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Ndetei DM, Wasserman D, Mutiso V, Shanley JR, Musyimi C, Nyamai P, Munyua T, Swahn MH, Osborn TL, Johnson NE, Memiah P, Bhui K, Gilbert S, Weisz JR, Javed A, Sourander A. Methods and associations of suicidality in Kenyan high school students: clinical and public health implications. BJPsych Open 2024; 10:e112. [PMID: 38738349 PMCID: PMC11094434 DOI: 10.1192/bjo.2024.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Most evidence on suicidal thoughts, plans and attempts comes from Western countries; prevalence rates may differ in other parts of the world. AIMS This study determined the prevalence of suicidal thoughts, plans and attempts in high school students in three different regional settings in Kenya. METHOD This was a cross-sectional study of 2652 high school students. We asked structured questions to determine the prevalence of various types of suicidality, the methods planned or effected, and participants' gender, age and form (grade level). We provided descriptive statistics, testing significant differences by chi-squared and Fisher's exact tests, and used logistic regression to identify relationships among different variables and their associations with suicidality. RESULTS The prevalence rates of suicidal thoughts, plans and attempts were 26.8, 14.9 and 15.7%, respectively. These rates are higher than those reported for Western countries. Some 6.7% of suicide attempts were not associated with plans. The most common method used in suicide attempts was drinking chemicals/poison (18.8%). Rates of suicidal thoughts and plans were higher for older students and students in urban rather than rural locations, and attempts were associated with female gender and higher grade level - especially the final year of high school, when exam performance affects future education and career prospects. CONCLUSION Suicidal thoughts, plans and attempts are prevalent in Kenyan high school students. There is a need for future studies to determine the different starting points to suicidal attempts, particularly for the significant number whose attempts are not preceded by thoughts and plans.
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Affiliation(s)
- David M. Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | | | - Victoria Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | | | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Pascalyne Nyamai
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Timothy Munyua
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; and World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Monica H. Swahn
- Department of Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, USA
| | | | - Natalie E. Johnson
- Shamiri Institute, Nairobi, Kenya; Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland; and University of Basel, Basel, Switzerland
| | | | - Kamaldeep Bhui
- Department of Psychiatry, Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, UK; National Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre; Oxford, UK; and World Psychiatric Association Collaborating Centre, Oxford, UK
| | - Sonja Gilbert
- Research Centre for Child Psychiatry, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; and INVEST Child Psychiatry, INVEST Research Flagship Center, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland
| | - John R. Weisz
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Afzal Javed
- World Psychiatric Association, Geneva, Switzerland
| | - Andre Sourander
- Research Centre for Child Psychiatry, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; INVEST Child Psychiatry, INVEST Research Flagship Center, Department of Clinical Medicine, Faculty of Medicine, University of Turku, Turku, Finland; and Department of Child Psychiatry, Turku University Hospital, Turku, Finland
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Singh G, Hansen JP, Hulgaard D, Damkjær M, Christiansen E. Impact of COVID-19 restrictions on self-poisoning behaviour with mild analgesics in Danish youth. Nord J Psychiatry 2024:1-9. [PMID: 38625374 DOI: 10.1080/08039488.2024.2339433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/20/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The COVID-19 pandemic prompted the implementation of precautions to contain the disease, including lockdowns and social isolation. Previous studies have investigated suicide rates among children and adolescents during the pandemic and have found varying results. We speculated how the two lockdowns influenced suicidal behaviour in children and adolescents in Denmark. OBJECTIVE This study aimed to investigate the effect of lockdowns during the COVID-19 pandemic on suicide attempts, as measured by the incidence rate in all self-poisonings with mild analgesics among children and adolescents. METHODS This national Danish registry-based study on children and adolescents used Poisson regression and interrupted time series analysis to examine the incidence rates and trends of self-poisonings with mild analgesics from 2019 to mid-2021. RESULTS For the period of this study, 1655 self-poisonings were registered. During the first lockdown, there was a slight, not statistically significant, decrease in self-poisoning rates (incidence rate ratio [IRR]) 0.98) compared to no lockdown. During the second lockdown, there was a significant increase in self-poisonings for the whole Danish population (IRR 1.85) with girls being slightly higher at risk (IRR 1.87). Being a girl or between the ages of 13-17 years old were risk factors for self-poisoning. CONCLUSION These findings indicate that the restrictions enforced during the second lockdown greatly impacted youth mental health, especially girls, leading to an 85% increase in self-poisonings. We hope for increased awareness of mental health in children and adolescents during possible future lockdowns.
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Affiliation(s)
- Gurbhej Singh
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jonathan Pommer Hansen
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Ditte Hulgaard
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Research Unit Mental Health, Children and Adult, Aabenraa, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Mads Damkjær
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Erik Christiansen
- Research Unit Mental Health, Children and Adult, Aabenraa, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Centre for Suicide Research, Odense, Denmark
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Jung J, Kim G, Kang SW, Jeong S, Kang Y, Lee JY, Myung W, Kim H, Lee H. Short-term exposure to ambient air pollution and injuries due to external causes according to intentions and mechanisms. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169202. [PMID: 38097073 DOI: 10.1016/j.scitotenv.2023.169202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023]
Abstract
Although injuries are a leading cause of death and affect the life expectancy of individuals who live with disabilities globally, the potential role of air pollution exposure on injuries due to external causes has received little scientific attention, especially compared with that given to the association of air pollution and non-external causes of morbidity and mortality. We investigated the association between emergency department visits for externally caused injuries and short-term exposure to major ambient air pollutants, with focus on the intentions and mechanisms of injuries. We identified 2,049,855 injured patients in Seoul, South Korea between 2008 and 2016 using the National Emergency Database. Daily short-term exposure to air pollution including particles <10 μm (PM10) and <2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), and ozone (O3) was estimated based on hourly concentrations. We employed a time-stratified case-crossover study design using a conditional Poisson regression model adjusted for meteorological variables, influenza epidemics, and holidays. Immediate exposure (lag 0) to most pollutants significantly increased the risk of total injuries (PM2.5, 0.42 %; NO2, 0.68 %; SO2, 1.05 %; CO, 0.57 %; O3, 1.86 % per interquartile range increment), and the associations differed according to the intention and mechanism of injury. Unintentional and assault injuries were significantly associated with air pollution exposure, whereas self-harm injuries showed no association. In mechanism-specific analyses, injuries caused by falls, blunt objects, penetration, traffic accidents, machinery, and slips were associated with specific air pollutants, even in the co-pollutant models. The associations were stronger in injured patients aged <15 years, and in males than in their counterparts. Our results suggest that short-term air pollution exposure might play a role in the risk of externally caused injuries and the association may differ depending on the intention and mechanism of injury, which provide important evidence for injury prevention and air quality strategies.
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Affiliation(s)
- Jiyun Jung
- Clinical Trial Center, Dongguk University Ilsan Hospital, Goyang, South Korea; Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Gyeongju, South Korea
| | - Gyeongchan Kim
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Sun-Woo Kang
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Subin Jeong
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Yoonjung Kang
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ho Kim
- Department of Public Health Science, School of Public Health, Seoul National University, Seoul, South Korea
| | - Hyewon Lee
- Department of Health Administration and Management, Soonchunhyang University Graduate School, Asan, South Korea; Department of Health Administration and Management, College of Medical Sciences, Soonchunhyang University, Asan, South Korea; Department of Software Convergence, Soonchunhyang University Graduate School, Asan, South Korea.
