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Wang W, Zhang J. Social Support, Psychological Strain, and Suicidality: Evidence from Chinese Universities. PSYCHOLOGY IN THE SCHOOLS 2024; 61:205-219. [PMID: 38505835 PMCID: PMC10948106 DOI: 10.1002/pits.23047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/28/2023] [Indexed: 03/21/2024]
Abstract
This study aimed to apply psychological strain theory to explore the relationship between psychological strain and suicidality among Chinese young adults with a moderating effect of perceived social support. A questionnaire was administered with the Multidimensional Scale of Perceived Social Support (MSPSS), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Psychological Strain Scale (PSS) among 13,250 college students across China. The main determinants of suicidal behavior were examined with multiple linear regression. Two steps of multiple regression were employed to define the moderating effect of social support. A positive relationship between psychological strain and suicidality was reported in the study, and social support was confirmed as a moderating factor between psychological strain and suicidal behavior.
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Affiliation(s)
- Wei Wang
- University of Delaware Department of Sociology and Criminal Justice, USA
| | - Jie Zhang
- Shandong University Center for Suicide Prevention Research, China, State University of New York Buffalo State University, USA
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2
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Lewis C, Fedock G, Garthe R, Lee C. Racial Differences in Suicidal Behaviors and Post-Suicide Attempt Treatment: a Latent Class Analysis of Incarcerated Men's Experiences. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01826-9. [PMID: 37938433 DOI: 10.1007/s40615-023-01826-9] [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: 11/23/2022] [Revised: 09/06/2023] [Accepted: 10/03/2023] [Indexed: 11/09/2023]
Abstract
Community-based research has found racial differences in suicide attempts for Black and White men and in how men are treated after a suicide attempt; however, prison-based research has largely not explored such differences. This study examined racial differences in the circumstances of incarcerated men's suicide attempts and investigated health care disparities in staff responses to these suicide attempts. With administrative data from three state prisons over a 5-year period, we conducted a latent class analysis to explore patterns of suicide attempts for 207 incarcerated men. We examined race as a predictor of class membership. Black men were more likely than White men to use a method of hanging/suffocation for attempting suicide, and they were also commonly subjected to segregation when they attempted suicide. Black men were less likely to receive health care post-attempt than White men. Given the findings of this study, several key researches, practices, and policy directions are needed to prevent suicide and promote the health and well-being of incarcerated men, particularly incarcerated Black men.
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Affiliation(s)
- Cashell Lewis
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, 969 E. 60th Street, Chicago, IL, 60637, USA.
| | - Gina Fedock
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, 969 E. 60th Street, Chicago, IL, 60637, USA
| | - Rachel Garthe
- School of Social Work, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Carol Lee
- Addiction Center, University of Michigan, Ann Arbor, MI, USA
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Grobman B, Kothapalli N, Mansur A, Lu CY. Risk of suicide among stroke survivors in the United States. J Stroke Cerebrovasc Dis 2023; 32:107272. [PMID: 37604081 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/15/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Stroke is the largest cause of disability and the 5th leading cause of death in the United States. Suicide is the 12th leading cause of death in the United States. However, little is known about the risk of suicide among people with a prior stroke. OBJECTIVES Using Multiple Cause of Death data (1999-2020) from the Centers for Disease Control and Prevention WONDER database, we examined via cross-sectional analysis the risk of suicide among survivors of stroke as compared to the general U.S. population and among subgroups within the United States. METHODS We assessed disparities in suicide rate among patients with stroke stratified by sex, race, urbanization levels, and census regions using the CDC WONDER multiple cause of death database. Standardized mortality rates were calculated to compare the suicide rate of stroke patients with the rates among demographic-matched cohorts and the general United States population. RESULTS As compared to the general population, stroke survivors had an elevated risk of suicide. Black stroke survivors had a lower rate of suicide as compared to the general population, while White stroke survivors and those in nonmetropolitan areas had an elevated risk compared to the general population. CONCLUSION There was a slightly elevated risk of suicide among people with a prior stroke in the United States. This risk may be elevated among White people and among people living in nonmetropolitan areas.
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Affiliation(s)
- Ben Grobman
- Harvard Medical School, Boston, Massachusetts, USA.
| | - Neeharika Kothapalli
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Arian Mansur
- Harvard Medical School, Boston, Massachusetts, USA
| | - Christine Y Lu
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA; Kolling Institute, Faculty of Medicine and Health, The University of Sydney and the Northern Sydney Local Health District, Sydney, NSW, Australia; School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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4
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Troya M, Spittal MJ, Pendrous R, Crowley G, Gorton HC, Russell K, Byrne S, Musgrove R, Hannah-Swain S, Kapur N, Knipe D. Suicide rates amongst individuals from ethnic minority backgrounds: A systematic review and meta-analysis. EClinicalMedicine 2022; 47:101399. [PMID: 35518122 PMCID: PMC9065636 DOI: 10.1016/j.eclinm.2022.101399] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Existing evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally. METHODS Databases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940. FINDINGS A total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4-17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2-139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9-1·7) with again a broad range amongst studies (RR 0·2-18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9-4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7-36·6). There was very substantial heterogeneity (I2 > 98%) between studies for all pooled estimates. INTERPRETATION The homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations. FUNDING No specific funding was provided to conduct this research. DK is funded by Wellcome Trust and Elizabeth Blackwell Institute Bristol. Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. Rebecca Musgrove is funded by the NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC-2016-003).
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Affiliation(s)
- M.Isabela Troya
- School of Public Health, College of Medicine and Health, University College Cork, 4.07 Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | | | - Grace Crowley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hayley C Gorton
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Kirsten Russell
- School of Psychological Sciences and Health, Graham Hills Building, 40 George Street, Glasgow, UK
| | - Sadhbh Byrne
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Rebecca Musgrove
- Centre for Mental Health and Safety, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Sciences Centre, University of Manchester, and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Navneet Kapur
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, The University of Manchester, Manchester, UK
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Corresponding author.
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Meda N, Miola A, Slongo I, Zordan MA, Sambataro F. The impact of macroeconomic factors on suicide in 175 countries over 27 years. Suicide Life Threat Behav 2022; 52:49-58. [PMID: 34032310 PMCID: PMC9292781 DOI: 10.1111/sltb.12773] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/05/2021] [Accepted: 03/28/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Every year, more than 800,000 people die by suicide, three-quarters of which are males. Economic factors influence suicide rates, but a worldwide perspective of their impact according to age and sex is lacking. METHOD We queried publicly available datasets on economic factors and on suicide rates stratified according to sex and age, from 1991 to 2017, for 175 countries. Thus, we analyzed approximately 21 million deaths by suicide using a multivariable regression model approach. RESULTS Every 1% increase in global unemployment rates is associated with a 1% upsurge in male deaths by suicide (Relative risk (RR) = 1.01 [CI 95% 1.00-1.01] with respect to females) or 5000 excess male deaths. A 1% higher unemployment rate also exerts age-specific effects on suicide rates, since, among adults aged 30-59, the suicide rate is increased by 2-3%. Lastly, for every 1000 US dollar increase in the GDP per capita, suicide rates are reduced by 2% (RR = 0.98 [0.98-0.98]), corresponding to a reduction of 14,000-15,000 suicide deaths per year globally. CONCLUSIONS Males who have lost their jobs in adulthood are those at higher risk of suicide and to whom financial support measures should be delivered in a timely manner.
