >1 year before index. Characteristics of the suicide attempt cohort were similar. Regression results found that risk of suicidal ideation was significantly higher for surgical patients (adjusted hazard ratio=1.21, 95% CI: 1.03-1.41), as was risk of suicide attempt (adjusted hazard ratio=1.62, 95% CI: 1.22-2.15). CONCLUSIONS Bariatric surgery appears to be associated with a greater risk of suicidal ideation and attempts than nonsurgical treatment of patients with severe obesity, suggesting that patients need careful monitoring for suicidal ideation and additional psychological support after bariatric surgery.
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Affiliation(s)
- Anna Hung
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
- Department of Population Health Sciences, Duke University, Durham, NC
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC
| | - Matthew L. Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
- Department of Population Health Sciences, Duke University, Durham, NC
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC
| | - Theodore S. Z. Berkowitz
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
| | - David E. Arterburn
- Department of Medicine, University of Washington, Seattle, WA
- Kaiser Permanente Washington Health Research Institute, Seattle
| | - James E. Mitchell
- University of North Dakota School of Medicine and Health Sciences, Fargo, ND Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Katharine A. Bradley
- Department of Medicine, University of Washington, Seattle, WA
- Kaiser Permanente Washington Health Research Institute, Seattle
- Department of Health Services, University of Washington, Seattle, WA
| | - Nathan A. Kimbrel
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Valerie A. Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
- Department of Population Health Sciences, Duke University, Durham, NC
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC
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Mehrabi A, Naghavi A, Afsharzada ME, Friedrich S, Forkmann T, Glaesmer H, Teismann T. Validation of the Farsi version of the Suicide Ideation and Behavior Scale. Front Psychiatry 2023; 14:1201193. [PMID: 37736059 PMCID: PMC10509848 DOI: 10.3389/fpsyt.2023.1201193] [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: 04/06/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023] Open
Abstract
Objective Suicide ideation and suicide attempts are prevalent in Farsi speaking populations. The present study aimed at validating the Farsi version of the Suicide Ideation and Behavior Scale (SIBS). Methods Reliability and validity of the Farsi version of the SIBS were established in a highly burdened Afghan student sample (N = 279). Internal consistency, convergent and discriminant validity were investigated, and confirmatory factor analysis was conducted. Results The Farsi version of the SIBS was shown to have a unidimensional structure with excellent internal consistency, as well as good convergent and divergent validity. Discussion The results suggest that the SIBS is a brief, reliable, and valid measure of current suicidal ideation and behavior that can be used in Farsi speaking populations.
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Affiliation(s)
- Ali Mehrabi
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Azam Naghavi
- Department of Counseling, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | | | - Sören Friedrich
- Department of Psychology, Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Thomas Forkmann
- Department of Clinical Psychology and Psychotherapy, University of Duisburg-Essen, Duisburg, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Tobias Teismann
- Department of Psychology, Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
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Auerbach RP, Lan R, Galfalvy H, Alqueza KL, Cohn JF, Crowley RN, Durham K, Joyce KJ, Kahn LE, Kamath RA, Morency LP, Porta G, Srinivasan A, Zelazny J, Brent DA, Allen NB. Intensive Longitudinal Assessment of Adolescents to Predict Suicidal Thoughts and Behaviors. J Am Acad Child Adolesc Psychiatry 2023; 62:1010-1020. [PMID: 37182586 PMCID: PMC10524866 DOI: 10.1016/j.jaac.2023.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Received: 05/27/2022] [Revised: 03/24/2023] [Accepted: 05/05/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Suicide is a leading cause of death among adolescents. However, there are no clinical tools to detect proximal risk for suicide. METHOD Participants included 13- to 18-year-old adolescents (N = 103) reporting a current depressive, anxiety, and/or substance use disorder who owned a smartphone; 62% reported current suicidal ideation, with 25% indicating a past-year attempt. At baseline, participants were administered clinical interviews to assess lifetime disorders and suicidal thoughts and behaviors (STBs). Self-reports assessing symptoms and suicide risk factors also were obtained. In addition, the Effortless Assessment of Risk States (EARS) app was installed on adolescent smartphones to acquire daily mood and weekly suicidal ideation severity during the 6-month follow-up period. Adolescents completed STB and psychiatric service use interviews at the 1-, 3-, and 6-month follow-up assessments. RESULTS K-means clustering based on aggregates of weekly suicidal ideation scores resulted in a 3-group solution reflecting high-risk (n = 26), medium-risk (n = 47), and low-risk (n = 30) groups. Of the high-risk group, 58% reported suicidal events (ie, suicide attempts, psychiatric hospitalizations, emergency department visits, ideation severity requiring an intervention) during the 6-month follow-up period. For participants in the high-risk and medium-risk groups (n = 73), mood disturbances in the preceding 7 days predicted clinically significant ideation, with a 1-SD decrease in mood doubling participants' likelihood of reporting clinically significant ideation on a given week. CONCLUSION Intensive longitudinal assessment through use of personal smartphones offers a feasible method to assess variability in adolescents' emotional experiences and suicide risk. Translating these tools into clinical practice may help to reduce the needless loss of life among adolescents.
