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Heisel MJ, Flett GL. Screening for suicide risk among older adults: assessing preliminary psychometric properties of the Brief Geriatric Suicide Ideation Scale (BGSIS) and the GSIS-Screen. Aging Ment Health 2022; 26:392-406. [PMID: 33327729 DOI: 10.1080/13607863.2020.1857690] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To initially assess psychometric properties of two abbreviated versions of the Geriatric Suicide Ideation Scale (GSIS): a 10-item Brief Geriatric Suicide Ideation Scale (BGSIS), and a 5-item Geriatric Suicide Ideation Scale-Screen (GSIS-Screen). METHODS A series of psychometric analyses was conducted, assessing the internal consistency, test-retest reliability, construct and predictive validity of the abbreviated GSIS scales. This was done by selecting-out GSIS items from a combined dataset of studies on suicide ideation in older adults: 1) The GSIS scale development study (n = 107); 2) A clinical trial of Interpersonal Psychotherapy (IPT) modified for suicidal older adults(n = 25); 3) A longitudinal study of risk and resiliency to suicide ideation in community-residing older adults (n = 173). RESULTS Overall findings demonstrated strong internal consistency, test-retest reliability, concurrent and predictive validity for the BGSIS and GSIS-Screen with older adults across community, clinical, and residential settings. CONCLUSION Study findings support the use of the abbreviated GSIS scales when conducting research on suicide risk identification among older adults. Future research is recommended testing these scales prospectively in public health, residential, and clinical settings, in research and healthcare delivery contexts.
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Affiliation(s)
- Marnin J Heisel
- Departments of Psychiatry and of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, USA
| | - Gordon L Flett
- Department of Psychology, York University, Toronto, Ontario, Canada
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2
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Passive Suicidal Ideation in Older Adults from 12 European Countries. JOURNAL OF POPULATION AGEING 2021. [DOI: 10.1007/s12062-021-09350-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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3
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Renemane L, Kivite-Urtane A, Rancans E. Suicidality and Its Relation with Physical and Mental Conditions: Results from a Cross-Sectional Study of the Nationwide Primary Care Population Sample in Latvia. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:970. [PMID: 34577893 PMCID: PMC8472357 DOI: 10.3390/medicina57090970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Physical and mental conditions are important risk factors for suicidality. However, there is no clear understanding of these relationships and the effect of co-occurrence on suicidality. We aimed to investigate the associations between current suicidality and mental disorders, physical conditions, and health-related factors in the nationwide primary care population in Latvia. Materials and Methods: A cross-sectional study was performed within the framework of the National Research Program BIOMEDICINE 2014-2017 at 24 primary care settings across Latvia in 2015. Adult patients were evaluated over one week at each facility. Socio-demographic variables, physical condition, and health-related factors were assessed on-site by trained psychiatrists. Mental disorders and suicidality were determined using the Mini International Neuropsychiatric Interview, and assessments were conducted over the telephone within two weeks after the visit to the general practitioner. Results: Of the 1485 cases, 18.6% reported suicidality. Only current depression, any anxiety disorder, any alcohol use disorder, and physical-mental multimorbidity were significantly associated with suicidality in the multivariate logistic regression analysis. Gastrointestinal diseases were associated with current depression alone (odds ratio (OR) 10.36; 95% confidence interval (CI) 2.34-45.76) and comorbid depression with any anxiety disorder (OR 7.55; 95% CI 2.15-26.49) among persons with current suicidality. Conclusions: Screening for depression, anxiety, and alcohol use disorders regularly among patients with physical illness may be important to help recognise suicidality in primary care that could improve the quality of life of patients and prevent suicides.