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Affiliation(s)
- Nicola Meda
- Department of MedicineUniversity of PadovaPadovaItaly
| | | | - Irene Slongo
- Department of General PsychologyUniversity of PadovaPadovaItaly
| | - Mauro Agostino Zordan
- Padova Neuroscience CenterUniversity of PadovaPadovaItaly,Department of BiologyUniversity of PadovaPadovaItaly
| | - Fabio Sambataro
- Padova Neuroscience CenterUniversity of PadovaPadovaItaly,Department of NeuroscienceUniversity of PadovaPadovaItaly
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Olfson M, Stroup TS, Huang C, Wall MM, Crystal S, Gerhard T. Suicide Risk in Medicare Patients With Schizophrenia Across the Life Span. JAMA Psychiatry 2021; 78:876-885. [PMID: 34037667 PMCID: PMC8156163 DOI: 10.1001/jamapsychiatry.2021.0841] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/15/2021] [Indexed: 11/14/2022]
Abstract
Importance Although adults with schizophrenia have an increased risk of suicide, sample size limitations of previous research have hindered characterizations of suicide risk across the life span. Objective To describe suicide mortality rates and correlates among adults with schizophrenia across the life span and standardized mortality ratios (SMRs) for suicide compared with the general US population. Design, Setting, and Participants Five national retrospective longitudinal cohorts of patients with schizophrenia in the Medicare program from January 1, 2007, to December 31, 2016, were identified by age: 18 to 34, 35 to 44, 45 to 54, 55 to 64, and 65 years or older. Death record information was obtained from the National Death Index. The total cohort included 668 836 Medicare patients with schizophrenia, 2 997 308 years of follow-up, and 2218 suicide deaths. Data were analyzed from September 30, 2020, to March 10, 2021. Main Outcomes and Measures For each age group, suicide mortality rates per 100 000 person-years and adjusted hazard ratios (aHRs) with 95% CIs of suicide were determined. Suicide SMRs were estimated for the total cohort and by sex and age cohorts standardized to the general US population by age, sex, and race/ethnicity. Results The study population of adults 18 years and older included 668 836 Medicare recipients with schizophrenia (52.5% men, 47.5% women). The total suicide rate per 100 000 person-years was 74.00, which is 4.5 times higher than that for the general US population (SMR, 4.54; 95% CI, 4.35-4.73) and included a rate of 88.96 for men and 56.33 for women, which are 3.4 (SMR, 3.39; 95% CI, 3.22-3.57) and 8.2 (SMR, 8.16; 95% CI, 7.60-8.75) times higher, respectively, than the rates for the general US population. Suicide rates were significantly higher for men (aHR, 1.44; 95% CI, 1.29-1.61) and those with depressive (aHR, 1.32; 95% CI, 1.17-1.50), anxiety (aHR, 1.15; 95% CI, 1.02-1.30), drug use (aHR, 1.55; 95% CI, 1.36-1.76), and sleep disorders (aHR, 1.22; 95% CI, 1.07-1.39), suicidal ideation (aHR, 1.41; 95% CI, 1.22-1.63), and suicide attempts or self-injury (aHR, 2.48; 95% CI, 2.06-2.98). The adjusted hazards of suicide were lower for Hispanic patients (aHR, 0.66; 95% CI, 0.54-0.80) or Black patients (aHR, 0.29; 95% CI, 0.24-0.35) than White patients. The suicide rate declined with age, from 141.95 (SMR, 10.19; 95% CI, 9.29-11.18) for patients aged 18 to 34 years to 24.01 (SMR, 1.53; 95% CI, 1.32-1.77) for patients 65 years or older. The corresponding declines per 100 000 person-years were from 153.80 (18-34 years of age) to 34.17 (65 years or older) for men and from 115.70 (18-34 years of age) to 18.66 (65 years or older) for women. In the group aged 18 to 34 years, the adjusted hazards of suicide risk were significantly increased for patients with suicide attempt or self-injury (aHR, 2.57; 95% CI, 18.20-2.04) and with comorbid drug use disorders (aHR, 1.48; 95% CI, 1.17-1.88), but not with comorbid depressive disorders (aHR, 0.99; 95% CI, 0.38-1.26) during the year before the start of follow-up. Conclusions and Relevance In this cohort study of adult Medicare patients with schizophrenia, suicide risk was elevated, with the highest absolute and relative risk among young adults. These patterns support suicide prevention efforts with a focus on young adults with schizophrenia, especially those with suicidal symptoms and substance use.
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Affiliation(s)
- Mark Olfson
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York
- Mailman School of Public Health, Columbia University, New York, New York
| | - T. Scott Stroup
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York
| | - Cecilia Huang
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey
| | - Melanie M. Wall
- Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York
- Mailman School of Public Health, Columbia University, New York, New York
| | - Stephen Crystal
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey
| | - Tobias Gerhard
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey
- Ernest Mario School of Pharmacy, Rutgers University, Piscataway, New Jersey
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Fehling KB, Selby EA. Suicide in DSM-5: Current Evidence for the Proposed Suicide Behavior Disorder and Other Possible Improvements. Front Psychiatry 2020; 11:499980. [PMID: 33613330 PMCID: PMC7891495 DOI: 10.3389/fpsyt.2020.499980] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
Suicide continues to be one of the greatest challenges faced by mental health clinicians and researchers, an issue made worse by increasing trends in the global suicide rate. Suicide behavior disorder (SBD) was introduced in DSM-5 as a disorder for further consideration and potential acceptance into the diagnostic system. There are numerous positive developments that would arise from the addition of a suicide-related diagnosis. Utilizing the 2009 guidelines established by Kendler and colleagues, the present review examines the evidence for SBD's validity and discusses the diagnosis' potential clinical benefits and limitations. Altogether, growing evidence indicates that SBD has preliminary validity and benefit. SBD presents with several significant limitations, however, and possible alternative additions to future DSMs are highlighted.
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Affiliation(s)
| | - Edward A Selby
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
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Walker RL, Talavera DC, Nomamiukor F, Madubata IJ, Alfano C, Vujanovic AA. Sleep-related problems and suicide behavior and ideation among Black and White trauma-exposed psychiatric inpatients. Compr Psychiatry 2019; 91:22-28. [PMID: 30992121 DOI: 10.1016/j.comppsych.2019.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 02/05/2019] [Accepted: 03/11/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Sleep-related problems (SRPs) are associated with increased risk for suicide-related behavior and death. Given that Black adults report greater SRPs as compared to White adults, the purpose of the current study was to examine sleep problems, suicide-related psychiatric admission, and suicide ideation, in Black and White trauma-exposed adults. METHOD Suicide-related behavior (i.e., intent, plan, and/or behavior) as reason for hospital admission was obtained via medical records review for 172 Black and White adults who were admitted to an acute-care psychiatric facility; all participants completed validated measures of sleep quality and suicide ideation. RESULTS Adjusted logistic regression analyses revealed that sleep-related daytime dysfunction (AOR = 4.32, p < .05) and poor sleep quality (AOR = 3.64, p < .05) were associated with significantly increased odds that Black participants were admitted for suicide-related psychiatric care. Poorer sleep quality (AOR = 2.10, p < .05) was also associated with increased odds of suicide-related admission among White participants. However, shorter sleep duration was marginally associated with suicide ideation in Black participants only. CONCLUSIONS SRPs may be related to suicide-related behavior and ideation differently for vulnerable Black and White adults. More research is needed to understand potential race group differences and mechanisms by which SRPs increase risk for suicide crisis across racial groups.
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Affiliation(s)
- Rheeda L Walker
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA.
| | - David C Talavera
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA; Harvard Medical School/Cambridge Health Alliance, Cambridge, MA 02139, USA
| | - Faith Nomamiukor
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA
| | - Ijeoma J Madubata
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA
| | - Candice Alfano
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA; Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX 30602-3013, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, TX 30602-3013, USA
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Assari S. Suicide Attempts in Michigan HealthCare System; Racial Differences. Brain Sci 2018; 8:E124. [PMID: 29966335 PMCID: PMC6071112 DOI: 10.3390/brainsci8070124] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/21/2018] [Accepted: 06/28/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Community-based studies have documented racial differences in social, psychiatric, and medical determinants of suicidal ideation; however, less is known about racial differences in the profile of suicide attempts in clinical settings. AIM The current study aimed to compare Blacks and Whites who attempted suicide for demographic factors, socioeconomic status, medical history, psychiatric disorders, and outcomes. METHODS This retrospective study was a retrospective chart review of DataDirect, which is an electronic data repository of the Michigan Health Care System, 2014 to 2017. This analysis included 6147 suicide attempts (5388 Whites and 759 Blacks). Race, sociodemographic factors, medical history, psychiatric disorders, and outcomes were measured. RESULTS Blacks and Whites with suicide attempt did not differ in age or gender, but varied by insurance type. Blacks were more commonly under Medicare and Medicaid, while Whites were more commonly under private insurance or self-pay (p < 0.05). Blacks with suicide attempt were more likely to be obese, while Whites with suicide attempt were more likely to be underweight. Frequency of psychiatric disorders, including depression, alcohol abuse, drug abuse, and psychosis, were not different between Whites and Blacks with suicide attempt; however, medical conditions showed a different profile across racial groups. When compared to Whites, Blacks had higher prevalence of uncomplicated hypertension, renal failure, chronic obstructive pulmonary disease, coagulopathy, and obesity (p < 0.05 for all comparisons). In contrast, Whites had higher prevalence of other neurological disorders than Blacks. There were no differences in in-patient survival rate between Whites and Blacks who attempted suicide. CONCLUSION There are considerable differences between Blacks and Whites with at least one suicide attempt. Although their psychiatric diagnoses seem to be similar, Blacks who have attempted suicide attempt have more medical comorbidities than their White counterparts. Lack of racial disparities in in-patient mortality rate of suicide attempts in the Michigan Health Care System is promising news given the higher physical health needs of Blacks when compared to Whites.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
- Center for Research on Ethnicity, Culture, and Health (CRECH), University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
- Department of Psychology, University of California Los Angeles (UCLA), Franz Hall, 502 Portola Plaza, Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
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Joe S, Scott ML, Banks A. What Works for Adolescent Black Males at Risk of Suicide: A Review. RESEARCH ON SOCIAL WORK PRACTICE 2018; 28:340-345. [PMID: 30546246 PMCID: PMC6289510 DOI: 10.1177/1049731517702745] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We reviewed the controlled studies that report outcome findings for Black adolescent males 24 years of age and younger at risk of suicide. Our review identified 48 articles published from 2000 to 2015, 33 that met our initial criteria for full-text articles review, resulting in 6 that met all inclusion criteria. We sought to understand what works for Black males experiencing suicide ideation or engaging in suicidal behaviors (e.g., attempts). We identified crossover effects for multisystemic therapy for reducing the risk for suicide ideation and attempts. Attachment-based family therapy was salient for use as a component of clinical practice for Black males being treated for suicide ideation. While remaining randomized control trials did involve Black youth, dis-aggregated data based on ethnicity and gender were not reported. Overall, the located studies are too few to provide unequivocal guidance for practice.
