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Chen XC, Coid J, Zhang YM, Xu JJ, Qiu YF, Yin XT, Han YW, Hu JM. Psychiatric disorder, traumatic experience and social deprivation in distinct subtypes of suicide attempt: a cross-national study using latent class analysis. BMC Public Health 2025; 25:1181. [PMID: 40155889 PMCID: PMC11951790 DOI: 10.1186/s12889-025-22159-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 03/01/2025] [Indexed: 04/01/2025] Open
Abstract
BACKGROUND Suicide attempts are critical predictors of suicide. Developing typologies of suicide attempt may indicate new prevention strategies, which have not been investigated by comparing developed and developing countries. Therefore, we aimed to explore the subtypes of suicide attempt and to compare the characteristics of these subtypes between developed and developing countries. METHODS This study included 2046 British and 4238 Chinese men aged 18 - 34 years old in households. Hierarchical multinomial regression models were performed to investigate associated factors of suicide attempt. Latent class analysis was employed to identify subtypes of suicide attempt. RESULTS We found that anxiety and psychosis were independently associated with suicide attempts among British and Chinese young men, while depression was independently associated with suicide attempts only among British young men. Three latent classes of suicide attempt were identified: depressed/anxious subtype was robust across the Eastern and Western cultural contexts; no psychiatric morbidity subtype featured by weakened social bonds was significant more prevalent among Chinese young men attempted suicide, whereas impulsive, trauma, psychopathology subtype was significant more prevalent among British men attempted suicide. CONCLUSIONS These differences of attempted suicide appeared to result from the distinct social factors in China and the UK. Weakened social bonds could be a new intervention target for Chinese young men attempted suicide, whereas chaotic lifestyles for that of British young men attempted suicide.
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Affiliation(s)
- Xia-Can Chen
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jeremy Coid
- Wolfson Institute of Preventive Medicine, Queen Mary University of London Wolfson Institute of Population Health, London, UK
- Brain Research Center and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Ya-Min Zhang
- Department of Neurobiology, Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jia-Jun Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu-Feng Qiu
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Xiao-Tong Yin
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yi-Wei Han
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Jun-Mei Hu
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan, China.
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Le NTH, Genuneit J, Brennecke G, von Polier G, White L, Radeloff D. Suicide among post-Arabellion refugees in Germany. BJPsych Open 2024; 10:e188. [PMID: 39450528 PMCID: PMC11698212 DOI: 10.1192/bjo.2024.755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 07/28/2024] [Accepted: 08/07/2024] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND Although immigrants are considered to be vulnerable to mental illness, there is limited knowledge regarding their suicide mortality. AIMS To investigate standardised mortality ratios (SMR) for suicide among the largest immigrant populations in Germany before and after the refugee movement of 2015. METHOD Data on immigrants and the general population in Germany between 2000 and 2020 were provided by the scientific section of the Federal Statistical Office. SMR with 95% confidence intervals were calculated by indirect standardisation for gender, age and calendar year for the pre-2015 and post-2015 time interval, first for all the immigrant populations studied and second for the Syrian, Afghan and Iraqi populations separately. RESULTS Immigrants from the countries studied showed a lower suicide risk compared with the German reference population (SMR = 0.38, 95% CI = 0.35-0.41). No differences in SMR were found between pre- and post-2015 time intervals, in either the aggregate data for all populations or the data for Syrian, Afghan and Iraqi populations. Post-2015, Afghan immigrants (SMR = 0.68, 95% CI = 0.54-0.83) showed a higher SMR than Syrians (SMR = 0.30, 95% CI = 0.25-0.36) or Iraqis (SMR = 0.37, 95% CI = 0.26-0.48). CONCLUSIONS Despite the many and varied stresses associated with flight, comparison of the pre- and post-2015 time intervals showed that the suicide risk of the populations studied did not change and was considerably lower than that of the German reference population. We attribute this to lower suicide rates in the countries of origin but also to flight-related selection processes that favour more resilient individuals.
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Affiliation(s)
- Nensy Thu Ha Le
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Jon Genuneit
- Paediatric Epidemiology, Department of Paediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Gerald Brennecke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Leipzig University, Leipzig, Germany; and Institute of Legal Medicine, University Medicine Halle (Saale), Halle (Saale), Germany
| | - Georg von Polier
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Lars White
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Daniel Radeloff
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, Leipzig University, Leipzig, Germany
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Nam B, Hong I. Trauma Exposure, Social Networks, and Suicide Risk Among North Korean Refugee Women in South Korea. Violence Against Women 2024; 30:2572-2587. [PMID: 37101391 DOI: 10.1177/10778012231170861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Exposure to adverse life events renders North Korean (NK) refugee women vulnerable to mental health problems, suicide risk being one of the most concerning. We examined bonding and bridging social networks as potential moderators of suicide risk among NK refugee women (N = 212). We found that exposure to traumatic events significantly increased suicidal behavior, but its impact was alleviated if they had a stronger bonding social network. The findings suggest that the negative impact of trauma on suicide can be reduced by strengthening bonding between people with similarities (i.e., family, individuals with the same country of origin).