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White P, Corcoran P, Griffin E, Arensman E, Barrett P. The burden of attempted hanging and drowning presenting to hospitals in Ireland between 2007 and 2019: a national registry-based study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:235-244. [PMID: 37525008 PMCID: PMC10838814 DOI: 10.1007/s00127-023-02525-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/27/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE To measure the impact of hospital-treated self-harm by hanging and drowning in Ireland in 2007-2019 and identify risk factors for these methods of self-harm. METHOD Data on all self-harm presentations to Irish hospitals between 2007 and 2019 were obtained from the National Self-Harm Registry Ireland, a national self-harm surveillance system. Multinomial regression was used to explore factors associated with attempted hanging and drowning. RESULTS The age-standardised incidence rate of attempted hanging and drowning increased by 126% and 45%, respectively, between 2007 and 2019. The incidence of both methods was highest among young people aged 15-24 years. The odds of presenting to hospital for attempted hanging were highest in males (aOR 2.85, 95% CI 2.72-3.00), people experiencing homelessness (aOR 1.32, 95% CI 1.16-1.49) and individuals living in the capital, Dublin (aOR 1.23, 95% CI 1.17-1.29). The odds of presenting for attempted drowning were highest in males (aOR 1.68, 95% CI 1.58-1.78) and people experiencing homelessness (aOR 2.69, 95% CI 2.41-2.99). CONCLUSION The incidence of hospital-treated self-harm by hanging and drowning is increasing in Ireland and is highest among adolescents and young adults. Males and people experiencing homelessness may be at highest risk and warrant targeted preventive interventions.
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Affiliation(s)
- Philippa White
- Department of Public Health (Cork & Kerry), HSE-South, St Finbarr's Hospital, Douglas Road, Cork, Ireland
| | - Paul Corcoran
- National Suicide Research Foundation, 4 Western Gateway Building, Western Road, Mardyke, Cork, Ireland
| | - Eve Griffin
- National Suicide Research Foundation, 4 Western Gateway Building, Western Road, Mardyke, Cork, Ireland
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
| | - Ella Arensman
- National Suicide Research Foundation, 4 Western Gateway Building, Western Road, Mardyke, Cork, Ireland
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
| | - Peter Barrett
- Department of Public Health (Cork & Kerry), HSE-South, St Finbarr's Hospital, Douglas Road, Cork, Ireland.
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
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Elhawary AE, Lashin HI, Fnoon NF, Sagah GA. Evaluation of the rate and pattern of suicide attempts and deaths by self-poisoning among Egyptians before and during the COVID-19 pandemic. Toxicol Res (Camb) 2023; 12:1113-1125. [PMID: 38145090 PMCID: PMC10734599 DOI: 10.1093/toxres/tfad103] [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: 08/23/2023] [Revised: 09/25/2023] [Accepted: 10/17/2023] [Indexed: 12/26/2023] Open
Abstract
Background Concerns about increased suicidal attempts, especially by self-poisoning as a consequence of Coronavirus disease 2019 (COVID-19) pandemic have been raised worldwide. Aim of the study This study aimed to evaluate the rate and pattern of suicide attempts and deaths by self-poisoning among patients admitted to Tanta University Poisoning Control Center one year before and following COVID-19 pandemic declaration in Egypt. It was conducted on the medical records of 3,200 poisoned patients, from March 2019 to February 2021. Demographic, toxicological data and patients' outcomes were collected. Results During the pandemic year, 63.8% of total admitted patients alleged suicidal self-poisoning. Adults significantly decreased from 59% to 52.3%, while adolescents significantly increased from 34.6% to 41.7%. Monthly numbers of admitted suicidal self-poisoned patients significantly decreased during the lockdown but significantly increased from 7% to 26.5%, during the peak of the second wave of the pandemic as well as suicidal deaths (increased from 1.9% to 21.2%). Suicidal self-poisoning in females increased late in the pandemic year and suicidal self-poisoning deaths were significantly reported from rural areas (P = 0.025). The delay time was significantly longer, length of hospital stay was significantly shorter, intensive care unit admission rates and suicidal deaths were significantly increased during the pandemic year (P < 0.001, 0.026, <0.001, <0.001, respectively). Phosphides were the most commonly used poison for committing suicide and suicidal deaths during this year. Conclusion Psychological support should be directed to females and adolescents, especially from rural areas in Egypt to help reduce suicidal attempts and deaths by self-poisoning during any future pandemics and lockdowns.
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Affiliation(s)
- Amira Elsayed Elhawary
- Forensic Medicine and Clinical Toxicology Department, 6 floor, Faculty of Medicine, Tanta University, Medical Campus, Al‑Geish Street, Tanta, Gharbia 31527, Egypt
| | - Heba Ibrahim Lashin
- Forensic Medicine and Clinical Toxicology Department, 6 floor, Faculty of Medicine, Tanta University, Medical Campus, Al‑Geish Street, Tanta, Gharbia 31527, Egypt
| | - Noha Fawzy Fnoon
- Neuropsychiatry Department, Faculty of Medicine, Tanta University, Medical Campus, Al‑Geish Street, Tanta, Gharbia 31527, Egypt
| | - Ghada Attia Sagah
- Forensic Medicine and Clinical Toxicology Department, 6 floor, Faculty of Medicine, Tanta University, Medical Campus, Al‑Geish Street, Tanta, Gharbia 31527, Egypt
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Kim HH, Lee JH, Song IH, Park YR. Characteristics and risk factors of suicide among people who attempted self-harm in South Korea: A longitudinal National Cohort Study in South Korea. Psychiatry Res 2023; 330:115613. [PMID: 38000207 DOI: 10.1016/j.psychres.2023.115613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
Although self-harm is known as a significant risk factor for suicide, there are insufficient studies on the characteristics of people who self-harmed and the factors affecting suicide using a national dataset in Asia. This study aimed to identify demographic, clinical, and socioeconomic factors of individuals who attempted self-harm concerning suicide mortality. By analyzing the Korean National Health Insurance Service data from 2002 to 2020, we compared the people who attempted self-harm to the general population and explored factors affecting suicide by using the Cox proportional hazards model. Older age, female sex, lower socioeconomic status, and psychiatric conditions were associated with higher self-harm attempts. Suicide was more prevalent among males with mild disabilities, using fatal self-harm methods, and higher Charlson Comorbidity Index (CCI) scores. Socioeconomic factors that were significantly related to self-harm attempt were relatively less significant in the suicide survival analysis, while male gender, older age, fatal self-harm methods, high CCI scores, psychiatric diagnosis, and drinking habits were significantly associated with lower suicide survival rates. These results showed that demographic, clinical and socioeconomic factors affecting self-harm differ from those affecting actual suicidal death after self-harm. These insights may assist in developing targeted prevention strategies for specific populations.
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Affiliation(s)
- Hye Hyeon Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea; Division of Biomedical Informatics, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jin Hyuk Lee
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - In Han Song
- Health & Mental Health Lab, Yonsei University Graduate School of Social Welfare, Seoul, South Korea; Institute for Convergence Science Academy, Yonsei University, Seoul, South Korea.
| | - Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea; Institute for Convergence Science Academy, Yonsei University, Seoul, South Korea; Graduate School of Medical Science, Brain Korea 21 FOUR Project, Yonsei University College of Medicine, Seoul, South Korea.
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Miranda R, Ortin-Peralta A, Macrynikola N, Nahum C, Mañanà J, Rombola C, Runes S, Waseem M. Content and Process of Adolescent Suicide Ideation: Implications for Risk Assessment. Res Child Adolesc Psychopathol 2023; 51:1657-1668. [PMID: 37318739 PMCID: PMC10721727 DOI: 10.1007/s10802-023-01092-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/16/2023]
Abstract
This study examined differences in the content and process of suicide ideation between adolescents presenting with recent suicide ideation or a suicide attempt in clinical settings. Across two combined study samples, adolescents (N = 229; 79% female; 73% Hispanic/Latine), ages 12-19, presenting with a recent suicide attempt, recent suicide ideation with a past suicide attempt history, or recent suicide ideation with no past suicide attempt history were interviewed in detail about the process and content of their suicide ideation. The group with suicide ideation and a past suicide attempt more often reported that their recent ideation lasted greater than 4 h compared to those with suicide ideation but no past suicide attempt history. The suicide attempt group more often considered ingestion as their first method of attempt, compared to the other two suicide ideation groups, and less often considered "other" methods (e.g., jumping from a height or onto train/traffic, hanging). Wish to die was lower in the ideation-only group, compared to both other groups. Separate analyses from Study 2 suggested that the majority of adolescents' suicide ideation contained imagery; however, a higher proportion of adolescents with suicide ideation and a past suicide attempt reported imagery in their ideation than those with ideation but no past attempt. Understanding what adolescents think about when they consider suicide and how they think about it may be informative about risk of a suicide attempt.