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Affiliation(s)
- Sean Joe
- Washington University in St. Louis, St. Louis, MO, USA
| | | | - Andrae Banks
- Washington University in St. Louis, St. Louis, MO, USA
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11
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Tomek S, Burton S, Hooper LM, Bolland A, Bolland J. Suicidality in Black American Youth Living in Impoverished Neighborhoods: Is School Connectedness a Protective Factor? SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-017-9241-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Ferguson A, Gilmour M. Non-Monosex Research Publication in U.S.-Based Social Work Journals Between 2008-2016. ACTA ACUST UNITED AC 2017; 15:23-37. [PMID: 29206572 DOI: 10.1080/23761407.2017.1391730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
An estimated 4% of men and 9% of women identify as non-monosex, a term for sexual identities outside of the heterosexual/homosexual binary, such as bisexual, pansexual, polysexual, and asexual. In addition to experiences of oppression shared with all sexual minorities, non-monosex-identifying persons face additional issues of monosex bias in their personal lives, in mass media, and in research. Despite social work's commitment to issues of social justice and inclusion, prior reviews of the literature have indicated a gap in research on non-monosex-identifying persons, which can lead to inappropriate clinical practices and continued stigmatization. The authors of this article examined the state of social work literature on non-monosex-identifying persons through a systematic review and content analysis of primary-study data-based publications from 2008 to 2016 in 24 social work journals based in the United States. Only four articles were found that met the inclusion criteria, and while 31% of the 357 total study participants identified as non-monosex, a content analysis showed subtle forms of monosex bias in the reporting of study results, such as collapsing of gay/lesbian participants with non-monosex participants and the use of marginalizing language. Implications and suggestions for future social work researchers are discussed.
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Affiliation(s)
- Aidan Ferguson
- a College of Social Work , Florida State University , Tallahassee , Florida , USA
| | - Matt Gilmour
- a College of Social Work , Florida State University , Tallahassee , Florida , USA
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13
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Assari S, Lankarani MM. Demographic and Socioeconomic Determinants of Physical and Mental Self-rated Health Across 10 Ethnic Groups in the United States. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2017; 3:185-193. [PMID: 31435528 DOI: 10.15171/ijer.2017.02] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims The aim of this study was to explore ethnic differences in demographic and socioeconomic determinants of poor physical and mental self-rated health (SRH) in the United States. Methods We used data from the Collaborative Psychiatric Epidemiology Surveys (CPES) 2001-2003, which included a national household probability sample of 18237 individuals including 520 Vietnamese, 508 Filipino, 600 Chinese, 656 other Asian, 577 Cuban, 495 Puerto Rican, 1442 Mexican, 1106 other Hispanic, 4746 African American, and 7587 non-Latino Whites. Demographic factors (age and gender), socioeconomic factors (education and income), body mass index (BMI), and physical and mental SRH were measured. Pearson correlation was used to explore correlates of physical and mental SRH across ethnic groups. Results While age was positively associated with poor physical SRH, ethnic groups differed in the effect of age on mental SRH. Age was positively associated with mental SRH among Vietnamese, Filipino, Chinese, Cuban, Puerto Rican, and African American individuals, but this was not so for other Asians, Mexicans, other Hispanics, and non-Hispanic Whites. Chinese and Cubans were the only groups where female gender was associated with poor physical and mental SRH. With other Asians being an exception, education and income were protective against poor physical and mental SRH in all ethnic groups. Ethnic groups also differed in how their mental and physical SRH reflect BMI. Conclusion Demographic and socioeconomic determinants of physical and mental SRH vary across ethnic groups. Poor physical and mental SRH are differently shaped by social determinants across ethnic groups. These ethnic differences may cause bias in health measurement in ethnically diverse populations.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Public Health, University of Michigan, USA
| | - Maryam Moghani Lankarani
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA. Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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14
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Nestadt PS, Triplett P, Fowler DR, Mojtabai R. Urban-Rural Differences in Suicide in the State of Maryland: The Role of Firearms. Am J Public Health 2017; 107:1548-1553. [PMID: 28817331 DOI: 10.2105/ajph.2017.303865] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess whether the use of firearms explains rural-urban differences in suicide rates. METHODS We performed a retrospective analysis on all 6196 well-characterized adult suicides in Maryland from 2003 through 2015. We computed rate ratios by using census data and then stratified by sex, with adjustment for age and race. RESULTS Suicide rates were higher in rural compared with urban counties. However, the higher rural suicide rates were limited to firearm suicides (incident rate ratio [IRR] = 1.66; 95% confidence interval [CI] = 1.20, 2.31). Nonfirearm suicide rates were not significantly higher in rural settings. Furthermore, 89% of firearm suicides occurred in men and the higher rural firearm suicide rate was limited to men (IRR = 1.36; 95% CI = 1.09, 1.69). Women were significantly less likely to complete suicide in rural areas (IRR = 0.63; 95% CI = 0.43, 0.94), regardless of method. CONCLUSIONS Male firearm use drives the increased rate of suicide in rural areas. The opposite associations between urbanicity and suicide in men and women may be driven by the male preference for firearms as a method for committing suicide.
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Affiliation(s)
- Paul S Nestadt
- Paul S. Nestadt and Ramin Mojtabai are with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Patrick Triplett is with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore. David R. Fowler is with the Office of the Chief Medical Examiner, Baltimore
| | - Patrick Triplett
- Paul S. Nestadt and Ramin Mojtabai are with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Patrick Triplett is with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore. David R. Fowler is with the Office of the Chief Medical Examiner, Baltimore
| | - David R Fowler
- Paul S. Nestadt and Ramin Mojtabai are with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Patrick Triplett is with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore. David R. Fowler is with the Office of the Chief Medical Examiner, Baltimore
| | - Ramin Mojtabai
- Paul S. Nestadt and Ramin Mojtabai are with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Patrick Triplett is with the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore. David R. Fowler is with the Office of the Chief Medical Examiner, Baltimore
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15
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Walker KL, Hirsch JK, Chang EC, Jeglic EL. Non-Suicidal Self-Injury and Suicidal Behavior in a Diverse Sample: The Moderating Role of Social Problem-Solving Ability. Int J Ment Health Addict 2017. [DOI: 10.1007/s11469-017-9755-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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16
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Walker R, Francis D, Brody G, Simons R, Cutrona C, Gibbons F. A Longitudinal Study of Racial Discrimination and Risk for Death Ideation in African American Youth. Suicide Life Threat Behav 2017; 47:86-102. [PMID: 27137139 DOI: 10.1111/sltb.12251] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 01/27/2016] [Indexed: 11/29/2022]
Abstract
Although multiple studies have found that African Americans commonly experience racial discrimination, available studies have yet to examine how perceived racism might be related to suicide vulnerability in African American youth. The purpose of this study was to examine a framework for how perceived racial discrimination contributes to symptoms of depression and anxiety as well as subsequent suicide ideation and morbid ideation. Data were obtained from 722 African American youth at mean age 10.56 years (SD = 0.64); a second wave of data was obtained 2 years later. Results revealed both a direct effect and mediated effects of perceived racism on later suicide and morbid ideation. For boys and girls, the effect of perceived racism was mediated by symptoms of depression. However, the association was mediated by anxiety for girls, but not for boys in the current sample. Implications for future research and interventions are discussed.
