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Stanley AR, Aguilar T, Holland KM, Orpinas P. Precipitating Circumstances Associated With Intimate Partner Problem-Related Suicides. Am J Prev Med 2023; 65:385-394. [PMID: 36933753 DOI: 10.1016/j.amepre.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 03/20/2023]
Abstract
INTRODUCTION In 2020, suicide was the 12th leading cause of death among adults in the U.S. Previous research has shown that one common precipitating circumstance among adult suicide decedents is experiencing intimate partner problems (IPPs), such as divorce, separation, romantic break-ups, arguments, conflicts, and intimate partner violence. This study examines how precipitating factors differ between IPP- and non-IPP-related suicides. METHODS In 2022, this study analyzed National Violent Death Reporting System data from adult suicide decedents in 48 states and 2 territories between 2003 and 2020. Multivariable logistic regression models were used to compare precipitating circumstances between IPP- and non-IPP-related suicides, controlling for sociodemographic characteristics. RESULTS Of the 402,391 suicides, 20% (n=80,717) were known to be IPP-related. Circumstances that significantly increased the odds of IPP-related suicides included a history of suicidal thoughts and attempts and mental health problems (depressed mood, alcohol problem, mental health diagnosis), life stressors (interpersonal violence perpetration and victimization, arguments, financial problems, job problems, family problems), and recent legal problems. Non-IPP-related suicides were more likely to occur among older individuals and to be precipitated by a physical health problem or crime. CONCLUSIONS The findings can inform prevention strategies that build resiliency and problem-solving skills, strengthen economic support, and identify and assist people at risk for IPP-related suicides. The Centers for Disease Control and Prevention's Suicide Resource for Action and Intimate Partner Violence Prevention resource packages highlight the best available evidence for policies, programs, and practices related to preventing suicides and IPP.
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Affiliation(s)
- Ayana R Stanley
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Tatiana Aguilar
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kristin M Holland
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Pamela Orpinas
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia
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Anjos TGD, Carvalho DSBD, Machado AC, Carvalho MDSLD, Lyrio AO, Souza ES, Gomes JDA, Hintz AM, Cruz SSD, Gomes-Filho IS, Figueiredo ACMG, Pereira MG. Associated factors to abusive alcoholic beverage consumption in suicide victims. Drug Alcohol Depend 2021; 221:108613. [PMID: 33662671 DOI: 10.1016/j.drugalcdep.2021.108613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Suicide is a worldwide phenomenon, as well as a challenge for public health, and alcoholic beverage abuse is one of the most important risk factors. However, the association between possible factors related to alcoholic beverage consumption in suicide victims has rarely been investigated. OBJECTIVE To evaluate the factors associated with abusive alcoholic beverage consumption among people who died from suicide in the Brazilian Federal District (BFD). METHOD A population-based and cross-sectional study with suicide victims in the BFD between 2016 and 2017. Information was collected about sociodemographic characteristics, autopsy appraisal, and drug use. A trained team evaluated all cases to define factors associated with abusive alcoholic beverage consumption. This outcome was measured using the Blood Alcohol Concentration. Poisson regression analysis was applied to calculate the Prevalence Ratios and respective populational confidence intervals. RESULTS The findings of the present study were collected from a database containing information related to 278 suicide victims. Being male and having cocaine identified in the toxicological test were the factors that showed a strong association with abusive alcohol beverage consumption in suicide victims. Other factors showed a slight association (PR < 1.5): having an education level with greater than 8 years of study, being black, having a professional occupation or being retired or pensioner, and having the presence of cannabis in the toxicological test. CONCLUSION Socioeconomic-demographic and behavioral factors proved to be positively associated with abusive alcoholic beverage consumption among suicide victims, suggesting the need for effective public health policy measures to combat this health problem.
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Affiliation(s)
| | | | | | | | | | - Elivan Silva Souza
- Department of Health of Univesity of Brasilia, Federal District, Brazil.
| | | | | | - Simone Seixas da Cruz
- Department of Epidemiology, Federal University of Recôncavo of Bahia, Bahia, Brazil.