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Affiliation(s)
- Randy P Auerbach
- Columbia University, New York, and New York State Psychiatric Institute, New York; Sackler Institute, New York.
| | - Ranqing Lan
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Hanga Galfalvy
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Kira L Alqueza
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | | | | | - Katherine Durham
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Karla J Joyce
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Rahil A Kamath
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | | | - Giovanna Porta
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Apoorva Srinivasan
- Columbia University, New York, and New York State Psychiatric Institute, New York
| | - Jamie Zelazny
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - David A Brent
- University Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Mournet AM, Bal VH, Kleiman EM. Concordance Between the Ask Suicide Screening Questions (ASQ) and Self-Injurious Thoughts and Behaviors Interview-Self Report (SITBI-SR) Among Autistic and Non-Autistic Adults. Arch Suicide Res 2023:1-12. [PMID: 37641571 DOI: 10.1080/13811118.2023.2252027] [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: 08/31/2023]
Abstract
OBJECTIVE This study sought to examine concordance between two commonly used measures of suicidal thoughts and behaviors: the Ask Suicide-Screening Questions (ASQ) and the Self-Injurious Thoughts and Behaviors Interview-Self Report (SITBI-SR). Agreement was operationalized as the presence past month suicidal ideation and lifetime suicide attempts. To explore the utilization of these tools among neurodiverse samples, we also examined the concordance across autistic and non-autistic adults. METHODS The sample consisted of 200 individuals recruited online. Half of the sample self-reported a diagnosis of autism. A series of Cohen's kappas and confidence intervals were computed to assess agreement between the ASQ and SITBI-SR. Cohen's kappa was computed separately for each set of comparisons for the autistic and non-autistic samples. RESULTS Past month suicidal ideation had a kappa of 0.61 (95%CI = 0.48-0.73). The kappa for lifetime suicide attempts was 0.86 (95%CI = 0.78-0.94). There were no significant differences in agreement between the two measures for autistic versus non-autistic individuals. CONCLUSIONS Current findings suggest that the ASQ and SITBI-SR have high concordance with one another. Given that the ASQ and the SITBI-SR are both validated in the general population and that concordance was high and not significantly different based on autism status, the current study provides preliminary evidence that the ASQ and the SITBI-SR function similarly for autistic individuals.HIGHLIGHTSPeople do not always respond consistently to different STB assessment methods.Findings suggest that the ASQ and SITBI-SR have high concordance with one another.Evidence provided that these measures function similarly for autistic individuals.
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Huang X, Sun Y, Wu A, Zhang X. Differences in the prevalence and clinical correlates of comorbid suicide attempts in patients with early- and late-onset major depressive disorder. Front Psychiatry 2023; 14:1173917. [PMID: 37588029 PMCID: PMC10426903 DOI: 10.3389/fpsyt.2023.1173917] [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: 02/25/2023] [Accepted: 05/09/2023] [Indexed: 08/18/2023] Open
Abstract
Objective There are many studies on differences in the onset age of major depressive disorder (MDD) patients. However, study on differences in clinical correlates of suicide attempts between early- and late-onset MDD patients is limited. The aim of this study was to investigate the differences in the prevalence and clinical correlates of suicide attempts in patients with early- and late-onset MDD in China. Methods A total of 1718 adult outpatients with MDD were recruited. Demographic and clinical data were collected. The 17-item Hamilton Rating Scale for Depression (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression-Severity (CGI-S) Scales were used to assess their depressive, anxiety, psychotic symptoms, and the severity of the clinical symptoms, respectively. Results The prevalence of suicide attempts was higher in late-onset MDD patients (291/1369, 21.3%) than in early-onset MDD patients (55/349, 15.8%) (p = 0.023). However after Bonferroni correction no significant difference was found in the prevalence of suicide attempts in late-onset and late-onset MDD patients (p > 0.05). In both early- and late-onset groups, univariate analysis showed that the following characteristics were significantly associated with suicide attempts: HAMA, HAMD and PANSS positive subscale scores, thyroid stimulating hormone (TSH) levels, blood glucose levels, systolic blood pressure (SBP), and diastolic blood pressure (DBP). In both the early- and late-onset groups, the prevalence rates of severe anxiety disorder and psychotic symptoms were significantly higher in the suicide attempt group than in the non-suicide attempt group. In regression analysis, disease duration, TSH levels and HAMA score were independently associated with suicide attempts in the early-onset group, while TSH levels, HAMA and HAMD score were independently associated with suicide attempts in the late-onset group. Conclusion This study suggests that suicide attempts are not frequent in early-onset outpatients with MDD compared with late-onset, and some clinical correlates are associated with suicide attempt in early- and late-onset MDD.
