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Üzer A, Uran C, Yılmaz E, Şahin ŞN, Ersin MK, Yılmaz RH, Çıkla A. The relationship between chronotype, psychological pain, problematic social media use, and suicidality among university students in Turkey. Chronobiol Int 2024; 41:504-512. [PMID: 38373906 DOI: 10.1080/07420528.2024.2320226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/13/2024] [Indexed: 02/21/2024]
Abstract
Chronotype has been extensively linked to various psychological outcomes, including suicide, which significantly impacts the mortality rate among young adults worldwide. Research on the extent of these links is still ongoing. This cross-sectional study aimed to explore the complex relationships between chronotype, internet addiction, problematic social media use (PSMU), psychological pain, and suicidality in a student population. A total of 571 Turkish students (65.3% female, mean age 20.3 ± 1.63 years) completed the following scales: the Suicide Probability Scale (SPS), the Mee-Bunney Psychological Pain Assessment Scale (MBPPAS), the Social Media Disorder Scale (SMDS), the Internet Addiction Test (IAT), the Morningness - Eveningness Questionnaire (MEQ), and the Hospital Anxiety and Depression Scale (HADS). The results showed that the relationship between chronotype and suicidality was partially mediated by SMDS and MBPPAS but not by anxiety, depression, or IAT. These findings suggest that psychological pain and PSMU may be important factors that contribute to suicidality in evening-type individuals. These findings have significant implications for the development of interventions aimed at reducing suicidality among evening-type individuals. By addressing the underlying factors of psychological pain and PSMU, it may be possible to mitigate the increased risk of suicidality among this population.
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Affiliation(s)
- Ahmet Üzer
- Faculty of Medicine, Department of Psychiatry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ceren Uran
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Elif Yılmaz
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Şeima Nur Şahin
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Muhammet Kaan Ersin
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Rohat Hasret Yılmaz
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ayça Çıkla
- Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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de la Torre-Luque A, Essau CA, Lara E, Leal-Leturia I, Borges G. Childhood emotional dysregulation paths for suicide-related behaviour engagement in adolescence. Eur Child Adolesc Psychiatry 2023; 32:2581-2592. [PMID: 36418505 DOI: 10.1007/s00787-022-02111-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 11/13/2022] [Indexed: 11/24/2022]
Abstract
This study aimed at identifying the heterogeneous trajectories of emotional dysregulation across childhood and to study the relationship between specific trajectories and adolescent suicide-related behaviour (SRB). Data from the Millennium Cohort Study (N = 13,853 children; 49.07% female, M = 3.13 years at baseline, SD = 0.2) were used to identify the emotional dysregulation trajectories from 3 to 8 years old, using growth mixture modelling. Moreover, 1992 participants (52.86% female) from the initial sample were used to study the relationship between childhood emotional dysregulation trajectory and engagement in both self-harm and suicide attempt at age 17, using logistic regression. Some other time-invariant and proximal (adolescent) risk factors were incorporated into this analysis. Six emotional dysregulation trajectories were identified. Self-harm at age 17 was significantly associated with the history of self-harm and other proximal factors, but not with emotional dysregulation trajectory membership. Childhood trajectories featured by earlier emotional dysregulation were associated with higher risk of lifetime suicide attempt, as well as other proximal factors (concurrent self-harm). This study found differential risk profiles involved in both SRB forms. A relationship between early emotional dysregulation and suicide attempt engagement in adolescence was identified. Early interventions should be developed to deal with SRB risk factors from childhood.
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Affiliation(s)
- Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Centre for Biomedical Research in Mental Health (CIBERSAM)School of Medicine, Universidad Complutense de Madrid, 2 Seneca Avenue, 28046, Madrid, Spain.
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.
| | | | - Elvira Lara
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
| | - Itziar Leal-Leturia
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
- Department of Psychiatry, Instituto de Investigacion Sanitaria Princesa (IIS-IP), Madrid, Spain
| | - Guilherme Borges
- Instituto Nacional de Psiquiatria Ramon de la Fuente Muñiz, Mexico City, Mexico
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Hermosillo-de-la-Torre AE, Arteaga-de-Luna SM, Arenas-Landgrave P, González-Forteza C, Acevedo-Rojas DL, Martínez KI, Rivera-Heredia ME. DBT-PAHSE Intervention for Reduce Emotion Dysregulation and Suicide Behavior in Mexican Early Adolescents: A Longitudinal Study. Healthcare (Basel) 2023; 11:healthcare11091311. [PMID: 37174853 PMCID: PMC10177943 DOI: 10.3390/healthcare11091311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
This study aimed to evaluate the effect of time on suicidal behavior, associated risk factors, and protective factors in early Mexican adolescents. Method: With a two-year longitudinal design, which included 18 of 34 adolescents who had previously participated in a DBT skills training program (DBT-PAHSE). The study evaluated ideation, suicide attempt, depression, emotional dysregulation, and psychological resources. Results: We observed differentiating significant differences over time in emotional dysregulation (F = 2.36 p = 0.04, η2= 0.12, β = 0.72), affective resources (F = 3.94, p = 0.01, η2 = 0.18, β = 0.82), and suicidal ideation. (F = 2.55, p = 0.03, η2= 0.13, β = 0.77). In conclusion, the DBT-PAHSE program prevented deaths by suicide. It showed a reduction in emotional dysregulation up to two years after the end of treatment and maintained an increase in emotional and social resources. However, improvements are required to reduce depression over time and strengthen psychological resources.