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Affiliation(s)
- Regina Miranda
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY, 10065, USA.
- The Graduate Center, City University of New York, New York, NY, 10016, USA.
| | - Ana Ortin-Peralta
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY, 10065, USA
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY, 10461, USA
| | - Natalia Macrynikola
- The Graduate Center, City University of New York, New York, NY, 10016, USA
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Caryn Nahum
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY, 10065, USA
- LIU Post, Brookville, NY, USA
| | - Jhovelis Mañanà
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY, 10065, USA
| | - Christina Rombola
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY, 10065, USA
| | - Sandra Runes
- New York City Health, Hospitals/Lincoln, Bronx, NY, USA
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Al Khatri M, Al Huseini S, Almaqbali M, Cucchi A, Al Saadi AK, Al Farsi A, Jose S, Al-Sibani N, Al-Adawi S. Sociodemographic Characteristics and Clinical Profile of Suicide Attempters Attending the Emergency Department at a Tertiary Care Hospital in Oman: A Retrospective Study. J Psychiatr Pract 2023; 29:390-402. [PMID: 37578418 DOI: 10.1097/pra.0000000000000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
OBJECTIVE This study examined the sociodemographic and clinical characteristics of individuals who attended the emergency department of a tertiary care center in Muscat, Oman following a suicide attempt. METHODS A retrospective study (N=154) was conducted between January 2015 and June 2018. Information that was collected included sociodemographic variables (age, nationality, sex, marital status, and occupation), risk (medical comorbidities, psychiatric history, substance misuse, alcohol misuse, and previous history of suicide attempts), and precipitating factors, as well as the chosen methods for the suicide attempts. RESULTS In all, 83.1% of the sample were Omanis, and women constituted 69.5%. The mean age of the sample was 27 years; 30% were students, 42% were unemployed, and 40.9% had a history of psychiatric disorders. Family conflict, suffering from chronic illness, and having social problems were the most common precipitating factors for the suicide attempt. The most common method used in the suicide attempt was drug overdose (48.1%), mainly involving paracetamol (acetaminophen) (40%). Significant gender differences emerged in precipitating factors, history of substance misuse, and methods of suicide. CONCLUSIONS The data from this study are consistent with international trends that suggest that women and younger age groups are the most vulnerable to suicide attempts. Although in its infancy, the type of research presented here could lay the groundwork for preventive interventions and programs.
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Krvavac S, Bystad M, Wynn R, Bukholm IRK, Jansson B. Characteristics of Patients Who Complete Suicide and Suicide Attempts While Undergoing Treatment in Norway: Findings from Compensation Claims Records. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4083. [PMID: 36901092 PMCID: PMC10002346 DOI: 10.3390/ijerph20054083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/19/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to identify characteristics that differentiate patients who complete suicide (SC) from patients with suicide attempts (SA) while undergoing treatment in Norway. We examined data from the Norwegian System of Patient Injury Compensation (Norsk Pasientskade Erstatning-NPE). Data were extracted from NPE case records from a 10-year period (2009-2019) for 356 individuals who attempted (n = 78) or died by (n = 278) suicide. The two groups differed significantly in the types of medical errors identified by experts. Inadequate suicide risk assessment tended to be proportionally and significantly more prevalent among SC compared to SA. There was a weak but significant trend that SA had received medication only, whereas SC had received both medication and psychotherapy. There were no significant differences with respect to age group, gender, diagnostic category, number of previous suicide attempts, inpatient/outpatient status, or category of responsible clinic. We conclude that suicide attempters and suicide completers differed in terms of identified medical errors. Focusing on the prevention of these and other types of errors could help to reduce the number of suicides of patients in treatment.
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Affiliation(s)
- Sanja Krvavac
- Department of Psychiatry, Helgeland Hospital Trust, 8802 Sandnessjøen, Norway
- Department of Health and Care Sciences, UiT The Arctic University of Tromsø, 9037 Tromsø, Norway
| | - Martin Bystad
- Division of Substance Use and Mental Health, University Hospital of North Norway, 9019 Tromsø, Norway
| | - Rolf Wynn
- Department of Clinical Medicine, UiT The Arctic University of Tromsø, 9038 Tromsø, Norway
- Department of Education, ICT and Learning, Østfold University College, 1757 Halden, Norway
| | - Ida Rashida Khan Bukholm
- The Norwegian System of Patient Injury Compensation, 0130 Oslo, Norway
- Faculty of Landscape and Society, The Norwegian University of Life Sciences, 1430 Ås, Norway
| | - Billy Jansson
- Department of Psychology and Social Work, Mid Sweden University, 831 25 Ostersund, Sweden
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Thaysa Bier de Sousa N, Vedana KGG, Zanetti ACG, de Souza J, da Silva AHS, Miasso AI. Intentional self-poisoning with medications: Occurrence, recurrence and suicide deaths. DEATH STUDIES 2023:1-9. [PMID: 36794403 DOI: 10.1080/07481187.2023.2175390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This study aimed to identify the sociodemographic and clinical factors associated with the occurrence and recurrence of intentional self-poisoning with medications (ISP-M), and suicide deaths by ISP-M in the state of Mato Grosso, Brazil. In this cross-sectional analytical study, we used logistic regression models to analyze data obtained through health information systems. Factors associated with use of ISP-M as a method were female gender, white skin color, occurrence in urban areas and at home. The ISP-M as a method was less reported in people presumed under the influence of alcohol. Lower chance of death by suicide using ISP-M was found among young people and adults (under 60 years old).
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Affiliation(s)
- Nágella Thaysa Bier de Sousa
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Kelly Graziani Giacchero Vedana
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Ana Carolina Guidorizzi Zanetti
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Jacqueline de Souza
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Amanda Heloisa Santana da Silva
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
| | - Adriana Inocenti Miasso
- Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
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El-Sarnagawy G, Hafez A, Amer R. Characteristics of suicidal poisoned patients admitted to tertiary care center during COVID-19 pandemic. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022; 58:138. [DOI: 10.1186/s41983-022-00577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/26/2022] [Indexed: 11/24/2022] Open
Abstract
Abstract
Background
Suicidal poisoning is a major concern during the COVID-19 pandemic that has several physical and mental hazards. This study aimed to evaluate the characteristics of suicidal poisoned patients admitted to a tertiary poison control center during the pandemic lockdown and assess COVID-related knowledge and attitude among those patients to identify the high-risk group for suicide. This cross-sectional study was conducted on acutely poisoned patients admitted to Tanta University Poison Control Center from June to December 2020. Upon admission, socio-demographic data, causative poisoning agents, COVID-related knowledge and attitude, Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HAM-D) were collected from all participants.
Results
A total of 254 poisoned patients were categorized into suicidal (85.04%) and accidental (14.96%) poisoning groups. The former was caused mainly by phosphides and was significantly associated with a history of using psychotropic medications and high HAM-A and HAM-D results. Logistic regression analysis showed that a history of psychiatric illness, low attitude scores, and high HAM-D scores were significant risk factors for suicidal poisoning.
Conclusions
Considerable number of suicidal poisoned patients had moderate-to-severe depressive symptoms, highlighting the importance of providing specialized psychiatric services in poisoning centers, particularly among vulnerable populations, to prevent the overwhelming repeated suicidal attempts.