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Affiliation(s)
- Xiao Huang
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yuan Sun
- Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Anshi Wu
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Arisoyin AE, Adeyemi AH, Okobi OE, Alaga AH, Adekunle OJ, Ajayi OO, Aladeniyi F, Oni EO, Okobi E, Okeaya-Inneh M, Young CL. Analyzing Trends in Suicide Attempts Among the Pediatric Population in the United States: A Study Using CDC's Youth Risk Behavior Surveillance System (YRBSS) Database. Cureus 2023; 15:e44099. [PMID: 37753036 PMCID: PMC10518429 DOI: 10.7759/cureus.44099] [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] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Background Suicide is a significant public health concern among the pediatric population in the United States. This study aims to comprehensively analyze suicide attempts among adolescents using data from the Youth Risk Behavior Surveillance System (YRBSS) maintained by the Centers for Disease Control and Prevention (CDC). Methods The pediatric population of grades 9-12 students (13-17 years old) was included in the study population, and data were collected from multiple cycles of the YRBSS survey. Descriptive statistics and time-trend analyses were conducted to examine attempted suicide rates based on location, gender, race/ethnicity, school grade level, and sexual orientation. Results Significant variations in attempted suicide rates were observed among different demographic groups. In 2021, of the subset with suicide attempt, females reported a higher prevalence of attempted suicide (13.3%, n=211), while males exhibited a lower rate (6.6%, n=104). Of the total studied population in 2021, Palau had the highest attempted suicide rate (25.2%, n=3924), followed by the Northern Mariana Islands (17.6%, n=2740). Over 1991-2021, no significant location-based variations were observed. In 2021, American Indian/Alaska Native adolescents had the highest attempted suicide rate at 16% (n=2491), followed by Black adolescents (14.5%, n=2258). Ninth-grade students reported higher rates in 2021 (11.6%, n=1806). Adolescents reporting both opposite-sex (36.7%, n=5715) and same-sex-only sexual contacts or both (32.9%, n=5123) exhibited notably higher rates in 2021. Conclusion This study highlights alarming attempted suicide rates in the US pediatric population, emphasizing the need for tailored prevention efforts and mental health support. It offers essential guidance for policymakers, researchers, and mental health professionals in developing evidence-based strategies to promote youth well-being and combat the impact of suicide attempts.
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Affiliation(s)
| | | | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | | | | | - Olamide O Ajayi
- Internal Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu, NGA
| | - Funmi Aladeniyi
- Department of Medicine, American University of Antigua, Antigua, ATG
| | - Esther O Oni
- General Practice, Ladoke Akintola University of Technology, Ogbomoso, NGA
| | - Emeka Okobi
- Dentistry, Ahmadu Bello University Teaching Hospital, Abuja, NGA
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Zangeneh A, Khademi N, Farahmandmoghadam N, Ziapour A, Naderlou R, Oghli SS, Teimouri R, Yenneti K, Moghadam S. Spatiotemporal clustering of suicide attempt in Kermanshah, West-Iran. Front Psychiatry 2023; 14:1174071. [PMID: 37583840 PMCID: PMC10425239 DOI: 10.3389/fpsyt.2023.1174071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [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: 02/25/2023] [Accepted: 07/18/2023] [Indexed: 08/17/2023] Open
Abstract
Background A suicide attempt is a major societal problem because it imposes high costs on societies worldwide. This paper analyses the spatiotemporal clustering of suicide attempt in Kermanshah, Iran from 2006-14. Methods This study draws on 18,333 individuals (7,234 males and 11,097 females) who attempted suicide across the Kermanshah province. Data was collected from the records of individuals registered in hospitals across the Kermanshah province between 2006 and 2014. Mean Center, Standard Deviational Ellipse (SDE), Moran's I and Kernel Density Estimation (KDE) in Arc/GIS10.6 software were used for the analysis of the spatial distribution of suicide attempt, while the chi-squared test in SPSS was used to examine the different demographic variables between groups within/outside spatial clusters of suicide. Results The results show that a total of 18,331 suicide attempts (39.46% male and 60.53% female) were reported between 2006 and 2014 in the Kermanshah province. The spatial pattern of suicide attempts was clustered in 16 clusters (6 high clusters and 10 low clusters) and statistically significant differences were found within and outside the hotspots of suicide attempts. Most hot spots were formed in and around cities. Younger people were at a greater risk. The rate of suicide attempts reduced in illiterate people and increased in people with university degrees. Unmarried people were associated with a higher risk of suicide attempt than was married status for both males and females. Conclusion The results of this study could help public health practitioners and policymakers in Iran prioritize resources and target efforts for suicide attempt prevention.
