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Nuñez Fadda SM, Ciambelli Romero HC, Gradilla Lizardo NS, Sánchez Castillón JA. An Ecological Inquiry on Young People's Suicidal Ideation at University: Individual, Relational and Cultural Factors and Their Interactions. Eur J Investig Health Psychol Educ 2023; 14:64-86. [PMID: 38248125 PMCID: PMC10814907 DOI: 10.3390/ejihpe14010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
To understand the factors related to suicidal ideation in university students, we examined individual and microsystemic variables with an ecological model organizing bidirectional influences between different dimensions. Suicidal ideation, psychological distress, multidimensional self-concept, loneliness, community social support, life satisfaction, family functioning, bullying victimization, and problematic use of virtual social networks were measured in a sample of 376 Mexican university students (67% women) from 18 to 34 years of age (M = 20.8). Data were collected in March 2020, before mandatory confinement for COVID started in Mexico. Discriminant analyses showed that psychological distress, loneliness, self-concept, life satisfaction, family functioning, internet violence/rejection, and informal social support predicted belonging to high or no suicidal ideation groups with 88% accuracy. Only psychological distress and family self-concept predicted suicidal ideation in multilinear regression analyses. There were differences by gender in multilinear regression, with family self-concept significant for women and physical self-concept, but not family self-concept for boys. Conclusions: Early Suicide prevention in universities should include periodic screening of psychological distress, loneliness, and virtual social media use to identify students that need further evaluation and intervention. University-based strategies of mental health promotion that strengthen family relationships and the sense of community, including gender-sensitive orientation, could enhance the effect of protective factors.
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Affiliation(s)
- Silvana Mabel Nuñez Fadda
- Child and Youth Research Laboratory (LAIIF), Psychology Department, Campus Vallarta, Coast University Center, University of Guadalajara, Puerto Vallarta 48280, Mexico; (H.C.C.R.); (N.S.G.L.); (J.A.S.C.)
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Song X, Zou S, Li Y, Chen L, Feng P, Xu P, Zhang H, Deng F, Xu H, Tao Y, Jin M, Ran M, Zhang H, Ma F, Wang Y, Yin L. Correlation between negative life events and suicide attempts among Yi adolescents with HIV/AIDS in Liangshan Prefecture. BMC Public Health 2023; 23:1600. [PMID: 37608310 PMCID: PMC10463523 DOI: 10.1186/s12889-023-16377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVE To investigate the incidence of suicide attempts among adolescents with HIV/AIDS in Liangshan Prefecture, Sichuan Province, as well as the correlation between negative life events, sleep, exercise, drug therapy and suicide attempts. METHODS A total of 180 Yi adolescents aged 11-19 years with HIV/AIDS in a county of Liangshan Prefecture, Sichuan Province, China, were investigated by census. The main outcome indicators included the incidence of suicide attempts and whether negative life events, sleep, exercise, drug therapy and other factors were related to suicide attempts. RESULTS We found that the incidence rate of suicide attempts among Yi adolescents with HIV/AIDS in Liangshan Prefecture was 13.9%. Negative life events were a risk factor for suicide attempts (OR = 1.047, p < 0.001, 95% CI 1.027-1.067). In the factors of negative life events, adaptation was a risk factor for suicide attempts (OR = 1.203, p = 0.026, 95% CI 1.022-1.416), and academic pressure showed a tendency to be a risk factor for suicide attempts (OR = 1.149, p = 0.077, 95% CI 0.985-1.339). However, the punishment factor, interpersonal stress factor and loss factor had no significant correlation with suicide attempts. There was no significant correlation between sleep, exercise, drug therapy and suicide attempts. CONCLUSION The proportion of suicide attempts among Yi adolescents with HIV/AIDS in Liangshan Prefecture is high and should be considered. Negative life events are independent risk factors for suicide attempts, and it is necessary to strengthen the screening and early intervention for suicide attempts in HIV/AIDS adolescents with definite negative life events.
