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Abstract
OBJECTIVE In recent years, there has been an increase in immigrant populations worldwide. This study aims to present the global prevalence of suicide between immigrants and refugees as well as to report the prevalence of suicide ideation, suicide mortality, suicide attempts, and plan of suicide. METHOD Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA's) rules were used as a guide in the current research path. PubMed and EMBASE were targeted for the study until December 2019. After collecting the data, the number of events and sample size extracted for each study and also pooled odds ratio and confidence interval (CI) were used to investigate the suicide ratio among immigrants and refugees compared to the native population. RESULTS Fifty-one studies were included in the meta-analysis to investigate suicide prevalence or suicide odds ratio. The prevalence of suicidal ideation was 16% (CI: 0.12-0.20, I2 = 99.4%), for attempted suicide was 6% (CI: 0.05-0.08, I2 = 98.0%), and for suicide plan prevalence was 4% (CI: 0.00-0.08, I2 = 96.8%). The prevalence of suicidal ideation was 10% (CI: 0.04-0.17, I2 = 0.0%) in men and 17% (CI: 0.10-0.24, I2 = 96.8%) in women. The prevalence of attempted suicide was 1% (CI: 0.01-0.02, I2 = 0.0%) in men and 7% (CI: 0.03-0.10, I2 = 94.4%) in women. The odds ratio of suicide mortality among immigrants was 0.91 (CI: 0.90-0.93, p < 0.001; I2 = 97.6%) and for attempted suicide was 1.15 (CI: 1.10-1.20, p < 0.001; I2 = 92.0%). Begg's test (p = 0.933) (Egger test; p = 0.936) rejected publication bias. CONCLUSION Given the high prevalence of suicide, especially suicide ideation and suicide attempts in immigrants, increased attention needs to be paid to the mental health of this population.
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Eylem O, van Straten A, de Wit L, Rathod S, Bhui K, Kerkhof AJFM. Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention. Pilot Feasibility Stud 2021; 7:30. [PMID: 33494831 PMCID: PMC7830826 DOI: 10.1186/s40814-021-00772-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 01/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiveness in reducing suicidal ideation when compared with the treatment as usual. METHODS Turkish migrants with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6-week guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow-up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis. RESULTS Eighty-five people signed up via the study website, and we included 18 (10 intervention, 8 waitlist control). While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression, and hopelessness scores were improved in both groups. CONCLUSION Although intended to be a definitive trial, the current study became a feasibility study with process evaluation to understand the components and how they operate. The online intervention was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, and careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not. TRIAL REGISTRATION Netherlands Trial Register, NTR5028 . Registered on 1 March 2015.
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Affiliation(s)
- Ozlem Eylem
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, 7 van der Boechorststraat, Amsterdam, 1081, BT, Netherlands.
- Amsterdam Institute of Public Health, Amsterdam, Netherlands.
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, EC1M 6BQ, UK.
| | - Annemieke van Straten
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, 7 van der Boechorststraat, Amsterdam, 1081, BT, Netherlands
- Amsterdam Institute of Public Health, Amsterdam, Netherlands
| | - Leonore de Wit
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, 7 van der Boechorststraat, Amsterdam, 1081, BT, Netherlands
- Amsterdam Institute of Public Health, Amsterdam, Netherlands
| | | | - Kamaldeep Bhui
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, EC1M 6BQ, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Ad J F M Kerkhof
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, 7 van der Boechorststraat, Amsterdam, 1081, BT, Netherlands
- Amsterdam Institute of Public Health, Amsterdam, Netherlands
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Ruiz RJ, Newman M, Suchting R, Pasillas RM, Records K, Stowe RP, Moore TA. Pregnant Mexican American Biopsychosocial/Cultural risks for adverse infant outcomes. Nurs Open 2020; 8:709-720. [PMID: 33570300 PMCID: PMC7877225 DOI: 10.1002/nop2.676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/09/2020] [Accepted: 10/12/2020] [Indexed: 12/19/2022] Open
Abstract
Aims To test a model of psychosocial/cultural/biological risk factors for poor birth outcomes in Latina pregnant women. Design An observational study measuring acculturation, progesterone, cortisol, cotinine, age, marital status, income, stress, depressive symptoms and coping. We tested a structural equation model to predict risk. Methods We obtained a convenience sample (N = 515) of low medical risk pregnant Mexican American Hispanic women at 22–24 weeks of gestation. Bilingual research nurses collected data from blood, urine and questionnaires. Self‐report measures were the Beck Depression Inventory‐II, the Perceived Stress Scale, the Acculturation Rating Scale for Mexican Americans‐II and the Brief Cope. We measured progesterone and cortisol in plasma and cotinine levels in urine by enzyme‐linked immunoassays. Results A PLS‐SEM model revealed that Mexican American Hispanic pregnant women who were younger, single, lower income, more acculturated and who had greater negative coping, stress and depression were most at risk for having earlier and smaller babies.
