Investigation to identify individual socioeconomic and health determinants of suicidal ideation using responses to a cross-sectional, community-based public health survey

Suicidal ideation in the year following diagnosis of relapsing-remitting multiple sclerosis: A longitudinal perspective

INTRODUCTION

Suicidal ideation (SI) is common in people with multiple sclerosis (pwMS) who have longstanding illness. Prevalence of SI in the weeks to months following diagnosis is unknown, as are factors associated with SI, and whether SI 'settles' over time for newly diagnosed individuals.

METHODS

We investigated SI in the FutureMS cohort, a nationally-representative relapsing-remitting MS sample (n = 440) recruited within weeks of diagnosis. SI was considered soon ('baseline'; median 60 days) and 12 months after diagnosis. A validated mood screen classified individuals SI/non-SI. We analysed associations of clinico-demographic variables with SI and change in SI status.

RESULTS

SI was present in 12.8 % (95 % CI = 0.10, 0.16) at baseline. Those with SI had greater disability and were more likely to be anxious, depressed, fatigued, report toileting difficulties and spasms. In regression analysis, baseline SI was associated with anxiety (p < 0.001) and depression (p = 0.002), though 16 % of those reporting SI scored just 'mild' for depression. At 12 months, 9.6 % (95 % CI = 0.07, 0.13) reported SI, non-significantly different than baseline. Individuals with poorest SI outcomes over 12 months had greater unemployment, disability, anxiety, depression, fatigue, toileting difficulties and spasms, but in regression analysis no variable was individually associated with SI change.

LIMITATIONS

SI is complex but measured in this study by single-item question.

CONCLUSION

SI soon after MS diagnosis is relatively common, not only when anxiety and depression are present, but also in individuals with only mild depression. Screening for SI is important, allowing clinicians to target support to newly diagnosed individuals.

The effects of psychological interventions on suicide for cancer patients: a systematic review and network meta-analysis

Numerous psychological interventions are available for suicidal and death ideation (SDI) and suicidal behavior among cancer patients. To identify the optimal psychological interventions for reducing SDI and suicidal behavior in cancer patients. However, it remains unclear which psychological intervention is the most effective. We performed a pairwise and network meta-analysis by searching seven databases from the date of inception until 8 April 2022. An important focus of this network meta-analysis was the comparison of the effects of various psychological interventions on the reduction of SDI and suicidal behavior among cancer patients. For determining efficacy, we used standardized mean differences (SMDs) and 95% confidence intervals (CIs). Besides, a pairwise meta-analysis, inconsistency test, network meta-analysis, the surface under the cumulative rankings curve (SUCRA), comparison-adjusted funnel plot, subgroup analysis, and sensitivity analysis were also carried out. A total of 8 studies involving 1,350 patients were searched in this study. It showed that empathy therapy (SUCRA = 95.3%) has the best effect among the six interventions. Comprehensive psychological intervention (SUCRA = 77.6%) was ranked in the top two positions, followed by meaning-centered therapy (SUCRA = 40.7%). Comparison-adjusted funnel plots revealed no significant publication bias. In addition, our conclusions have not changed significantly after the sensitivity analysis. In this network meta-analysis, empathy therapy was identified as the optimal choice for reducing SDI and suicidal behaviors in cancer patients. Further multi-center and high-quality RCT studies should be conducted to make our conclusion more rigorous.

A State-of-the-Science Review of the Effect of Damp- and Mold-Affected Housing on Mental Health

BACKGROUND

While it is well-established that exposure to dampness or mold in homes negatively affects physical health, the association with mental health remains less well evidenced. As plausible psychosocial and biological pathways exist between dampness and mold exposure and poor mental health, a review of evidence is required.

OBJECTIVE

This State-of-the-Science review sought to assess what is known about the mental health effects of dampness or mold exposure and identify gaps in the literature and priorities for further research.

METHODS

A comprehensive search of electronic databases (MEDLINE, Embase, PsycInfo, Global Health, Web of Science, and Scopus) was conducted to identify relevant studies published from 2003 to 2023. Eligible studies included observational study designs such as cohort and cross-sectional studies. Target studies for review assessed the effect of dampness and/or mold on mental health outcomes.

RESULTS

Of the 1,169 records retrieved, 19 studies met the inclusion criteria. The available evidence described positive associations between residential dampness/mold exposure and poor mental health. In adults, associations were observed for outcomes such as depression, stress, and anxiety, while for children, associations were observed for emotional symptoms and emotional dysregulation.