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Affiliation(s)
- Alicia E Hermosillo-de-la-Torre
- Psychology Department, Center for Social Sciences and Humanities of The Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico
| | - Stephania M Arteaga-de-Luna
- Psychology Department, Center for Social Sciences and Humanities of The Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico
| | | | | | - Denise L Acevedo-Rojas
- Psychology Department, Center for Social Sciences and Humanities of The Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico
| | - Kalina I Martínez
- Psychology Department, Center for Social Sciences and Humanities of The Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico
| | - María E Rivera-Heredia
- Psychology Faculty, Michoacan University of San Nicolás de Hidalgo, Morelia 58110, Mexico
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Gonda X, Dome P, Serafini G, Pompili M. How to save a life: From neurobiological underpinnings to psychopharmacotherapies in the prevention of suicide. Pharmacol Ther 2023; 244:108390. [PMID: 36940791 DOI: 10.1016/j.pharmthera.2023.108390] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/10/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
The impact of suicide on our societies, mental healthcare, and public health is beyond questionable. Every year approximately 700 000 lives are lost due to suicide around the world (WHO, 2021); more people die by suicide than by homicide and war. Although suicide is a key issue and reducing suicide mortality is a global imperative, suicide is a highly complex biopsychosocial phenomenon, and in spite of several suicidal models developed in recent years and a high number of suicide risk factors identified, we still have neither a sufficient understanding of underpinnings of suicide nor adequate management strategies to reduce its prevalence. The present paper first overviews the background of suicidal behavior including its epidemiology, prevalence, age and gender correlations and its association with neuropsychiatric disorders as well as its clinical assessment. Then we give an overview of the etiological background, including its biopsychosocial contexts, genetics and neurobiology. Based on the above, we then provide a critical overview of the currently available intervention options to manage and reduce risk of suicide, including psychotherapeutic modalities, traditional medication classes also providing an up-to-date overview on the antisuicidal effects of lithium, as well as novel molecules such as esketamine and emerging medications and further molecules in development. Finally we give a critical overview on our current knowledge on using neuromodulatory and biological therapies, such as ECT, rTMS, tDCS and other options.
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Affiliation(s)
- Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary.
| | - Peter Dome
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Chen J, Zhang Y, Cheng F, Xie J, Zhang K, Hu D. Symptom distress and suicidal ideation among Chinese ovarian cancer patients: A moderated mediation model of depression and suicide resilience. Front Psychol 2023; 14:1073995. [PMID: 36895757 PMCID: PMC9989189 DOI: 10.3389/fpsyg.2023.1073995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/03/2023] [Indexed: 02/25/2023] Open
Abstract
Objective The aim of this study was to examine whether depression mediates the relationship between symptom distress and suicidal ideation in Chinese patients with ovarian cancer, and whether this mediating effect was moderated by suicide resilience. Methods From March to October 2022, this cross-sectional study was performed in a three Grade 3A hospital and an oncology specialty hospital in Wuhan, Hubei Province, China. Ultimately, 213 ovarian cancer patients completed anonymous self-report. Bootstrapping method was used for regression analysis to test the mediating and moderating effects. Results Among the 213 participants, 29.58% (n = 63) exhibited significant suicidal ideation. Symptom distress was positively associated with suicidal ideation, and depression partially mediated this relationship. Suicide resilience moderated the relationship between depression and suicidal ideation. In ovarian cancer patients with low suicide resilience, the effect of symptom distress on suicidal ideation through depression was greater, while in patients with high suicide resilience, this effect was attenuated. Conclusion Our study suggests that symptom distress could be more likely to lead to suicidal ideation as depression levels increase in ovarian cancer patients. Fortunately, suicide resilience could attenuate this negative effect.
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Affiliation(s)
- Jie Chen
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yinying Zhang
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Cheng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinzhi Xie
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Keke Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Kanner AM. Suicidality in Patients With Epilepsy: Why Should Neurologists Care? Front Integr Neurosci 2022; 16:898547. [PMID: 35712347 PMCID: PMC9196893 DOI: 10.3389/fnint.2022.898547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/30/2022] [Indexed: 11/26/2022] Open
Abstract
Suicidality is a relatively common comorbidity in patients with epilepsy (PWE). Population-based studies have revealed lifetime prevalence rates of 25% of suicidal ideation (SI). In addition, PWE without comorbid psychiatric disorders has two to three higher risk of committing suicide and this risk increases by 12- to 32-fold in the presence of various psychiatric disorders. Risk factors are multiple and include socio-demographic, genetic, age and gender, and psychiatric comorbidities. Among the latter, mood, anxiety, and psychotic disorders have been found to be common risk factors for suicidality in PWE, but iatrogenic causes resulting from pharmacotherapy with antiseizure drugs or epilepsy surgery can also cause SI and behavior. Suicidality and epilepsy have a complex bidirectional relation, whereas PWE are at increased risk of suicidality and vice-versa. Common pathogenic mechanisms operant in both conditions may explain this bidirectional relation. SI can be easily identified in outpatient epilepsy clinics with screening instruments and can be treated and thus prevent its escalation to suicidal attempts and completed suicide. The aim of this manuscript is to review these data in detail.