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Affiliation(s)
- Rheeda Walker
- Department of Psychology, University of Houston, Houston, TX, USA
| | - David Francis
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Gene Brody
- Center for Family Research, University of Georgia, Athens, GA, USA
| | - Ronald Simons
- Department of Sociology, University of Georgia, Athens, GA, USA
| | - Carolyn Cutrona
- Department of Psychology, Iowa State University, Ames, IA, USA
| | - Frederick Gibbons
- Department of Psychology, University of Connecticut, Storrs, CT, USA
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17
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Burrows S, Vaez M, Laflamme L. Sex-specific suicide mortality in the South African urban context: The role of age, race, and geographical location. Scand J Public Health 2016; 35:133-9. [PMID: 17454916 DOI: 10.1080/14034940600975773] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Aims: This study investigates the importance of sociodemographic and geographical characteristics for suicide risks in the South African urban context. Suicide epidemiology is under-researched in low- and middle-income countries, and such knowledge is important not only for local and national policy, but also for a global understanding of the phenomenon. Methods: Sex-specific crude and adjusted odds ratios (95% confidence intervals) for suicide by age, race, and city are assessed using logistic regression. Cases aged 45+ years, classified as ``Coloured'' (a category denoting mixed racial origin), and living in Cape Town are used as reference groups. Additionally, the proportion of leading suicide methods within groups was estimated (95% confidence intervals). Results: For males, compared with each reference group, the odds of suicide are significantly higher during middle adulthood, among Asians and particularly among Whites, and among residents of all but one city. Patterns for women differ in magnitude and distribution. Suicide odds are significantly higher in all age groups, particularly 15—24 years, among Whites, and among residents of all other cities, particularly Nelson Mandela or Buffalo City. Males living in Tshwane and Black females have lower odds of suicide. The distribution of methods across age, race, and city groups varies little for males but substantially for females. Conclusions: Age, race, and city play independent roles in sex-specific suicide rates. As for high-income settings, age, race, method and city are important in sex-specific suicide in the urban South African context. Possible underlying mechanisms deserve greater attention for context-relevant preventive efforts.
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Affiliation(s)
- Stephanie Burrows
- Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
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18
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Abstract
The World Health Organization estimates that in the year 2000, approximately one million people died from suicide worldwide. Over the last 45 years, suicide rates have increased by 60%, with a particularly precipitous rise among young people. The underlying psychology of suicide is complex and individual. However, certain themes emerge from studying individuals who have attempted or completed suicides. This paper will provide an overview of suicide and suicidal behaviour as it relates to trauma practitioners, detailing risk factors, biologic and genetic interactions, and opportunities for prevention and treatment.
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Affiliation(s)
- Marie Crandall
- Department of Surgery, Northwestern University, Chicago, IL 60611, USA,
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19
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Musci RJ, Hart SR, Ballard ED, Newcomer A, Van Eck K, Ialongo N, Wilcox H. Trajectories of Suicidal Ideation from Sixth through Tenth Grades in Predicting Suicide Attempts in Young Adulthood in an Urban African American Cohort. Suicide Life Threat Behav 2016; 46:255-65. [PMID: 26395337 DOI: 10.1111/sltb.12191] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 06/26/2015] [Indexed: 11/27/2022]
Abstract
The trajectory of suicidal ideation across early adolescence may inform the timing of suicide prevention program implementation. This study aimed to identify developmental trajectories of suicidal ideation among an urban cohort of community-residing African Americans (AA) longitudinally followed from middle school through early adulthood (ages 11-19 years). Subtypes based on the developmental course of suicidal ideation from late childhood through mid-adolescence were identified using longitudinal latent class analysis (LLCA) with 581 AA adolescents (52.7% male; 71.1% free or reduced school meals). The developmental trajectories of suicidal ideation were then used to predict suicide attempts in young adulthood. Our LLCA indicated two subtypes (i.e., ideators and nonideators), with 8% of the sample in the ideator class. This trajectory class shows a peak of suicidal ideation in seventh grade and a steady decline in ideation in subsequent grades. Additionally, suicidal ideation trajectories significantly predicted suicide attempt. Results of these analyses suggest the need for suicide prevention approaches prior to high school for AA youth.
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Affiliation(s)
- Rashelle J Musci
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shelley R Hart
- Department of Child Development, California State University, Chico, CA, USA
| | | | - Alison Newcomer
- Department of Psychology, The Catholic University of America, Washington, DC, USA
| | - Kathryn Van Eck
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Nicholas Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Holly Wilcox
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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20
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Bakhiyi CL, Calati R, Guillaume S, Courtet P. Do reasons for living protect against suicidal thoughts and behaviors? A systematic review of the literature. J Psychiatr Res 2016; 77:92-108. [PMID: 27014850 DOI: 10.1016/j.jpsychires.2016.02.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 01/22/2016] [Accepted: 02/26/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Few studies have investigated protective factors against suicide. OBJECTIVES To identify whether reasons for living (RFL), measured with the Reasons for Living Inventory (RFLI), protect against suicidal ideation (SI), attempts (SA) and suicide death. METHOD This systematic review followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) statement guidelines. PubMed database was searched for studies published until October 2015. Studies were eligible if they used RFLI or one of its versions. All eligible studies were included, regardless of study design, quality indicators, and target populations. No publication year limit was imposed. We included 39 studies. RESULTS RFL may protect against SI and SA and yield a predictive value. The role of two specific reasons for living (Moral Objections to Suicide and Survival and Coping Beliefs) was particularly emphasized. No study investigating suicide death was found. CONCLUSION RFL may moderate suicide risk factors and correlate with resilience factors. Moreover, RFL may depend on and interact with numerous factors such as DSM-IV Axis I disorders, personality disorders and features, coping abilities and social support. Clinicians could develop therapeutic strategies aimed at enhancing RFL, like Dialectical Behavior Therapy and Cognitive Behavioral Therapies, to prevent suicidal thoughts and behaviors and improve the care management of suicidal patients.
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Affiliation(s)
- Camélia Laglaoui Bakhiyi
- Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; Psychiatric Unit, CHU Casablanca, Hassan II University, Casablanca, Morocco; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France.
| | - Raffaella Calati
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France
| | - Sébastien Guillaume
- Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France
| | - Philippe Courtet
- Department of Emergency Psychiatry & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; FondaMental Foundation, France
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21
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Fisher LB, Overholser JC, Dieter L. Methods of committing suicide among 2,347 people in Ohio. DEATH STUDIES 2015; 39:39-43. [PMID: 24932592 PMCID: PMC4268074 DOI: 10.1080/07481187.2013.851130] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The present study explored gender differences in suicidal methods, aiming to identify ways to improve our identification of individuals at risk for suicide. Preferred suicide methods vary by demographics; however, method-specific risk factors have not been consistently identified. All suicidal deaths (N=2,347) in a large urban county were identified over a 15-year period (1994-2008). The majority of men used shooting and hanging. In contrast, women relied on a variety of methods, including self-poisoning, shooting, hanging, and carbon monoxide poisoning. Significant demographic differences are evident among individuals who die by shooting and self-poisoning.
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Affiliation(s)
- Lauren B Fisher
- a Department of Psychology , Case Western Reserve University , Cleveland , Ohio , USA
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22
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Synergistic Effects of Lifetime Psychiatric Disorders on Suicidal Ideation Among Blacks in the USA. J Racial Ethn Health Disparities 2014. [DOI: 10.1007/s40615-014-0034-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Newton-John TRO. Negotiating the Maze: Risk Factors for Suicidal Behavior in Chronic Pain Patients. Curr Pain Headache Rep 2014; 18:447. [DOI: 10.1007/s11916-014-0447-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Joe S, Ford BC, Taylor RJ, Chatters LM. Prevalence of suicide ideation and attempts among Black Americans in later life. Transcult Psychiatry 2014; 51:190-208. [PMID: 24107655 DOI: 10.1177/1363461513503381] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article provides the first national estimates of the prevalence and correlates of nonfatal suicidal behavior among older Black Americans. There is a lack of national data on suicide ideation and attempts across ethnic classifications of Blacks in a nationally representative sample. Data are a subsample from the National Survey of American Life (NSAL), a national U.S. adult household probability sample of 5,191 Black Americans. The WHO Composite International Diagnostic Interview (CIDI) was used to assess older Blacks for nonfatal suicidal behavior and 14 DSM-IV disorders. Bivariate and multivariate logistic regression analyses were employed to delineate patterns and correlates of nonfatal suicidal behavior. The estimated lifetime prevalence of suicidal ideation and attempts among older Blacks in the United States was 6.1% and 2.1%, respectively. On an average it took 2.5 and 5.7 years respectively to go from ideation to attempts or from planning to attempts. Surprisingly, among older Black adults, men reported attempting suicide and seriously consider taking their own lives more than women. Older Blacks at higher risk for suicide attempts were middle aged, had poorer health, were anxious, and had multiple DSM-IV disorders. The results also show that approximately 1 in 4 attempters and 2 in 5 ideators have never sought treatment for their emotional or psychological problems. Preventative care, particularly screening in primary care settings, should consider these findings when treating older Black Americans for psychiatric-related risk.