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Affiliation(s)
- Boyoung Nam
- Department of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Ijun Hong
- School of Social Welfare, Yonsei University, Seoul, Republic of Korea
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Spataro G, Ventriglio A, Signorelli MS, Marrazzo G. Suicide among migrants: a comprehensive narrative review of literature. Int Rev Psychiatry 2024; 36:413-423. [PMID: 39470087 DOI: 10.1080/09540261.2024.2327389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 10/30/2024]
Abstract
Suicidality among migrants represents a multifaceted and complex issue with significant implications and challenges for public mental health and policies. This narrative review aims to explore the factors contributing to suicidality within the migrant groups, consequently highlighting the need for tailored interventions and supporting strategies. Firstly, we reviewed the evidences on the prevalence of suicidal ideation, attempted suicides, and deaths by suicide among migrants. The results were extremely heterogeneous, mostly depending on the different migrant group considered. Significant differences in suicide risk have been found depending on the legal status of migrants and their country of origin/migration. The second section explored the protective and risk factors for suicidal ideation and behaviours in different migrant groups. The analysis concluded that a set of factors may interact in various ways, contributing to a heterogeneous and complex framework underpinning the phenomenon of suicide. Migration itself may be a challenging and traumatizing experience, characterized by social isolation, cultural dislocation and adjustment, as well as economic and financial distress, all of which may exacerbate pre-existing mental health vulnerabilities or trigger new mental disorders. Acculturative stress, discrimination, and language barriers further compound these challenges, often hindering access to mental health services.
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Affiliation(s)
- Gaspare Spataro
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental medicine, University of Foggia, Foggia, Italy
| | | | - Giovanna Marrazzo
- UOC Psichiatria Azienda Ospedaliera Universitaria Paolo Giaccone, Palermo, Italy
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Chen XC, Xu JJ, Yin XT, Qiu YF, Yang R, Wang ZY, Han YW, Wang QK, Zhai JH, Zhang YS, Ran MS, Hu JM. Mediating role of anxiety and impulsivity in the association between child maltreatment and lifetime non-suicidal self-injury with and without suicidal self-injury. J Affect Disord 2024; 347:57-65. [PMID: 37995923 DOI: 10.1016/j.jad.2023.11.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Child maltreatment can increase the risk of lifetime non-suicidal self-injury (NSSI) and suicidal self-injury (SSI), but there is limited knowledge regarding the differences of potentially psychological mechanisms between NSSI with and without SSI. METHODS Participants, 3918 community-based Chinese young men aged 18-34 years in Chengdu, were included in this study. We investigated the association between depression, anxiety, psychosis, child maltreatment, adulthood traumatic events, impulsivity, alcohol dependence, drug abuse, and lifetime of NSSI among participants with and without SSI. Parallel mediation analysis was utilized to explore the mediators for the relation between child maltreatment and NSSI. RESULTS The prevalence of lifetime NSSI was 6.1 % (95 % CI: 5.4 %-6.9 %) among young men. Anxiety and impulsivity partially mediated the effect of child maltreatment on NSSI either with (indirect effect: 51.2 %) or without SSI (indirect effect: 34.3 %). Depression was independently and significantly associated with only NSSI but not with NSSI+SSI. Alcohol dependence and psychosis were independently and significantly associated with NSSI+SSI and mediated the effect of child maltreatment on NSSI+SSI. LIMITATIONS The cross-sectional survey data limits the robustness of the proof to the causal relationships. CONCLUSIONS Anxiety and impulsivity are associated with NSSI either with or without SSI and partially mediate the effect of child maltreatment on NSSI. Depression is associated with only NSSI, while alcohol dependence and psychosis are only associated with NSSI+SSI. It could be crucial to improve treatment and recovery of alcohol dependence and psychosis for preventing young men engaged in NSSI from attempting SSI.
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Affiliation(s)
- Xia-Can Chen
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jia-Jun Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiao-Tong Yin
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yu-Feng Qiu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Rui Yang
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Zi-Ye Wang
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yi-Wei Han
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Qi-Kai Wang
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jin-Hui Zhai
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yu-Shu Zhang
- Institute of Forensic Medicine, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Mao-Sheng Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
| | - Jun-Mei Hu
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China.
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Ager W, El Chammay R, Lechner J, Ventevogel P, Vijayakumar L. Displaced, Dispossessed and Silenced: The Need for Suicide Prevention and Response for Conflict-affected Populations. INTERVENTION 2021. [DOI: 10.4103/intv.intv_24_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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