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Affiliation(s)
- Lubova Renemane
- Department of Psychiatry and Narcology, Riga Stradins University, Tvaika Street 2, LV-1005 Riga, Latvia;
| | - Anda Kivite-Urtane
- Department of Public Health and Epidemiology, Institute of Public Health, Riga Stradins University, Dzirciema Street 16, LV-1007 Riga, Latvia;
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Tvaika Street 2, LV-1005 Riga, Latvia;
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Jonson M, Sigström R, Mellqvist Fässberg M, Wetterberg H, Rydén L, Rydberg Sterner T, Hedna K, Lagerlöf Nilsson U, Skoog I, Waern M. Passive and active suicidal ideation in Swedish 85-year-olds: Time trends 1986-2015. J Affect Disord 2021; 290:300-307. [PMID: 34020204 DOI: 10.1016/j.jad.2021.04.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/20/2021] [Accepted: 04/25/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Older adults have high suicide rates. We investigated potential time trends in the prevalence of passive and active suicidal ideation in 85-year-olds. Further, we examined factors associated with such ideation in this age group. METHODS Population-based samples of 85-year-olds were interviewed in 1986 (N = 347), 2008 (N = 426) and 2015 (N = 320). Past-month passive/active suicidal ideation was evaluated with the Paykel questions. RESULTS Reporting any type of passive or active suicidal ideation was less common in 2008 (7.3%, p < 0.001) and 2015 (7.2%, p < 0.001) compared to 1986 (16.4%). The change was driven by decreases in passive ideation. Passive/active suicidal ideation was associated with higher MADRS score (OR: 1.2, 95% CI: 1.1-1.2, p < 0.001), institution residence (OR: 3.9, 95% CI: 1.7-8.9, p = 0.001) and feelings of loneliness (OR: 2.7, 95% CI: 1.4-5.2, p = 0.003). When stratified by sex, it was associated with institution residence (OR: 3.7, 95% CI: 1.4-9.9, p = 0.008) and feelings of loneliness (OR: 3.0, 95% CI: 1.4-6.3, p = 0.005) in women. In men, we observed a tenfold higher risk in those without partners (OR: 9.8, 95% CI: 2.9-33.5, p < 0.001). LIMITATIONS While differential three-year mortality was not observed in 1986, mortality was higher among non-participants in 2008 and 2015. This might have inflated cohort differences in passive/active suicidal ideation. CONCLUSION An initial decrease in the prevalence of passive/active suicidal ideation in 85-year-olds was observed but this positive trend did not persist. Results underline that preventive strategies targeting loneliness and focusing on institutional settings are needed, as are interventions for men without partners.
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Affiliation(s)
- Mattias Jonson
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Affective Clinic, Gothenburg, Sweden.
| | - Robert Sigström
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Clinic of Cognition and Old Age Psychiatry, Gothenburg, Sweden
| | - Madeleine Mellqvist Fässberg
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Hanna Wetterberg
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Lina Rydén
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Khedidja Hedna
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden; Statistikkonsulterna Jostat & Mr Sample AB, Gothenburg, Sweden
| | - Ulrika Lagerlöf Nilsson
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Department of Historical Studies, Faculty of Humanities, University of Gothenburg, Sweden
| | - Ingmar Skoog
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Clinic of Cognition and Old Age Psychiatry, Gothenburg, Sweden
| | - Margda Waern
- Center for Ageing and Health (Age Cap), Department of Psychiatry and Neurochemistry, University of Gothenburg, Sweden; Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden
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The effect of assisted dying on suicidality: a synthetic control analysis of population suicide rates in Belgium. J Public Health Policy 2020; 42:86-97. [PMID: 32895484 DOI: 10.1057/s41271-020-00249-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Adoption of assisted dying has rapidly grown, but many groups caution that these policies can cause suicide contagions. If those urging caution are correct, jurisdictions with these policies will experience increased suicides. This study aimed to determine the changes in population suicide rates in Belgium before and after its 2002 policy using the synthetic control method (SCM) and generalized synthetic control method (GSCM). As comparisons we used additional European Union members that have not adopted these policies. GSCM showed an average annual suicide rate increase of 0.73 per 100,000 population (95% CI - 5.7 to 7.2; p = 0.80). Placebo testing based on the SCM analysis showed equal outcomes for Belgium and the comparisons. This study failed to show evidence of association between implementation of legislation legitimizing assisted dying and population suicide rates. The threat of suicide contagion has influenced policy discussions in the past, but this study suggests that there is presently no indication for policy-makers to view suicide contagions as a concerning side effect of assisted dying legislation.