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Affiliation(s)
- Alireza Zangeneh
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nahid Khademi
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Farahmandmoghadam
- Clinical Research Development Center, Imam Khomeini and Mohammad Kermanshahi Hospitals, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reyhane Naderlou
- Geography and Urban Planning, University of Zanjan, Zanjan, Iran
| | - Somayyeh Shalchi Oghli
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Raziyeh Teimouri
- UniSA Creative, University of South Australia, Adelaide, SA, Australia
| | - Komali Yenneti
- School of Architecture and the Built Environment, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, United Kingdom
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Hu C, Jiang W, Huang J, Lin J, Huang J, Wang M, Xie J, Yuan Y. The amplitude of low-frequency fluctuation characteristics in depressed adolescents with suicide attempts: a resting-state fMRI study. Front Psychiatry 2023; 14:1228260. [PMID: 37575559 PMCID: PMC10419264 DOI: 10.3389/fpsyt.2023.1228260] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/18/2023] [Indexed: 08/15/2023] Open
Abstract
Background The amplitude of low-frequency fluctuation (ALFF) is a measure of spontaneous brain activity derived from resting-state functional magnetic resonance imaging (rs-fMRI). Previous research has suggested that abnormal ALFF values may be associated with major depressive disorder (MDD) and suicide attempts in adolescents. In this study, our aim was to investigate the differences in ALFF values between adolescent MDD patients with and without a history of suicide attempts, and to explore the potential utility of ALFF as a neuroimaging biomarker for aiding in the diagnosis and prediction of suicide attempts in this population. Methods The study included 34 adolescent depression patients with suicide attempts (SU group), 43 depression patients without suicide attempts (NSU group), and 36 healthy controls (HC group). Depression was diagnosed using a threshold score greater than 17 on the Hamilton Depression Rating Scale (HDRS). The rs-fMRI was employed to calculate zALFF values and compare differences among the groups. Associations between zALFF values in specific brain regions and clinical variables such as emotion regulation difficulties were explored using Pearson partial correlation analysis. Receiver-Operating Characteristics (ROC) analysis assessed the ability of mean zALFF values to differentiate between SU and NSU groups. Results Significant differences in zALFF values were observed in the left and right inferior temporal gyrus (l-ITG, r-ITG) and right fusiform gyrus (r-FG) among the three groups (GRF corrected). Both SU and NSU groups exhibited increased zALFF values in the inferior temporal gyrus compared to the HC group. Furthermore, the SU group showed significantly higher zALFF values in the l-ITG and r-FG compared to both the NSU group and the HC group. Partial correlation analysis revealed a negative correlation between zALFF values in the left superior and middle frontal gyrus (l-SFG, l-MFG) and the degree of emotional dysregulation in the SU group (R = -0.496, p = 0.003; R = -0.484, p = 0.005). Combining zALFF values from the l-ITG and r-FG achieved successful discrimination between depressed adolescents with and without suicide attempts (AUC = 0.855) with high sensitivity (86%) and specificity (71%). Conclusion Depressed adolescents with suicidal behavior exhibit unique neural activity patterns in the inferior temporal gyrus and fusiform gyrus. These findings highlight the potential utility of these specific brain regions as biomarkers for identifying suicide risk in depressed adolescents. Furthermore, associations between emotion dysregulation and activity in their frontal gyrus regions were observed. These findings provide preliminary yet pertinent insights into the pathophysiology of suicide in depressed adolescents.
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Affiliation(s)
- Changchun Hu
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jie Huang
- Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jian Lin
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jialing Huang
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mei Wang
- Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jian Xie
- Department of Clinical Psychology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhong Da Hospital, School of Medicine, Southeast University, Nanjing, China
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Liu J, Zhu X, Liu Y, Jia F, Yuan H, Wang Q, Zhang X, Li Z, Du X, Zhang X. Association between triglyceride glucose index and suicide attempts in patients with first-episode drug-naïve major depressive disorder. Front Psychiatry 2023; 14:1231524. [PMID: 37575577 PMCID: PMC10416446 DOI: 10.3389/fpsyt.2023.1231524] [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: 05/30/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Abstract
Objective Triglyceride glucose (TyG) index has been suggested as an alternative indicator of insulin resistance (IR); however, the association between TyG index and suicide attempts (SA) in major depressive disorder (MDD) is unclear. The aim of this study was to investigate the relationship between TyG index and SA in Chinese patients with first-episode drug-naïve (FEDN) MDD. Methods This cross-sectional study enrolled 1,718 patients with FEDN MDD aged 34.9 ± 12.4 years from the First Hospital of Shanxi Medical University (Taiyuan, Shanxi Province, China) from September 2016 to December 2018. Multivariable binary logistic regression analysis was used to estimate the association between TyG index and the risk of SA. A two-piecewise linear regression model was used to investigate the threshold effects if non-linearity associations existed. Interaction and stratified analyses were performed based on sex, education, marital status, comorbid anxiety, and psychotic symptoms. Results Multivariable logistic regression analysis revealed that TyG index was positively associated with the risk of SA after adjusting for confounders (OR = 1.35, 95% CI: 1.04-1.75, p = 0.03). Smoothing plots also showed a nonlinear relationship between TyG index and SA, with the inflection point of TyG index being 9.29. On the right of the inflection point, a positive association between TyG index and SA was detected (OR = 3.47, 95% CI: 1.81 to 6.66, p < 0.001), while no significant association was observed on the left side of the inflection point (OR = 1.14, 95% CI: 0.79 to 1.66, p = 0.476). Conclusion The relationship between TyG index and SA risk was non-linear and exhibited a threshold effect in Chinese patients with FEDN MDD. When TyG index was greater than 9.29, they showed a significant positive correlation.