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25
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McCullumsmith CB, Clark CB, Perkins A, Fife J, Cropsey KL. Gender and racial differences for suicide attempters and ideators in a high-risk community corrections population. CRISIS 2013. [PMID: 23195454 DOI: 10.1027/0227-5910/a000160] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Community corrections populations are a high-risk group who carry multiple suicide risk factors. AIMS To identify factors correlated with historical suicide attempts and ideation among African-American men, African-American women, White men, and White women in a community corrections population. METHOD Self-report data from 18,753 enrollees in community corrections were analyzed. Multinomial logistic regression analyses were conducted to determine associations between historical suicidal ideation and attempts among the four demographic groups. RESULTS Participants with historical suicide attempts tended to be younger, White, female, be taking psychotropic medication, have a history of physical or sexual abuse, and meet criteria for dependence on alcohol, amphetamines, cocaine, opioids, or sedatives. Five variables were commonly associated with suicide attempts for all four race/gender groups: younger age, being on disability or retirement, taking psychotropic medication, history of sexual or physical abuse, and cocaine dependence. Other demographic variables had race or gender specificities as risk factors for suicide attempts. CONCLUSIONS Participants had high rates of historical suicide attempts with unique correlates differentiating attempters from ideators among different racial and gender groups. Cocaine dependence was universal predictor of suicide attempts, while other substance dependencies show specific racial and gender profiles associated with suicide attempts.
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26
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Yen S, Weinstock LM, Andover MS, Sheets ES, Selby EA, Spirito A. Prospective predictors of adolescent suicidality: 6-month post-hospitalization follow-up. Psychol Med 2013; 43:983-993. [PMID: 22932393 PMCID: PMC3663078 DOI: 10.1017/s0033291712001912] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The aim of this study was to examine prospective predictors of suicide events, defined as suicide attempts or emergency interventions to reduce suicide risk, in 119 adolescents admitted to an in-patient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Method Structured diagnostic interviews and self-report instruments were administered to adolescent participants and their parent(s) to assess demographic variables, history of suicidal behavior, psychiatric disorders, family environment and personality/temperament. RESULTS Baseline variables that significantly predicted time to a suicide event during follow-up were Black race, high suicidal ideation in the past month, post-traumatic stress disorder (PTSD), childhood sexual abuse (CSA), borderline personality disorder (BPD), low scores on positive affectivity, and high scores on aggression. In a multivariate Cox regression analysis, only Black race, CSA, positive affect intensity and high aggression scores remained significant. CONCLUSIONS Our findings suggest the following for adolescent populations: (1) in a very high-risk population, risk factors for future attempts may be more difficult to ascertain and some established risk factors (e.g. past suicide attempt) may not distinguish as well; and (2) cross-cutting constructs (e.g. affective and behavioral dysregulation) that underlie multiple psychiatric disorders may be stronger predictors of recurrent suicide events than psychiatric diagnoses. Our finding with respect to positive affect intensity is novel and may have practical implications for the assessment and treatment of adolescent suicide attempters.
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Affiliation(s)
- S Yen
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02906, USA.
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27
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Rogers JR, Russell EJ. A Framework for Bridging Cultural Barriers in Suicide Risk Assessment. COUNSELING PSYCHOLOGIST 2013. [DOI: 10.1177/0011000012471823] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The incidence and prevalence of death by suicide and nonlethal suicidal behaviors such as suicide attempts, thoughts, and feelings are increasing in the United States and throughout the world. Efforts to prevent suicide deaths and suicide attempts, and reduce the likelihood that suicidal thoughts and feelings will lead to those outcomes, rest on the accuracy of suicide risk assessments primarily conducted in the context of clinical interviews. Despite being armed with lists of empirically derived “correlates” of suicide (i.e., risk factors), suicide risk assessment continues to be a challenging task faced by counseling psychologists and other mental health professionals on a daily basis. As Shea (1999) has suggested, this challenge in a large part is a function of differing values and beliefs regarding suicide between the clinician and the client that create barriers to accurate assessment. The thesis of this contribution to the Major Contribution is that the barriers to suicide risk assessment are much broader than values and beliefs when in the context of cultural differences between the clinician and client. Thus, we present an argument for the adoption of a set of compatibility heuristics as a framework for suicide risk assessment in the cross-cultural suicide risk assessment environment.
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28
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Widom CS, Czaja S, Wilson HW, Allwood M, Chauhan P. Do the long-term consequences of neglect differ for children of different races and ethnic backgrounds? CHILD MALTREATMENT 2013; 18:42-55. [PMID: 23076836 DOI: 10.1177/1077559512460728] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Scant research has examined how children of different races or ethnic backgrounds manifest consequences of neglect. We examined multiple domains of functioning (academic/intellectual, social/behavioral, and psychiatric), three theories (racial invariance, double jeopardy, and resilience), and potential confounding variables. Children with documented cases of neglect (ages 0-11) and matched controls without such histories were followed up and interviewed in adulthood (N = 1,039). The sample was 47.3% female, 62.4% White, 34.3% Black, and 3.4% Hispanic. Black and White neglected children showed negative consequences for IQ, reading ability, and occupational status compared to controls. Compared to same race and ethnic group controls, neglected White children showed extensive mental health consequences, Black children showed more anxiety and dysthymia, and Hispanic children showed increased risk for alcohol problems. Black and White neglected children differed in risk for violence compared to same race controls: Neglected Black children were arrested for violence two times more often than Black controls, whereas neglected White children were more likely than White controls to report engaging in violence. Findings provide some support for each theory (racial invariance, double jeopardy, and resilience). Understanding the factors that account for similarities and differences in consequences requires further investigation. Implications for research and policy are discussed.
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29
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Abstract
This article explored the origins and implications of the underdiagnosis of affective disorders in African-Americans. MEDLINE and old collections were searched using relevant key words. Reference lists from the articles that were gathered from this procedure were reviewed. The historical record indicated that the psychiatric perception of African-Americans with affective disorders changed significantly during the last 200 years. In the antebellum period, the mental disorders of slaves mostly went unnoticed. By the early 20th century, African-Americans were reported to have high rates of manic-depressive disorder compared with whites. By the mid-century, rates of manic-depressive disorder in African-Americans plummeted, whereas depression remained virtually nonexistent. In recent decades, diagnosed depression and bipolar disorder, whether in clinical or research settings, were inexplicably low in African-Americans compared with whites. Given these findings, American psychiatry needs to appraise the deep-seated effects of historical stereotypes on the diagnosis and treatment of African-Americans.
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30
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Kendal WS, Kendal WM. Comparative Risk Factors for Accidental and Suicidal Death in Cancer Patients. CRISIS 2012; 33:325-34. [DOI: 10.1027/0227-5910/a000149] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Cancer patients appear at higher risk of accidental death and suicide. The reasons for this and how suicide and accidental death relate remain unclear. Aims: To clarify and contrast risk factors for such deaths among cancer patients. Methods: A SEER (1973–2007) analysis was conducted on 4,449,957 cancer patients comparing all causes of death (COD) to accidental and suicidal deaths through competing hazards, relative risk and proportional hazards models. SEER did not provide psychological assessments; the analysis was confined to their standard epidemiological and clinicopathological parameters. Results: 2,557,385 overall deaths yielded 16,879 (0.66%) accidents and 6,589 (0.26%) suicides. Mortality reached its highest incidence immediately after diagnosis and obeyed Pareto type II distributions. The major identifiable risk factor for suicide was male gender; for accidental death, First Nations ethnicity; and all COD, metastases. Minor factors for suicide included metastases, advanced age, and respiratory as well as head and neck tumors, whereas for accidental death they were male gender, metastases, advanced age, and brain tumors. Conclusions: Differences were observed in the risk patterns of suicide and accidental death, suggesting distinct etiologies. A high incidence of suicides and accidental deaths following diagnosis (attributed by some to stress from the diagnosis of cancer) correlated here with overall mortality and indicators of physical morbidity. Cancer patients with the above identifiable risk factors warrant supportive attention.
