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Asper M, Osika W, Dalman C, Pöllänen E, Simonsson O, Flodin P, Sidorchuk A, Marchetti L, Awil F, Castro R, Niemi ME. Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review. BJPsych Open 2022; 8:e181. [PMID: 36214114 PMCID: PMC9551492 DOI: 10.1192/bjo.2022.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors. AIMS The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health. METHOD Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health. RESULTS The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure. CONCLUSIONS Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.
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Affiliation(s)
- Michaela Asper
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Walter Osika
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Elin Pöllänen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | | | | | - Rosa Castro
- Federation of European Academies of Medicine, Belgium
| | - Maria E Niemi
- Department of Global Public Health, Karolinska Institutet, Sweden
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Kamekis A, Rachiotis G, Markaki A, Samara V, Symvoulakis EK. Employment and suicidal rates during economic recession: A country-targeted integrative review. Int J Soc Psychiatry 2021; 67:801-815. [PMID: 33135535 DOI: 10.1177/0020764020969740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The economic crisis' effects on suicide rates for countries undergoing or exiting austerity measures have been widely debated. This integrative review aimed to identify, appraise, and synthesize available evidence of employment status effect on suicide mortality rates in Greece during the recent economic recession period. METHODS A literature review of studies evaluating suicides in the general Greek population, as well as across age and gender groups, in relation to employment during the economic crisis period was performed. PubMed electronic database was searched for relevant articles published in English or Greek language from 2009 up to February 2020. Appraisal was carried out based on the Hierarchy of Evidence Rating System and the GRADE guidelines. RESULTS A total of 24 articles met all inclusion criteria with 20 of them at level IV, 2 at level VII, and 2 at level VIII. A total of 18 studies reported increase of suicide rates during the economic recession period. About 12 studies examined the co-relation between unemployment and suicide rate, with ten studies showing a positive correlation. Moreover, thirteen studies reported data on the effect of gender and age variables on suicide rates. CONCLUSION Evidence shows that suicide mortality rates in Greece increased after the eruption of economic recession, particularly after the implementation of radical austerity measures (2011-2014). This increase was positively correlated with unemployment and was more prominent among males of working age. Further in depth epidemiological research of regional variations in terms of profile and contributing or enabling factors of suicidal behavior is needed.
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Affiliation(s)
| | - George Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
| | - Adelais Markaki
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Vasiliki Samara
- Department of Educational and Social policy, University of Makedonia, Thessaloniki, Central Macedonia, Greece
| | - Emmanouil K Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
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Karakasi MV, Kevrekidis DP, Voultsos P, Trypsiannis G, Manolopoulos VG, Raikos N, Pavlidis P. Investigation of patterns and dynamics of substance users: A long-term toxicology study on a sample of the Greek population between 2005 and 2019. J Forensic Sci 2021; 66:1841-1854. [PMID: 34128547 DOI: 10.1111/1556-4029.14776] [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] [Received: 02/02/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
The purpose of the present study is to investigate dynamics underlying drug abuse and identify statistical correlations/patterns of forensic findings and sociodemographic factors in a population of illicit substance users. The following long-term studies were conducted: (a) a retrospective autopsy cohort study on autopsy incidents with available toxicological screening results (N = 482) in investigation of any possible forensic associations of exposure to illicit drugs; and (b) a cross-sectional study on a sample of arrested drug law offenders with available toxicological screening results (N = 195) as well as cluster analysis in order to possibly identify user profiles. Although outside the scope of the present study, ethanol was generally considered to be the main substance of abuse, as more than half of the premature deaths reported tested positive on the ethanol toxicology screen. Cannabis and opioid use was associated with unintentional causes of death, while an association of deliberate self-harm was noted with opioid and benzodiazepine use. Both cannabis and opioid use correlated with significantly younger ages (more than a decade) of premature death. Most frequently, an onset of substance use was reported in the early 20s with cannabis use. Although 65.3% of the subjects were diagnosed as dependent and unable to eliminate substance use on their own, only 7.7% of the subjects in the users' population had ever accessed appropriate support through rehabilitation programs.
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Affiliation(s)
- Maria-Valeria Karakasi
- Laboratory of Forensic Sciences, Democritus University of Thrace - School of Medicine, Alexandroupolis, Greece.,Third University Department of Psychiatry, AHEPA University General Hospital - Department of Mental Health, Aristotle University - Faculty of Medicine, Thessaloniki, Greece
| | | | - Polichronis Voultsos
- Department of Forensic Medicine & Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Grigorios Trypsiannis
- Laboratory of Medical Statistics, Democritus University of Thrace - School of Medicine, Alexandroupolis, Greece
| | - Vangelis G Manolopoulos
- Laboratory of Pharmacology, Democritus University of Thrace - School of Medicine, Alexandroupolis, Greece
| | - Nikolaos Raikos
- Department of Forensic Medicine & Toxicology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pavlos Pavlidis
- Laboratory of Forensic Sciences, Democritus University of Thrace - School of Medicine, Alexandroupolis, Greece
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Paraschakis A, Karageorgiou V, Efstathiou V, Douzenis A, Boyokas I, Michopoulos I. Characteristics of completed suicides after Greek financial crisis onset: A comparative time-series analysis study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:305-314. [PMID: 32803401 DOI: 10.1007/s00127-020-01939-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 08/07/2020] [Indexed: 11/30/2022]
Abstract
Severe financial crises could influence a country's suicide trends and characteristics. We aimed to highlight differences among suicide completers before and after the onset of Greece's serious debt crisis of 2010 based exclusively on forensic data. The sample's size permitted a further elaboration by means of a time series analysis too. Data were collected from the Piraeus Department of Forensic Medicine for the period 1992-2016. We extracted information on sociodemographic parameters, psychiatric medication and alcohol intake, suicide method, place and month of suicide. The "after crisis onset" group (2011-2016) was significantly older (p = 0.039)-primarily due to differences in the 55-64 age group-, had more frequently used psychiatric medications (p < 0.001), less often alcohol (p = 0.001) and died more frequently by immolation (p = 0.001). These differences were-almost exclusively-due to changes regarding male suicidal behavior. Time series analysis indicates that no strong increasing trend in total (male + female) suicide count can be observed, despite a local increase in 2009-2010. Antidepressant-positive suicides show an increase after 2010, whereas alcohol-positive suicides show a decrease. Future predicted forecasts for antidepressant-positive suicides indicate a decrease (from 5.6 per year in 2018 to 4.3 per year in 2025) whereas an increase is predicted in alcohol-positive suicides (7.7 per year in 2017, 9.36 per year in 2025). Middle-aged men, compared to middle-aged women, presumably found it harder to adjust to economic hardship after the crisis onset. Finally, comparatively more men than women who died by suicide appear to have started and/or complied with psychiatric treatment after 2010.