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Affiliation(s)
| | - Matt Newman
- Serenity Research & Consulting, LLC, Austin, TX, USA
| | - Robert Suchting
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Kathie Records
- School of Nursing, The University of Northern Colorado, Greeley, CO, USA
| | | | - Tiffany A Moore
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
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Brandt L, Henssler J, Müller M, Wall S, Gabel D, Heinz A. Risk of Psychosis Among Refugees: A Systematic Review and Meta-analysis. JAMA Psychiatry 2019; 76:1133-1140. [PMID: 31411649 PMCID: PMC6694397 DOI: 10.1001/jamapsychiatry.2019.1937] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE This systematic review and meta-analysis is, to date, the first and most comprehensive to focus on the incidence of nonaffective psychoses among refugees. OBJECTIVE To assess the relative risk (RR) of incidence of nonaffective psychosis in refugees compared with the RR in the native population and nonrefugee migrants. DATA SOURCES PubMed, PsycINFO, and Embase databases were searched for studies from January 1, 1977, to March 8, 2018, with no language restrictions (PROSPERO registration No. CRD42018106740). STUDY SELECTION Studies conducted in Denmark, Sweden, Norway, and Canada were selected by multiple independent reviewers. Inclusion criteria were (1) observation of refugee history in participants, (2) assessment of effect size and spread, (3) adjustment for sex, (4) definition of nonaffective psychosis according to standardized operationalized criteria, and (5) comparators were either nonrefugee migrants or the native population. Studies observing ethnic background only, with no explicit definition of refugee status, were excluded. DATA EXTRACTION AND SYNTHESIS The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed for extracting data and assessing data quality and validity as well as risk of bias of included studies. A random-effects model was created to pool the effect sizes of included studies. MAIN OUTCOMES AND MEASURES The primary outcome, formulated before data collection, was the pooled RR in refugees compared with the nonrefugee population. RESULTS Of the 4358 screened articles, 9 studies (0.2%) involving 540 000 refugees in Denmark, Sweden, Norway, and Canada were included in the analyses. The RR for nonaffective psychoses in refugees was 1.43 (95% CI, 1.00-2.05; I2 = 96.3%) compared with nonrefugee migrants. Analyses that were restricted to studies with low risk of bias had an RR of 1.39 (95% CI, 1.23-1.58; I2 = 0.0%) for refugees compared with nonrefugee migrants, 2.41 (95% CI, 1.51-3.85; I2 = 96.3%) for refugees compared with the native population, and 1.92 (95% CI, 1.02-3.62; I2 = 97.0%) for nonrefugee migrants compared with the native group. Exclusion of studies that defined refugee status not individually but only by country of origin resulted in an RR of 2.24 (95% CI, 1.12-4.49; I2 = 96.8%) for refugees compared with nonrefugee migrants and an RR of 3.26 (95% CI, 1.87-5.70; I2 = 97.6%) for refugees compared with the native group. In general, the RR of nonaffective psychosis was increased in refugees and nonrefugee migrants compared with the native population. CONCLUSIONS AND RELEVANCE Refugee experience appeared to be an independent risk factor in developing nonaffective psychosis among refugees in Denmark, Sweden, Norway, and Canada. These findings suggest that applying the conclusions to non-Scandinavian countries should include a consideration of the characteristics of the native society and its specific interaction with the refugee population.
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Affiliation(s)
- Lasse Brandt
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Jonathan Henssler
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Müller
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland,Institute of Health Economics and Clinical Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - Stephanie Wall
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - David Gabel
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité–Universitätsmedizin Berlin, Berlin, Germany,Berlin School of Mind and Brain, Berlin, Germany,Bernstein Center of Computational Neuroscience, Berlin, Germany
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5
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Dunlavy AC, Juárez S, Toivanen S, Rostila M. Suicide risk among native- and foreign-origin persons in Sweden: a longitudinal examination of the role of unemployment status. Soc Psychiatry Psychiatr Epidemiol 2019; 54:579-590. [PMID: 30421040 DOI: 10.1007/s00127-018-1621-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 10/30/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE Prior research has documented an association between unemployment and elevated suicide risk. Yet, few Swedish studies have explicitly considered how such risk may vary by different migration background characteristics among persons of foreign-origin, who often experience diverse forms of labor market marginalization. This study examines the extent to which unemployment status may differentially influence suicide risk among the foreign-origin by generational status, region of origin, age at arrival, and duration of residence. METHODS Population-based registers were used to conduct a longitudinal, open cohort study of native-origin and foreign-origin Swedish residents of working age (25-64 years) from 1993 to 2008. Hazard ratios and 95% confidence intervals for suicide mortality were estimated using gender-stratified Cox proportional hazards models. RESULTS Elevated suicide risk observed among foreign-origin unemployed groups was generally of a similar or lower magnitude than that found in unemployed native-origin, although unemployed second-generation Swedish men demonstrated significantly greater (p < 0.05) excess risk of suicide than that observed among their native-origin counterparts. Unemployed foreign-born men with a younger age at arrival and longer duration of residence demonstrated an increased risk of suicide, while those who arrived as adults, and a shorter duration of residence did not show any increased risk. Among foreign-born women, excess suicide risk persisted regardless of age at arrival and duration of residence in the long-term unemployed. CONCLUSIONS Multiple migration background characteristics should be considered when examining relationships between employment status and suicide among the foreign-origin.