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Ligier F, Body Lawson F, Lamourette M, Giguère CE, Lesage A, Séguin M. Comparing Childhood Characteristics of Adopted and Non-adopted Individuals Deceased by Suicide. Front Psychiatry 2022; 13:756306. [PMID: 35722592 PMCID: PMC9203736 DOI: 10.3389/fpsyt.2022.756306] [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: 08/10/2021] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Across the globe more than 35,000 children a year are adopted by non-relatives, and some studies suggest that adopted individuals may be more vulnerable to developing mental disorders. To map the differences in suicide risk factors in adopted and non-adopted individuals, this study will compare the development of mental disorders as well as life events occurring before the age of 18 for both adopted and non-adopted individuals deceased by suicide. METHODS This study included 13 adopted and 26 non-adopted individuals deceased by suicide as well as 26 non-adopted living control individuals. Cases were taken from a data bank created over the last decade by researchers of [our institution] comprising a mixture of 700 suicide cases and living control individuals aged from 14 to 84. Adopted and non-adopted individuals deceased by suicide; adopted individuals deceased by suicide and non-adopted living control individuals were each compared on Axis I and II disorders, early life events, and burdens of adversity. RESULTS Results show significant differences, with a higher rate of Attention Deficit Hyperactivity Disorder, mental health comorbidity and Cluster C personality disorders among adopted individuals. Furthermore, adopted individuals have higher adversity scores prior to the age of 15. CONCLUSION This study underlines the fact that adoptive families need to be supported throughout adoption. Health care professionals need specialized training on this matter, and the psychological challenges adopted individuals face need to be treated at the earliest juncture.
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Affiliation(s)
- Fabienne Ligier
- McGill Group on Suicide Studies, Montréal, QC, Canada.,Psychiatry Department, Montréal University, Montréal, QC, Canada.,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,EA 4360 APEMAC, Université de Lorraine, Nancy, France.,PUPEA, Centre Psychothérapique de Nancy, Laxou, France
| | | | | | - Charles-Edouard Giguère
- Banque Signature, Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Alain Lesage
- McGill Group on Suicide Studies, Montréal, QC, Canada.,Psychiatry Department, Montréal University, Montréal, QC, Canada.,Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,Québec Network on Suicide Research, Québec, QC, Canada
| | - Monique Séguin
- McGill Group on Suicide Studies, Montréal, QC, Canada.,Québec Network on Suicide Research, Québec, QC, Canada.,Department of Psychoeducation and Psychology, Québec University, Québec, QC, Canada.,Centre Intégré de Santé et Service Social de l'Outaouais (CISSSO), Gatineau, QC, Canada
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Decision-making and cognitive control in adolescent suicidal behaviors: a qualitative systematic review of the literature. Eur Child Adolesc Psychiatry 2021; 30:1839-1855. [PMID: 32388626 DOI: 10.1007/s00787-020-01550-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 04/28/2020] [Indexed: 12/12/2022]
Abstract
Suicide and suicidal behaviors represent a leading cause of morbidity and mortality during adolescence. While several lines of evidence suggest that suicidal behaviors are associated with risky decisions and deficient cognitive control in laboratory tasks in adults, comparatively less is known about adolescents. Here, we systematically reviewed the literature on the association between these neurocognitive variables and adolescent suicidal behaviors. The online search strategy identified 17 neurocognitive studies examining either cognitive control or decision-making processes in adolescents with past suicidal behaviors. Several studies have reported that adolescents with a history of suicidal behaviors present neuropsychological differences in the cognitive control (using Go/NoGo, suicide Stroop Test, continuous performance test, suicide/death Implicit Association Test), and decision-making (Iowa Gambling Task, Cambridge Gambling Task, cost computation, delay discounting, loss aversion tasks) domains. Due to a lack of replication or conflicting findings, our systematic review suggests that no firm conclusion can be drawn as to whether altered decision-making or poor cognitive control contribute to adolescent suicidal behaviors. However, these results collectively suggest that further research is warranted. Limitations included scarcity of longitudinal studies and a lack of homogeneity in study designs, which precluded quantitative analysis. We propose remediating ways to continue neuropsychological investigations of suicide risk in adolescence, which could lead to the identification of novel therapeutic targets and predictive markers, enabling early intervention in suicidal youth.
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Lombardo F, Daly M. Analyzing suicide life stories on Wikipedia with Highway_star and other textual visualization tools. SN SOCIAL SCIENCES 2021; 1:268. [PMID: 34729497 PMCID: PMC8553402 DOI: 10.1007/s43545-021-00272-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/05/2021] [Indexed: 11/29/2022]
Abstract
Being responsible for a death every 40s, suicide is a major public health concern (Brunier et al. 2019). Even if many of its risk factors are social (Van Orden et al. 2010), there are surprisingly few qualitative sociological studies about the phenomenon. This study aim is to provide a life-story sociological analysis of suicidal trajectories. Two challenges are identified: gathering suicidal narrative and maintaining a quantitative foreground in order to deepen and rationalize the interpretation of data. They are both faced using a self-made, free to use, open access, algorithm: Highway_star (https://github.com/matheo-daly/highway_star). Two corpora of Wikipedia biographies of people who died by suicide in the 1920s (N = 82) and 2020s (N = 49) are gathered. Following an application of Fritze Schütze's methodology (Schütze, 2014), classical textual visualizations are produced. A Hierarchical Descending Classification, a Factorial Correspondence Analysis and a Similarity Analysis reveal five narration categories centered around different topics: cinema, death, family, poetry and politics. As none of those visualizations focuses on the developmental aspect of the biography, they offer limited interest for a life-story investigation. The second functionality of the Highway_star tool, which represents a narrative's unfolding with a Sankey Diagram, allows completing the analysis. It shows interesting differences between decades or gender. An example of the last being that men narratives tend to be more complex and achievement focused, while the women ones are more linear and family centered. The study's range has limitations. A major one is related to the corpus and the inability to identify clearly which parts of the narratives are associated to fame and which to suicide. Another one is linked to the Highway_star tool that sometimes lack of flexibility.
