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Morton M, Wang S, Tse K, Chung C, Bergmans Y, Ceniti A, Flam S, Johannes R, Schade K, Terah F, Rizvi S. Gatekeeper training for friends and family of individuals at risk of suicide: A systematic review. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:1838-1871. [PMID: 34125969 DOI: 10.1002/jcop.22624] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 06/12/2023]
Abstract
AIMS Gatekeeper training (GKT) is an important suicide prevention strategy. Studies have evaluated the effectiveness of GKT in different populations, often neglecting family and friends who play a vital role in caring for people with suicide risk. This review evaluated GKT programs targeting family and friends to determine their effectiveness in this specific population. METHODS Academic databases were searched for studies on GKT programs. Programs involving family and friends caring for people with suicide risk were assessed for any impact on knowledge, self-efficacy, attitudes, and suicide prevention skills. RESULTS Seventeen studies were reviewed. GKT showed significant gains on outcomes of interest. Three studies targeted family and friends, with one involving them in program creation and conduction and another adjusting the program after their input. CONCLUSIONS GKT programs have potentially positive effects on family and friends caring for people with suicide risk. Few programs address the specific needs of this group, and programs adapted specifically for them are scarce. Future program development recommendations are discussed.
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Affiliation(s)
- Michael Morton
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Shijing Wang
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Kristen Tse
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Carolyn Chung
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Yvonne Bergmans
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Amanda Ceniti
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Shelley Flam
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Robb Johannes
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Health Promotions Program, Fred Victor, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Kathryn Schade
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Flora Terah
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
| | - Sakina Rizvi
- Arthur Sommer Rotenberg Suicide and Depression Studies Program, St. Michael's Hospital, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Suicide Attempts in Turkish University Students: The Role of Cognitive Style, Hopelessness, Cognitive Reactivity, Rumination, Self-esteem, and Personality Traits. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2020. [DOI: 10.1007/s10942-020-00354-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dong M, Zeng LN, Lu L, Li XH, Ungvari GS, Ng CH, Chow IHI, Zhang L, Zhou Y, Xiang YT. Prevalence of suicide attempt in individuals with major depressive disorder: a meta-analysis of observational surveys. Psychol Med 2019; 49:1691-1704. [PMID: 30178722 DOI: 10.1017/s0033291718002301] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Suicide attempt (SA), which is one of the strongest predictors of completed suicide, is common in major depressive disorder (MDD) but its prevalence across epidemiological studies has been mixed. The aim of this comprehensive meta-analysis was to examine the pooled prevalence of SA in individuals with MDD. METHODS A systematic literature search was conducted in PubMed, Embase, PsycINFO, Web of Science and Cochrane Library from their commencement date until 27 December 2017. Original studies containing data on prevalence of SA in individuals with MDD were analyzed. RESULTS In all, 65 studies with a total of 27 340 individuals with MDD were included. Using the random effects model, the pooled lifetime prevalence of SA was 31% [95% confidence interval (CI) 27-34%], 1-year prevalence was 8% (95% CI 3-14%) and 1-month prevalence was 24% (95% CI 15-34%). Subgroup analyses revealed that the lifetime prevalence of SA was significantly associated with the patient setting, study region and income level, while the 1-month prevalence of SA was associated with only the patient setting. CONCLUSION This meta-analysis confirmed that SA was common in individuals with MDD across the world. Careful screening and appropriate interventions should be implemented for SA in the MDD population.