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Affiliation(s)
- Wayne S. Kendal
- Division of Radiation Oncology, The Ottawa Hospital Cancer Centre, The University of Ottawa, Canada
- The Ottawa Hospital Research Institute, Canada
| | - Wendy M. Kendal
- Department of Family and Community Medicine, St. Paul’s Hospital, Vancouver, Canada
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31
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Study of ethnic differences in suicide attempts in Kuwait. MIDDLE EAST CURRENT PSYCHIATRY 2012. [DOI: 10.1097/01.xme.0000413051.76274.d2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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32
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Hirsch JK, Chang EC, Jeglic EL. Social problem solving and suicidal behavior: ethnic differences in the moderating effects of loneliness and life stress. Arch Suicide Res 2012; 16:303-15. [PMID: 23137220 DOI: 10.1080/13811118.2013.722054] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objective of this study was to examine the combined moderating effects of life stress and loneliness on the association between social problem solving ability (SPS) and suicidal behaviors. We assessed SPS, suicidal behavior, loneliness, and stressful life events in a sample of 385 ethnically diverse college students. Overall, only loneliness moderated the association between SPS and suicidal behaviors. Across ethnic groups, loneliness moderated the association between SPS and suicidal behavior for Blacks, Whites, and Asians; life stress was a moderator for Hispanics. For most individuals, loneliness increases the strength of the association between poor problem-solving and suicidal behaviors. For Hispanics, life stress exacerbates this relationship. Ethnically-specific prevention strategies targeting loneliness and life stress may promote effective problem-solving, reducing suicide risk.
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Affiliation(s)
- Jameson K Hirsch
- Department of Psychology, East Tennessee State University, P.O. Box 70649, Johnson City, TN 37614 USA.
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Lawlor C, Johnson S, Cole L, Howard LM. Ethnic variations in pathways to acute care and compulsory detention for women experiencing a mental health crisis. Int J Soc Psychiatry 2012; 58:3-15. [PMID: 21059630 PMCID: PMC3257000 DOI: 10.1177/0020764010382369] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Much recent debate on excess rates of compulsory detention and coercive routes to care has focused on young black men; evidence is less clear regarding ethnic variations among women and factors that may mediate these. AIM To explore ethnic variations in compulsory detentions of women, and to explore the potential role of immediate pathways to admission and clinician-rated reasons for admission as mediators of these differences. METHOD All women admitted to an acute psychiatric inpatient ward or a women's crisis house in four London boroughs during a 12-week period were included. Data were collected regarding their pathways to care, clinician-rated reasons for admission, hospital stays, and social and clinical characteristics. RESULTS Two hundred and eighty seven (287) women from white British, white other, black Caribbean, black African and black other groups were included. Adjusting for social and clinical characteristics, all groups of black patients and white other patients were significantly more likely to have been compulsorily admitted than white British patients; white British patients were more likely than other groups to be admitted to a crisis house and more likely than all the black groups to be admitted because of perceived suicide risk. Immediate pathways to care differed: white other, black African and black other groups were less likely to have referred themselves in a crisis and more likely to have been in contact with the police. When adjustment was made for differences in pathways to care, the ethnic differences in compulsory admission were considerably reduced. DISCUSSION There are marked ethnic inequities not only between white British and black women, but also between white British and white other women in experiences of acute admission. Differences between groups in help-seeking behaviours in a crisis may contribute to explaining differences in rates of compulsory admission.
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Slama F, Merle S, Ursulet G, Charles-Nicolas A, Ballon N. Prevalence of and risk factors for lifetime suicide attempts among Caribbean people in the French West Indies. Psychiatry Res 2011; 190:271-4. [PMID: 21906819 DOI: 10.1016/j.psychres.2011.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Revised: 05/22/2011] [Accepted: 08/13/2011] [Indexed: 11/17/2022]
Abstract
It has been suggested that Black people show lower suicidality than White people. The few conflicting studies estimating lifetime prevalence of suicide attempts in Caribbean populations were mainly carried out in the UK and the USA. Our aim was to investigate the prevalence of lifetime suicide attempts among the French Caribbean general population still living in the West Indies. As part of an international epidemiological multicenter study under the authority of the World Health Organization French Collaborating Centre, we interviewed 887 individuals selected from the general population in the Caribbean island of Martinique, using the Mini International Neuropsychiatric Interview. Among the interviewed individuals, 4.4% (N=39) reported having attempted suicide. Younger age, lifetime diagnoses of major mood disorder, panic disorder and alcohol dependence were all associated with a lifetime history of suicide attempts. Lifetime prevalence of suicide attempts among the French Caribbean general population was almost half as much as that measured in continental France.
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Affiliation(s)
- Frédéric Slama
- Albert Chenevier University Hospitals, Department of Psychiatry, Créteil cedex, France.
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35
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Day-Vines NL. The Escalating Incidence of Suicide Among African Americans: Implications for Counselors. JOURNAL OF COUNSELING AND DEVELOPMENT 2011. [DOI: 10.1002/j.1556-6678.2007.tb00486.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
BACKGROUND Suicide rates vary widely across nations and ethnic groups. This study aims to explore potential factors contributing to inter-ethnic differences in suicide rates. METHOD Study subjects came from a case-control psychological autopsy study conducted in Taiwan, including 116 consecutive suicides from two aboriginal groups and Taiwanese Han; 113 of them each matched with two living controls. Gender-, age- and method-specific suicide rates, population attributable fraction (PAF) of suicide for five major risk factors, help-seeking before suicide and emergency medical aid after suicide were compared between the three ethnic groups. RESULTS One aboriginal group (the Atayal) had significantly higher adjusted rate ratios (RR) of suicide than the other aboriginal group (the Ami) [RR 0.20, 95% confidence intervals (CI) 0.12-0.34] and the Han (RR 0.26, 95% CI 0.16-0.40). Such differences can be explained by higher PAFs of suicide for three major risk factors (substance dependence, PAF 47.6%, 95% CI 25.5-64.2; emotionally unstable personality disorder, PAF 52.7%, 95% CI 32.8-69.0; family history of suicidal behaviour, PAF 43.5%, 95% CI 23.2-60.2) in this group than in the other two groups. This higher suicide rate was substantially reduced from 68.2/100 000 per year to 9.1/100 000 per year, comparable with the other two groups, after stepwise removal of the effects of these three risk factors. Suicide rates by self-poisoning were also significantly higher in this group than in the other two groups. CONCLUSIONS Higher rates of specific risk factors and use of highly lethal pesticides for suicide contributed to the higher suicide rate in one ethnic group in Taiwan. These findings have implications for developing ethnicity-relevant suicide prevention strategies.
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Affiliation(s)
- I C Liu
- Department of Psychiatry, Fu Jen Catholic University, Taipei County, Taiwan
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Castle K, Conner K, Kaukeinen K, Tu X. Perceived racism, discrimination, and acculturation in suicidal ideation and suicide attempts among black young adults. Suicide Life Threat Behav 2011; 41:342-51. [PMID: 21535094 PMCID: PMC8378508 DOI: 10.1111/j.1943-278x.2011.00033.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
During young adulthood the suicide rate among Blacks rises dramatically and approaches that of the U.S. general population, requiring that prevention efforts include a focus on Black young adults. Although most research on suicidality among Blacks has focused on risk factors observed in the dominant culture, in this study the authors examined associations between perceived discrimination, racism, and acculturation with lifetime suicidal ideation (SI) and suicide attempt (SA) among Black young adults. Two hundred fifty Black or African American individuals aged 18-24 residing in a midsize northeastern city were recruited to participate through advertisements. Participants filled out self-report questionnaires. Logistic regressions were used to examine the association of each predictor with SI and SA. Greater perceived acculturation was associated with SI in univariate and multivariate models. There were no other statistically significant results concerning the predictors of interest. The link between perceived acculturation and SI is consistent with limited available data, indicating the need for further study including the potential mechanism(s) for the association. Limitations include the cross-sectional design and reliance on subjective measures.
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Affiliation(s)
- Kathryn Castle
- Kathryn Castle and Kenneth Conner, Department of Psychiatry, University of Rochester Medical Center (URMC), NY 14642, USA.