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Séguin M, Beauchamp G, Notredame CÉ. Adversity Over the Life Course: A Comparison Between Women and Men Who Died by Suicide. Front Psychiatry 2021; 12:682637. [PMID: 34447322 PMCID: PMC8382958 DOI: 10.3389/fpsyt.2021.682637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study sets out to compare the presence of life events across different domains throughout the life course which may contribute to the burden of adversity experienced differently among men and women who died by suicide. Method: In a sample of 303 individuals (213 men and 90 women), data was derived from extensive clinical interviews conducted with informants. Models allowed the identification of patterns of life trajectories. Results: Overall, the burden of adversity was similar across the life course except for the 5-9, 25-29, and 30-34 age ranges, where a significant difference appeared between genders [t-test = 2.13 (p < 0.05), 2.16 (p < 0.05) and 3.08 (p < 0.005), respectively] that seems to disadvantage women. The early adversities of violence and neglect, between 0 and 19 years old, are important for both groups. During the life course, women were more exposed to interpersonal adverse events such as being victims of negligence and violence, relational difficulties or abuse from their spouse, as well as tension with their own children. Men encountered more academic difficulties, legal entanglements and financial difficulties, and were more than three times more likely to develop an alcohol/drug abuse problem than women. Conclusions: The data suggests some gender differences in exposure to longstanding and severe life problems contributing to suicide vulnerability. For women, the continuing burden emerges from chronic interpersonal adversities, whereas, for men, the adverse events are to a larger degree socially exposed, compounded with alcohol misuse. The adversities, especially those of a public or social nature, may be witnessed by others, which should favor the detection of vulnerability over the life course, and psychosocial or mental health services should be offered and provided earlier during the life course. Yet more men die by suicide than women. Resiliency and protective factors may benefit women to a greater degree. Future research should tackle the challenge of investigating these important elements. Meanwhile, from a public health perspective, access to psychosocial and mental health services and social acceptability of seeking services should be part of an ongoing effort in all institutional structures as a way of decreasing downstream mental health problems and vulnerability to suicide.
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Affiliation(s)
- Monique Séguin
- Department of Psychology, University of Quebec in Outaouais, Gatineau, QC, Canada
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montreal, QC, Canada
- Réseau Québécois sur le Suicide, les Troubles de l'humeur et les Troubles Associés (RQSHA), Montreal, QC, Canada
| | - Guy Beauchamp
- Réseau Québécois sur le Suicide, les Troubles de l'humeur et les Troubles Associés (RQSHA), Montreal, QC, Canada
| | - Charles-Édouard Notredame
- Réseau Québécois sur le Suicide, les Troubles de l'humeur et les Troubles Associés (RQSHA), Montreal, QC, Canada
- INSERM UMR1172 Lille Neurosciences et Cognition, Nord-Pas-de-Calais, Lille, France
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Suicidal ideation and attempt in adolescents exposed to maternal smoking across pregnancy and childhood: A 20-year prospective cohort study. J Affect Disord 2021; 286:10-18. [PMID: 33652357 DOI: 10.1016/j.jad.2021.02.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Few studies investigated the association between maternal smoking during pregnancy and offspring suicide risk, none considering postnatal smoking exposure. We investigated associations between maternal smoking patterns during the pre- and postnatal periods and adolescent suicidal ideation and attempt. METHODS We identified longitudinal patterns of maternal smoking from the prenatal period to the end of childhood (children's age 12 years, 10 assessments) among participants in the Québec Longitudinal Study of Child Development (N = 1623). We estimated associations between maternal smoking patterns and offspring self-reported suicidal ideation and attempt (ages 13-20). Background confounding factors (e.g., socioeconomic, familial, mental health) were controlled using propensity score inverse-probability weighting (IPW). RESULTS Participants reporting suicidal ideation and attempt were 9.3% and 8.4%, respectively. We identified four maternal smoking patterns: non-smoking (66.5%), increasing (5.5%), decreasing (9.3%), persistent (18.5%). Children exposed to persistent (OR=2.92, CI=1.99-4.30) and increasing (OR=2.06, CI=1.13-3.74) maternal smoking were more likely to attempt suicide, compared to non-exposed children. Accounting for confounding factors using IPW fully explained the association between increasing smoking and suicide attempt (OR=0.95, CI=0.39-2.09) but only reduced the association between persistent exposure and suicide attempt (OR=2.30, CI=1.04-4.99). No increased suicide attempt risk was found for children of mothers with a decreased smoking pattern. We found no associations for suicidal ideation. LIMITATIONS Propensity score cannot account for unmeasured confounding factors; attrition limits generalizability. CONCLUSIONS Offspring of mothers who smoked persistently and heavily prenatally and postnatally were at increased risk of suicide attempt in adolescence. Future studies should elucidate biological and psychosocial mechanisms potentially at play in these associations.