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Affiliation(s)
- Antonios Paraschakis
- Psychiatric Hospital of Attica "Dafni", 374 Athinon Ave, Postal Code 12462, Athens, Greece.
| | - Vasilios Karageorgiou
- 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, "Attikon" General Hospital, Athens, Greece
| | - Vasiliki Efstathiou
- 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, "Attikon" General Hospital, Athens, Greece
| | - Athanassios Douzenis
- 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, "Attikon" General Hospital, Athens, Greece
| | - Ilias Boyokas
- Piraeus Department of Forensic Medicine, Piraeus, Greece
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, "Attikon" General Hospital, Athens, Greece
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Al-Waheeb S, Al-Kandery N, Al-Omair N, Mahdi A. Patterns of suicide in Kuwait from 2014 to 2018. Public Health 2020; 187:1-7. [PMID: 32866817 DOI: 10.1016/j.puhe.2020.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/13/2020] [Accepted: 07/19/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Suicide is a public health problem in many countries around the world and is one of the top ten causes of death internationally. We performed a retrospective study from 2014 to 2018 to study the patterns of suicide in Kuwait. STUDY DESIGN After reviewing files from the General department of Criminal Evidence, we collected a total of 297 in our study period that were signed out as suicide fatalities. METHODS The relationship between demographic factors (e.g. age, sex, residential area) and suicides were studied using various statistical methodologies. RESULTS The majority of the 297 samples were in the age range of 19-35 years (180; 60.6%) and 36-65 years (107; 36%). Males constituted the majority of cases (241; 81.1%). The sample consisted of 20 different nationalities. More than half of the 297 samples were Indian (179; 60.2%), whereas Kuwaitis were a minority (22; 7.4%). Hanging was the preferred method of suicide in our study population (269; 90.6%). The governorate of Ahmadi had the highest death toll (89; 30%), followed by Farwaniyah (77; 25.9%) and Jahra (64; 21.5%). CONCLUSION The government of the State of Kuwait needs to target the group that has the largest number of fatalities by increasing education and awareness of employers and employees to the danger of this condition and the driving factors that lead people to it.
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Affiliation(s)
- S Al-Waheeb
- Department of Clinical Pathology, Faculty of Medicine, Kuwait University, Jabriyah City, State of Kuwait, Kuwait.
| | - N Al-Kandery
- General Department of Criminal Evidence, Ministry of Interior, Farwaniyah City, State of Kuwait, Kuwait
| | - N Al-Omair
- General Department of Criminal Evidence, Ministry of Interior, Farwaniyah City, State of Kuwait, Kuwait
| | - A Mahdi
- General Department of Criminal Evidence, Ministry of Interior, Farwaniyah City, State of Kuwait, Kuwait
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Male depressive traits in relation to violent suicides or suicide attempts: A systematic review. J Affect Disord 2020; 262:55-61. [PMID: 31707247 DOI: 10.1016/j.jad.2019.10.054] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/09/2019] [Accepted: 10/28/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Male sex is a consistently reported risk factor for violent suicide. It has been suggested that this association may be driven by so-called male depression - as operationalized by the Gotland Male Depression Scale (GMDS). The aim of this systematic review was to investigate if males dying by or attempting suicide with violent methods, display symptoms compatible with male depression. METHODS This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic search of PubMed, Embase and PsycINFO was performed using search terms covering: male sex, violent suicide/suicide attempt, and symptoms of male depression from the GMDS. Subsequently, a qualitative synthesis of studies meeting predefined inclusion criteria was carried out. RESULTS A total of 28 studies reporting on 91,933 violent suicides and 113 violent suicide attempts were included in the qualitative synthesis. The suicide/suicide attempt methods reported in these studies were predominantly shooting, hanging or drowning. The only two symptoms from the GMDS that was reported in relation to violent suicides/suicide attempts was overconsumption of alcohol or drugs and suicide attempts in the biological family. No studies had systematically assessed suicide victims or attempters for symptoms of male depression. LIMITATIONS Publication-, selection-, and information biases may have affected this review. CONCLUSIONS Symptoms of male depression are rarely reported in relation to violent suicides/suicide attempts. The most likely explanation for this finding is that there has been little focus on this potential association. Future studies should address this void.
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