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Affiliation(s)
- Andrea C Dunlavy
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, Sveaplan, 106 91, Stockholm, Sweden.
| | - Sol Juárez
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, Sveaplan, 106 91, Stockholm, Sweden
| | - Susanna Toivanen
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, Sveaplan, 106 91, Stockholm, Sweden.,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Mikael Rostila
- Department of Public Health Sciences, Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Sveavägen 160, Sveaplan, 106 91, Stockholm, Sweden
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Heredia Montesinos A, Aichberger MC, Temur-Erman S, Bromand Z, Heinz A, Schouler-Ocak M. Explanatory models of suicidality among women of Turkish descent in Germany: A focus group study. Transcult Psychiatry 2019; 56:48-75. [PMID: 30131021 DOI: 10.1177/1363461518792432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Women of Turkish descent in Germany show higher rates of suicidal behavior compared to their host populations and men of Turkish descent. This indicates a demand for a better understanding of suicidality in this group. Nine focus groups ( N = 61) were conducted to assess explanatory models including patterns of distress, perceived causes, course/consequences of and reactions towards a suicidal crisis, help-seeking behavior, and potential intervention and prevention strategies. All participants were of Turkish descent living in Berlin, Germany. The focus groups included two with professionals such as psychiatrists or psychotherapists, two with Community Mothers, three with women from the community (ages: 18 -34, 35 -49, 50+), and of three suicide attempters (ages: 18 -33, 38 -66). Data were analyzed using the methodology of thematic analysis. Results show that suicide-related behaviors, attitudes, and help-seeking behavior have gender and culture-specific characteristics. Two central themes were identified: the impact of family and community and the impact of German society. Participants stated that they believe that family and community pressures as well as discrimination and lack of acceptance cause social isolation. Fear of stigmatization and dishonoring themselves or their family, as well as shame and self-stigma decrease the likelihood of reaching out for help. Recommended strategies are community and family interventions, promotion of integration and social inclusion, awareness campaigns to destigmatize suicidality and the use of mental health services, empowerment of women, as well as the improvement of cultural sensitivity and competency of services.
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Affiliation(s)
| | | | | | - Zohra Bromand
- Psychiatric University Clinic of Charité at St. Hedwig Hospital
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"We Went Out to Explore, But Gained Nothing But Illness": Immigration Expectations, Reality, Risk and Resilience in Chinese-Canadian Women with a History of Suicide-Related Behaviour. Cult Med Psychiatry 2018; 42:504-534. [PMID: 29383554 DOI: 10.1007/s11013-018-9566-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Suicide is a complex and tragic outcome driven by biological, psychological, social and cultural factors. Women of Chinese descent and women who have immigrated to other countries have higher rates of suicidal ideation and behaviour, and immigration-related stress may contribute. To understand the experiences of immigration and their relationship with distress and suicide-related behaviour in Chinese women who have immigrated to Canada. 10 semi-structured qualitative interviews with Chinese women who have immigrated to Toronto, Canada and have a history of suicide-related behaviour were completed and analyzed using a constructivist grounded theory methodology. Immigration-related and acculturation stress stemmed from unmet expectations and harsh realities. These repeated experiences resulted in hopelessness, helplessness, and alienation, which are risk factors for suicide and suicide-related behaviour. However, immigration-related support can also increase hope, self-efficacy and connectedness to foster recovery and resilience. This is the first qualitative study focusing on immigration experiences and its relationship to suicide-related behaviour in Chinese immigrant women. Knowledge of immigration and acculturation stressors can a) help identify and support women at risk for suicide and b) form a target for social intervention for all immigrant women, regardless of suicide risk.
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Abstract
Abstract.Background: Asylum seekers have increased risk of suicide and
suicidal behavior, with differences related to origin, gender, and age. There
are barriers to communication in clinical encounters between asylum seekers and
clinicians. There is insufficient knowledge about how communication in the
clinical encounter affects the suicide risk in female asylum seekers.
Aims: To explore the documented communication between
female asylum-seeking suicide attempters and clinicians and how it affects
treatment. Method: The medical records of 18 asylum-seeking
women who had attempted suicide were analyzed with content analysis.
Results: Communication between patients and clinicians was
affected by: the unbearable realities of the women; difficulties for clinicians
in decoding languages of distress, and understanding trauma and subjective
meanings of suicide; challenges of combining patients' and clinicians'
perspectives; and a sense of shared powerlessness. Limitations:
The medical records did not give direct access to the patient's experience,
only to the patient as documented by the clinician. Conclusion:
The results suggest that clinicians working with asylum seekers who have
attempted suicide need to develop an understanding of social and cultural
factors and of trauma issues. A question for further study is how an enhanced
integration of context and subjectivity in psychiatric practice would equip
clinicians for the specific challenges encountered.