DISCUSSION

Identified studies generally reported associations between exposure to dampness/mold in the home and poorer mental and emotional health. Given the methodological limitations present in the current evidence base, it is recommended that more research be conducted. https://doi.org/10.1289/EHP14341.

Education and suicidal ideation in Europe: A systematic review and meta-analysis

BACKGROUND

Understanding predictors of suicidal ideation (SI) is crucial for preventing suicides. Given Europe's high suicide rates and the complex nature of SI, it is essential to also examine social determinants like education as potential risk factors for SI in this region. This systematic review and meta-analysis investigates the association between formal/vocational education and SI in Europe.

METHODS

Electronic databases (PubMed, Web of Science, PsycINFO, PSYNDEX) were searched until November 2022. Included studies involved European populations examining associations between education and SI. Pooled Odds Ratios (OR) with 95 % confidence intervals (CI) were calculated using random-effects models. Heterogeneity was assessed with the heterogeneity variance τ2 and I2 statistic; subgroup analyses were performed based on study characteristics. Risk of bias was assessed using an adaption of the Newcastle-Ottawa Scale.

RESULTS

From 20,564 initial studies, 41 were included in the meta-analysis (outlier-adjusted, 96,809 study participants). A negative, insignificant association (OR = 0.86, 95 % CI: 0.75; 1.00) was observed between education and SI, with significant heterogeneity (τ2 = 0.09, I2 = 73 %). Subgroup analyses indicated that population type, age group, categorization of education, timeframe of SI assessment, and study quality significantly moderated the effect size.

LIMITATIONS

Heterogeneity across studies limits generalizability. The cross-sectional design precludes establishing causal relationships, and social desirability bias may have underestimated the association between education and SI.

CONCLUSIONS

This systematic review and meta-analysis suggests a trend towards a protective effect of education on the emergence of SI in Europe. Future research, preferably with longitudinal study design examining various covariates, should systematically consider educational inequalities in SI.

Predictors of self-harm and emergency department attendance for self-harm in deprived communities

Emergency departments (EDs) are often the first point of contact for individuals following self-harm. The majority of previous research relies on hospital-based data, yet only a minority of individuals who self-harm in the community present to healthcare services. The study design is cross-sectional survey design. Data from the National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC) Household Health Survey, a community-based public health survey in North West England, was collected using stratified random sampling. Three thousand four hundred twelve people were recruited in 2018 from relatively disadvantaged areas. The sample included 1490 men and 1922 women aged 18 to 100 years (M = 49.37, SD = 18.91). Logistic regression analysis was employed to examine demographic, health and socioeconomic predictors of self-harm and ED attendance for self-harm. Age (18-24 years), lower financial status, depression, anxiety and physical and mental health co-morbidity was associated with significantly higher levels of self-harm. People aged 18-24 years, with physical and mental health co-morbidity and lower levels of social support had significantly higher levels of attending EDs for self-harm. Improving people's financial situations, social connectivity, mental and physical health may help to reduce individual risk for self-harm and strain on health services.

Longitudinal investigation of the presence of different trajectories and associated health and socio-economic determinants, for participants who report suicidal ideation within a community-based public health survey

OBJECTIVE

Given the paucity of evidence-based research investigating different suicidal ideation profiles and trajectories, this project sought to investigate health and socio-economic factors associated with the presence of suicidal ideation and changes in ideation over time.

DESIGN

Longitudinal cohort design, using logistic regression analysis.

SETTING

A public health survey was administered at two timepoints in a community setting across the North West of England. In the 2015/2016 survey, participants were recruited from high (n=20) and low (n=8) deprivation neighbourhoods. In the 2018 survey, only the 20 high-deprivation neighbourhoods were included.

PARTICIPANTS

4287 people were recruited in 2015/2016 and 3361 were recruited in 2018. The 2018 sample was subdivided into those who responded only in 2018 (n=2494: replication sample) and those who responded at both timepoints (n=867: longitudinal sample).

PRIMARY OUTCOME MEASURES

Suicide ideation was the dependent variable which was assessed using item 9 of the Patient Health Questionnaire instrument.