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Affiliation(s)
- Xiaozhen Song
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Shoukang Zou
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Yangling Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Liyu Chen
- Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - Ping Feng
- Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - Peiwei Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Fang Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Hanmei Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yuanmei Tao
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Meijiang Jin
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Maojia Ran
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Fanghua Ma
- Antiviral Treatment Center, Zhao jue County People's Hospital, Shenzhen, China
| | - Ying Wang
- Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
| | - Li Yin
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
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Park J, Chandran A. Associations of only-child status with health outcomes and risky behaviors in Korean middle- and high-school students: An outcome-wide analysis. Prev Med Rep 2022; 31:102101. [PMID: 36820385 PMCID: PMC9938333 DOI: 10.1016/j.pmedr.2022.102101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/27/2022] Open
Abstract
The proportion of children who are the only child in the family are increasing. Several associations between only-child status and health outcomes or risky behaviors have been identified, but no study has explored associations across a wide range of outcomes in a single study. We used the 2019 Korea Youth Risk Behavior Survey, a nationwide cross-sectional survey of 57,303 middle and high school students, to perform an outcome-wide analysis on six health outcomes and risky behaviors, i.e. alcohol use, asthma, body mass index, sexual activity, smoking, and suicide attempt. Individual multivariable logistic regression models examined associations between single-child status and each outcome or behavior. Of the eligible 38,211 students, 5,334 students (14.0 %) were the only child in their family, while 32,877 students (86.0 %) had siblings. Of the six selected outcomes and behaviors, alcohol use (aOR 0.88, 95 % CI 0.82-0.94), asthma (aOR 1.22, 95 % CI 1.10-1.35) and sexual activity (aOR 1.16, 95 % CI 1.02-1.31) were significantly associated with only-child status. Thus, being the only child among South Korean adolescents is both a potential protective factor and risk factor for different health outcomes and behaviors. Future research is warranted to corroborate these findings and identify mechanisms, which could provide evidence for reducing adverse outcomes and behaviors in adolescents.
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Lawrence TI, Mcfield AA. Does Conduct, Oppositional Defiant, and Panic Disorder Symptoms Associate with Suicidal Ideations Among African American Adolescents? JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1179-1189. [PMID: 36439662 PMCID: PMC9684375 DOI: 10.1007/s40653-022-00452-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 05/25/2023]
Abstract
Previous studies suggest that mental illness symptoms among adolescents, such as conduct disorder, oppositional defiant disorder, and panic disorder symptoms often associate with suicidal ideations. Despite this, few studies have examined whether these mental illness symptoms associate with suicidal ideations among African American adolescents. To address these limitations, the current study examined whether conduct disorder, oppositional defiant disorder, and panic disorder symptoms associated with suicidal ideations (N = 261). Using binominal logistic regression, results suggest that conduct disorder symptoms were associated with a higher likelihood of endorsing suicidal ideations than oppositional defiant disorder symptoms. Finally, panic disorder symptoms and gender differences were not associated with suicidal ideations. Preventive efforts and psychotherapy implications are discussed.
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Affiliation(s)
- Timothy I. Lawrence
- Prairie View, A&M University, P. O Box 519 MS, 100 University Dr, Prairie View, Texas 77446 USA
| | - Ariel A. Mcfield
- Psychology Department , University of Texas Permian Basin, 4901 E University Blvd, Odessa, TX 79762 USA
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Self-reported sleep quality and mental health mediate the relationship between chronic diseases and suicidal ideation among Chinese medical students. Sci Rep 2022; 12:18835. [PMID: 36336709 PMCID: PMC9637738 DOI: 10.1038/s41598-022-23207-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 10/26/2022] [Indexed: 11/08/2022] Open
Abstract
High prevalence and strong associations of chronic disease, poor sleep quality, poor mental health, and suicidal ideation (SI) have been reported worldwide. However, the underlying mechanism remains unexamined. The participants were 2646 Chinese medical college students with an average age of 20.13 years. Pittsburgh Sleep Quality Index, the Kessler Psychological Distress Scale, and SI was evaluated. The lifetime SI, past 12-month SI, and chronic disease prevalence rates were 10.0%, 8.4%, and 4.6%, respectively. The results of logistic regression analysis in this study found that chronic disease, self-reported poor sleep quality, poor mental health, gender and scholarship were associated with lifetime SI. Similar results were also found for 12-month SI with an exception of region. This result indicated that the effects of chronic diseases on the SI were mediated by self-reported sleep quality and mental health. Physical diseases, sleep-related concerns, and mental health issues need to be addressed through a multidisciplinary team approach and various delivery systems to prevent SI among medical college students.