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Meyfroidt N, Wyckaert S, Bouckaert F, Wampers M, Mazereel V, Bruffaerts R. Suicide in Belgian psychiatric inpatients. A matched case-control study in a Belgian teaching hospital. Arch Psychiatr Nurs 2020; 34:8-13. [PMID: 32248938 DOI: 10.1016/j.apnu.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 11/14/2019] [Accepted: 12/12/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Patients admitted to a psychiatric hospital show an increased risk for suicide but specific risk factors are not well understood. METHODS In this case-control study we describe suicides (n = 37) that took place during admission in a Flemish psychiatric teaching hospital between 2007 and 2015 and investigate predictive factors for suicide. RESULTS Inpatient suicide is a rare condition (37 patients among 20,442 admission periods between 2007 and 2015). Most inpatients who completed suicide were diagnosed with a mood disorder (68%); 38% committed suicide in the first month of hospitalization and 19% in the first week following admission. The majority of suicides took place just before or during the weekend (57%), with hanging as the prominent method (41%). Multivariate analysis showed that hopelessness was the only significant risk factor for inpatient suicide. CONCLUSIONS Inpatient suicide remains a very rare event in inpatient care. Enquiring and managing hopelessness is essential in inpatient treatment of psychiatric patients.
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Affiliation(s)
- Nancy Meyfroidt
- AZ Jan Portaels, Vilvoorde, Belgium; Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium.
| | - Sabine Wyckaert
- Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium.
| | - Filip Bouckaert
- Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium; Center for Neuropsychiatry, Dept. Neurosciences, KU Leuven.
| | - Martien Wampers
- Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium.
| | - Victor Mazereel
- Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium.
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, KU Leuven, Leuven, Belgium; Center for Public Health Psychiatry, Dep. Neurosciences, KU Leuven.
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Rancans E, Renemane L, Kivite-Urtane A, Ziedonis D. Prevalence and associated factors of mental disorders in the nationwide primary care population in Latvia: a cross-sectional study. Ann Gen Psychiatry 2020; 19:25. [PMID: 32280360 PMCID: PMC7137231 DOI: 10.1186/s12991-020-00276-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/28/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Mental disorders are common amongst patients in primary care. There are no published studies on the prevalence of mental disorders in primary care patients in Latvia. The purpose of the study was to evaluate the current prevalence of mental disorders in the nationwide Latvian primary care population and to study possible associated factors and comorbidity of mental disorders. METHODS A cross-sectional study within the framework of the National Research Program BIOMEDICINE 2014-2017 was performed at 24 primary care settings across Latvia. Adult patients seen over a 1-week time period at each facility were invited to participate in the study. Sociodemographic variables (age, sex, education, employment and marital status, place of residence, and ethnicity) were assessed onsite. A Mini-International Neuropsychiatric Interview assessment was conducted over the telephone within 2 weeks after the visit to the general practitioner (GP). RESULTS Overall, 1485 individuals completed the interview. The current prevalence of any mental disorder was 37.2% and was significantly greater in women. Mood disorders (18.4%), suicidality (18.6%) and anxiety disorders (15.8%) were the most frequent diagnostic categories. The current prevalence of any mood disorder was associated with being 50-64 years of age, female sex, economically inactive status, divorced or widowed marital status and urban place of residence, whilst any current anxiety disorder was associated with female sex, lower education, and single marital status; however, being of Russian ethnicity and residing in a small city were protective factors. Suicidality was associated with female sex, lower education, unemployment or economically inactive status, being divorced or widowed and residing in a small city. The comorbidity rates between mental disorders varied from 2.9 to 53.3%. CONCLUSIONS High prevalence rates of mental disorders, comorbidity and certain associated socio-demographic factors were found in primary care settings in Latvia. This highlights the importance of screening for depression and anxiety disorders and suicidal risk assessment by GPs. The results are fundamentally important for integrative medicine, monitoring and promotion of mental healthcare at the primary care level, as well as for healthcare policy and development of strategic plans in Latvia.