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38
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Congdon P. The spatial pattern of suicide in the US in relation to deprivation, fragmentation and rurality. URBAN STUDIES (EDINBURGH, SCOTLAND) 2011; 48:2101-2122. [PMID: 22069804 DOI: 10.1177/0042098010380961] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Analysis of geographical patterns of suicide and psychiatric morbidity has demonstrated the impact of latent ecological variables (such as deprivation, rurality). Such latent variables may be derived by conventional multivariate techniques from sets of observed indices (for example, by principal components), by composite variable methods or by methods which explicitly consider the spatial framework of areas and, in particular, the spatial clustering of latent risks and outcomes. This article considers a latent random variable approach to explaining geographical contrasts in suicide in the US; and it develops a spatial structural equation model incorporating deprivation, social fragmentation and rurality. The approach allows for such latent spatial constructs to be correlated both within and between areas. Potential effects of area ethnic mix are also included. The model is applied to male and female suicide deaths over 2002–06 in 3142 US counties.
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Cooper J, Murphy E, Webb R, Hawton K, Bergen H, Waters K, Kapur N. Ethnic differences in self-harm, rates, characteristics and service provision: three-city cohort study. Br J Psychiatry 2010; 197:212-8. [PMID: 20807966 DOI: 10.1192/bjp.bp.109.072637] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Studies of self-harm in Black and minority ethnic (BME) groups have been restricted to single geographical areas, with few studies of Black people. AIMS To calculate age- and gender-specific rates of self-harm by ethnic group in three cities and compare characteristics and outcomes. METHOD A population-based self-harm cohort presenting to five emergency departments in three English cities during 2001 to 2006. RESULTS A total of 20 574 individuals (16-64 years) presented with self-harm; ethnicity data were available for 75%. Rates of self-harm were highest in young Black females (16-34 years) in all three cities. Risk of self-harm in young South Asian people varied between cities. Black and minority ethnic groups were less likely to receive a psychiatric assessment and to re-present with self-harm. CONCLUSIONS Despite the increased risk of self-harm in young Black females fewer receive psychiatric care. Our findings have implications for assessment and appropriate management for some BME groups following self-harm.
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Affiliation(s)
- Jayne Cooper
- Centre for Suicide Prevention, University of Manchester, UK.
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Abstract
Primary care clinicians who care for cancer patients are integral to the recognition, diagnosis, and management of depression in this population. A review of risk factors that may make patients more likely to develop depression can be a useful first step in screening for depression. Several screening instruments may guide clinicians in further work-up of patients suspected of being depressed. Depression is treatable in this patient population and prompt management may have a positive impact on overall outcomes. Pharmacologic and psychotherapeutic treatment options are numerous, and consideration of specific cancer treatments, including side-effect profiles, patient comorbidity, patient preference, and clinician resources, should direct management.
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Affiliation(s)
- Danielle Snyderman
- Division of Geriatric Medicine, Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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41
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Bittner JG, Hawkins ML, Atteberry LR, Ferdinand CH, Medeiros RS. Impact of Traumatic Suicide Methods on a Level I Trauma Center. Am Surg 2010. [DOI: 10.1177/000313481007600211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Suicide is a major, preventable public health issue. Although firearm-related mechanisms commonly result in death, nonfirearm methods cause significant morbidity and healthcare expenditures. The goal of this study is to compare risk factors and outcomes of firearm and nonfirearm traumatic suicide methods. This retrospective cohort study identified 146 patients who attempted traumatic suicide between 2002 and 2007 at a Level I trauma center. Overall, mean age was 40.2 years, 83 per cent were male, 74 per cent were white, and mean Injury Severity Score (ISS) was 12.7. Most individuals (53%) attempted suicide by firearms and 25 per cent died (84% firearm, 16% nonfirearm techniques). Subjects were more likely to die if they were older than 60 years-old, presented with an ISS greater than 16, or used a firearm. On average, patients using a firearm were older and had a higher ISS and mortality rate compared with those using nonfirearm methods. There was no statistical difference between cohorts with regard to gender, ethnicity, positive drug and alcohol screens, requirement for operation, intensive care unit admission, and hospital length of stay. Nonfirearm traumatic suicide prevention strategies aimed at select individuals may decrease overall attempts, reduce mechanism-related mortality, and potentially impact healthcare expenditures.
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Affiliation(s)
- James G. Bittner
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
| | - Michael L. Hawkins
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
| | - Linda R. Atteberry
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
| | - Colville H. Ferdinand
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
| | - Regina S. Medeiros
- Section of Trauma/Critical Care Surgery, Department of Surgery, Medical College of Georgia School of Medicine, Augusta, Georgia
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Bryant-Davis T, Ullman SE, Tsong Y, Tillman S, Smith K. Struggling to survive: sexual assault, poverty, and mental health outcomes of African American women. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2010; 80:61-70. [PMID: 20397989 DOI: 10.1111/j.1939-0025.2010.01007.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A substantial body of research documents the mental health consequences of sexual assault including, but not limited to, depression, posttraumatic stress disorder, substance use, and suicidality. Far less attention has been given to the mental health effects of sexual assault for ethnic minority women or women living in poverty. Given African American women's increased risk for sexual assault and increased risk for persistent poverty, the current study explores the relationship between income and mental health effects within a sample of 413 African American sexual assault survivors. Hierarchical regression analyses revealed that after controlling for childhood sexual abuse there were positive relationships between poverty and mental health outcomes of depression, posttraumatic stress disorder, and illicit drug use. There was no significant relationship between poverty and suicidal ideation. Counseling and research implications are discussed.
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Affiliation(s)
- Thema Bryant-Davis
- Graduate School of Education and Psychology, Pepperdine University, Encino, CA 91436, USA.
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43
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Exploring the mental health of black men who have sex with men. Community Ment Health J 2009; 45:272-84. [PMID: 19291399 DOI: 10.1007/s10597-009-9186-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Accepted: 02/23/2009] [Indexed: 10/21/2022]
Abstract
Current research indicates that black men who have sex with men (MSM) are disproportionately burdened by depressive distress and anxiety disorders as compared to their white gay and heterosexual counterparts. This study utilizes focus groups to qualitatively explore issues surrounding the mental health status of this population in an attempt to shed light on potential influencing and determinant factors. Twenty-two self-identified black, or multi-racial including black, MSM residing in Atlanta, Georgia participated in two focus groups--11 subjects each, respectively. Categories that emerged from data analysis include: knowledge/experiences, attitudes/beliefs, societal action/behavior, identity development, relationship functionality, and mental health status. Overarching themes for each category were delineated.
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44
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Purselle DC, Heninger M, Hanzlick R, Garlow SJ. Differential association of socioeconomic status in ethnic and age-defined suicides. Psychiatry Res 2009; 167:258-65. [PMID: 19395050 PMCID: PMC2736599 DOI: 10.1016/j.psychres.2008.02.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 02/04/2008] [Accepted: 02/06/2008] [Indexed: 11/26/2022]
Abstract
Suicide rates vary among racel- and age-defined groups, yet little is known about how suicide risk factors differentially impact individual groups. This study assessed differential associations of socioeconomic status among age- and race-defined groups of suicide victims. A database containing demographic information on declared suicides in Fulton County, GA, from 1 January 1988 through 31 December 2003 was combined with annual per capita income by zip code in Atlanta, GA. Analyses were performed to evaluate differential associations of socioeconomic status among age- and race-defined groups of suicide victims. Compared with the respective ethnic populations of Fulton County, white suicide victims lived in areas with lower per capita income ($51,232 vs. $35,893); African American suicide victims did not ($17,384 vs. $18,179). Elderly suicide victims (>or= 65 years) were more likely to live in the lowest per capita income areas compared with other age groups (OR 1.80, 95% C.I. 1.14, 2.84). Cox proportional hazards models showed increasing income increased the instantaneous risk of suicide among adolescents (HR 2.76; 95% C.I. 2.15, 3.53), particularly African American adolescents (HR 4.22; 95% C.I. 2.19, 8.11), and decreased risk among the elderly (HR 0.58; 95% C.I. 0.50, 0.68). Socioeconomic status had differential associations among age- and race-defined groups of suicide victims.