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Wu Z, Zou Z, Wang F, Xiang Z, Zhu M, Long Y, Tao H, Palaniyappan L, Liu Z. Family functioning as a moderator in the relation between perceived stress and psychotic-like experiences among adolescents during COVID-19. Compr Psychiatry 2021; 111:152274. [PMID: 34560369 PMCID: PMC8448722 DOI: 10.1016/j.comppsych.2021.152274] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/28/2021] [Accepted: 09/15/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has increased psychological stress among adolescents, and the relation between perceived stress (PS) and psychotic-like experiences (PLEs) has been well-established. However, little is known about the role of family functioning (FF) in this relation, especially when adolescents experienced the extended lockdown period with family members. METHODS A total of 4807 adolescents completed this retrospective paper-and-pencil survey after school reopening between May 14th and June 6th, 2020 in Hunan Province, China. We measured PS with the Perceived stress scale (PSS-10), PLEs with the eight positive items from Community Assessment of Psychic Experiences (CAPE-8), and FF with the Family APGAR scale. We conducted subgroup analysis based on three FF levels (good, moderate, and poor) determined by previous studies. Finally, correlation and moderation analysis were performed to detect the effect of FF in the relation between PS and PLEs after adjusting for demographic variables. RESULTS Adolescents with poor FF had higher levels of PS and higher prevalence of PLEs compared to those with good FF (both p < 0.001). FF was negatively associated with both PS (r = -0.34, p < 0.001) and PLEs (r = -0.29, p < 0.001). Higher FF significantly attenuated the effect of PS on PLEs after adjusting for sex and age (effect = -0.011, bootstrap 95% CI -0.018, -0.005). CONCLUSION Our findings indicate that well-functioned family could protect against stress-induced PLEs among adolescents during this crisis. Thus family system could be an early interventional target for distressing psychotic-like experiences in youngsters.
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Affiliation(s)
- Zhipeng Wu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Zhulin Zou
- The High School Attached to Hunan Normal University, Bocai Experimental School, Changsha, Hunan, China
| | - Feiwen Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Zhibiao Xiang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Mengran Zhu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Yicheng Long
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Haojuan Tao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China
| | - Lena Palaniyappan
- Lawson Health Research Institute, London, ON, Canada; Robarts Research Institute, Western University, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada
| | - Zhening Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; China National Clinical Research Center on Mental Disorders, Changsha, Hunan, China.
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Gui Z, Ren X, Li X, Zhou C, Sun L. Parents parenting styles differences were associated with lifetime suicidal ideation: Evidences from the Chinese medical college students. J Health Psychol 2021; 27:2420-2434. [PMID: 34538113 DOI: 10.1177/13591053211044532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aims to explore the association between parents parenting styles differences and lifetime suicidal ideation (LSI). The sample included 2598 Chinese medical students. Results showed that 10.5% of students reported LSI. Moreover, total differences in parenting styles (OR = 1.04, 95% CI = 1.02, 1.06), parental nurture rejects differences (OR = 1.11, 95% CI = 1.04, 1.18), parental emotional warmth differences (OR = 1.08, 95% CI = 1.03, 1.14), and parental overprotective differences (OR = 1.11, 95% CI = 1.06, 1.16), obtain a scholarship, physical disease and mental health were associated with LSI. The major finding reminds us of the importance of consistent parenting style for suicide prevention.