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Affiliation(s)
- Min Dong
- Unit of Psychiatry,Faculty of Health Sciences,University of Macau,Macao SAR,China
| | - Liang-Nan Zeng
- Department of Neurosurgery,The Affiliated Hospital of Southwest Medical University,Luzhou,China
| | - Li Lu
- Unit of Psychiatry,Faculty of Health Sciences,University of Macau,Macao SAR,China
| | - Xiao-Hong Li
- The National Clinical Research Center for Mental Disorders, China & Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University,Beijing,China
| | - Gabor S Ungvari
- University of Notre Dame Australia/Marian Centre,Perth,Australia
| | - Chee H Ng
- Department of Psychiatry,University of Melbourne,Melbourne, Victoria,Australia
| | - Ines H I Chow
- Unit of Psychiatry,Faculty of Health Sciences,University of Macau,Macao SAR,China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics,School of Public Health, Capital Medical University & Beijing Municipal Key Laboratory of Clinical Epidemiology,Beijing,China
| | - Yuan Zhou
- CAS Key Laboratory of Behavioral Science & Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences,Beijing,China
| | - Yu-Tao Xiang
- Unit of Psychiatry,Faculty of Health Sciences,University of Macau,Macao SAR,China
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Canal-Rivero M, Lopez-Moriñigo JD, Barrigón ML, Perona-Garcelán S, Jimenez-Casado C, David AS, Obiols-Llandrich JE, Ruiz-Veguilla M. The role of premorbid personality and social cognition in suicidal behaviour in first-episode psychosis: A one-year follow-up study. Psychiatry Res 2017. [PMID: 28622570 DOI: 10.1016/j.psychres.2017.05.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND High suicide attempt (SA) rates have been reported in first-episode psychosis (FEP) patients, particularly during the first year after the illness onset. Despite previous studies establishing several risk factors for suicidal behaviour in FEP, premorbid personality and social cognition have not been sufficiently investigated to date. OBJECTIVE To test whether personality traits and social cognition are associated with SAs in FEP over a 12-month follow-up. METHOD Sixty-five FEP patients were evaluated at first contact with mental health services. The presence of SAs was recorded at six and twelve months after first presentation. Bivariate and multivariate analyses explored the influence of a range of sociodemographic and clinical variables, including premorbid personality and social cognition-related Theory of Mind (ToM) measures, on SAs. RESULTS SAs were associated with greater severity of symptoms at first hospitalization with psychotic symptoms (OR = 2.18, 95% CI = 1.25-3.82), schizoid personality traits (OR = 1.62, 95% CI = 1.02-2.57) and impairment in a first-order false belief task (OR = 4.26, 95% CI = 1.05-17.31) in the multivariate models. CONCLUSIONS Symptom severity at illness onset, premorbid schizoid personality traits and ToM impairment emerged as predictors of SA in this FEP sample, which, if replicated, may be useful in identifying high-risk groups and implementing more targeted suicide prevention programs in FEP.
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Affiliation(s)
- Manuel Canal-Rivero
- Virgen del Rocío University Hospital, Seville, Spain; Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J D Lopez-Moriñigo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M L Barrigón
- Department of Psychiatry, Hospital Fundación Jiménez Díaz and IIS Fundación Jiménez Díaz, Madrid, Spain, Universidad Autónoma de Madrid, Madrid, Spain
| | - S Perona-Garcelán
- Virgen del Rocío University Hospital, Seville, Spain; Department of Personality, Evaluation and Psychological Treatment, University of Seville, Seville, Spain
| | | | - A S David
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J E Obiols-Llandrich
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Ruiz-Veguilla
- Grupo Neurodesarrollo y Psicosis Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla UGC Salud Mental HVR, Spain
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Liu SI, Huang YH, Wu YH, Huang KY, Huang HC, Sun FJ, Huang CR, Sung MR, Huang YP. Temperament traits in suicidal and non-suicidal mood disorder patients in Taiwan. Psychiatry Res 2017; 253:260-266. [PMID: 28407557 DOI: 10.1016/j.psychres.2017.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 02/27/2017] [Accepted: 04/02/2017] [Indexed: 12/13/2022]
Abstract
Suicide is a major social and clinical problem in Asia. Although studies have suggested that personality traits are possible risk factors for suicide, no study has been conducted among Chinese to compare the temperament traits of suicidal and non-suicidal mood disorder patients with those of healthy controls. This study compared temperament traits of two patient groups, those with a mood disorder who have attempted suicide (n=204), and those with a mood disorder who have not attempted suicide (n=160), and compared the traits of these patients to those of healthy controls (n=178), assessed by Cloninger's Tridimensional Personality Questionnaire and the Brown-Goodwin Aggression Inventory. Patients with suicidal attempts had significantly higher novelty seeking and aggression scores than healthy controls and patients without suicidal attempts. Two groups of patients with mood disorder had significantly higher harm avoidance scores than the healthy controls. However, patients with suicidal attempts did not have higher harm avoidance scores than patients without suicidal attempts. This study confirms findings that harm avoidance and mood disorder are related, and extends them by suggesting that those with a mood disorder and suicide attempts have higher novelty seeking and lifetime aggression scores than those without suicidal attempt, either patients or healthy controls.