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Affiliation(s)
- Maria Sundvall
- 1 Transcultural Center, Stockholm County Council, Sweden.,2 Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - David Titelman
- 3 National Center for Suicide Research and Prevention of Mental Ill-Health, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Sofie Bäärnhielm
- 1 Transcultural Center, Stockholm County Council, Sweden.,4 Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
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McMahon EM, Corcoran P, Keeley H, Cannon M, Carli V, Wasserman C, Sarchiapone M, Apter A, Balazs J, Banzer R, Bobes J, Brunner R, Cozman D, Haring C, Kaess M, Kahn JP, Kereszteny A, Bitenc UM, Nemes B, Poštuvan V, Sáiz PA, Sisask M, Tubiana A, Värnik P, Hoven CW, Wasserman D. Mental health difficulties and suicidal behaviours among young migrants: multicentre study of European adolescents. BJPsych Open 2017; 3:291-299. [PMID: 29234521 PMCID: PMC5707442 DOI: 10.1192/bjpo.bp.117.005322] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/11/2017] [Accepted: 10/19/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Migration has been reported to be associated with higher prevalence of mental disorders and suicidal behaviour. AIMS To examine the prevalence of emotional and behavioural difficulties, suicidal ideation and suicide attempts among migrant adolescents and their non-migrant peers. METHOD A school-based survey was completed by 11 057 European adolescents as part of the Saving and Empowering Young Lives in Europe (SEYLE) study. RESULTS A previous suicide attempt was reported by 386 (3.6%) adolescents. Compared with non-migrants, first-generation migrants had an elevated prevalence of suicide attempts (odds ratio (OR) 2.08; 95% CI 1.32-3.26; P=0.001 for European migrants and OR 1.86; 95% CI 1.06-3.27; P=0.031 for non-European migrants) and significantly higher levels of peer difficulties. Highest levels of conduct and hyperactivity problems were found among migrants of non-European origin. CONCLUSIONS Appropriate mental health services and school-based supports are required to meet the complex needs of migrant adolescents. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.
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Affiliation(s)
- Elaine M McMahon
- , PhD, National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Paul Corcoran
- , PhD, National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Helen Keeley
- , MD, MRCPsych, Child and Adolescent Psychiatry, Health Service Executive, Cork, Ireland
| | - Mary Cannon
- , PhD, FRCPsych, Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Vladimir Carli
- , MD, PhD, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Camilla Wasserman
- , PhD, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden; Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York, USA
| | - Marco Sarchiapone
- , MD, PhD, Department of Medicine and Health Science, University of Molise, Campobasso, Italy; National Institute for Health, Migration and Poverty, Rome, Italy
| | - Alan Apter
- , MD, Schneider Children's Medical Centre of Israel, Tel-Aviv University, Tel Aviv, Israel
| | - Judit Balazs
- , MD, PhD, Vadaskert Child and Adolescent Psychiatry Hospital, Budapest, Hungary; Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | | | - Julio Bobes
- , MD, PhD, Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Romuald Brunner
- , MD, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Doina Cozman
- , MD, PhD, Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christian Haring
- , MD, MSc, Department Psychiatry and Psychotherapy, Tirol Kliniken, Hospital Hall in Tyrol, Innsbruck, Austria
| | - Michael Kaess
- , MD, Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Jean-Pierre Kahn
- , MD, PhD, University of Lorraine, Nancy, France and Centre Hospitalier Régional Universitaire de Nancy, Nancy, France; Department of Psychiatry and Clinical Psychology, Centre Psychothérapique de Nancy, Nancy, France
| | - Agnes Kereszteny
- , MA, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary; Doctoral School of Semmelweis University, Budapest, Hungary
| | - Ursa Mars Bitenc
- , BSc, Slovene Centre for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia
| | - Bogdan Nemes
- , MD, PhD, Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Vita Poštuvan
- , PhD, Slovene Centre for Suicide Research, Andrej Marusic Institute, University of Primorska, Koper, Slovenia
| | - Pilar A Sáiz
- , MD, PhD, Centro de Investigación Biomédica en Red de Salud Mental - CIBERSAM, University of Oviedo, Oviedo, Spain
| | - Merike Sisask
- , PhD, Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia; School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
| | - Alexandra Tubiana
- , MA, Department of Psychiatry and Clinical Psychology, Centre Psychothérapique de Nancy, Nancy, France
| | - Peeter Värnik
- , PhD, Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn, Estonia
| | - Christina W Hoven
- , DrPh, MPH, Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, New York, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Danuta Wasserman
- , MD, PhD, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
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Radeloff D, Lempp T, Kettner M, Rauf A, Bennefeld-Kersten K, Freitag CM. Male suicide rates in German prisons and the role of citizenship. PLoS One 2017; 12:e0178959. [PMID: 28591187 PMCID: PMC5462390 DOI: 10.1371/journal.pone.0178959] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/21/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Prisoners are at a particularly high risk of suicide. In contrast to other psychosocial risk factors it remains unclear to what degree the risk of suicide differs between prisoners with local citizenship and foreigners. In order to provide more detailed information for suicide prevention in prisons, this study aims to compare suicide rates (SR) between these populations in German criminal custody. METHODS Based on a German national database of completed suicide in custody, suicides by prisoners were analysed and compared with epidemiological data of the prison population and the general population, stratified for German and foreign citizenship. Data analysis was adjusted for differences in the age distribution of both populations by calculating standard mortality ratios (SMR) for suicide. RESULTS SR were higher in prisoners with German citizenship than those with foreign citizenship (SR = 76.5 vs. SR = 42.8, P<0.01). This association was not specific to the prison population, as the higher SR in citizens compared to non-citizens (SR = 19.3 vs. SR = 9.0, P<0.01) were also found in the general population. The association between prison suicide and citizenship was comparable in juvenile and adult prisoners, indicating its relevance to both the juvenile and adult detention systems. CONCLUSION Imprisonment is associated with a substantially increased risk of suicide in both German and non-German citizens, a finding which needs to be taken into consideration by the justice system. The lower suicide risk in non-German citizens is independent of whether or not they are in custody.