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Affiliation(s)
- Junjun Liu
- Nanjing Meishan Hospital, Nanjing, China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | - Xiaomin Zhu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yang Liu
- Nanjing Meishan Hospital, Nanjing, China
| | - Fengnan Jia
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | | | - Qingyuan Wang
- Clinical Medical Department, The Second Clinical Medical College, Nanjing Medical University, Nanjing, China
| | - Xiaobin Zhang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Medical College of Soochow University, Suzhou, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Peng C, Cheng J, Rong F, Wang Y, Tan Y, Yu Y. Specific effects of five subtypes of childhood maltreatment on suicide behaviours in Chinese adolescents: the moderating effect of sex and residence. Epidemiol Psychiatr Sci 2023; 32:e45. [PMID: 37431295 PMCID: PMC10387488 DOI: 10.1017/s2045796023000604] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023] Open
Abstract
AIMS Although childhood maltreatment has been widely supported to be a robust predictor of suicide behaviours, the effects of different childhood maltreatment subtypes remain controversial and inconclusive. Moreover, whether the effects differ by sex in urban and rural adolescents is still unknown. This study aimed to quantify the associations between five subtypes of childhood maltreatment and different suicide behaviour involvement. METHODS A multistage cluster sampling method was adopted from April to December 2021 for adolescents aged 12 to 18 across five representative provinces of China. The Childhood Trauma Questionnaire-Short Form was used to measure childhood maltreatment subtypes. Suicide behaviour involvement was classified as none group, suicide ideator, suicide planner and suicide attempter. Confounding variables include demographic characteristics, smoking, drinking alcohol, depression and anxiety. RESULTS Among a total of 18,980 adolescents, 2021 (10.6%) were suicide ideator, 1595 (8.4%) were suicide planner and 1014 (5.3%) were suicide attempter. Rural females had the highest proportion of suicide ideator (13.8%) and suicide planner (11.5%). Multinomial logistic regression analysis indicated that five childhood maltreatment subtypes were independently associated with suicide behaviours, except for associations between sexual abuse and suicide ideator as well as suicide planner (p > 0.05). Moreover, these associations differ by sex and residence. After adjusted for interactions of different subtypes, structural equation model indicated that the direct effects of childhood maltreatment subtypes on suicide behaviours from high to low were emotional abuse (β = 0.363, p < 0.001), physical abuse (β = 0.100, p < 0.001) and sexual abuse (β = 0.033, p = 0.003), while the effects of physical neglect and emotional neglect were not significant (p > 0.05). CONCLUSIONS Five subtypes of childhood maltreatment have specific and non-equivalence associations with suicide behaviours. Emotional abuse may have the strongest effect, and sexual abuse have an acute effect on suicide behaviours. Suicide prevention programs for Chinese adolescents could focus on those who experienced emotional, physical and sexual abuse. Furthermore, strategies should be tailored by sex and residence, and rural females deserve more attention.
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Affiliation(s)
- Chang Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Junhan Cheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fajuan Rong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yafei Tan
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yizhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Su YJ, Yu HT, Liu TY, Lu KH, Tu CC, Lin YC, Chen RC. Trends in suicide attempts and suicide deaths before and during the COVID-19 pandemic in New Taipei City, Taiwan: an interrupted time-series analysis. Psychol Med 2023; 53:4364-4372. [PMID: 35477437 PMCID: PMC10388328 DOI: 10.1017/s0033291722001155] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/26/2022] [Accepted: 04/05/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global health crisis that may cause mental health problems and heighten suicide risk. We investigated the impact of the COVID-19 pandemic on trends in suicide attempts and suicide deaths in New Taipei City, Taiwan. METHODS The current study used the official daily data on suicide attempts and deaths in New Taipei City, Taiwan (4 million inhabitants) between 2015 and 2020 from the Taiwan National Suicide Prevention Reporting System. Interrupted time-series (ITS) analyses with parameters corrected by the estimated autocorrelations were applied on weekly aggregated data to examine whether the suicide trends during the early COVID-19 pandemic (late January to July 2020) deviated from previous trends (January 2015 to late January 2020). The impact due to the suicide prevention policy change was also examined (since August 2020). RESULTS ITS analyses revealed no significant increases in both mean and trend on weekly suicide deaths during the COVID-19 pandemic and after the policy change. In contrast, there was a significant increasing trend in weekly suicide attempts since the COVID-19 outbreak at the rate of 1.54 attempts per week (95% confidence interval 0.49-2.60; p = 0.004). Sex difference analysis revealed that, however, this increasing trend was observed only in females not in males. CONCLUSIONS The COVID-19 pandemic has different impacts on suicides attempts and deaths during the early pandemic in New Taipei City, Taiwan. The COVID-19 outbreak drastically increased the trend of suicide attempts. In contrast, the number of suicide deaths had remained constant in the investigated periods.