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Affiliation(s)
- Shen-Ing Liu
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, Taipei, Taiwan; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
| | - Yu-Hsin Huang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Ying-Hui Wu
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Kuo-Yang Huang
- Department of Psychiatry, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Hui-Chun Huang
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Chiu-Ron Huang
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ming-Ru Sung
- Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan
| | - Yo-Ping Huang
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
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Psychological and physical pain as predictors of suicide risk: evidence from clinical and neuroimaging findings. Curr Opin Psychiatry 2017; 30:159-167. [PMID: 28067727 DOI: 10.1097/yco.0000000000000314] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE OF REVIEW Suicide is a multidimensional clinical phenomenon with complex biological, social and psychological risk factors. Therefore, it is imperative for studies to focus on developing a unified understanding of suicide risk that integrates current clinical and neurobiological findings. A recent line of research has implicated different classifications of pain in understanding suicide risk, including the concepts of psychache and pain tolerance. Although psychache is defined as the experience of unbearable psychological pain, pain tolerance refers to the greatest duration or intensity of painful stimuli that one is able to bear. This review will focus on integrating current clinical and neurobiological findings by which psychache and pain tolerance confer suicide risk. RECENT FINDINGS Results indicate that psychache has been identified as a significant risk factor for suicide and that psychache may be associated with the neurocircuitry involved in the modulation of physical pain. Converging evidence has also been found linking pain tolerance to self-injurious behaviours and suicide risk. The experience of psychache and physical pain in relation to other predictors of suicide, including reward processing, hopelessness and depression, are further discussed. SUMMARY Future research examining the pain-suicide connection is required to understand the mechanism behind clinically relevant risk factors for suicide, which can ultimately inform the construction of empirically supported suicide risk assessment and intervention techniques.
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Schulze UME, Rosenfeld L, Keller F, Fegert JM. Was die Angst vermag …. PSYCHOTHERAPEUT 2017. [DOI: 10.1007/s00278-016-0161-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Clinical and genetic factors associated with suicide in mood disorder patients. Eur Arch Psychiatry Clin Neurosci 2016; 266:181-93. [PMID: 26626456 DOI: 10.1007/s00406-015-0658-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 11/17/2015] [Indexed: 12/14/2022]
Abstract
Suicidality is a continuum ranging from ideation to attempted and completed suicide, with a complex etiology involving both genetic heritability and environmental factors. The majority of suicide events occur in the context of psychiatric conditions, preeminently major depression and bipolar disorder. The present study investigates clinical factors associated with suicide in a sample of 553 mood disorder patients, recruited within the 'Psy Pluriel' center, Centre Européen de Psychologie Médicale, and the Department of Psychiatry of Erasme Hospital (Brussels). Furthermore, genetic association analyses examining polymorphisms within COMT, BDNF, MAPK1 and CREB1 genes were performed in a subsample of 259 bipolar patients. The presence or absence of a previous suicide attempt and of current suicide risk were assessed. A positive association with suicide attempt was reported for younger patients, females, lower educated, smokers, those with higher scores on depressive symptoms and higher functional disability and those with anxiety comorbidity and familial history of suicidality in first- and second-degree relatives. Anxiety disorder comorbidity was the stronger predictor of current suicide risk. No associations were found with polymorphisms within COMT and BDNF genes, whereas significant associations were found with variations in rs13515 (MAPK1) and rs6740584 (CREB1) polymorphisms. From a clinical perspective, our study proposes several clinical characteristics, such as increased depressive symptomatology, anxiety comorbidity, functional disability and family history of suicidality, as correlates associated with suicide. Genetic risk variants in MAPK1 and CREB1 genes might be involved in a dysregulation of inflammatory and neuroplasticity pathways and are worthy of future investigation.
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