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Caetano R, Kaplan MS, Kerr W, McFarland BH, Giesbrecht N, Kaplan Z. Suicide, Alcohol Intoxication, and Age Among Whites and American Indians/Alaskan Natives. Alcohol Clin Exp Res 2020; 44:492-500. [PMID: 31782530 PMCID: PMC7018549 DOI: 10.1111/acer.14251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 11/18/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Among American Indians/Alaskan Natives (AI/ANs), suicides are disproportionately high among those younger than 40 years of age. This paper examines suicide and alcohol intoxication (postmortem BAC ≥ 0.08 g/dl) by age among Whites and AI/ANs to better understand the reasons for the high rate of suicide among AI/ANs for those younger than 40. METHODS Data come from the restricted 2003 to 2016 National Violent Death Reporting System (NVDRS), with postmortem information on 79,150 White and AI/AN suicide decedents of both genders who had a BAC test in 32 states of the United States. RESULTS Among Whites, 39.3% of decedents legally intoxicated are younger than 40 years of age, while among AI/ANs the proportion is 72.9% (p < 0.001). Multivariable logistic regression with data divided by age shows that in the 18 to 39 age group, AI/ANs are about 2 times more likely than Whites to have a postmortem BAC ≥ 0.08. Veteran status compared to nonveteran, and history of alcohol problems prior to suicide were also associated with BAC ≥ 0.08. Suicide methods other than by firearm and a report of the presence of 2 or more suicide precipitating circumstances were protective against BAC ≥ 0.08. Results for the age group 40 years of age and older mirror those for the younger group with 1 exception: Race/ethnicity was not associated with BAC level. CONCLUSIONS The proportion of suicide decedents with a BAC ≥ 0.08 is higher among AI/ANs than Whites, especially among those 18 to 39 years of age. However, acute alcohol intoxication does not fully explain differences in suicide age structure between AI/ANs and Whites.
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Affiliation(s)
- Raul Caetano
- Prevention Research Center, Berkeley, California
| | - Mark S Kaplan
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, California
| | | | - Bentson H McFarland
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
| | - Norman Giesbrecht
- Social & Epidemiological Research Department, Centre for Addiction & Mental Health, Toronto, Ontario, Canada
| | - Zoe Kaplan
- Prevention Research Center, Berkeley, California
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Kron M, Grewal R, Idso J, Prough M, Sundaram C, Klein S, Nida J, Jumbam D, Garringer K. Mental health indicators in APEC. Int J Soc Psychiatry 2019; 65:92-97. [PMID: 30595067 DOI: 10.1177/0020764018819631] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND The World Economic Forum (2011) concluded that the economic impact of mental illness is the single most important contributor among all non-communicable diseases to loss of productivity. The 21 economies represented by Asia Pacific Economic Cooperation (APEC) responded to that information with efforts to address mental health as an integral component of economic development. AIM In order to help assess the progress of APEC region compared to other regions of the world, the World Health Organization (WHO) granted us access to a subset of the 2014 Mental Health Atlas database containing health indicators from all 21 APEC economies. METHODS APEC-specific data were extracted using the same format used by WHO in its Mental Health Atlas to compare/contrast data in APEC versus the six WHO regions of the world. RESULTS It was observed that mental health workforces in APEC include a higher number of psychiatrist providers compared with WHO regions. Suicide rates reported in three APEC economies are among the highest in the world. All APEC economies continue their individual and coordinated efforts to support their ' APEC Roadmap to Promote Mental Wellness in a Healthy Asia Pacific (2014-2020)'. CONCLUSION Significant challenges for APEC members exist to coordinate regional efforts to improve mental health due to highly variable income levels, existing health infrastructures and social preferences. The findings in this report may serve as a helpful baseline for measuring success within the APEC region by 2020, the year in which progress in support of economic development will be reassessed.
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Affiliation(s)
- Michael Kron
- 1 Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - John Idso
- 2 Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | - Scott Klein
- 3 University of Notre Dame, Notre Dame, IN, USA
| | - John Nida
- 3 University of Notre Dame, Notre Dame, IN, USA
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Chakravorty S, Smith RV, Perlis ML, Grandner MA, Kranzler HR. Circadian Pattern of Deaths Due to Suicide in Intoxicated Alcohol-Dependent Individuals. J Clin Psychiatry 2018; 79. [PMID: 30358241 PMCID: PMC7486887 DOI: 10.4088/jcp.17m11800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 04/24/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Alcohol intoxication and dependence are risk factors for suicide, a leading cause of death in the United States. We examined the hours of peak and nadir in completed suicides over a 24-hour period among intoxicated, alcohol-dependent individuals. We also evaluated suicide-related factors associated with intoxication at different times of the day. METHODS We analyzed cross-sectional data from the 2003-2010 National Violent Death Reporting System provided by 16 US states. In the primary database, the deceased individuals' alcohol-dependent status was classified as "yes" or "no or unknown." We restricted the analysis to alcohol-dependent individuals with alcohol level data available (N = 3,661). The primary outcome measure was the reported time of death. Secondary outcome measures were predisposing and injury-related factors. Individuals were classified on the basis of their blood alcohol level (BAL) as heavy drinking (BALH [≥ 80 mg/dL]) or non-heavy drinking (BALO [< 80 mg/dL]). The time of injury was divided into 1-hour bins, which were used to compute the incidence of suicide over 24 hours. We also evaluated the association between clinical factors and BALH for each of six 4-hour time periods beginning at 00:01 hours. RESULTS The majority (73.4%) of individuals showed evidence of alcohol consumption prior to committing suicide. BALH was observed in 60.7% of all individuals. Peak incidences in suicide were identified at 21:00 for BALH and 12:00 for BALO, with nadirs at 05:00 and 03:00 hours, respectively. In a multivariable analysis, between 20:01 and 00:00 hours, BALH was associated with more risk and protective factors than BALO. CONCLUSIONS Identifying critical times and associated risk factors for suicidal behavior may contribute to suicide prevention efforts in intoxicated alcohol-dependent individuals.