RESULTS

The prevalence of suicidal ideation was 11% (n=454/4319) at 2015/2016 and 16% (n=546/3361) at 2018.Replication study results highlighted: persistent debilitation from physical ill health and/or medication side effects; demographic factors (ie, middle-aged, single or never married); and personal coping strategies (ie, smoking) as risk factors for suicidal ideation. A static/improved financial position and high levels of empathy were protective factors.Longitudinal study results confirmed three suicidal ideation trajectories: 'onset', 'remission' and 'persistence'. Similar findings to the replication study were evidenced for the onset and persistence trajectories. Persistent suicidal ideation was synonymous with higher levels of practical support which may correspond to the higher levels of debilitation and functional disability reported within this group. Remission was characterised by fewer debilitating factors and higher levels of self-agency.

CONCLUSION

A greater appreciation of the heterogeneity of suicidal trajectories should lead to the implementation of broad clinical assessments and targeted interventions.

The Patient Population of a No-Cost, Student-Run LGBTQ+ Mental Health Clinic: A Case for Equitable and Trauma-Informed Care

Introduction

LGBTQ+ individuals experience disproportionately high rates of mental health disorders. Subpopulations of this community experience unique risk factors and barriers to accessing care.

Method

This study analyzes chart review data of patients (n=49) of an LGBTQ+-specific, student-run, free mental health clinic in NYC between March 2019 and July 2021.

Result

Most common diagnoses were mood disorders (55%) and anxiety disorders (53%). 88% of patients reported experiencing lifetime traumatic events; 20% of patients met criteria for PTSD.

Conclusion

Further research is needed to characterize vulnerable subpopulations to create equitable, accessible, and competent mental health care resources for the LGBTQ+ community.

The association of social, economic, and health-related variables with suicidal and/or self-harm thoughts in individuals admitted to a psychiatric inpatient unit during the COVID-19 pandemic: An exploratory study

Individuals with pre-existing psychiatric diagnoses appear to be vulnerable to worsening mental health symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Furthermore, psychiatric hospitalizations during the pandemic may be complicated by increased risk of SARS-Cov-2 infection and limited social engagement due to changes in hospital policies. The objective of our exploratory study was to determine whether social, economic, and health-related variables were associated with thoughts of suicide and/or self-harm since March 2020 in individuals admitted to a psychiatric inpatient unit during the COVID-19 pandemic. Chi-square tests revealed four variables were significantly associated with thoughts of suicide and/or self-harm: 1) difficulty with cancellation of important events, 2) some form of loneliness, 3) decreased time spent in green spaces, and 4) increased time spent using devices with screens. The logistic regression model showed a significant association between suicidal and/or self-harm thoughts and cancellation of important events. Further investigation of the loneliness variable components revealed a significant association between suicidal and/or self-harm thoughts and feeling a lack of companionship, feeling isolated, and feeling alone. These results suggest that social challenges experienced during the pandemic were associated with negative mental health symptoms of individuals admitted to a psychiatric inpatient unit.

Impacts of psychological wellbeing with HIV/AIDS and cancer among sexual and gender minorities: A systematic review and meta-analysis

Background

The agony and economic strain of cancer and HIV/AIDS therapies severely impact patients' psychological wellbeing. Meanwhile, sexual minorities experience discrimination and mental illness. LGBT individuals with cancer and HIV/AIDS play two roles. It is important to understand and examine this groups mental wellbeing.

Objective

The purpose of this study is to synthesize current studies on the impact of HIV/AIDS and cancer on LGBT patients' psychological wellbeing.

Methods

This research uses a systematic literature review at first and later stage a meta-analysis was run on the same review. In this study, data from Google academic and Web of Science has been used to filter literature. PRISMA 2020 Flow Diagram seeks research on LGBT cancer and HIV/AIDS patients. The above sites yielded 370 related papers, some of which were removed due to age or inaccuracy. Finally, meta-analyses was done on 27 HIV/AIDS and 33 cancer patients's analyse.

Results

The research included 9,898 LGBT cancer sufferers with AIDS and 14,465 cancer sufferers with HIV/AIDS. Using meta-analysis, we discovered the gap in psychological wellbeing scores between HIV/AIDS LGBT and non-LGBT groups ranged from -10.86 to 15.63. The overall score disparity between the HIV/AIDS LGBT and non-LGBT groups was 1.270 (95% CI = 0.990-1.560, Z = 86.58, P < 0.1). The disparity in psychological wellbeing scores between cancer LGBT group and general group varies from -8.77 to 20.94 in the 34 papers examined in this study. Overall, the psychological wellbeing score disparity between the cancer LGBT subset and the general group was 12.48 (95% CI was 10.05-14.92, Test Z-value was 268.40, P-value was <0.1).