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Affiliation(s)
- Elmars Rancans
- 1Department of Psychiatry and Narcology, Riga Stradins University, 2 Tvaika Str, Riga, LV-1005 Latvia
| | - Lubova Renemane
- 1Department of Psychiatry and Narcology, Riga Stradins University, 2 Tvaika Str, Riga, LV-1005 Latvia
| | - Anda Kivite-Urtane
- 2Department of Public Health and Epidemiology, Riga Stradins University, 9 Kronvalda Ave, Riga, LV-1010 Latvia
| | - Douglas Ziedonis
- 3University of California San Diego, Biomedical Sciences Building, Room 1310, 9500 Gilman Drive #0602, La Jolla, San Diego, CA 92093 USA
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Gleeson H, Hafford-Letchfield T, Quaife M, Collins DA, Flynn A. Preventing and responding to depression, self-harm, and suicide in older people living in long term care settings: a systematic review. Aging Ment Health 2019; 23:1467-1477. [PMID: 30392380 DOI: 10.1080/13607863.2018.1501666] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: The well documented demographic shift to an aging population means that more people will in future be in need of long term residential care. Previous research has reported an increased risk of mental health issues and suicidal ideation among older people living in residential care settings. However, there is little information on the actual prevalence of depression, self-harm, and suicidal behavior in this population, how it is measured and how care homes respond to these issues. Method: This systematic review of international literature addressed three research questions relating to; the prevalence of mental health problems in this population; how they are identified and; how care homes try to prevent or respond to mental health issues. Results: Findings showed higher reported rates of depression and suicidal behavior in care home residents compared to matched age groups in the community, variation in the use of standardised measures across studies and, interventions almost exclusively focused on increasing staff knowledge about mental health but with an absence of involvement of older people themselves in these programmes. Conclusion: We discuss the implications of these findings in the context of addressing mental health difficulties experienced by older people in residential care and future research in this area.
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Affiliation(s)
- Helen Gleeson
- Department of Mental Health, Social Work & Interprofessional Learning, School of Health and Education, Room T304, Middlesex University , London
| | - Trish Hafford-Letchfield
- Professor of Social Care, Department of Mental Health, Social Work, Interprofessional Learning and Integrative Medicine School of Health and Education Middlesex University , London , UK
| | - Matthew Quaife
- Department of Mental Health, Social Work & Interprofessional Learning, School of Health & Education, Middlesex University , London , UK
| | - Daniela A Collins
- Director of Programmes Mental Health, Department of Mental Health, Social Work & Interprofessional Learning, School of Health and Education, Middlesex University , London , UK
| | - Ann Flynn
- Staff Tutor and Locality Lead (London & South East), Open University London and the South East, Faculty of Wellbeing, Education and Language Studies, School of Health, Wellbeing and Social Care , Milton Keynes , UK
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9
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Rethinking suicides as mental accidents: Towards a new paradigm. J Affect Disord 2019; 252:141-151. [PMID: 30981951 DOI: 10.1016/j.jad.2019.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/27/2019] [Accepted: 04/07/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Since its beginnings, suicide research has made great progress in terms of empirical findings. However, in contrast to empirical knowledge, the theoretical understanding of suicides has shown only minimal progress. Missing interdisciplinary bridges and the lack of a unifying paradigm have been major obstacles. This paper examines the starting points for a rethink. METHODS In the first step, we identified major challenges in suicide research, which have been obstructing a better understanding. In the second step, we determined a new concept of suicide that is highly compatible with epidemiological results and meets the requirements of interdisciplinary usability. In the third step, the implications of this paradigm were explored by relating it to two process typologies, the one characterizing the temporal dynamics of suicide processes, and the other representing risk mechanisms / factors occurring at different stages of suicide processes. RESULTS Since suicides are rare events and often appear to be "rash acts", they can be conceived of as mental accidents or, more precisely, as failures to withstand temporary suicide impulses. This paradigm is suitable for synchronously implementing different personal, psychopathological, societal and situational perspectives. It applies to a high proportion of suicides and works well when being exposed to different typologies of suicide processes. CONCLUSIONS The mental accident paradigm provides an interdisciplinary starting point in suicidology that offers new perspectives in research, prediction and prevention.
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Teismann T, Lukaschek K, Hiller TS, Breitbart J, Brettschneider C, Schumacher U, Margraf J, Gensichen J. Suicidal ideation in primary care patients suffering from panic disorder with or without agoraphobia. BMC Psychiatry 2018; 18:305. [PMID: 30249220 PMCID: PMC6154913 DOI: 10.1186/s12888-018-1894-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 09/17/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Suicidal ideation is common in patients suffering from panic disorder. The present study investigated rates of suicidal ideation and risk factors for suicidal ideation in a sample of primary care patients suffering from panic disorder with or without agoraphobia. METHODS A total of N = 296 patients [n = 215 (72.6%) women; age: M = 43.99, SD = 13.44] were investigated. Anxiety severity, anxiety symptoms, avoidance behavior, comorbid depression diagnosis, severity of depression, age, sex, employment status, living situation and frequency of visits at the general practitioner were considered as risk factors of suicidal ideation. RESULTS Suicidal ideation was experienced by 25% of the respondents. In a logistic regression analysis, depression diagnosis and depression severity emerged as significant risk factors for suicidal ideation. Anxiety measures were not associated with suicidal ideation. CONCLUSION Suicidal ideation is common in primary care patients suffering from panic disorder with or without agoraphobia. Individuals with greater burden of mental illness in terms of mood disorder comorbidity and depressive symptomatology are especially likely to suffer from suicidal ideation.