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The Impact of a Harry Potter-Based Cognitive-Behavioral Therapy Skills Curriculum on Suicidality and Well-being in Middle Schoolers: A Randomized Controlled Trial. J Affect Disord 2021; 286:134-141. [PMID: 33721740 DOI: 10.1016/j.jad.2021.02.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/20/2021] [Accepted: 02/07/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the impact of a Harry Potter-based mental health literacy curriculum, imparting cognitive behavioral therapy (CBT) skills, on suicidality and well-being in middle-schoolers. METHODS Students (aged 11-14; grades 7-8) who received a 3-month teacher-delivered intervention embedded in the language arts curriculum (N=200) were compared to a wait-list control group (N=230) in the largest urban school board in Canada. Suicidality defined as a composite measure of self-reported suicidal ideation and attempts [primary outcome], self-reported emotion dysregulation, interpersonal chaos, confusion about self, and impulsivity [Life Problems Inventory (LPI)] and self-reported depression and anxiety symptoms [Revised Child Anxiety and Depression Scale (RCADS)] were the outcomes of interest. Measurements occurred prior to and after curriculum delivery with independent t-tests used to compare mean change scores between groups clustered by class. RESULTS Thirty-seven English teachers in 46 classes across 15 schools comprised the planned study cohort. Composite suicidality scores were significantly worse in the control than intervention group at endpoint (0.05±0.54 vs. 0.17±0.47, t= -2.60, df=428, p=0.01). There were also significant improvements in LPI and RCADS scores in the intervention group compared to controls (LPI:-3.74±7.98 vs. 1.16±10.77 t=5.28, df=428, p<.001; RCADS: (-3.08±5.49 vs. -1.51±6.53 t=2.96, df=429, p=0.01). Sub-analyses revealed that these improvements were largely driven by a significant difference in scores in girls. LIMITATIONS Sample size constraints as study terminated prematurely during COVID pandemic. CONCLUSIONS This study demonstrates significant improvement in suicidality, emotional regulation, self-concept, interpersonal difficulties, depression and anxiety in youth, particularly girls following this intervention. Replication studies in larger samples are needed to confirm these results.
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Eloir J, Ducro C, Nandrino JL. Using Life Trajectories Analysis to Characterize Suicide Attempts in Prison. CRISIS 2021; 43:361-367. [PMID: 33890827 DOI: 10.1027/0227-5910/a000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Suicide in prison is a major problem and several risk factors have been identified in the literature (e.g., period of incarceration, depressive disorders). Aims: The study examined the impact of several risk factors for suicide attempts before and during incarceration using life trajectory analysis of inmates by interviews with informants. Method: The lifetime of inmates with a history of suicide attempts (ISA; n = 20) or without (IWSA; n = 29) was recounted on a life chart according to four main domains (health, life events, relationships, and judiciary domain) organized in two different periods (predetention and current detention). Life charts were compared between the two groups and a predictive model of suicide risk was constructed using logistic regression and receiving operating characteristic curve analysis. Results: Before detention, more depressive experiences were observed in ISA than in IWSA, and ISA reported more behavioral disorders than IWSA during current detention. Moreover, the total burden for ISA was greater than that for IWSA. The predictive model identified three dimensions for differentiating ISA from IWSA: mood disorders before detention, behavioral disorders, and the quality of relationships with nuclear family during detention. Limitations: Interviews with inmates would have been informative. Conclusion: The accumulation of life events and behavioral manifestations should be incorporated in the developmental trajectory as a therapeutic model regarding suicide in prison.
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Affiliation(s)
- Julien Eloir
- SCALab - Cognitive and Affective Sciences Laboratory, University of Lille, Villeneuve d'Ascq, France.,Medical Unit of Bapaume Prison, Hospital Center of Arras, France
| | - Claire Ducro
- SCALab - Cognitive and Affective Sciences Laboratory, University of Lille, Villeneuve d'Ascq, France
| | - Jean-Louis Nandrino
- SCALab - Cognitive and Affective Sciences Laboratory, University of Lille, Villeneuve d'Ascq, France
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Filipe AM, Lloyd S, Larivée A. Troubling Neurobiological Vulnerability: Psychiatric Risk and the Adverse Milieu in Environmental Epigenetics Research. FRONTIERS IN SOCIOLOGY 2021; 6:635986. [PMID: 33912612 PMCID: PMC8072338 DOI: 10.3389/fsoc.2021.635986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
In post-genomic science, the development of etiological models of neurobiological vulnerability to psychiatric risk has expanded exponentially in recent decades, particularly since the neuromolecular and biosocial turns in basic research. Among this research is that of McGill Group for Suicide Studies (MGSS) whose work centers on the identification of major risk factors and epigenetic traits that help to identify a specific profile of vulnerability to psychiatric conditions (e.g., depression) and predict high-risk behaviors (e.g., suicidality). Although the MGSS has attracted attention for its environmental epigenetic models of suicide risk over the years and the translation of findings from rodent studies into human populations, its overall agenda includes multiple research axes, ranging from retrospective studies to clinical and epidemiological research. Common to these research axes is a concern with the long-term effects of adverse experiences on maladaptive trajectories and negative mental health outcomes. As these findings converge with post-genomic understandings of health and also translate into new orientations in global public health, our article queries the ways in which neurobiological vulnerability is traced, measured, and profiled in environmental epigenetics and in the MGSS research. Inspired by the philosophy of Georges Canguilhem and by literature from the social studies of risk and critical public health, we explore how the epigenetic models of neurobiological vulnerability tie into a particular way of thinking about the normal, the pathological, and the milieu in terms of risk. Through this exploration, we examine how early life adversity (ELA) and neurobiological vulnerability are localized and materialized in those emerging models while also considering their broader conceptual and translational implications in the contexts of mental health and global public health interventions. In particular, we consider how narratives of maladaptive trajectories and vulnerable selves who are at risk of harm might stand in as a "new pathological" with healthy trajectories and resilient selves being potentially equated with a "new normal" way of living in the face of adversity. By troubling neurobiological vulnerability as a universal biosocial condition, we suggest that an ecosocial perspective may help us to think differently about the dynamics of mental health and distress in the adverse milieu.