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Affiliation(s)
- Yi-Jen Su
- Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsiu-Ting Yu
- Department of Psychology, National Chengchi University, Taipei, Taiwan
- Research Center for Mind, Brain & Learning, National Chengchi University, Taipei, Taiwan
| | - Ting-Yu Liu
- Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Hung Lu
- Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Chung-Chieh Tu
- Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Yu-Ching Lin
- Department of Health, New Taipei City Government, New Taipei City, Taiwan
| | - Ran-Chou Chen
- Department of Health, New Taipei City Government, New Taipei City, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Chu C, Stanley IH, Marx BP, King AJ, Vogt D, Gildea SM, Hwang IH, Sampson NA, O’Brien R, Stein MB, Ursano RJ, Kessler RC. Associations of vulnerability to stressful life events with suicide attempts after active duty among high-risk soldiers: results from the Study to Assess Risk and Resilience in Servicemembers-longitudinal study (STARRS-LS). Psychol Med 2023; 53:4181-4191. [PMID: 35621161 PMCID: PMC9701247 DOI: 10.1017/s0033291722000915] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 11/05/2022]
Abstract
BACKGROUND The transition from military service to civilian life is a high-risk period for suicide attempts (SAs). Although stressful life events (SLEs) faced by transitioning soldiers are thought to be implicated, systematic prospective evidence is lacking. METHODS Participants in the Army Study to Assess Risk and Resilience in Servicemembers (STARRS) completed baseline self-report surveys while on active duty in 2011-2014. Two self-report follow-up Longitudinal Surveys (LS1: 2016-2018; LS2: 2018-2019) were subsequently administered to probability subsamples of these baseline respondents. As detailed in a previous report, a SA risk index based on survey, administrative, and geospatial data collected before separation/deactivation identified 15% of the LS respondents who had separated/deactivated as being high-risk for self-reported post-separation/deactivation SAs. The current report presents an investigation of the extent to which self-reported SLEs occurring in the 12 months before each LS survey might have mediated/modified the association between this SA risk index and post-separation/deactivation SAs. RESULTS The 15% of respondents identified as high-risk had a significantly elevated prevalence of some post-separation/deactivation SLEs. In addition, the associations of some SLEs with SAs were significantly stronger among predicted high-risk than lower-risk respondents. Demographic rate decomposition showed that 59.5% (s.e. = 10.2) of the overall association between the predicted high-risk index and subsequent SAs was linked to these SLEs. CONCLUSIONS It might be possible to prevent a substantial proportion of post-separation/deactivation SAs by providing high-risk soldiers with targeted preventive interventions for exposure/vulnerability to commonly occurring SLEs.
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Affiliation(s)
- Carol Chu
- Minneapolis VA Health Care System, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ian H. Stanley
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Brian P. Marx
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Andrew J. King
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Dawne Vogt
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Sarah M. Gildea
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Irving H. Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Robert O’Brien
- VA Health Services Research and Development Service, Washington, DC, USA
| | - Murray B. Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- School of Public Health, University of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, La Jolla, CA, USA
| | - Robert J. Ursano
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Marrero RJ, Bello M, Morales-Marrero D, Fumero A. Emotion Regulation Difficulties, Family Functioning, and Well-Being Involved in Non-Suicidal Self-Injury and Suicidal Risk in Adolescents and Young People with Borderline Personality Traits. Children (Basel) 2023; 10:1057. [PMID: 37371288 DOI: 10.3390/children10061057] [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] [Received: 05/18/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
Individuals with a borderline personality disorder (BPD) or BPD traits usually have a lifetime history of harmful behaviors. Emotion regulation difficulties are a risk factor for suicide, whereas adequate family functioning and well-being play an important protective role. This study aims to determine the role of emotion regulation difficulties, well-being, and family functioning in the suicide risk and non-suicidal self-injury (NSSI) in adolescents and young people with BPD traits. From a sample of 285 young people, 103 (36.1%) had BPD traits (mean age = 16.82, SD = 2.71), and 68.93% were females. The results showed significant differences in personal and family variables according to the type of harmful behavior. Suicide attempts (SA) were mainly predicted by difficulties in impulse control, whereas NSSI was predicted by low family satisfaction. Programs designed to prevent SA and NSSI should consider individual differences, as well as the type of harmful behaviors exhibited.