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Affiliation(s)
- Zhen Gui
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, China.,National Health Commission of China (NHC) Key Lab of Health Economics and Policy Research (Shandong University), China
| | - Xuehan Ren
- Department of Biostatistics, Gilead Sciences, Inc., CA, USA
| | - Xiao Li
- Personalized Healthcare, Genentech, Inc., CA, USA
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, China.,National Health Commission of China (NHC) Key Lab of Health Economics and Policy Research (Shandong University), China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, China.,National Health Commission of China (NHC) Key Lab of Health Economics and Policy Research (Shandong University), China.,Center for Suicide Prevention Research, Shandong University, China
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Abstract
BACKGROUND Many people who consider suicide do not translate these intentions into action. Although prisoners constitute a particularly high-risk group for suicide, little is known about the factors that distinguish those who think about suicide from those who attempt suicide. METHODS Participants were 1326 adult offenders (1203 men) randomly selected from 15 Belgian prisons, representing 14% of the national prison population. Multivariate regression analysis compared prisoners who attempted suicide (n = 277) with those who thought about suicide but never made an attempt (n = 312) on a range of established risk factors. RESULTS Among the 589 participants reporting a lifetime history of suicidal ideation (44% of the total sample), almost half (47%) had made a suicide attempt. Relative to those who only thought about suicide, participants who attempted suicide were more likely to be violent offenders (aOR 2.33, 95% CI 1.49-3.62) and have a history of non-suicidal self-injury (aOR 3.19, 95% CI 2.09-4.86). The presence of self-reported mental disorder diagnosis (aOR = 2.84, 95% CI 1.91-4.24) and illicit substance abuse (aOR = 2.01, 95% CI 1.24-3.28) also independently differentiated prisoners who attempted v. considered suicide. CONCLUSION This study provides preliminary evidence that behavioural and mental health factors are implicated in the transition from thoughts to acts of suicide in prisoners. Prospective studies are warranted to explore whether these risk factors predict progression from ideation to action over time.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy (IRCP), Faculty of Law and Criminology, Ghent University, Belgium
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, UK
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Favril L, O’Connor RC, Hawton K, Vander Laenen F. Factors associated with the transition from suicidal ideation to suicide attempt in prison. Eur Psychiatry 2020; 63:e101. [PMID: 33183374 PMCID: PMC7737175 DOI: 10.1192/j.eurpsy.2020.101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although research has identified a wide range of risk factors for suicidal behavior in prisoners, it does not establish who is most likely to act on their suicidal thoughts while incarcerated. METHODS Self-report data were collected from a random sample of 1,203 adult men incarcerated across 15 prisons in Belgium, who represent 12% of all male prisoners nationwide. RESULTS One-third (33%) of participants reported having suicidal thoughts during their incarceration, of whom 26% attempted suicide in prison (9% of all prisoners). Factors independently associated with suicide attempt among prisoners with suicidal ideation were violent offending (adjusted odds ratio [aOR] = 2.64, 95% confidence interval [CI] 1.33-5.23), in-prison drug use (aOR = 2.30, 95% CI 1.25-4.22), exposure to suicidal behavior (aOR = 1.96, 95% CI 1.04-3.68), and a lifetime history of nonsuicidal self-injury (aOR = 1.90, 95% CI 1.08-3.36). While related to suicidal thoughts, markers of psychiatric morbidity and aspects of the prison regime were not associated with the progression to suicide attempt. CONCLUSIONS Many prisoners who think about suicide do not attempt suicide while incarcerated. Factors associated with suicidal ideation are distinct from those that govern the transition to suicidal behavior. Our findings lend support to the hypothesis that behavioral disinhibition might act as a catalyst in the translation of suicidal thoughts into action.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rory C. O’Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Freya Vander Laenen
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
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Ati NAL, Paraswati MD, Windarwati HD. What are the risk factors and protective factors of suicidal behavior in adolescents? A systematic review. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2020; 34:7-18. [DOI: 10.1111/jcap.12295] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/22/2020] [Accepted: 09/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Niken A. L. Ati
- School of Nursing, Faculty of Medicine Brawijaya University Malang Indonesia
| | - Mareta D. Paraswati
- School of Nursing, Faculty of Medicine Brawijaya University Malang Indonesia
| | - Heni D. Windarwati
- School of Nursing, Faculty of Medicine Brawijaya University Malang Indonesia
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Epstein S, Roberts E, Sedgwick R, Polling C, Finning K, Ford T, Dutta R, Downs J. School absenteeism as a risk factor for self-harm and suicidal ideation in children and adolescents: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2020; 29:1175-1194. [PMID: 30989389 PMCID: PMC7116080 DOI: 10.1007/s00787-019-01327-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/30/2019] [Indexed: 11/29/2022]
Abstract
Self-harm and suicidal ideation in children and adolescents are common and are risk factors for completed suicide. Social exclusion, which can take many forms, increases the risk of self-harm and suicidal ideation. One important marker of social exclusion in young people is school absenteeism. Whether school absenteeism is associated with these adverse outcomes, and if so to what extent, remains unclear. To determine the association between school absenteeism and both self-harm (including completed suicide) and suicidal ideation in children and adolescents, we conducted a systematic review of observational studies. We conducted meta-analysis and report a narrative synthesis where this was not possible. Meta-analysis of cross-sectional studies showed that school absenteeism was associated with an increased risk of self-harm [pooled adjusted odds ratio (aOR) 1.37, 95% confidence interval 1.20-1.57, P = 0.01] and of suicidal ideation (pooled aOR 1.20, 95% CI 1.02-1.42, P = 0.03). A small number of studies showed that school absenteeism had a longitudinal association with both adverse outcomes. Heterogeneity in the exposure and outcome variables, study design and reporting was prominent and limited the extent to which it was appropriate to pool results. School absenteeism was associated with both self-harm and suicidal ideation in young people, but this evidence was derived from a small number of cross-sectional studies. Further research into the mechanisms of this association could help to inform self-harm and suicide prevention strategies at clinical, school and population levels.