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Affiliation(s)
- Subhajit Chakravorty
- Corporal Michael J. Crescenz VA Medical Center, Perelman School of Medicine, MIRECC, 2nd Fl, Postal Code 116, 3900 Woodland Ave, Philadelphia, PA 19104. .,Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rachel V Smith
- University of Louisville School of Nursing, Louisville, Kentucky, USA
| | - Michael L Perlis
- Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Henry R Kranzler
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Characteristics of completed suicide in different blood alcohol concentrations in Korea. Forensic Sci Int 2017; 281:37-43. [DOI: 10.1016/j.forsciint.2017.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/08/2017] [Accepted: 10/11/2017] [Indexed: 11/19/2022]
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Wong YJ, Wang L, Li S, Liu H. Circumstances preceding the suicide of Asian Pacific Islander Americans and White Americans. DEATH STUDIES 2017; 41:311-317. [PMID: 28010247 DOI: 10.1080/07481187.2016.1275888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the circumstances preceding suicide among Asian and Pacific Islander Americans (APIAs) and White American decedents using data from the National Violent Death Reporting System in the United States. After controlling for gender and age, APIAs had lower rates of recent disclosure of suicide ideation, recent mental health treatment, recent mental health problems, and intimate partner problems, but higher rates of school problems than White Americans. There were also significant Race × Age moderation effects for recent mental health, financial, and school problems and a significant Race × Gender moderation effect for intimate partner problems.
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Affiliation(s)
- Y Joel Wong
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Lei Wang
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Shaozhuan Li
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Huabing Liu
- b School of Education, Loyola University Chicago , Chicago , Illinois , USA
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Park CHK, Yoo SH, Lee J, Cho SJ, Shin MS, Kim EY, Kim SH, Ham K, Ahn YM. Impact of acute alcohol consumption on lethality of suicide methods. Compr Psychiatry 2017; 75:27-34. [PMID: 28288368 DOI: 10.1016/j.comppsych.2017.02.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 01/26/2017] [Accepted: 02/26/2017] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The influence of acute alcohol consumption on the factors related to suicide remains understudied. Thus, the present study investigated the relationship between blood alcohol content (BAC) and the lethality of suicide methods. METHODS Autopsy data on 315 South Korean suicide completers with a positive BAC were collected from a nationwide pool between May 2015 and November 2015, and the methods were dichotomised as suicide methods of low lethality (SMLL; drug/chemical overdose and sharp objects, n=67) and suicide methods of high lethality (SMHL; everything else, n=243). BAC at the time of autopsy and various suicide-related factors of these two groups were compared with logistic regression analyses. RESULTS Compared to suicide completers with a BAC in the lowest range of 0.011-0.049%, suicide completers with a BAC in the range of 0.150-0.199% were more likely to use SMHL (odds ratio [OR]: 3.644, 95% confidence interval [CI]: 1.221-10.874). Additionally, the adoption of SMHL was significantly associated with the absence of a psychiatric illness (OR: 0.433, 95% CI: 0.222-0.843) and a younger age; the OR for high BAC among subjects in their 40s was 0.266 (95% CI: 0.083-0.856); in their 50s, 0.183 (95% CI: 0.055-0.615); and in their 60s, 0.057 (95% CI: 0.015-0.216). CONCLUSIONS The relationship between BAC and suicide method lethality was represented by a bell-shaped pattern in which suicide methods of high lethality were more likely to be used by suicide completers with mid-range BAC levels. The increased impulsivity and impairments in particular executive functions, including planning and organization, associated with acute alcohol use may influence the selection of a particular suicide method based on its lethality.
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Affiliation(s)
- C Hyung Keun Park
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Seong Ho Yoo
- Institute of Forensic Medicine and Department of Forensic Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Jaewon Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Sung Joon Cho
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Min-Sup Shin
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Eun Young Kim
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Mental Health Center, Seoul National University Health Care Center, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea.
| | - Se Hyun Kim
- Department of Neuropsychiatry, Dongguk University International Hospital, Dongguk University Medical School, 27 Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10326, Republic of Korea.
| | - Keunsoo Ham
- Psychological Forensics Division, National Forensic Service, 10 Ipchun-ro, Wonju-si, Gangwon-do 26460, Republic of Korea.
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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