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Affiliation(s)
- Rosario J Marrero
- Departamento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología y Logopedia, Universidad de La Laguna, 38200 La Laguna, Spain
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, 38200 La Laguna, Spain
| | - Macarena Bello
- Instituto Andrés Bello, 38007 Santa Cruz de Tenerife, Spain
| | - Daida Morales-Marrero
- Departamento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología y Logopedia, Universidad de La Laguna, 38200 La Laguna, Spain
| | - Ascensión Fumero
- Departamento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología y Logopedia, Universidad de La Laguna, 38200 La Laguna, Spain
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, 38200 La Laguna, Spain
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Li Y, Liao Z, Huang Q, Wang Q, Ren H, Chen X, Lin S, Wang C, Tang Y, Hao J, Wang X, Shen H, Zhang X. Prevalence and influencing factors of suicide in first-episode and drug-naive young major depressive disorder patients with impaired fasting glucose: a cross-sectional study. Front Psychiatry 2023; 14:1171814. [PMID: 37363165 PMCID: PMC10289199 DOI: 10.3389/fpsyt.2023.1171814] [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: 02/22/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Background An association exists between major depression disorder (MDD), suicide attempts, and glucose metabolism, but suicide attempts in young MDD patients with comorbid impaired fasting glucose (IFG) have been less well studied. The purpose of this study was to examine the prevalence and risk factors for suicide attempts in young, first-episode, drug-naive (FEDN) MDD patients with comorbid IFG. Methods We recruited 917 young patients with FEDN MDD, 116 of whom were judged to have combined IFG because their blood glucose was >6.0. We collected anthropological and clinical data on all of them. The Hamilton Depression Scale (HAMD) score, the Hamilton Anxiety Scale (HAMA) score and the Positive and Negative Syndrome Scale (PANSS) positive subscale score were used to assess their clinical symptoms. Blood glucose, plasma thyroid function and lipid indicators were measured. Results The prevalence of suicide attempts in young MDD patients with IFG was 32.8% (38/116). Furthermore, among young MDD patients with comorbid IFG, suicide attempters had more severe depression and anxiety symptoms, more comorbid psychotic symptom, higher levels of antibody of thyroid stimulating hormone and thyroid peroxidases (TPOAb), and more severe lipid metabolism disorders than those without suicide attempts. In addition, HAMA scores and TPOAb were independently associated with suicide attempts in young patients with FEDN MDD. Conclusion Our study suggests that young MDD patients with IFG have a high rate of suicide attempts. Some clinical symptoms and thyroid function parameters may be the risk factor for suicide attempts in young MDD patients with impaired glucose metabolism.
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Affiliation(s)
- Yifan Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zhenjiang Liao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qiuping Huang
- Department of Applied Psychology, School of Humanities and Management, Hunan University of Chinese Medicine, Changsha, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Honghong Ren
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xinxin Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Shuhong Lin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chenhan Wang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Ying Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jingyue Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xuhao Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hongxian Shen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Okobi OE, Egbujo U, Darke J, Odega AS, Okereke OP, Adisa OT, Salawu MA, Kimble R. Association of Bullying Victimization With Suicide Ideation and Attempt Among School-Going Adolescents in Post-conflict Liberia: Findings From the Global School-Based Health Survey. Cureus 2023; 15:e40077. [PMID: 37425537 PMCID: PMC10326865 DOI: 10.7759/cureus.40077] [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] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Background School-based bullying is a global problem that negatively impacts the victims' and perpetrators' health and well-being. There is a paucity of data regarding bullying in schools and its association with suicide behaviors among adolescents in Liberia. Objective The study investigated the impact of bullying victimization on suicidal thoughts and suicide attempts among adolescents in Liberia. It aimed to provide insights into the consequences of bullying victimization on adolescents' mental health regarding their thoughts of self-harm and suicide attempts. Methods The study utilized data from the 2017 Liberia Global School-based Health Survey (GSHS) to analyze information on 2744 students between the ages of 11 and 18 years, with 52.4% being males. Prevalence rates of bullying victimization and suicide behaviors were calculated using descriptive statistics. Multiple logistic regressions were used to model the relationship between being bullied and experiencing suicidal behaviors (ideation and attempts). Results Among the 2744 adolescents examined, 20% experienced suicidal thoughts, with about 30% of the adolescents reporting suicide attempts at some point in the year preceding the survey. Within 30 days prior to the survey, the prevalence of bullying victimization was 50%, with 44.9% experiencing frequent victimization (3 or more days). Bullying victimization was significantly linked to increased odds of suicidal ideation with planning (aOR: 1.86; P < 0.001), at least a suicide attempt (aOR: 2.16; P < 0.001), and multiple attempts at suicide (aOR: 2.67; P < 0.001). We also observed that a greater number of days bullied was dose-dependently associated with higher odds for suicide ideation and attempts. Conclusion These findings support and extend those from other developing countries, highlighting the association between school-based bullying and suicidal behaviors. The relatively high prevalence of bullying among adolescents in Liberia underscores the importance of implementing effective anti-bullying policies and suicide prevention strategies in schools.