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12
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Sefid Fard Jahromi M, Eghbal MH, Rahmanian V. Epidemiology of suicide and suicide attempts in Jahrom district, Southern Iran in light of COVID pandemic: A prospective observational study. Health Sci Rep 2022; 5:e933. [PMCID: PMC9662693 DOI: 10.1002/hsr2.933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/18/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mina Sefid Fard Jahromi
- Psychiatry, Research Center for Non‐Communicable Diseases Jahrom University of Medical Sciences Jahrom Iran
| | - Mohammad Hadi Eghbal
- Faculty of Medicine, Research Center for Social Determinants of Health Jahrom University of Medical Sciences Jahrom Iran
| | - Vahid Rahmanian
- Epidemiology, Research Center for Social Determinants of Health Jahrom University of Medical Sciences Jahrom Iran
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13
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Vidal-Ribas P, Govender T, Yu J, Livinski AA, Haynie DL, Gilman SE. The developmental origins of suicide mortality: a systematic review of longitudinal studies. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-02092-6. [PMID: 36205791 PMCID: PMC10207387 DOI: 10.1007/s00787-022-02092-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022]
Abstract
Suicide prevention efforts generally target acute precipitants of suicide, though accumulating evidence suggests that vulnerability to suicide is partly established early in life before acute precipitants can be identified. The aim of this systematic review was to synthesize evidence on early life vulnerability to suicide beginning in the prenatal period and extending through age 12. We searched PubMed, Embase, PsycNet, Web of Science, Scopus, Social Services Abstracts, and Sociological Abstracts for prospective studies published through January 2021 that investigated early life risk factors for suicide mortality. The search yielded 13,237 studies; 54 of these studies met our inclusion criteria. Evidence consistently supported the link between sociodemographic (e.g., young maternal age at birth, low parental education, and higher birth order), obstetric (e.g., low birth weight), parental (e.g., exposure to parental death by external causes), and child developmental factors (e.g., exposure to emotional adversity) and higher risk of suicide death. Among studies that also examined suicide attempt, there was a similar profile of risk factors. We discuss a range of potential pathways implicated in these associations and suggest that additional research be conducted to better understand how early life factors could interact with acute precipitants and increase vulnerability to suicide.
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Affiliation(s)
- Pablo Vidal-Ribas
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
| | - Theemeshni Govender
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Jing Yu
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Alicia A Livinski
- Office of Research Services, National Institutes of Health Library, OD, NIH, Bethesda, MD, USA
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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14
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Increased incidence of high-lethality suicide attempts after the declaration of the state of alarm due to the COVID-19 pandemic in Salamanca: A real-world observational study. Psychiatry Res 2022; 312:114578. [PMID: 35526503 PMCID: PMC9040395 DOI: 10.1016/j.psychres.2022.114578] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 04/19/2022] [Accepted: 04/24/2022] [Indexed: 11/30/2022]
Abstract
The coronavirus pandemic has led to people getting involved in harmful behaviors. In our observational study, we assessed 241 patients with suicidal thoughts or behaviors in the emergency room before, during, and after the lockdown, from January to July 2020. After the lockdown, retired patients made higher-lethality attempts, and consultations related to suicide were less frequent, but active suicidal behaviors were more frequent. Men tended to use more lethal methods, and women made more suicidal gestures and had more suicide-related consultations. We observed an increase in the lethality of the attempts after the declaration of the state of alarm.
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15
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Yook V, Kim H, Kim EJ, Kim Y, Lee G, Choi JH, Shin MH, Jeon HJ. Psychological autopsy study comparing suicide decedents with and without a history of suicide attempts in a nationwide sample of South Korea. Suicide Life Threat Behav 2022; 52:190-198. [PMID: 33811661 DOI: 10.1111/sltb.12750] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 11/26/2022]
Abstract
The majority of suicide decedents die on their initial attempt. To bring attention to suicide decedents without a suicide attempt history, the current study explored their demographic, clinical, and suicide-related characteristics. The data were derived from the Korea National Investigation of Suicide Victims Study, which assessed all suicide cases from 2013 to 2017 recorded in police investigation reports. We compared suicide decedents with and without a history of nonfatal attempts using the Korea Psychological Autopsy Checklist for Police Records (K-PAC). Out of 5228 cases included in our study, 3147 (60.2%) died on their first suicide attempt. Demographically, those who were male, older than 65, employed, and married/widowed were more likely to die on their initial attempt. Clinically, those who died on their initial attempt were more likely to have never been diagnosed with psychiatric disorders, whereas those who died on a repeated attempt were more likely to have been diagnosed with mood disorders. In terms of suicide-related factors, experiencing relationship problems and complaining about physical discomfort were associated with dying on an initial attempt. Depressed affect, self-harming behaviors, and talking about suicide or death were associated with repeated attempts.
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Affiliation(s)
- Vidal Yook
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Korea Psychological Autopsy Center (KPAC), Seoul, Korea
| | - Hyewon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Ji Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Korea Psychological Autopsy Center (KPAC), Seoul, Korea
| | - Yuwon Kim
- Research Institute for Future Medicine, Samsung Medical Center, Seoul, South Korea
| | - Gusang Lee
- Korea Psychological Autopsy Center (KPAC), Seoul, Korea
| | - Jin Hwa Choi
- Korea Psychological Autopsy Center (KPAC), Seoul, Korea
| | - Myung-Hee Shin
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Korea Psychological Autopsy Center (KPAC), Seoul, Korea.,Department of Health Sciences & Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea.,Department of Medical Device Management & Research, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea.,Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
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16
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Maleitzke T, Zocholl D, Topp T, Dimitrov-Discher A, Daus E, Reaux G, Zocholl M, Conze RN, Kolster M, Weber P, Fleckenstein FN, Scheutz Henriksen L, Stöckle U, Fuchs T, Gümbel D, Spranger N, Ringk A, Märdian S. Quality and quantity of serious violent suicide attempts during the COVID-19 pandemic. Front Psychiatry 2022; 13:927696. [PMID: 35928775 PMCID: PMC9343723 DOI: 10.3389/fpsyt.2022.927696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While repeated shutdown and lockdown measures helped contain the spread of SARS-CoV-2 during the COVID-19 pandemic, social distancing and self-isolation negatively impacted global mental health in 2020 and 2021. Although suicide rates did reportedly not increase during the first months of the pandemic, long-term data, and data on the quality of serious violent suicide attempts (SVSAs) are not available to date. MATERIALS AND METHODS Orthopaedic trauma patient visits to the emergency department (ED), ED trauma team activations, and SVSAs were retrospectively evaluated from January 2019 until May 2021 in four Level-I Trauma Centers in Berlin, Germany. SVSAs were assessed for suicide method, injury pattern and severity, type of treatment, and length of hospital stay. RESULTS Significantly fewer orthopaedic trauma patients presented to EDs during the pandemic (n = 70,271) compared to the control (n = 84,864) period (p = 0.0017). ED trauma team activation numbers remained unchanged. SVSAs (corrected for seasonality) also remained unchanged during control (n = 138) and pandemic (n = 129) periods, and no differences were observed for suicide methods, injury patterns, or length of hospital stay. CONCLUSION Our data emphasize that a previously reported rise in psychological stress during the COVID-19 pandemic does not coincide with increased SVSA rates or changes in quality of SVSAs.