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Affiliation(s)
- Sophie Epstein
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
- South London and Maudsley NHS Foundation Trust, London, UK.
- Department of Child and Adolescent Psychiatry, King's College London, London, UK.
| | - Emmert Roberts
- South London and Maudsley NHS Foundation Trust, London, UK
- National Addiction Centre, King's College London, London, UK
- Department of Psychological Medicine, King's College London, London, UK
| | - Rosemary Sedgwick
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - Catherine Polling
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, King's College London, London, UK
| | | | - Tamsin Ford
- University of Exeter Medical School, Exeter, UK
| | - Rina Dutta
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, King's College London, London, UK
| | - Johnny Downs
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
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Ryu S, Lee H, Lee DK, Kim SW, Kim CE. Detection of Suicide Attempters among Suicide Ideators Using Machine Learning. Psychiatry Investig 2019; 16:588-593. [PMID: 31446686 PMCID: PMC6710424 DOI: 10.30773/pi.2019.06.19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 06/19/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE We aimed to develop predictive models to identify suicide attempters among individuals with suicide ideation using a machine learning algorithm. METHODS Among 35,116 individuals aged over 19 years from the Korea National Health & Nutrition Examination Survey, we selected 5,773 subjects who reported experiencing suicide ideation and had answered a survey question about suicide attempts. Then, we performed resampling with the Synthetic Minority Over-sampling TEchnique (SMOTE) to obtain data corresponding to 1,324 suicide attempters and 1,330 non-suicide attempters. We randomly assigned the samples to a training set (n=1,858) and a test set (n=796). In the training set, random forest models were trained with features selected through recursive feature elimination with 10-fold cross validation. Subsequently, the fitted model was used to predict suicide attempters in the test set. RESULTS In the test set, the prediction model achieved very good performance [area under receiver operating characteristic curve (AUC)=0.947] with an accuracy of 88.9%. CONCLUSION Our results suggest that a machine learning approach can enable the prediction of individuals at high risk of suicide through the integrated analysis of various suicide risk factors.
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Affiliation(s)
- Seunghyong Ryu
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Hyeongrae Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Dong-Kyun Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Chul-Eung Kim
- Mental Health Research Institute, National Center for Mental Health, Seoul, Republic of Korea
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13
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Baiden P, Tadeo SK, Graaf G, Respress BN. Examining the Association between Weapon Carrying on School Property and Suicide Attempt among Adolescents in the United States. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:570-582. [PMID: 31264533 DOI: 10.1080/19371918.2019.1635945] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Suicidal behaviors among adolescents in the United States are the second leading cause of death and has been steadily increasing over the years. Although access to and possession of a weapon may facilitate the transition from suicidal ideation to a suicide attempt, few studies have examined the association between weapon carrying and suicide attempts among adolescents. The objective of this study was to examine the association between weapon carrying on school property and suicide attempt among adolescents. Data for this study came from the 2017 Youth Risk Behavior Surveillance System. A sample of 14,547 adolescents aged 14-18 years old (50.5% female) was analyzed using logistic regression. Of the 14,547 adolescents, 4% carried a weapon on school property, and 7.7% attempted suicide during the past 12 months. In the multivariate logistic regression, adolescents who reported carrying a weapon on school property had more than double the odds of attempting suicide when compared to their counterparts who did not carry a weapon on school property. Other significant predictors of suicide attempt include sexual minority, history of forced sexual intercourse, school bullying and cyberbullying victimization, feeling sad or hopeless, and substance use. Examining the association between weapon carrying and suicide attempt among adolescents would contribute to early identification of adolescents who are likely to engage in suicidal behaviors.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington , Arlington , TX , USA
| | - Savarra K Tadeo
- School of Social Work, The University of Texas at Arlington , Arlington , TX , USA
| | - Genevieve Graaf
- School of Social Work, The University of Texas at Arlington , Arlington , TX , USA
| | - Brandon N Respress
- College of Nursing and Health Innovation, The University of Texas at Arlington , Arlington , TX , USA