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Affiliation(s)
- Okelue E Okobi
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | - Uzoamaka Egbujo
- Internal Medicine, Lagos University Teaching Hospital, Lagos, NGA
| | - Jennifer Darke
- Education, Institute for Teacher Education and Continuing Professional Development (ITECPD), Kumasi, GHA
- Education, University of Education, Winneba, Kumasi, GHA
| | - Amaka S Odega
- Community and Family Medicine, Windsor University School of Medicine, Basseterre, KNA
- Public Health, University of South Wales, Cardiff, GBR
- Family Medicine, Olabisi Onabanjo University, Sagamu, NGA
- Psychiatry, PsycIME, London, CAN
| | | | - Olufunmilola T Adisa
- Internal Medicine and Psychiatry, Lagos State University College of Medicine, Lagos, NGA
| | - Mujeeb A Salawu
- Medicine and Surgery, University of Ilorin College of Health Sciences, Ilorin, NGA
- Internal Medicine and Psychiatry, Houston Health department, Houston, USA
| | - Rita Kimble
- Research and Development, University of Maryland, Laurel, USA
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Zhang T, Mantel Ä, Runeson B, Sidorchuk A, Rück C, Stephansson O, Larsson H, Chang Z, Mataix-Cols D, Fernández de la Cruz L. Maternal suicide attempts and deaths in the first year after cesarean delivery. Psychol Med 2023; 53:3056-3064. [PMID: 34911599 PMCID: PMC10235649 DOI: 10.1017/s0033291721005109] [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: 07/02/2021] [Revised: 11/11/2021] [Accepted: 11/23/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cesarean delivery (CD) has been associated with postpartum psychiatric disorders, but less is known about the risk of suicidal behaviors. We estimated the incidence and risk of suicide attempts and deaths during the first postpartum year in mothers who delivered via CD v. vaginally. METHOD All deliveries in Sweden between 1973 and 2012 were identified. The mothers were followed since delivery for 12 months or until the date of one of the outcomes (i.e. suicide attempt or death by suicide), death by other causes or emigration. Associations were estimated using Cox proportional hazards regression models. RESULTS Of 4 016 789 identified deliveries, 514 113 (12.8%) were CDs and 3 502 676 (87.2%) were vaginal deliveries. During the 12-month follow-up, 504 (0.098%) suicide attempts were observed in the CD group and 2240 (0.064%) in the vaginal delivery group (risk difference: 0.034%), while 11 (0.0037%) deaths by suicide were registered in the CD group and 109 (0.0029%) in the vaginal delivery group (risk difference: 0.008%). Compared to vaginal delivery, CD was associated with an increased risk of suicide attempts [hazard ratio (HR) 1.46; 95% CI 1.32-1.60], but not of deaths by suicide (HR 1.44; 95% CI 0.88-2.36). CONCLUSIONS Maternal suicidal behaviors during the first postpartum year were uncommon in Sweden. Compared to vaginal delivery, CD was associated with a small increased risk of suicide attempts, but not death by suicide. Improved understanding of the association between CD and maternal suicidal behaviors may promote more appropriate measures to improve maternal mental well-being and further reduce suicidal risks.
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Affiliation(s)
- Tianyang Zhang
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Ängla Mantel
- Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Bo Runeson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Olof Stephansson
- Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Hultsjö S, Persdotter A, Jakobsson M, Löfgren F, Annerhult S, Wärdig R. Nurses' experiences of suicide attempts in palliative care. Palliat Support Care 2023:1-6. [PMID: 36974670 DOI: 10.1017/s147895152300024x] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVES To describe nurses' experiences of caring for individuals who have attempted suicide in specialized palliative care and to describe if the care of these individuals changed after the suicide attempt. METHODS A qualitative, descriptive study was conducted. Nine nurses working in specialized palliative care units were interviewed following a semi-structured interview guide. Conventional content analysis was used in the analysis process. RESULTS The results are presented in 3 categories: "A suicide attempt evokes strong emotions," "Health-care efforts changed after the suicide attempt," and "Experiences for the rest of working life." Suicide attempts aroused emotions in nurses such as frustration, compassion, and feelings of being manipulated. The relationship between the nurse and the individual was strengthened after the suicide attempt, and their conversations became deeper and changed in nature. Health-care efforts relating to the individual increased after the suicide attempt. SIGNIFICANCE OF RESULTS The results of the study can create an awareness that the palliative process also includes the risk of suicide and can be used to create conditions for nurses to be able to handle questions about suicide without fear. The results of the study can be used as an "eye opener" to the fact that suicidality occurs in palliative care. In summary, there is a critical need for nursing education in suicide risk assessment and continued follow-up care for patients at risk of suicide within palliative care.
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Affiliation(s)
- Sally Hultsjö
- Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden
- Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anna Persdotter
- Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Maria Jakobsson
- Department of Advanced Home Care in Norrköping, Region Östergötland, Norrköping, Sweden
| | - Frida Löfgren
- Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Sofia Annerhult
- Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Rikard Wärdig
- Division of Nursing and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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