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Affiliation(s)
- Tazio Maleitzke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Dario Zocholl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Tobias Topp
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Orthopaedic, Trauma, Hand and Reconstructive Surgery, Berlin, Germany
| | - Annika Dimitrov-Discher
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
| | - Elly Daus
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
| | - Gabriel Reaux
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
| | - Malin Zocholl
- Department of Orthopaedic, Trauma, Hand and Reconstructive Surgery, Vivantes Hospital Friedrichshain, Berlin, Germany
| | - Rolf Nicolas Conze
- Department of Orthopaedic, Trauma, Hand and Reconstructive Surgery, Vivantes Hospital Friedrichshain, Berlin, Germany
| | - Moritz Kolster
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Philipp Weber
- Center for Orthopaedics and Trauma Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Florian Nima Fleckenstein
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany.,Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Louise Scheutz Henriksen
- International Centre for Research and Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ulrich Stöckle
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
| | - Thomas Fuchs
- Department of Orthopaedic, Trauma, Hand and Reconstructive Surgery, Vivantes Hospital Friedrichshain, Berlin, Germany
| | - Denis Gümbel
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Nikolai Spranger
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany
| | - Alexander Ringk
- Center for Orthopaedics and Trauma Surgery, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Sven Märdian
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
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17
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Ramesh P, Taylor PJ, McPhillips R, Raman R, Robinson C. A Scoping Review of Gender Differences in Suicide in India. Front Psychiatry 2022; 13:884657. [PMID: 35669273 PMCID: PMC9165759 DOI: 10.3389/fpsyt.2022.884657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Much of the published literature on suicide comes from high income countries. In countries such as India, female suicide rates exceed the global suicide rate and suicide rates found in their male counterparts. Results from previous studies indicate that factors related to suicide among men and women in India are different from those seen in high-income countries. To date, no reviews have considered the relationship between gender and suicide in India. Therefore, the aim of this scoping review is to provide a comprehensive understanding of existing literature reporting gender differences in suicide rates, methods, risk factors and antecedent factors in India by reviewing published studies. METHOD A scoping review was conducted to map the existing literature on gender differences in suicide in India. To identify peer-reviewed publications, online databases PsycINFO and Embase were searched. The search terms were [suicid* AND India*]. The searches took place in November 2020 and May 2021, with no language restrictions. Articles published from 2014 onwards from India were included. Reference lists of selected studies were searched for studies that could meet the inclusion criteria. RESULTS This review identified 17 studies that met the inclusion criteria. The ratio between women and men who die by suicide in India is much lower than in high-income countries. Hanging was found to be a more commonly used method of suicide among both men and women, in comparison to high-income countries where hanging is more common among men. This review also identified several gaps in the literature. There were few studies that examined suicide among transgender Indians. There was limited literature on gender differences in risk and protective factors for suicide. Limitations such as the omission of a lack of gender-based analyses in several studies and under-reporting of suicide rates were identified. CONCLUSION Understanding suicide within the context of individual countries is essential in designing culture-appropriate suicide prevention strategies. This review identified an urgent need to establish and evaluate suicide surveillance systems in India. Furthermore, additional research is warranted to understand suicide among individuals who identify outside the gender binary, and gender-specific risk and protective factors.
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Affiliation(s)
- Parvathy Ramesh
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Peter J Taylor
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Rebecca McPhillips
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Rajesh Raman
- Department of Psychiatry, JSS Medical College, JSS University, Mysore, India
| | - Catherine Robinson
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
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18
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Wakim E, El Hage S, Safi S, El Kareh A, El Masri J, Salameh P. Insights in Neuropsychiatry: Suicide and Self-Mutilation in the Mena Region- a Bibliometric Quantitative and Co-occurrence Medline-Based Analysis. Cureus 2021; 13:e18680. [PMID: 34786259 PMCID: PMC8580160 DOI: 10.7759/cureus.18680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/11/2021] [Indexed: 11/05/2022] Open
Abstract
Background Little is known about self-mutilation and suicide-related research in the Arab world. Aim We aim to quantify research activity related to suicide and self-mutilation, according to socio-economic factors, and assess inter-regional collaborations and trends of topics in the Arab world in the last 16 years. Methods A search was conducted through the PubMed database to find articles related to suicide and self-mutilation, according to author affiliation in the 22 Arab countries between 2004 and 2019 (inclusive), and standardized according to mean population, suicide, and self-mutilation disability associated life years (DALY), and gross domestic product (GDP). VOS Viewer was used for keyword and organization co-occurrence analysis. Results Only 0.61% of articles related to suicide and self-mutilation published between 2004 and 2019 were of Arab origin, compared to 1.76% in South America and 7.94% in Far East Asia. Suicide and self-mutilation articles make up 0.09% of the total publications in the Arab region. Egypt, Saudi Arabia, and Lebanon had the highest number of published articles related to suicide and self-mutilation. When comparing publications per million persons, Lebanon and Kuwait ranked first with 5.15 and 3.40 publications per million persons. Lebanon showed the highest number of publications per USD billion GDP, with 0.75 publications. The highest number of publications per 1% self-injury-related DALY was recorded in Saudi Arabia, with 46.97 publications. In recent years, VOS Viewer revealed poor inter-regional collaborations and a modest but increasing trend towards depression, poisoning, and cross-sectional studies. Conclusion Despite increasing publications, the region still lags in terms of suicide and self-mutilation research activity. A pan-Arab strategy should be implemented to refine suicide-related research and increase mental health awareness.
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Affiliation(s)
- Elyas Wakim
- Orthopaedics, Faculty of Medical Sciences - Lebanese University, Hadath, LBN
| | - Said El Hage
- General Medicine, Faculty of Medical Sciences - Lebanese University, Hadath, LBN
- Neurosciences, Faculty of Medical Sciences - Lebanese University, Hadath, LBN
| | - Steven Safi
- Epidemiology and Public Health, Faculty of Medical Sciences - Lebanese University, Hadath, LBN
| | - Antonio El Kareh
- General Medicine, Faculty of Medical Sciences - Lebanese University, Hadath, LBN
| | - Jad El Masri
- Neurosciences, Faculty of Medical Sciences - Lebanese University, Hadath, LBN
- General Medicine, Faculty of Medical Sciences - Lebanese University, Hadath, LBN
| | - Pascale Salameh
- Public Health, Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie - Liban, Beirut, LBN
- Public Health, University of Nicosia Medical School, Nicosia, CYP
- Pharmacy, Faculty of Medical Sciences - Lebanese University, Hadath, LBN
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19
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Lawes JC, Peden AE, Bugeja L, Strasiotto L, Daw S, Franklin RC. Suicide along the Australian coast: Exploring the epidemiology and risk factors. PLoS One 2021; 16:e0251938. [PMID: 34015048 PMCID: PMC8136651 DOI: 10.1371/journal.pone.0251938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/05/2021] [Indexed: 01/22/2023] Open
Abstract
Suicide is an increasing global concern with multiple risk factors, yet location-based understanding is limited. In Australia, surf lifesavers (SLS) and lifeguards patrol the coast, performing rescues and assisting injured people, including people who suicide. This study is a descriptive epidemiological analysis of Australian coastal suicide deaths. The results will be used to inform training and support surf lifesaving personnel and suicide prevention organisations. This is a population-based cross-sectional study of suicide deaths at Australian coastal locations (between 1 January 2005 and 31 December 2019). Data were sourced from the National Coronial Information System and SLS Australia's Incident Report Database. Analyses explored decedent, incident, and risk factors by sex and method. Across the study period, there were 666 coastal suicide deaths (71.0% male, 43.4% jumping from high places [X80]). Males were more likely to suicide by other means (hanging, self-poisoning, firearm discharge; n = 145, 83.8%), compared to females who were more likely to suicide by drowning ([X71]; n = 77, 37.7%). In one third (n = 225, 38.3%) toxicology was a contributing factor. The risk of coastal suicides was 10.3 times higher during the seven-days prior to their birthday (p<0.001). Evidence of mental ill health was reported in 61.4% (n = 409) of cases and evidence of suicidal behaviour was reported for 37.4% of decedents (n = 249), more prevalent in females. SLS responded in 10.7% (n = 71) of coastal suicides (most jumps from high places; n = 36, 50.7%). Coastal suicides differ to national trends suggesting that location-based differences should be considered during development of preventative and protective measures, especially at a community level. Accessibility, availability, perceived lethality and symbolic qualities are proposed to influence suicide location decisions. These results will guide support and education strategies for surf lifesaving personnel, contributes to established, ongoing suicide surveillance efforts (including hot-spot identification) and add to the limited literature exploring place-based suicide.