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Kim J, Yoon SY. Association between socioeconomic attainments and suicidal ideation by age groups in Korea. Int J Soc Psychiatry 2018; 64:628-636. [PMID: 30084278 DOI: 10.1177/0020764018792592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Suicidal ideation is a strong antecedent of suicidal behavior, associated with increased likelihood of suicide. Thus, suicidal ideation serves to identify which groups are at more risk of suicide and has policy implications for targeting groups to prevent suicide. AIMS: A substantial body of research has addressed potential determinants of suicide ideation in Korea. Little attention has been paid, however, to analyzing the extent to which socioeconomic attainments (education, household income, and employment status) are associated with risk of suicidal ideation, drawing on nationally representative data. METHODS: Data were drawn from the 2012 Korea Welfare Panel Study (KOWEPS). Among the 12,606 respondents, the findings are based on 1,500 young adults (age 18-35) and 3,469 middle-aged adults (age 36-55) who answered a question about suicidal ideation. RESULTS: For young adults, respondents from 2-year and 4-year colleges and higher had lower probabilities of suicidal ideation compared with respondents from high school. People out of the labor force also exhibited an elevated risk of suicidal ideation compared with those in waged employment. Middle-aged adults displayed different patterns. Middle-aged respondents from 4-year colleges or higher had an increased likelihood of suicidal ideation. The likelihood of reporting suicidal ideation was predicted to decrease as household income increased only for middle-aged adults. CONCLUSIONS: The information about suicidal ideation was obtained from only one question of self-response, which limits the validity of the suicidal ideation measurement. The cross-sectional setting of the data prevents us from estimating causal relationships. Nevertheless, the findings imply that age-specific policy should be implemented to ameliorate differential risk for suicidal ideation and benefit public mental health in the long run.
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Zhang Y, Zhang OR, Li R, Flores A, Selek S, Zhang XY, Xu H. Psychiatric stressor recognition from clinical notes to reveal association with suicide. Health Informatics J 2018; 25:1846-1862. [PMID: 30328378 DOI: 10.1177/1460458218796598] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Suicide takes the lives of nearly a million people each year and it is a tremendous economic burden globally. One important type of suicide risk factor is psychiatric stress. Prior studies mainly use survey data to investigate the association between suicide and stressors. Very few studies have investigated stressor data in electronic health records, mostly due to the data being recorded in narrative text. This study takes the initiative to automatically extract and classify psychiatric stressors from clinical text using natural language processing-based methods. Suicidal behaviors were also identified by keywords. Then, a statistical association analysis between suicide ideations/attempts and stressors extracted from a clinical corpus is conducted. Experimental results show that our natural language processing method could recognize stressor entities with an F-measure of 89.01 percent. Mentions of suicidal behaviors were identified with an F-measure of 97.3 percent. The top three significant stressors associated with suicide are health, pressure, and death, which are similar to previous studies. This study demonstrates the feasibility of using natural language processing approaches to unlock information from psychiatric notes in electronic health record, to facilitate large-scale studies about associations between suicide and psychiatric stressors.
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Affiliation(s)
- Yaoyun Zhang
- The University of Texas Health Science Center at Houston, USA
| | | | - Rui Li
- The University of Texas Health Science Center at Houston, USA
| | | | | | | | - Hua Xu
- The University of Texas Health Science Center at Houston, USA
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Exploratory analysis of mediators of the relationship between childhood maltreatment and suicidal behavior. J Adolesc 2018; 69:103-112. [PMID: 30286328 DOI: 10.1016/j.adolescence.2018.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/23/2018] [Accepted: 09/17/2018] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Suicide is a major public health concern. One consistently cited risk factor for suicide is childhood maltreatment, which also may play a role in the transition from suicidal ideation to suicidal behavior. METHOD The current study aimed to examine the relationship between childhood maltreatment and suicide attempts during adolescence (N = 4834; 52.1% female; 67.5% Caucasian). Data from the U.S. National Longitudinal Study of Adolescent Health were utilized. Forty-six theoretically-relevant risk factors were explored as potential mediators of this relationship using an exploratory mediation data analytic method. RESULTS Results demonstrated a significant childhood maltreatment - suicide attempt relationship only among females. After considering demographics and suicidal ideation, having received counseling in the previous 12 months was the most influential mediator, followed by having a friend attempt suicide in the previous 12 months. CONCLUSIONS These findings highlight potential gender differences in the relationship between childhood maltreatment and later suicide attempts, and, moreover, the importance of assessing for recent exposure to peer suicidal behavior in suicide risk assessments.