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Affiliation(s)
- Tobias Teismann
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Massenbergstraße 11, 44787, Bochum, Germany.
| | - Karoline Lukaschek
- 0000 0004 0477 2585grid.411095.8Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians- University Munich, Pettenkoferstr. 10, D-80336 Munich, Germany ,Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany
| | - Thomas S. Hiller
- Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich-Schiller-Universität, Bachstr. 18, D-07743 Jena, Germany
| | - Jörg Breitbart
- Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich-Schiller-Universität, Bachstr. 18, D-07743 Jena, Germany
| | - Christian Brettschneider
- 0000 0001 2180 3484grid.13648.38Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | - Ulrike Schumacher
- 0000 0000 8517 6224grid.275559.9Centre for Clinical Studies, Jena University Hospital, Salvador-Allende-Platz 27, D-07747 Jena, Germany
| | - Jürgen Margraf
- 0000 0004 0490 981Xgrid.5570.7Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Massenbergstraße 11, 44787 Bochum, Germany
| | - Jochen Gensichen
- 0000 0004 0477 2585grid.411095.8Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians- University Munich, Pettenkoferstr. 10, D-80336 Munich, Germany ,Institute of General Practice and Family Medicine, Jena University Hospital, Friedrich-Schiller-Universität, Bachstr. 18, D-07743 Jena, Germany
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Berman AL. Risk Factors Proximate to Suicide and Suicide Risk Assessment in the Context of Denied Suicide Ideation. Suicide Life Threat Behav 2018; 48:340-352. [PMID: 28429385 DOI: 10.1111/sltb.12351] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 02/02/2017] [Indexed: 02/05/2023]
Abstract
Health care providers have significant opportunities to identify individuals at near-term risk for suicide, but lack empirical data on near-term risk factors. This study aimed to identify dynamic, state-related risk factors observed by clinical practitioners within the last 30 days of life of 157 patients who died by suicide and to compare these near-term risk factors among patients who denied versus responded positively to having suicide ideation (SI) when last asked by a clinical practitioner prior to their death. Risk factors charted for the majority of all decedents were a history of prior suicide ideation and/or suicide attempt, current anxiety/agitation and sleep problems, current interpersonal problems or job/financial strain, current comorbid diagnoses, current social isolation/withdrawal, and a family history of mental disorder. Two-thirds of patients denied having SI when last asked and one-half of these patients were dead by suicide within 2 days. Decedents who denied having SI were quite similar in charted diagnoses, symptoms, behaviors, and environmental circumstances to decedents who responded affirmatively to having SI. Reliance on verbalized or reported SI as a gateway to a suicide risk assessment is questioned and the need for better understanding near-term risk for suicide, particularly in the absence of stated SI, is highlighted.
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Affiliation(s)
- Alan L Berman
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Gender differences and stage-specific influence of parent-adolescent conflicts on adolescent suicidal ideation. Psychiatry Res 2017; 255:424-431. [PMID: 28668758 DOI: 10.1016/j.psychres.2017.06.077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 05/13/2017] [Accepted: 06/24/2017] [Indexed: 01/19/2023]
Abstract
This study examined familial and peer related factors as predictors of suicidal ideation in school students. Total 2896 participants were included from Taiwan Youth Project released data, a longitudinal survey of adolescent suicidal ideation at ages 15, 18, and 20. Logistic regression analysis risk factors associated with adolescent suicidal ideation reveled differences during the developmental stages. After adjusted for psychological symptoms, effect of quarrels with parents on suicidal ideation lasts in early and middle stages; in the late adolescent stage, only cigarette or alcohol use remained significant. Girls who reported quarrels with parents had the highest level of suicidal ideation before age 18. Stage- and gender-specific differences may provide appropriate intervention strategies for parents and teachers preventing adolescent suicidal ideation.
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