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Affiliation(s)
- Jasmin C. Lawes
- Surf Life Saving Australia, Bondi Beach, Sydney, New South Wales, Australia
- Beach Safety Research Group, School of Biological, Earth and Environmental Sciences, UNSW Sydney, Kensington, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Amy E. Peden
- Beach Safety Research Group, School of Biological, Earth and Environmental Sciences, UNSW Sydney, Kensington, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- School of Population Health, Faculty of Medicine, UNSW Sydney, Kensington, New South Wales, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
- Monash Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Luke Strasiotto
- Surf Life Saving Australia, Bondi Beach, Sydney, New South Wales, Australia
| | - Shane Daw
- Surf Life Saving Australia, Bondi Beach, Sydney, New South Wales, Australia
| | - Richard C. Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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20
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Ammerman BA, Burke TA, Jacobucci R, McClure K. Preliminary investigation of the association between COVID-19 and suicidal thoughts and behaviors in the U.S. J Psychiatr Res 2021; 134:32-38. [PMID: 33360222 DOI: 10.1016/j.jpsychires.2020.12.037] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/02/2020] [Accepted: 12/09/2020] [Indexed: 11/16/2022]
Abstract
Evidence suggests that the negative consequences of COVID-19 may extend far beyond its considerable death toll, having a significant impact on psychological well-being. Despite work highlighting the link between previous epidemics and elevated suicide rates, there is limited research on the relationship between the COVID-19 pandemic and suicidal thoughts and behaviors. Utilizing an online survey, the current study aimed to better understand the presence, and extent, of the association between COVID-19-related experiences and past-month suicidal thoughts and behaviors among adults in the United States recruited via Amazon Mechanical Turk (n = 907). Results support an association between several COVID-19-related experiences (i.e., general distress, fear of physical harm, effects of social distancing policies) and past-month suicidal ideation and suicide attempts. Further, a significant proportion of those with recent suicidal ideation explicitly link their suicidal thoughts to COVID-19. Exploratory analyses highlight a potential additional link between COVID-19 and suicidal behavior, suggesting that a portion of individuals may be intentionally exposing themselves to the virus with intent to kill themselves. These findings underscore the need for suicide risk screening and access to mental health services during the current pandemic. Particular attention should be paid to employing public health campaigns to disseminate information on such services to reduce the enormity of distress and emotional impairment associated with COVID-19 in the United States.
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Affiliation(s)
- Brooke A Ammerman
- University of Notre Dame, Department of Psychology, Notre Dame, IN, USA.
| | - Taylor A Burke
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA
| | - Ross Jacobucci
- University of Notre Dame, Department of Psychology, Notre Dame, IN, USA
| | - Kenneth McClure
- University of Notre Dame, Department of Psychology, Notre Dame, IN, USA
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21
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Yang JH, Rhee SJ, Park CHK, Kim MJ, Shin D, Lee JW, Kim J, Kim H, Lee HJ, Ha K, Ahn YM. Self-Transcendence Mediates the Relationship between Early Trauma and Fatal Methods of Suicide Attempts. J Korean Med Sci 2021; 36:e39. [PMID: 33527782 PMCID: PMC7850863 DOI: 10.3346/jkms.2021.36.e39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/22/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Early trauma is known to be a risk factor of suicide-related behavior. On the other hand, people who attempt suicide using a fatal method are reported to be more likely to complete suicide. In this study, we assumed that early trauma affects an individual's temperament and character and thereby increases the risk of a fatal method of suicide attempts. METHODS We analyzed 92 people with a history of previous suicide attempts. We compared the Temperament and Character Inventory-Revised scores between the groups with and without early trauma, and between the groups with and without a history of suicide attempt using fatal methods through an analysis of covariance with age, sex, and presence of a psychiatric history as covariates. A mediation analysis was conducted of the relationship between early trauma and fatal methods of suicide attempt with self-transcendence as a mediator. RESULTS Higher self-transcendence was reported in the fatal group (27.71 ± 13.78 vs. 20.97 ± 12.27, P = 0.010) and the early trauma group (28.05 ± 14.30 vs. 19.43 ± 10.73, P = 0.001), respectively. The mediation model showed that self-transcendence mediates the relationship between early trauma and fatal methods of suicide attempt. The 95% confidence intervals for the direct and indirect effect were (-0.559, 1.390) and (0.026, 0.947), respectively. CONCLUSION Self-transcendence may mediate the relationship between early trauma and fatal methods of suicide attempt. Self-transcendence may be associated with unhealthy defenses and suicidal behavior for self-punishment and may constitute a marker of higher suicide risk.
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Affiliation(s)
- Jeong Hun Yang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | | | - Min Ji Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Daun Shin
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Won Lee
- Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Korea
| | - Junghyun Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Hyeyoung Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Hyun Jeong Lee
- Department of Psychiatry and Behavioral Science, National Cancer Center, Goyang, Korea
- Division of Cancer Control & Policy, National Cancer Center, Goyang, Korea
| | - Kyooseob Ha
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea.
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Smith Z. Death due to hanging: a retrospective descriptive study of the socioeconomic and demographic profiles of hanging victims in central South Africa. Forensic Sci Med Pathol 2021; 17:223-229. [PMID: 33492631 DOI: 10.1007/s12024-020-00352-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2020] [Indexed: 11/30/2022]
Abstract
Hanging by the neck is the leading method of suicide globally. The epidemiological risk factors for suicidal hanging can contribute to construct a socioeconomic and demographic profile of hanging victims. These profiles can then be used to identify individuals at the highest risk for committing suicide by hanging for referral to a suicide prevention program. The aim of this study was to describe the socioeconomic and demographic profiles of hanging victims in Bloemfontein, South Africa. A retrospective descriptive study was performed using data from the Bloemfontein Forensic Mortuary, for the period 1 January 2008 to 31 December 2015. In total, 9085 autopsies were performed during the study period; 355 (3.9%) were hanging victims. The median age of the victims was 31.4 (range 11-78) years, with 138 (38.9%) cases being 21-30 years of age. Three hundred and twenty-three (91.0%) of the victims were male, 227 (63.9%) were single, 201 (56.6%) were unemployed, and 129 (36.3%) completed their high school education. The most common location where the hanging occurred was at home. Single, unemployed males 21-40 years of age were found to have the highest risk for committing suicide by hanging. The group at the lowest risk were married and employed individuals older than 60 years, who had a tertiary education. We report the first socioeconomic and demographic profiles of individuals who commit suicide by hanging in central South Africa, emphasizing the need for a National Suicide Prevention Program via a multidisciplinary team approach.
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Affiliation(s)
- Zandré Smith
- Department of Forensic Medicine, University of the Free State and Bloemfontein Forensic Mortuary, 22 James Dick Street, 9300, Wilgehof, Bloemfontein, South Africa.
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Witry M, Clayden A. Student pharmacist personal and work experiences with people displaying warning signs of suicidal ideation. Ment Health Clin 2020; 10:244-249. [PMID: 32685336 PMCID: PMC7337995 DOI: 10.9740/mhc.2020.07.244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction Student pharmacists, in their roles as trainees, technicians, and peers, may interact with people displaying suicide warning signs. Providing suicide gatekeeping training to student pharmacists may prepare them to engage people at risk. Measuring the extent to which student pharmacists have encountered people displaying warning signs of suicide may help contextualize the potential importance of training student pharmacists in suicide gatekeeping. The objective was to describe student pharmacists' awareness of someone they know having attempted or died by suicide and whether they have heard statements suggesting suicide risk in their personal and work life. Methods An anonymous electronic survey was administered to 111 student pharmacists before engaging in question-persuade-refer training as part of their second-year pharmacy curriculum. Respondents were asked for demographics and if Someone ever told you something concerning where you wondered if they were thinking about suicide for both work and one's personal life. Descriptive statistics and chi-squared tests were used to compare items by gender. Results There were 111 responses to the survey for a 100% response rate. Concerning statements related to suicide were reported by 71.2% of respondents in their personal life and by 34.2% of students while at work. There were no differences based on gender. Discussion A significant proportion of student pharmacists have personal, peer, and professional exposure related to people with potential suicidal ideation. These findings emphasize the need for broad approaches for training students and pharmacists in suicide gatekeeping as a new public health role.