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Affiliation(s)
- Angela Marques Filipe
- Department of Sociology and Centre for Research on Children & Families, McGill University, Montréal, QC, Canada
- Centre for Biomedicine, Self & Society, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Stephanie Lloyd
- Department of Anthropology, Université Laval, Québec, QC, Canada
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Affleck W, Chawky N, Beauchamp G, Inukpuk MM, Annanack E, Paradis V, Séguin M. Suicides in Nunavik: a life course study. Int J Circumpolar Health 2021; 80:1880143. [PMID: 33691591 PMCID: PMC7954501 DOI: 10.1080/22423982.2021.1880143] [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] [Indexed: 11/03/2022] Open
Abstract
This study reports results of a life course study conducted with Inuit in Nunavik to obtain information on the life adversities and cumulative burden of adversity for three groups: those who died by suicide, those who attempted suicide, and those who experienced suicidal ideation but never attempted. The study involved different levels of collaboration between health authorities, front-line health workers and the research team. Results indicate that substance misuse and relational difficulties are most associated with the burden of adversity for those people who died by suicide, while bullying is most associated with the burden of adversity for those people who have made suicide attempts and those who have never made a suicide attempt. Specifically targeting parent–child relations, substance misuse, and bullying may be an important upstream strategy for reducing future suicidality in Nunavik.
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Affiliation(s)
- William Affleck
- Department of Psychology and Psycho-education, Institut Universitaire En Santé Mentale Douglas, Montreal, Canada.,Université Du Québec En Outaouais (UQO), Gatineau, Canada
| | - Nadia Chawky
- Department of Psychology and Psycho-education, Institut Universitaire En Santé Mentale Douglas, Montreal, Canada
| | - Guy Beauchamp
- Université Du Québec En Outaouais (UQO), Gatineau, Canada
| | - Martha Malaya Inukpuk
- Sungirtuivik Family House, Inukjuaq, Canada.,Nunavik Regional Board of Health and Social Services, Kuujuaq, Canada
| | | | - Véronique Paradis
- Nunavik Regional Board of Health and Social Services, Kuujuaq, Canada
| | - Monique Séguin
- Department of Psychology and Psycho-education, Institut Universitaire En Santé Mentale Douglas, Montreal, Canada.,Université Du Québec En Outaouais (UQO), Gatineau, Canada
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16
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Fu X, Yang J, Liao X, Shen Y, Ou J, Li Y, Chen R. Parents' and medical staff's experience of adolescents with suicide-related behaviors admitted to a general hospital in China: qualitative study. BMC Psychiatry 2021; 21:62. [PMID: 33509152 PMCID: PMC7845109 DOI: 10.1186/s12888-021-03057-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 01/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Currently, there is increasing awareness of suicide-related behaviors. Mental health services are a key location for assisting people with suicide-related behaviors. However, few studies focused on the evaluation and experience of the mental health care system from families and the medical staff's perspective in China. The study aims to explore parents' and the front-line medical staff's experience of an adolescent with suicide-related behaviors admitted to the psychiatry department of a general hospital in China. DESIGN Qualitative study was employed in the study. Participants were recruited from a general hospital in China characterized by high levels in the Chinese mental health system. METHODS Semi-structured in-depth interviews were conducted exploring their experience and perceptions when an adolescent was admitted to the hospital. The theme analysis method is used for data analysis. RESULTS Participants expressed dissatisfaction in the psychiatric department. Other barriers in their work were identified, such as the shortage of staff and difficulties in caring or communicating with patients. Besides, the imperfect treatment system also contributes to the low satisfaction of patients and their families. Two themes and six subthemes were identified: 1) staff perceive patients with SRBs as difficult to engage (feelings of helplessness, the need for compassion, challenges of professional self-efficacy, the recommendations to the health care service); 2) parents not satisfied with the existing hospital services (doubt the hospitalization treatment and the advice to the health care service). CONCLUSION This study found that insufficient staffing and lacking of systematic professional treatment models are the major challenges. We suggest increasing the input of mental health resources to expand and train the mental health service team and establish a complete set of a treatment model for SRBs.
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Affiliation(s)
- Xi Fu
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- XiangYa Nursing School, Central South University, Changsha, 410011, Hunan, China
| | - Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- XiangYa Nursing School, Central South University, Changsha, 410011, Hunan, China
| | - Xiaoli Liao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
- XiangYa Nursing School, Central South University, Changsha, 410011, Hunan, China
| | - Yidong Shen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Jianjun Ou
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
- XiangYa Nursing School, Central South University, Changsha, 410011, Hunan, China.
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
- XiangYa Nursing School, Central South University, Changsha, 410011, Hunan, China.
| | - Runsen Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, and China National Technology Institute on Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
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Auerbach RP, Pagliaccio D, Allison GO, Alqueza KL, Alonso MF. Neural Correlates Associated With Suicide and Nonsuicidal Self-injury in Youth. Biol Psychiatry 2021; 89:119-133. [PMID: 32782140 PMCID: PMC7726029 DOI: 10.1016/j.biopsych.2020.06.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 12/23/2022]
Abstract
There is no definitive neural marker of suicidal thoughts and behaviors (STBs) or nonsuicidal self-injury (NSSI), and relative to adults, research in youth is more limited. This comprehensive review focuses on magnetic resonance imaging studies reporting structural and functional neural correlates of STBs and NSSI in youth to 1) elucidate shared and independent neural alternations, 2) clarify how developmental processes may interact with neural alterations to confer risk, and 3) provide recommendations based on convergence across studies. Forty-seven articles were reviewed (STBs = 27; NSSI = 20), and notably, 63% of STB articles and 45% of NSSI articles were published in the previous 3 years. Structural magnetic resonance imaging research suggests reduced volume in the ventral prefrontal and orbitofrontal cortices among youth reporting STBs, and there is reduced anterior cingulate cortex volume related to STBs and NSSI. With regard to functional alterations, blunted striatal activation may characterize STB and NSSI youth, and there is reduced frontolimbic task-based connectivity in suicide ideators and attempters. Resting-state functional connectivity findings highlight reduced positive connectivity between the default mode network and salience network in attempters and show that self-injurers exhibit frontolimbic alterations. Together, suicidal and nonsuicidal behaviors are related to top-down and bottom-up neural alterations, which may compromise approach, avoidance, and regulatory systems. Future longitudinal research with larger and well-characterized samples, especially those integrating ambulatory stress assessments, will be well positioned to identify novel targets that may improve early identification and treatment for youth with STBs and NSSI.