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Affiliation(s)
- David C. Purselle
- Mental Health Service Line, Atlanta VA Medical Center, 116A, 1670 Clairmont Road, Atlanta, GA 30033, USA, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michael Heninger
- Fulton County Medical Examiner's Office, Atlanta, GA, USA, Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA
| | - Randy Hanzlick
- Fulton County Medical Examiner's Office, Atlanta, GA, USA, Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA
| | - Steven J. Garlow
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
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45
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Joe S, Baser RS, Neighbors HW, Caldwell CH, Jackson JS. 12-month and lifetime prevalence of suicide attempts among black adolescents in the National Survey of American Life. J Am Acad Child Adolesc Psychiatry 2009; 48:271-282. [PMID: 19182692 PMCID: PMC2760075 DOI: 10.1097/chi.0b013e318195bccf] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Provide nationally representative data on the prevalence and psychiatric correlates of suicidal ideation and attempts among African American and Caribbean black adolescents in the United States. METHOD Data on nonfatal suicidal behavior among 1,170 African American and Caribbean black adolescents aged 13 to 17 years are from the National Survey of American Life-Adolescent, a nationally representative household survey of adults with an attached adolescent sample conducted between February 2001 and June 2003. RESULTS Nationwide black adolescents reported having a lifetime prevalence of 7.5% for suicidal ideation and 2.7% for attempts. The 12-month prevalence of suicidal ideation and attempt was 3.2% and 1.4%, respectively. Among all respondents, 4% of black American adolescents and 7% of female subjects were projected to attempt suicide by age 17 years. African American adolescents were approximately five times more likely than Caribbean black adolescents to attempt suicide. Almost half of the National Survey of American Life-Adolescent respondents who reported a suicide attempt had never met criteria for any of the DSM-IV disorders by the time of their attempts. CONCLUSIONS Clinicians should be trained to screen for suicidal behavior, even among those without DSM-IV disorders, when treating black adolescents, particularly female subjects. In addition, preventive efforts should consider ethnic differences in suicide risk and targeting nonclinical settings.
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Affiliation(s)
- Sean Joe
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan.
| | - Raymond S Baser
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan
| | - Harold W Neighbors
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan
| | - Cleopatra H Caldwell
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan
| | - James S Jackson
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan
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Richardson-Vejlgaard R, Sher L, Oquendo MA, Lizardi D, Stanley B. Moral objections to suicide and suicidal ideation among mood disordered Whites, Blacks, and Hispanics. J Psychiatr Res 2009; 43:360-5. [PMID: 18499127 PMCID: PMC3785087 DOI: 10.1016/j.jpsychires.2008.03.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Revised: 03/17/2008] [Accepted: 03/25/2008] [Indexed: 11/17/2022]
Abstract
UNLABELLED Understanding the beliefs that protect individuals against suicide can help to enhance suicide prevention strategies. One measure of suicide non-acceptability is the moral objections to suicide (MOS) sub-scale of the reasons for living inventory (RFLI). This study examined the MOS and suicidal ideation of White, Black, and Hispanic individuals with mood disorders. We expected minority individuals to have stronger objections to suicide. METHOD Eight hundred and four, White (588), Black (122) and Hispanic (94) participants with DSM-IV diagnoses of MDD or bipolar disorder were administered the scale for suicide ideation, the reasons for living inventory and several measures of clinical distress. RESULTS Higher suicidal ideation was modestly correlated with lower MOS scores overall (r=0.15, p=0.001). Among Blacks however the relationship was inverted: despite having higher suicidal ideation than Whites or Hispanics, Blacks reported the least accepting attitudes toward suicide. CONCLUSION These results suggest that attitudes regarding the acceptability of suicide may be independent of suicidal ideation.
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Affiliation(s)
- Randall Richardson-Vejlgaard
- Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY 10032, USA.
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47
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Slama F, Dehurtevent B, Even JD, Charles-Nicolas A, Ballon N, Slama R. Characteristics of a French African Caribbean epidemiological psychiatric sample with a history of suicide attempt. Suicide Life Threat Behav 2008; 38:720-7. [PMID: 19152303 DOI: 10.1521/suli.2008.38.6.720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Research on vulnerability factors among ethnic groups, independent of primary psychiatric diagnosis, may help to identify groups at risk of suicidal behavior. French African Caribbean general psychiatric patients (N = 362) were recruited consecutively and independently of the primary psychiatric diagnosis. Demographic and clinical characteristics and lifetime history of suicide attempts were recorded. Sixty-five patients (18%) had a history of at least one suicide attempt. Presence of professional qualifications, children, poor social contacts, treatment with benzodiazepine at inclusion, and poor treatment compliance were all associated with a lifetime history of suicide attempts.
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Affiliation(s)
- Frédéric Slama
- Secteur Nord Atlantique, Hôspital Colson, Fort de France, Martinique.
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48
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Hadjizacharia P, Brown CVR, Teixeira PGR, Chan LS, Yang K, Salim A, Inaba K, Rhee P, Demetriades D. Traumatic suicide attempts at a level I trauma center. J Emerg Med 2008; 39:411-8. [PMID: 18996669 DOI: 10.1016/j.jemermed.2008.04.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2007] [Revised: 01/30/2008] [Accepted: 04/13/2008] [Indexed: 12/23/2022]
Abstract
BACKGROUND The purpose of this study is to characterize traumatic suicide attempts (TSA) by age, gender, race, and mechanism of injury. METHODS This is a retrospective review of TSA patients (identified by E-codes) admitted to our urban, level I trauma center from 1992 through 2005. Mechanisms of TSA included jump from height, firearm (gunshot wound [GSW]), cutting or piercing instrument (stab wound [SW]), and motor vehicle (MV)-related. Patients were categorized in groups by age in years (< 18, 18-35, 36-54, 55-69, ≥ 70). RESULTS A total of 876 TSA patients were identified; 83% were male, with a mean age of 35 years and a mean Injury Severity Score of 10. The most common mechanism was SW (39%), followed by jump (26%), GSW (21%), and MV-related (13%). Primary mechanism of TSA varied by age (p < 0.0001), with GSW most common in those patients aged < 18 years (64%) and ≥ 70 years (44%), and SW most common in all other age groups. Overall, 16% of TSAs were successful. The adjusted odds ratio (AOR) for mortality for age 70+ vs. age 36-54 was 12.4 (95% confidence interval [CI] 2.3-78, p = 0.005), and the AOR for mortality from GSW vs. SW was 9.8 (95% CI 2.6-44, p = 0.001). CONCLUSIONS The most common mechanism for TSA was SW, although GSW was the most effective. The mechanism of choice for TSA depends on age, with the extremes of age more commonly choosing a firearm. Age and method of TSA are significant contributing factors to success of suicide attempts.
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Affiliation(s)
- Pantelis Hadjizacharia
- Division of Trauma Surgery and Surgical Critical Care, University of Southern California, Los Angeles, California, USA
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49
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Goldston DB, Molock SD, Whitbeck LB, Murakami JL, Zayas LH, Hall GCN. Cultural considerations in adolescent suicide prevention and psychosocial treatment. AMERICAN PSYCHOLOGIST 2008; 63:14-31. [PMID: 18193978 PMCID: PMC2662358 DOI: 10.1037/0003-066x.63.1.14] [Citation(s) in RCA: 235] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African American, American Indian and Alaska Native, Asian American and Pacific Islander, and Latino adolescents, and the implications of these contexts for suicide prevention and treatment. Several cross-cutting issues are discussed, including acculturative stress and protective factors within cultures; the roles of religion and spirituality and the family in culturally sensitive interventions; different manifestations and interpretations of distress in different cultures; and the impact of stigma and cultural distrust on help-seeking. The needs for culturally sensitive and community- based interventions are discussed, along with future opportunities for research in intervention development and evaluation.
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Affiliation(s)
- David B Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, Nc 27101, USA.
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50
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Viana GN, Zenkner FDM, Sakae TM, Escobar BT. Prevalência de suicídio no Sul do Brasil, 2001-2005. JORNAL BRASILEIRO DE PSIQUIATRIA 2008. [DOI: 10.1590/s0047-20852008000100008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: Descrever e avaliar a incidência de suicídio em indivíduos procedentes da Associação dos Municípios da Região de Laguna (Amurel), no período de 2001 a 2005. MÉTODOS: Estudo transversal com coleta de dados no Instituto Médico Legal (IML) de Tubarão, referentes a todos os óbitos ocorridos entre 2001 e 2005, que tiveram como causa de morte o suicídio. Para todos os casos inclusos no estudo, os dados foram retirados dos prontuários do IML por meio do preenchimento de uma ficha de dados. RESULTADOS: A idade média dos suicidas pesquisados ficou em 44 anos, com predomínio do sexo masculino (79,6%). A maioria dos casos não tinha união estável (38,8%) e utilizou com mais freqüência o enforcamento como método, com 68,4% dos óbitos. As profissões mais comuns entre os suicidas foram os serviços gerais e agricultores. A cidade com mais incidência foi Grão Pará com coeficiente de 20,2. CONCLUSÃO: Verificou-se que a incidência da região de Amurel está dentro das estatísticas catarinenses com coeficiente de 7,9. O principal método para cometer o suicídio foi o enforcamento, e os homens se matam quase quatro vezes mais que as mulheres.
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