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Affiliation(s)
- Matthew Witry
- Graduate Student, University of Iowa School of Social Work, Iowa City, Iowa
| | - Alyssa Clayden
- Graduate Student, University of Iowa School of Social Work, Iowa City, Iowa
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Son JM, Jeong J, Ro YS, Hong W, Hong KJ, Song KJ, Do Shin S. Effect of previous emergency psychiatric consultation on suicide re-attempts - A multi-center observational study. Am J Emerg Med 2020; 38:1743-1747. [PMID: 32738470 DOI: 10.1016/j.ajem.2020.05.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The emergency department (ED) is one of the first gateways when suicide attempt patients seek health care services. The purpose of this study was to analyze the hypothesis that people who received emergency psychiatric services in previous suicide attempts will have a lower mortality rate in current ED visits owing to subsequent suicide attempts. METHOD This retrospective study included patients who visited six EDs, and participated in the injury surveillance and in-depth suicide surveillance for 10 years, from January 2008 to December 2017. The study subjects were adult patients 18 years or older who visited EDs due to suicide attempts. The main explanatory variable is whether psychiatric treatment was provided in previous suicide attempts. The main outcome variable was suicide related mortality. RESULTS The study included 2144 suicide attempt patients with a previous history of suicide attempts. Among these, 1335 patients (62.2%) had received psychiatric treatment in previous suicide attempts. Mortality was significantly different between the psychiatric consultation group (n = 33, 2.5%) and non-consultation group (n = 47, 5.8%) (P < 0.01). In multivariate logistic regression analysis, previous psychiatric consultation showed a significant association with low mortality (adjusted OR 0.41; 95% CI [0.23-0.72]) and selecting non-fatal suicide methods (adjusted OR 0.47; 95% CI [0.36-0.61]). CONCLUSION Patients who received psychiatric consultation in previous suicide attempts had a lower suicide-related mortality in current ED visits as compared to patients who did not, and this may have been related to choosing non-fatal suicide methods.
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Affiliation(s)
- Jeong Min Son
- Department of Emergency Medicine, Seoul National University Hospital, South Korea
| | - Joo Jeong
- Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea.
| | - Young Sun Ro
- Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
| | - Wonpyo Hong
- Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea
| | - Kyoung-Jun Song
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea; Department of Emergency Medicine, Seoul National University Boramae Medical Center, South Korea
| | - Sang Do Shin
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea; Department of Emergency Medicine, Seoul National University College of Medicine, South Korea
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25
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Kim AM. Factors associated with the suicide rates in Korea. Psychiatry Res 2020; 284:112745. [PMID: 31951868 DOI: 10.1016/j.psychres.2020.112745] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/05/2019] [Accepted: 01/01/2020] [Indexed: 11/26/2022]
Abstract
The suicide rate in the Republic of Korea remains among the highest in the world, which needs to be examined in various aspects. This study investigated factors associated with the suicide rates in Korea. The suicide rates of 251 districts in Korea in 2015 and their relationships with the prevalence of heavy drinking, health care provision, and religion as well as demographic characteristics were examined with a Pearson correlations and a multiple linear regression analysis. The suicide rate in Korea was 26.5 per 100,000 persons in 2015. The regression analysis showed that the income level of the region, as represented by the average national health insurance premium, had a negative association with the suicide rate and that the prevalence of heavy drinking and the percentage of the population aged 65 and above had positive associations with the suicide rate. While the unemployment rate and the proportion of Catholics showed negative relationships with the suicide rate in the correlation matrix, the association was statistically insignificant in the regression analysis. Special attention should be given to excessive drinking and socio-economically disadvantaged conditions in taking measures to prevent suicide.
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Affiliation(s)
- Agnus M Kim
- Department of Health Policy and Management, Seoul National University College of Medicine, 103 Daehangno, Jongno-gu, Seoul 03080, Republic of Korea.
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26
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Beringuel BM, Costa HVVD, Silva APDSC, Bonfim CVD. Mortality by suicide in the State of Pernambuco, Brazil (1996-2015). Rev Bras Enferm 2020; 73 Suppl 1:e20180270. [DOI: 10.1590/0034-7167-2018-0270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 03/02/2019] [Indexed: 12/26/2022] Open
Abstract
ABSTRACT Objective: To describe the epidemiological characteristics of suicide mortality in the state of Pernambuco, from 1996 to 2015. Method: Study with data from the Sistema de Informações sobre Mortalidade. The simple linear regression model was used to verify the trend in the period analyzed. Results: There were 6,229 suicides, of which 3,390 (54.4%) occurred in the second decade of study. The mortality rate was 4.7 per 100,000 inhabitants. The temporal trend presented a decrease of 23.5% (p=0.031). For the male sex and the age range between 20 and 39 years, there was a decline in self-inflicted death of 23.8% (p=0.018) and 26.1% (p=0.046), respectively. Conclusion: The temporal analysis revealed a reduction in suicide mortality coefficients. This observation may contribute to better targeting of health interventions, optimizing resources and efforts, especially in suicide prevention.
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Takeda K, Sugawara N, Matsuda T, Shimada A, Nagata T, Kashiwagi H, Hirabayashi N, Okada T. Mortality and suicide rates in patients discharged from forensic psychiatric wards in Japan. Compr Psychiatry 2019; 95:152131. [PMID: 31669788 DOI: 10.1016/j.comppsych.2019.152131] [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: 04/12/2019] [Revised: 09/11/2019] [Accepted: 09/17/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Japanese forensic mental health services for patients with psychiatric disorders under the Medical Treatment and Supervision Act was initiated in 2005; however, the prognosis of those patients is not well-known, particularly regarding mortality and suicide. This study aimed to evaluate the all-cause mortality and suicide rate in forensic psychiatric outpatients who had been discharged from forensic psychiatric wards in Japan. METHODS Participants included 966 patients who had been discharged from forensic psychiatric wards. Data were collected from July 15, 2005 to July 15, 2018 at 29 of the 33 forensic psychiatric wards in Japan. Only the patients who provided written informed consent were included. We and collaborators at each forensic psychiatric ward identified demographic data of participants from the medical records for the inpatient treatment period. The reintegration coordinators, who belonged to the Ministry of Justice, investigated the prognosis of the participants during the outpatient treatment order period. We then connected demographic data and participants' prognosis for analysis. The crude rates (CRs) and standardized mortality ratios (SMRs) were calculated to analyze all-cause mortality and suicide rates. Univariate analysis was performed to examine the factors associated with all-cause mortality and suicide rates using the Cox proportional hazards ratio model. RESULTS The participants included 3.3 times as many men (n=739) compared to women (n=227), and their combined mean age was 47.3 (SD=12.9). The most common primary psychiatric diagnosis was psychotic disorders (81.3%). The mean follow-up period was 790.2 days (SD=369.6). The total observation period was 2091.2 person-years. The CR for all-cause death was 812.9 per 100,000 person-years (95% CI [426.5, 1199.4]), while the SMR for all-cause death was 2.2 (95% CI [1.3, 3.5]). The CR for completed suicide was 478.2 per 100,000 person-years (95% CI [181.8, 774.6]). The suicide SMR was 17.9 (95% CI [8.6, 32.9]) overall, 7.7 (95% CI [2.5, 18.0]) for men, and 79.4 (95% CI [25.8, 185.2]) for women. Univariate analysis showed that women had higher completed suicide risk than men (hazard ratio=3.599, 95% CI [1.041, 12.445]). CONCLUSION The all-cause mortality and completed suicide rates were higher in participants than observed in the general population consistent with the results of previous international studies.