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Affiliation(s)
- Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA,Division of Clinical Developmental Neuroscience, Sackler Institute, New York, New York, USA, Corresponding author: 1051 Riverside Drive, Pardes 2407, New York, NY 10032;
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Grace O. Allison
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Kira L. Alqueza
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Maria Fernanda Alonso
- Department of Psychiatry, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
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Lunde KB, Mehlum L, Melle I, Qin P. Deliberate self-harm and associated risk factors in young adults: the importance of education attainment and sick leave. Soc Psychiatry Psychiatr Epidemiol 2021; 56:153-164. [PMID: 32556378 PMCID: PMC7847451 DOI: 10.1007/s00127-020-01893-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/09/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE The prevalence of deliberate self-harm (DSH) is high in young adults. However, few studies have examined risk in this specific age group. We, therefore, examined the relative influence and interactive nature of a wide range of potential sociodemographic and sick leave related risk factors in young adults, aged 18-35 years, using Norwegian register data. METHODS All subjects with at least one episode of hospital presentation for DSH registered in the Norwegian Patient Register during the period 2008-2013 were compared with age, gender and date matched population controls using a nested case-control design. The relative influence of factors and their interactions were assessed using conditional logistic regression and recursive partitioning models. RESULTS 9 873 study cases were compared to 186 092 controls. Socioeconomic status, marital status, sick leave and several demographic factors influenced risk for DSH. Specifically, low education (OR 7.44, 95% CI 6.82-8.12), current sick leave due to psychiatric disorders (OR 18.25, 95% CI 14.97-22.25) and being previously married (OR 3.83, 95% CI 3.37-4.36) showed the highest effect sizes. Importantly, there was an interaction between education and sick leave, where those with either low education and no sick leave (OR 13.33, 95% CI 11.66-15.23) or high education and sick leave (OR 18. 87, 95% CI 17.41-24.21) were the subgroups at highest risk. CONCLUSION DSH in young adults is associated with multiple sociodemographic and health disadvantages. Importantly, the two high-risk subgroups imply different pathways of risk and a need for differentiated preventative efforts.
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Affiliation(s)
- Ketil Berge Lunde
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Lars Mehlum
- grid.5510.10000 0004 1936 8921National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- grid.5510.10000 0004 1936 8921NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ping Qin
- grid.5510.10000 0004 1936 8921National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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19
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The Classification of the Persistent Infection Risk for Human Papillomavirus among HIV-Negative Men Who Have Sex with Men: Trajectory Model Analysis. BIOMED RESEARCH INTERNATIONAL 2020. [DOI: 10.1155/2020/8174983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. To classify the infection risk of human papillomavirus (HPV) among human immunodeficiency virus- (HIV-) negative men who have sex with men (MSM) using group-based trajectory modeling (GBTM). Methods. This study collected data on demographic and sexual behavior characteristics by questionnaires at semiannual visits from March 1st, 2016 to December 31th, 2017. Researchers collected anal exfoliated cells to finish HPV testing and blood samples to finish HIV testing at baseline and follow-up visits. Accumulative infection numbers of different types of HPV as the primary outcome and the follow-up visits as the independent predicator to build a GBTM model. Results. There were 500 potentially eligible HIV-negative participants at baseline, 361 (72.2%) of whom were included in this study after screening. Three trajectory groups were identified as the best-fitted GBTM model. Trajectory 1, defined as decreased group (DG) accounted for 44.6% (161/361) of the sample, showed a declining pattern with visits. Trajectory 2, defined as flat group (FG) accounted for 49.6% (179/361) of the sample, showed a flat pattern with visits. Trajectory 3, regarded as the increased group (IG) accounted for 5.8% (21/361) of the sample, showed an uptrend. Compared to the DG, risk factors for the FG included receptive anal intercourse (AOR, 2.24; 95% CI, 1.36-3.71), occasional condom use in anal sex during the past six months (AOR, 1.90; 95% CI, 1.16-3.14), experience of transactional sex with males in the past year (AOR, 3.60; 95% CI, 1.12-11.54), and substance use (AOR, 1.81; 95% CI, 1.08-3.04). Risk factors for the IG included receptive anal intercourse (AOR, 2.81; 95% CI, 1.04-7.70), occasional condom use in anal sex during the past six months (AOR, 3.93; 95% CI, 1.40-11.01), and history of other STIs (AOR, 5.72; 95% CI, 1.40-23.46). Conclusion. The MSM data in this study showed three distinct developmental trajectories (DG, FG, and IG) of HPV infection among HIV-negative MSM, with receptive anal intercourse and occasional condom use in anal sex during the past six months being the risk factors associated with FG and IG.