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Affiliation(s)
- Daniel Radeloff
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Leipzig, Germany
- * E-mail:
| | - Thomas Lempp
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | - Mattias Kettner
- Institute of Forensic Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Amna Rauf
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
| | | | - Christine M. Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany
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[Mental disorders of immigrants in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:527-32. [PMID: 25893739 DOI: 10.1007/s00103-015-2143-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Currently the majority of data regarding indicators of psychiatric morbidity of migrant and minority groups in Germany is derived from studies on help-seeking behavior, mental health service use, or data from population studies, which were not specifically aimed at including migrants. Such data are only available for certain groups, for example, population-based studies on psychiatric disorders and suicidal behavior among Turkish migrants have been conducted, while, comprehensive data on the psychiatric morbidity among major migrant groups in Germany are still rather limited. Barriers to recruiting migrants for health studies, difficulties in assessing psychiatric morbidity in multi-cultural samples, observed as feasibility problems, are among the factors that interfere with population-based studies.
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Webb RT, Antonsen S, Pedersen CB, Mok PLH, Cantor-Graae E, Agerbo E. Attempted suicide and violent criminality among Danish second-generation immigrants according to parental place of origin. Int J Soc Psychiatry 2016; 62:186-97. [PMID: 26613752 PMCID: PMC5089542 DOI: 10.1177/0020764015615904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Immigrant populations in Western European countries have grown in their size and diversity, but little is known about risks of self-directed and externalised violence among second-generation immigrants. AIMS To compare risks for attempted suicides and violent offending among second-generation immigrants to Denmark according to parental region of origin versus the native Danish population. METHODS Data from interlinked national Danish registers were used (N = 1,973,614). Parental origin outside Denmark was categorised thus: Asia, Africa, Middle East, Greenland, other Scandinavian countries, elsewhere in Europe and all other regions. We estimated gender-specific cumulative incidence and incidence rate ratios (IRRs) versus native Danes. RESULTS In virtually all subgroups of second-generation immigrants, risk was elevated for the two adverse outcomes in both genders. Females generally had greater elevations in attempted suicide risk, and males had greater elevations in violent offending risk. For attempted suicide, especially large IRRs were observed for males and females whose parents emigrated from Greenland; for violent offending, risks were particularly raised for males and females of Middle Eastern, Greenlandic and African origin. Adjustment for socioeconomic status partially explained these associations. CONCLUSION Western European nations should develop preventive programmes tailored towards specific second-generation immigrant populations, with integrated approaches jointly tackling suicidality and violence.
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Affiliation(s)
- Roger T Webb
- Centre for Mental Health and Safety, University of Manchester, Manchester, UK
| | - Sussie Antonsen
- National Centre for Register-based Research (NCRR) and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Carsten B Pedersen
- National Centre for Register-based Research (NCRR) and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Pearl L H Mok
- Centre for Mental Health and Safety, University of Manchester, Manchester, UK
| | | | - Esben Agerbo
- National Centre for Register-based Research (NCRR) and Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
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van Bergen DD, Saharso S. Suicidality of young ethnic minority women with an immigrant background: The role of autonomy. EUROPEAN JOURNAL OF WOMEN'S STUDIES 2015. [DOI: 10.1177/1350506815609740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ethnic minority status and female gender convey a risk for suicidal behavior, yet research of suicidality of ethnic minority female immigrants is scarce. The authors of this article conducted qualitative interviews with 15 young women (of four ethnicities) in the Netherlands, who either had attempted suicide or contemplated suicide, and analyzed these in a narrative psychology tradition. Suicidality was associated with despair and frustration over the violation of the women’s personal autonomy and self-integrity regarding strategic life choices. Autonomy restrictions and violations followed two patterns, which are interconnected with four criteria regarding the capacity for autonomy. Findings are discussed with referral to Durkheim and feminist theories of autonomy.