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Affiliation(s)
- Koji Takeda
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan; Section of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Norio Sugawara
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, 4-2-2, Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Taro Matsuda
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Akihiro Shimada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Takako Nagata
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Hiroko Kashiwagi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Naotsugu Hirabayashi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8551, Japan
| | - Takayuki Okada
- Section of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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Botham AD. Suicide: Exploring the Relationship Between Modality and Population Demographic (San Mateo County, CA, USA 2007-2018): A Population-Based Study. J Forensic Sci 2019; 64:1750-1760. [PMID: 31157918 DOI: 10.1111/1556-4029.14090] [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: 01/23/2019] [Revised: 05/04/2019] [Accepted: 05/07/2019] [Indexed: 11/27/2022]
Abstract
Forensic suicidology is a growing discipline as the world struggles to reduce escalating suicide rates. Most research focuses on trends and risks, but no study examines the relationship between cultural identity and suicide modality as a means of understanding hyper-local risk factors. This study cross-referenced race and suicide method for 720 coroner decedents. More than half (58%) of Asian suicides are asphyxial, while 20% are firearm-related. Comparatively, 26% of White suicides are asphyxial; 35% are firearm-related. Males outnumber females at greater than 2:1 in every racial category except Asian. While the study demographic is unique, many trends confirm conventional suicide wisdom. The finding of male predominance in the White and Hispanic groups confirms long-standing clinical knowledge regarding sex-related risk for suicide. Understanding patterns unique to a locality can leverage policy and practices that reduce access to suicide means, aiding preventative efforts, and benefitting the growing field of death investigation.
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Park CHK, Lee JW, Lee SY, Moon JJ, Jeon DW, Shim SH, Cho SJ, Kim SG, Lee J, Paik JW, Kim MH, Kim S, Park JH, You S, Jeon HJ, Rhee SJ, Ahn YM. The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior: Study rationale, methodology, and baseline sample characteristics of a long-term, large-scale, multi-center, prospective, naturalistic, observational cohort study. Compr Psychiatry 2019; 88:29-38. [PMID: 30468986 DOI: 10.1016/j.comppsych.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study is a prospective, naturalistic, observational cohort study, aiming to identify predictors of suicide attempt and suicide characteristics in the Korean suicidal population. The findings intend to contribute to a thorough understanding of suicidal phenomena and development of suicide prevention guidelines. The present cross-section study examines the study rationale, methodology, and baseline characteristics of the participants. METHODS Participants were enrolled via the hospital and community gateways, establishing the hospital-based cohort (HC) and community-based cohort (CC), respectively. Baseline assessment was conducted on sociodemographic, clinical, diagnostic, and psychopathological aspects. The Columbia-Suicide Severity Rating Scale was used to investigate suicidality. RESULTS A total of 800 suicidal people aged 15 years or older were enrolled from 8 university hospitals and 8 community mental health welfare centers (CMHWCs), among whom 480 (60%) were suicidal ideators and 320 (40%) were attempters. The ideators comprised 207 CC and 273 HC participants, whereas the attempters, 34 CC and 286 HC participants. Despite their lower severity in some measures, including suicidal ideation, compared with their HC counterparts, the CC participants within each group of ideators or attempters presented clinically significant psychopathology. Moreover, alcohol use problems and past suicide attempt were more likely to be found in CC participants. Only 11.1% to 21.6% of the participants in each of the four groups (defined by the cohorts and the ideators/attempters) were on any type of psychiatric treatment. CONCLUSIONS Suicidal visitors to CMHWCs need to be as closely monitored as suicidal patients in university hospitals, especially considering their association with problem drinking and past suicide attempt. A cautious assumption is that the high suicide rate in Korea might be partly attributable to the low proportion of patients receiving psychiatric services.
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Affiliation(s)
- C Hyung Keun Park
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Jae Won Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Sang Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, 895 Muwangno, Iksan, Jeollabuk-do 54538, Republic of Korea
| | - Jung-Joon Moon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Dong-Wook Jeon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soon Chun Hyang University Cheonan Hospital, Soon Chun Hyang University, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, 21 Namdongdea-ro 774 gil, Namdong-gu, Incheon 21565, Republic of Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14584, Republic of Korea.
| | - Jeewon Lee
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do 14584, Republic of Korea
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University Medical Center, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Wonju Severance Christian Hospital, 20 Ilsan-ro, Wonju, Gangwon-do, Republic of Korea.
| | - Seokho Kim
- Department of Sociology, College of Social Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University College of Medicine, 2066 Seobu-ro, Jangan-gu, Suwon 16419, Republic of Korea
| | - Sungeun You
- Department of Psychology, College of Social Sciences, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungcheongbuk-do 28644, Republic of Korea.
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea.
| | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
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Suicide Methods According to Age and Sex: An Analysis of Data of 239,565 Suicide Victims in the Republic of Korea From 1991 to 2015. J Nerv Ment Dis 2018; 206:770-775. [PMID: 30273273 DOI: 10.1097/nmd.0000000000000889] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Because suicide is irreversible, prevention is paramount. For the optimal strategy to reduce lethal means, we sought to investigate age- and sex-associated variations in suicide methods. Data on annual causes of death from 1991 to 2015 in the Republic of Korea were used. Major sociodemographic correlates of the five suicide methods were analyzed by multiple multinominal logistic regression analysis. Among a total of 239,565 suicides from 1991 to 2015, hanging was most common. Gas poisoning sharply increased from 2007 to 2015. The gap between hanging and the second most common method of suicide has increased from 659 in 2004 to 4,433 in 2015. Charcoal burning was most commonly used by males younger than 45 years of age, whereas pesticide was commonly used by both sexes ages 55 years and older. Our results suggest that age- and sex-specific suicide prevention strategies are needed, particularly for gas and pesticide poisoning.
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Factors Affecting Suicide Method Lethality Among Suicide Attempters in the Korea National Suicide Survey. J Nerv Ment Dis 2018; 206:202-210. [PMID: 28902068 DOI: 10.1097/nmd.0000000000000735] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This is the first national survey study in South Korea investigating the relationship between suicide lethality and the clinical information of suicide attempters. An interview questionnaire was used to assess their sociodemographic factors, medical and psychiatric information, and two suicide scales, the Columbia-Suicide Severity Rating Scale and the Suicide Intent Scale. Suicide methods were categorized as low and high lethality; low lethality covered drug overdose or self-cutting behavior, and high lethality covered all other methods. High and low lethality suicide method groups were significantly different in demographic, medical, and psychiatric factors. The two scale score distributions differed significantly across two groups, and the difference was also valid for the subcategory analyses of the Suicide Intent Scale. Multiple factors such as older age, male sex, no previous psychiatric history, and previous suicide attempt, as well as high suicide intent by means of suicide scale, affect selection of suicide method of high lethality.
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Liaugaudaite V, Mickuviene N, Raskauskiene N, Naginiene R, Sher L. Lithium levels in the public drinking water supply and risk of suicide: A pilot study. J Trace Elem Med Biol 2017; 43:197-201. [PMID: 28385387 DOI: 10.1016/j.jtemb.2017.03.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 03/13/2017] [Accepted: 03/21/2017] [Indexed: 01/27/2023]
Abstract
Suicide is a major public health concern affecting both the society and family life. There are data indicating that higher level lithium intake with drinking water is associated with lower suicide rate. This pilot study examined the relationship between lithium levels in drinking water and suicide rates in Lithuania. Twenty-two samples from public drinking water systems were taken in 9 cities of Lithuania. The lithium concentration in these samples was determined by inductively coupled plasma mass spectrometry (ICP-MS). The suicide data were obtained from the Lithuania Database of Health Indicators, and comprised all registered suicides across all ages and gender within the 5-year period from 2009 to 2013. The study demonstrated an inverse correlation between levels of lithium (log natural transformed), number of women for 1000 men and standardized mortality rate for suicide among total study population. After adjusting for confounder (the number of women for 1000 men), the lithium level remained statistically significant in men, but not in women. Our study suggested that higher levels of lithium in public drinking water are associated with lower suicide rates in men. It might have a protective effect on the risk of suicide in men.
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Affiliation(s)
- Vilma Liaugaudaite
- Behavioral Medicine Institute of the Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Narseta Mickuviene
- Behavioral Medicine Institute of the Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Nijole Raskauskiene
- Behavioral Medicine Institute of the Lithuanian University of Health Sciences, Palanga, Lithuania
| | - Rima Naginiene
- Neuroscience Institute of the Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Leo Sher
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA
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