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Analysis of Suicide Risk in Patients with Penile Cancer and Review of the Literature. Clin Genitourin Cancer 2018; 16:e257-e261. [DOI: 10.1016/j.clgc.2017.09.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 11/19/2022]
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Li D, Zhang R, Liu S, Liu J, Zhang T. The Characteristics of Chinese Adolescents With Suicidal Ideation: A Mixed-Methods Approach. JOURNAL OF ADOLESCENT RESEARCH 2017. [DOI: 10.1177/0743558417723603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We conducted a mixed-methods study to explore the characteristics of Chinese adolescents with suicidal ideation, using both quantitative and qualitative data and analysis. Participants were N = 244 adolescents, who completed self-report assessments of suicidal ideation, as well as indices of psychological functioning and well-being. A subset of n = 6 high and n = 6 low suicidal ideation adolescents participated in the follow-up interviews. Among the quantitative results, as compared with adolescents with low suicidal ideation, adolescents with high suicidal ideation reported significantly higher scores for stressful life events, coping-avoidant strategies, loneliness, and depression, as well as significantly lower scores for coping-approach strategies. Among the qualitative results, adolescents with high suicidal ideation demonstrated the following characteristics: (a) most troubled by academic pressures and relations, (b) negative self-evaluations, (c) maladaptive understanding of life and death, (d) individual-oriented attributions, and (e) negative coping strategies and self-fulfilling prophesy. These findings contribute to the early identification of adolescents who are at higher risk for suicide, further expand the stress and coping model with the distress-to-meaninglessness framework, and suggest that improving positive self-evaluation may be a focus of prevention and intervention.
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Affiliation(s)
- Dan Li
- Shanghai Normal University, Shanghai, China
| | - Rongwei Zhang
- Shanghai Normal University, Shanghai, China
- Fujian Polytechnic of Information Technology, Fuzhou, China
| | | | | | - Ting Zhang
- Zhejiang Industry & Trade Vocational College, Wenzhou, China
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Muñoz-Sánchez JL, Delgado C, Sánchez-Prada A, Pérez-López M, Franco-Martín MA. Use of New Technologies in the Prevention of Suicide in Europe: An Exploratory Study. JMIR Ment Health 2017; 4:e23. [PMID: 28655705 PMCID: PMC5506332 DOI: 10.2196/mental.7716] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 05/23/2017] [Accepted: 05/29/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND New technologies are an integral component of today's society and can complement existing suicide prevention programs. Here, we analyzed the use of new technologies in the prevention of suicide in 8 different European countries. OBJECTIVE The aim of this paper was to assess the opinions of professionals in incorporating such resources into the design of a suicide prevention program for the region of Zamora in Spain. This investigation, encompassed within the European project entitled European Regions Enforcing Actions against Suicide (EUREGENAS), includes 11 regions from 8 different countries and attempts to advance the field of suicide prevention in Europe. METHODS Using a specifically designed questionnaire, we assessed the opinions of 3 different groups of stakeholders regarding the use, frequency of use, facilitators, content, and format of new technologies for the prevention of suicide. The stakeholders were comprised of policy and public management professionals, professionals working in the area of mental health, and professionals related to the social area and non-governmental organizations (NGOs). A total of 416 participants were recruited in 11 regions from 8 different European countries. RESULTS The utility of the new technologies was valued positively in all 8 countries, despite these resources being seldom used in those countries. In all the countries, the factors that contributed most to facilitating the use of new technologies were accessibility and free of charge. Regarding the format of new technologies, the most widely preferred formats for use as a tool for the prevention of suicide were websites and email. The availability of information about signs of alarm and risk factors was the most relevant content for the prevention of suicide through the use of new technologies. The presence of a reference mental health professional (MHP) was also considered to be a key aspect. The countries differed in the evaluations given to the different formats suggesting that the cultural characteristics of the country should be taken into account. CONCLUSIONS New technologies are much appreciated resources; however they are not often underused in the field of suicide prevention. The results of this exploratory study show that new technologies are indeed useful resources and should be incorporated into suicide prevention programs.
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