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Webb RT, Antonsen S, Mok PLH, Agerbo E, Pedersen CB. National Cohort Study of Suicidality and Violent Criminality among Danish Immigrants. PLoS One 2015; 10:e0131915. [PMID: 26121654 PMCID: PMC4488292 DOI: 10.1371/journal.pone.0131915] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 06/08/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Immigrant populations in western societies have grown in their size and diversity yet evidence is incomplete for their risks of suicidality and criminal violence. We examined these correlated harmful behaviours in a national cohort. AIMS (i) Compare absolute risk between first and second generation immigrants, foreign-born adoptees and native Danes by plotting cumulative incidence curves to onset of early middle age; (ii) estimate sex-specific relative risks for these immigrant type subgroups vs. native Danes; (iii) examine effect modification by higher vs. lower socio-economic status. METHODS In a cohort of over two million persons, attempted suicides and violent crimes were investigated using data from multiple interlinked registers. We plotted sex-specific cumulative incidence curves and estimated incidence rate ratios. RESULTS In the whole study cohort, 1414 people died by suicide, 46,943 attempted suicide, and 51,344 were convicted of committing a violent crime. Among all immigrant subgroups combined, compared with native Danes, relative risk of attempted suicide was greater in female immigrants (incidence rate ratio, 1.59; 95% confidence interval: CI 1.54-1.64) than in male immigrants (1.26; CI 1.20-1.32), and vice versa for relative risk of violent offending in male immigrants (2.36; CI 2.31-2.42) than in female immigrants (1.74; CI 1.62-1.87). Risk for both adverse outcomes was significantly elevated in virtually every gender-specific immigrant type subgroup examined. Violent crime risk was markedly raised in first generation immigrant males and in the Danish born male children of two immigrant parents. However, male immigrants of lower social status had lower risk of attempted suicide than their native Danish peers. CONCLUSION Young immigrants of both first and second generation status face serious challenges and vulnerabilities that western societies need to urgently address. Relative risk patterns for these adverse outcomes vary greatly between the genders and also by socioeconomic status. This high degree of heterogeneity points to the existence of modifiable factors that are amenable to positive change and a potential for effective intervention.
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Affiliation(s)
- Roger T. Webb
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, United Kingdom
- * E-mail:
| | - Sussie Antonsen
- NCRR—National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU—Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Pearl L. H. Mok
- Centre for Mental Health and Safety, Institute of Brain, Behaviour and Mental Health, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, United Kingdom
| | - Esben Agerbo
- NCRR—National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU—Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Carsten B. Pedersen
- NCRR—National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU—Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
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Gilliver SC, Sundquist J, Li X, Sundquist K. Recent research on the mental health of immigrants to Sweden: a literature review. Eur J Public Health 2015; 24 Suppl 1:72-9. [PMID: 25108001 DOI: 10.1093/eurpub/cku101] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
UNLABELLED The arrival of large numbers of economic migrants and refugees has seen the Swedish immigrant population increase rapidly. Research has shown that immigrants may be more susceptible to mental disorders because of traumatic events prior to immigration and adverse circumstances in their new country. The aim of this literature review is to summarize and interpret recent research on the mental health of immigrants to Sweden. METHODS A systematic search for relevant literature in PubMed was performed on 13 February 2014. Relevant literature was limited to original research articles published between 1 January 1994 and 13 February 2014. Content relating to mental disorders and suicide was reviewed and summarized. RESULTS Nationwide studies showed increased risks of common mental disorders such as depression, as well as psychotic disorders, in immigrants to Sweden compared to native Swedes. However, the results are complex, with notable differences between different immigrant groups and between males and females. Risk of suicide was increased in some immigrant groups, but decreased in others. There has been little qualitative research on the mental health of immigrants and few intervention studies have targeted immigrants. CONCLUSION Immigrants to Sweden are a mixed group with differing, but often increased, risks of mental disorders. Targeted qualitative and intervention studies may facilitate efforts to develop and implement preventive methods for immigrants at high risk of mental ill health, and to tailor treatment to the specific needs of different immigrant groups.
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Affiliation(s)
- Stephen C Gilliver
- 1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University / Region Skåne, Malmö, Sweden
| | - Jan Sundquist
- 1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University / Region Skåne, Malmö, Sweden2 Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Xinjun Li
- 1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University / Region Skåne, Malmö, Sweden
| | - Kristina Sundquist
- 1 Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University / Region Skåne, Malmö, Sweden2 Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
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Nikolaidis C, Nena E, Agorastakis M, Constantinidis TC. Differences in survival and cause-specific mortality in a culturally diverse Greek population, 1999-2008. J Public Health (Oxf) 2015; 38:71-5. [PMID: 25740904 DOI: 10.1093/pubmed/fdv018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Modern urban populations exhibit considerable internal heterogeneity. Several social groups, such as ethnic minorities or immigrants, constitute individual clusters with different demographic and epidemiological characteristics. METHODS Death records were collected from the Municipality Registry between 1999 and 2008. Kaplan-Meier survival analysis was conducted for (i) natively born Greeks, (ii) former USSR-repatriated Greeks and (iii) Roma. Further evaluation was conducted by log-rank (Mantel-Cox) test. Relative mortality rates were assessed by means of cross-tabulation (Pearson's χ(2)). RESULTS Statistically significant differences in median survival were observed among the three social groups (P < 0.001). The relative mortality from infectious diseases was higher in the Roma population compared with natively born Greeks, odds ratio (OR) = 8.31 [confidence interval (CI) 95% 3.19-21.61]. More than 70% of these deaths were attributed to respiratory tract infections and were associated with children under the age of 5. Excess mortality due to external causes, injuries and substance abuse was observed in repatriated males compared with their natively born counterparts, OR = 2.27 (CI 95% 1.35-3.81). CONCLUSIONS Specific public health interventions are required, to improve the survival of different cultural groups. For example, improvement of immunization status and increase in overall hygiene awareness can ameliorate high infant/childhood mortality in Roma population, while social integration can help reduce acculturation-related mortality among repatriated Greeks.