Conclusion

Inflammation and fibrosis in HIV/AIDS and cancer sufferers adversely affect their psychological wellbeing.

Improving the sense of city belonging among migrant elderly following family from an elderly service perspective: a cross-sectional study

Background

The migrant elderly following family (MEFF), who migrates to new community to reunite with families, may face challenges of city integration and belonging. This study aims to explore from an elderly service perspective how to improve the sense of city belonging for MEFFs with and without hypertension/diabetes conditions.

Methods

Data were derived from the 2017 China Migrants Dynamic Survey and China National Statistical Yearbooks in 2017. The study included 882 MEFFs with hypertension or diabetes and 1266 MEFFs without hypertension and diabetes. Hierarchical linear modeling was applied to analyze the effects of individual and provincial elderly services on sense of city belonging among the MEFF with and without hypertension/diabetes.

Results

The MEFFs with hypertension or diabetes exhibited a greater sense of city belonging when they were familiar with a wider range of health education topics (γ = 0.05, p = 0.033) and were in those provinces with a greater number of licensed doctors (γ = 0.39, p < 0.001) and hospitals (p = 0.042). For those MEFFs without hypertension or diabetes, social security cards (γ = 0.57, p < 0.001) and awareness of a wider range of health education topics (γ = 0.07, p = 0.018) may help to improve their sense of city belonging.

Conclusion

This study calls for strengthening the accessibility in inclusive elderly services, and minimizing or even eliminating the inequality in elderly services at the individual and provincial levels to increase sense of city belonging among the MEFFs. For the MEFFs with hypertension or diabetes, health managers should focus on improving health information dissemination and increasing the number of doctors per 1000 people as well as and the number of hospitals to enhance the sense of city belonging. Moreover, the government should strengthen social security and health education to facilitate the adaptation and integration of MEFFs without hypertension and diabetes into the host city.

Attitudes toward Transsexuality, Empathy, and Bullying in Young Population

Affective-sexual and gender diversity is an increasingly distinctive and extended reality and should be acknowledged and respected. From a psychosocial and educational point of view, it is appropriate to review young people’s attitudes and knowledge regarding this, relating them to aspects such as empathy, violence, or bullying, to implement quality education in the early stages of primary education. The main objective of this study was to analyze the relationship between empathy levels, attitudes toward transsexuality, and bullying among Spanish university students. The sample consisted of 247 students. Instruments were administered to evaluate negative attitudes toward transsexual people, gender ideology, transphobia, bullying, and empathy. Inverse relationships were found between transphobia and empathy. Regression analysis demonstrated the predictive ability of empathy on attitudes toward transsexual people. The results of this study are expected to increase awareness in society and encourage appropriate, satisfactory, or tolerable coexistence, in which all individuals can be free to live and express themselves. While the results indicated that the quality of life of transgender people has comparatively improved, there is still a long way to go.

Does neighbourhood identification buffer against the effects of socioeconomic disadvantage on self-harm?

BACKGROUND

Socioeconomic disadvantage and lack of group belonging (i.e., social identity) have been linked to poor mental health. However, no research has investigated the relationship between neighbourhood identity and self-harm, nor whether identifying with one's neighbourhood can mitigate the effects of economic stress on self-harm.

METHODS

Pre-registered secondary data analysis of a large (N = 3412) community health survey conducted in disadvantaged areas of North West England.

RESULTS

Despite the sample having a relatively high and therefore restricted level of disadvantage, individual and geographic indicators of disadvantage, as well as neighbourhood identification, were unique and strong predictors of self-harm thoughts and behaviours across several analyses. Specifically, experiencing disadvantage and disidentification predicted significantly higher odds of self-harm and self-harm thoughts. No consistent interactive effects emerged.

LIMITATIONS

The cross-sectional design limits firm conclusions regarding causal effects of neighbourhood identity and disadvantage on self-harm. However, causal direction is supported by past research and theory. The data is self-report, which is subject to response bias. The sample was also recruited from a region of the UK with low numbers of residents from ethnic minority backgrounds.

CONCLUSIONS

The results are consistent with past research indicating an association between social identity and better mental health, but for the first time extend these effects to self-harm. The findings demonstrate the importance of considering social and economic factors when attempting to prevent suicide and understand and treat self-harm thoughts.