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Affiliation(s)
- Christos Nikolaidis
- Laboratory of Hygiene and Environmental Protection, Medical Department, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Evangelia Nena
- Laboratory of Hygiene and Environmental Protection, Medical Department, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - Michalis Agorastakis
- Laboratory of Demographic Analysis, Department of Planning and Regional Development, University of Thessaly, Volos 38334, Greece
| | - Theodore C Constantinidis
- Laboratory of Hygiene and Environmental Protection, Medical Department, Democritus University of Thrace, Alexandroupolis 68100, Greece
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Suicide attempt rates and intervention effects in women of Turkish origin in Berlin. Eur Psychiatry 2015; 30:480-5. [PMID: 25596777 DOI: 10.1016/j.eurpsy.2014.12.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Revised: 10/09/2014] [Accepted: 12/14/2014] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Ethnic minority groups show elevated suicide attempt rates across Europe. Evidence suggests a similar trend for women of Turkish origin in Germany, yet data on suicidal behaviour in minorities in Germany is scarce. The objective was to examine rates of suicidal behaviour, underlying motives, and to explore the effectiveness of an intervention program. METHODS From 05/2009-09/2011, data on all suicide attempts among women of Turkish origin who presented at a hospital-based emergency unit in Berlin, Germany, were collected. A multi-modal intervention was conducted in 2010 and the effects of age, generation and the intervention on suicide attempt rates were examined. RESULTS At the start, the highest rate was found in women aged 18-24years with 225.4 (95% CI=208.8-242.0)/100,000. Adjustment disorder was the most prevalent diagnosis with 49.7% (n=79), being more common in second-generation women (P=.004). Further analyses suggested an effect of the intervention in the youngest age group (trend change of ß=-1.25; P=.017). CONCLUSION Our findings suggest a particularly high rate of suicide attempts by 18-24-year-old, second-generation women of Turkish origin in Berlin. Furthermore, our results suggest a trend change in suicide attempts in women aged 18-24years related to a population-based intervention program.
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Lipsicas CB, Mäkinen IH, Wasserman D, Apter A, Kerkhof A, Michel K, Renberg ES, Van Heeringen K, Värnik A, Schmidtke A. Repetition of attempted suicide among immigrants in Europe. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2014; 59:539-47. [PMID: 25565687 PMCID: PMC4197788 DOI: 10.1177/070674371405901007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/01/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To compare frequencies of suicide attempt repetition in immigrants and local European populations, and the timing of repetition in these groups. METHOD Data from 7 European countries, comprising 10 574 local and 3032 immigrant subjects, were taken from the World Health Organization European Multicentre Study on Suicidal Behaviour and the ensuing Monitoring Suicidal Behaviour in Europe (commonly referred to as MONSUE) project. The relation between immigrant status and repetition of suicide attempt within 12-months following first registered attempt was analyzed with binary logistic regression, controlling for sex, age, and method of attempt. Timing of repetition was controlled for sex, age, and the recommended type of aftercare. RESULTS Lower odds of repeating a suicide attempt were found in Eastern European (OR 0.50; 95% CI 0.41 to 0.61, P < 0.001) and non-European immigrants (OR 0.68; 95% CI 0.51 to 0.90, P < 0.05), compared with the locals. Similar patterns were identified in the sex-specific analysis. Eastern European immigrants tended to repeat their attempt much later than locals (OR 0.58; 95% CI 0.35 to 0.93, P < 0.05). In general, 32% of all repetition occurred within 30 days. Repetition tended to decrease with age and was more likely in females using harder methods in their index attempt (OR 1.29; 95% CI 1.08 to 1.54, P < 0.01). Large variations in the general repetition frequency were identified between the collecting centres, thus influencing the results. CONCLUSIONS The lower repetition frequencies in non-Western immigrants, compared with locals, in Europe stands in contrast to their markedly higher tendency to attempt suicide in general, possibly pointing to situational stress factors related to their suicidal crisis that are less persistent over time. Our findings also raise the possibility that suicide attempters and repeaters constitute only partially overlapping populations.
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Affiliation(s)
- Cendrine Bursztein Lipsicas
- Doctoral Graduate, National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institute and Stockholm County Council's Centre for Suicide Research and Prevention, Stockholm, Sweden
| | - Ilkka Henrik Mäkinen
- Professor, Department of Sociology, Uppsala University, Uppsala, Sweden; Professor, Stockholm Centre on Health of Societies in Transition, School of Social Sciences, Södertörn University, Södertörn, Sweden
| | - Danuta Wasserman
- Professor, National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institute and Stockholm County Council's Centre for Suicide Research and Prevention, Stockholm, Sweden; Head of World Health Organization Lead Collaborating Centre of Mental Health Problems and Suicide across Europe, Stockholm, Sweden
| | - Alan Apter
- Professor, Feinberg Child Study Center and the Department of Child and Adolescent Psychiatry, Schneider Children Medical Center, Petah-Tikva, Israel
| | - Ad Kerkhof
- Professor, Department of Clinical Psychology, Vrije Universiteit, Amsterdam, the Netherlands
| | - Konrad Michel
- Professor, University Psychiatric Services, Bern, Switzerland
| | - Ellinor Salander Renberg
- Professor, Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden
| | - Kees Van Heeringen
- Professor, University Department of Psychiatry and Medical Psychology, Unit for Suicide Research, University Hospital, Gent, Belgium
| | - Airi Värnik
- Professor, Estonian-Swedish Mental Health and Suicidology Institute, Tallinn, Estonia; Professor, Tallinn University, Tallinn, Estonia
| | - Armin Schmidtke
- Professor, Unit for Clinical Psychology, Department of Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany
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Gender-differences in risk factors for suicidal behaviour identified by perceived burdensomeness, thwarted belongingness and acquired capability: cross-sectional analysis from a longitudinal cohort study. BMC Psychol 2014; 2:20. [PMID: 25815191 PMCID: PMC4363058 DOI: 10.1186/2050-7283-2-20] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 07/09/2014] [Indexed: 11/25/2022] Open
Abstract
Background The Interpersonal-Psychological Theory of Suicidal Behavior (IPT) is supported by recent epidemiological data. Unique risk factors for the IPT constructs have been identified in community epidemiological studies. Gender differences in these risk factors may contribute substantially to our understanding of suicidal risk, and require further investigation. The present study explores gender differences in the predictors and correlates of perceived burdensomeness, thwarted belongingness and acquired capability for suicide. Methods Participants (547 males, 739 females) aged 32–38 from the PATH through Life study, an Australian population-based longitudinal cohort study (n=1,177) were assessed on perceived burdensomeness, thwarted belongingness and acquired capability for suicide using the Interpersonal Needs Questionnaire and Acquired Capability for Suicide Survey, and on a range of demographic, social support, psychological, mental health and physical health measures. Gender differences in the predictors of the IPT constructs were assessed using linear regression analyses. Results Higher perceived burdensomeness increased suicide ideation in both genders, while higher thwarted belongingness increased suicide ideation only in females. In females, thwarted belongingness was uniquely related to perceived burdensomeness, while greater physical health was significantly associated with greater thwarted belongingness in males but not in females. There were trends suggesting greater effects of being single and greater perceived burdensomeness for men, and stronger effects of less positive friendship support for women associated with greater thwarted belongingness. Conclusions Men and women differ in the pattern of psychological characteristics that predict suicide ideation, and in the factors predicting vulnerability. Suicide prevention strategies need to take account of gender differences.
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Bhugra D, Gupta S, Schouler-Ocak M, Graeff-Calliess I, Deakin N, Qureshi A, Dales J, Moussaoui D, Kastrup M, Tarricone I, Till A, Bassi M, Carta M. EPA Guidance Mental Health Care of Migrants. Eur Psychiatry 2014; 29:107-15. [DOI: 10.1016/j.eurpsy.2014.01.003] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 01/08/2014] [Accepted: 01/12/2014] [Indexed: 11/28/2022] Open
Abstract
AbstractMigration is an increasingly commonplace phenomenon for a number of reasons. People migrate from rural to urban areas or across borders for reasons including economic, educational or political. There is increasing recent research evidence from many countries in Europe that indicates that migrants are more prone to certain psychiatric disorders. Because of their experiences of migration and settling down in the new countries, they may also have special needs such as lack of linguistic abilities which must be taken into account using a number of strategies at individual, local and national policy levels. In this guidance document, we briefly present the evidence and propose that specific measures must be taken to improve and manage psychiatric disorders experienced by migrants and their descendants. This improvement requires involvement at the highest level in governments. This is a guidance document and not a systematic review.
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Bursztein Lipsicas C, Mäkinen IH, Wasserman D, Apter A, Bobes J, Kerkhof A, Michel K, Renberg ES, van Heeringen K, Värnik A, Schmidtke A. Immigration and recommended care after a suicide attempt in Europe: equity or bias? Eur J Public Health 2013; 24:63-5. [PMID: 23813716 DOI: 10.1093/eurpub/ckt090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This report describes the investigation of care recommendations in the medical system across European countries to immigrants who attempted suicide. Data from seven European countries with 8865 local and 2921 immigrant person-cases were derived from the WHO/EURO Multicentre Study on Suicidal Behaviour and ensuing MONSUE (Monitoring Suicidal Behaviour in Europe) project. The relationship between immigrant status and type of aftercare recommended was analysed with binary logistic regression, adjusting for gender, age, method of attempt and the Centre collecting the data. Clear disparities were identified in the care recommendation practices toward immigrants, compared with hosts, over and above differing policies by the European Centres.
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Affiliation(s)
- Cendrine Bursztein Lipsicas
- 1 National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP) at Karolinska Institutet and Stockholm County Council's Centre for Suicide Research and Prevention, Sweden
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