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Notredame CE, Chawky N, Beauchamp G, Vaiva G, Séguin M. The Role of Adolescence in Development Paths Toward Suicide: Specificities and Shaping of Adversity Trajectories. Front Psychiatry 2020; 11:557131. [PMID: 33192671 PMCID: PMC7661797 DOI: 10.3389/fpsyt.2020.557131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/14/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose: Adolescence is a key period of transitions in the psychological, cognitive, neurobiological and relational domains, which is associated to high susceptibility to adverse life experiences. However, the way adolescent development alters life paths toward suicide remains unclear. Thereby, we aimed at testing whether and how adolescence interfered with the adversity trajectories of individuals who died by suicide. Methods: In a sample of 303 individuals who died by suicide, longitudinal Burden of Adversity ratings were derived from extensive psychological autopsies and life trajectory narrative interviews conducted with informants. Piecewise Joint Latent Class Models allowed the identification of patterns of adversity trajectories and tested the introduction of breakpoints in life-paths. Classes inferred from the optimal model were compared in terms of socio-demographics, psychopathology, and rate of different adverse life events. Results: The most accurate model derived 2 trajectory patterns with a breakpoint in early adolescence. In the first class (n = 39), the burden of adversity increased steadily from birth to death, which occurred at 23 (SE = 1.29). In the second class (n = 264), where individuals died at 43 years of age (SE = 0.96), the burden of adversity followed a similar trajectory during infancy but stabilized between 10 and 14 years and started to increase again at about 25. Childhood family instability, dependent events, exposure to suicide, intra-family sexual victimization and affective disorders at death were more frequent in class 1. Conclusions: A bifurcation in trajectories between early and late suicides occurs during adolescence. The dynamic pattern of adversity during this period is a key issue to understand the developmental heterogeneity in suicide risk.
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Affiliation(s)
- Charles-Edouard Notredame
- Psychiatry Department, CHU Lille, Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, Lille, France
- Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France
- Réseau Québécois sur le suicide, les troubles de l'humeur et les troubles associés, Douglas University Mental Health Institute, Verdun, QC, Canada
| | - Nadia Chawky
- Réseau Québécois sur le suicide, les troubles de l'humeur et les troubles associés, Douglas University Mental Health Institute, Verdun, QC, Canada
- McGill Group for Suicide Studies, Douglas University Mental Health Institute, Verdun, QC, Canada
| | - Guy Beauchamp
- Réseau Québécois sur le suicide, les troubles de l'humeur et les troubles associés, Douglas University Mental Health Institute, Verdun, QC, Canada
| | - Guillaume Vaiva
- Psychiatry Department, CHU Lille, Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, Lille University, Lille, France
- Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France
- Centre National de Ressources et Résilience pour les Psychotraumatismes (Cn2r), Lille, France
| | - Monique Séguin
- Groupement d'Étude et de Prévention du Suicide, Saint-Benoît, France
- Réseau Québécois sur le suicide, les troubles de l'humeur et les troubles associés, Douglas University Mental Health Institute, Verdun, QC, Canada
- McGill Group for Suicide Studies, Douglas University Mental Health Institute, Verdun, QC, Canada
- Department of Psychology, Université du Québec en Outaouais, Gatineau, QC, Canada
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21
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Eloir J, Ducro C, Nandrino JL. Determining Sexual Offender Profiles From Life Trajectories. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2020; 32:521-542. [PMID: 30739585 DOI: 10.1177/1079063219828782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
To study qualitatively the development of a heteroaggressive behavior, we applied retrospective analytical method based on categorization of life events. The aim of this study was to establish the life trajectories of sexual offenders through interviews with second sources: the inmate's relatives and psychologists. The life trajectories of incarcerated sexual offenders were retraced to build individual life charts. These life charts grouped individual life events into four main domains: health, life events, the relational sphere, and the judicial and prison sphere. In a sample of 40 inmate participants, four different profiles of sex offenders and therefore life trajectories were identified according to the abovementioned domains: (a) "Early life events and behavior disorders" (n = 14), (b) "Abandonment issues" (n = 4), (c) "Behavior and socioaffective disorders" (n = 9), and (d) "Behavioral hyperadaptation and coldness" (n = 13). Expert judges classified the life trajectories with satisfactory interjudge agreement (k = 0.70). This research has clinical implications for integrating different life events into developmental trajectories and focusing psychological support for the individual.
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Affiliation(s)
- Julien Eloir
- SCALab, UMR CNRS 9193, Université de Lille, France
- Centre Hospitalier d'Arras, France
| | - Claire Ducro
- SCALab, UMR CNRS 9193, Université de Lille, France
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22
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Almquist YB, Rojas Y, Vinnerljung B, Brännström L. Association of Child Placement in Out-of-Home Care With Trajectories of Hospitalization Because of Suicide Attempts From Early to Late Adulthood. JAMA Netw Open 2020; 3:e206639. [PMID: 32484554 PMCID: PMC7267851 DOI: 10.1001/jamanetworkopen.2020.6639] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/21/2020] [Indexed: 11/15/2022] Open
Abstract
Importance Children placed in out-of-home care (OHC) have higher rates of suicidal behaviors, including suicide attempts, compared with those who grow up in their family of origin. Several studies have shown that this elevated risk persists into young adulthood. Yet, our knowledge about any longer-term associations of OHC with suicide attempts is limited. Objective To examine how childhood experiences of placement in OHC are associated with trajectories of hospitalization because of suicide attempts (HSA) from early into late adulthood. Design, Setting, and Participants This prospective birth cohort study that was conducted in Stockholm, Sweden, and analyzed in March 2020 included 14 559 individuals born in 1953 who were living in the greater metropolitan of Stockholm in November 1963 and followed through registers up until December 2016. Exposures Childhood experiences of OHC based on information from the Social Register (age 0-19 years). Main Outcomes and Measures Hospitalization because of suicide attempts based on in-patient care data from the National Patient Register. Group-based trajectory modeling was used to cluster individuals according to their probabilities of HSA across adulthood (age 20-63 years). Results In this cohort of 14 559 individuals (7146 women [49.1%]), 1320 individuals (9.1%) had childhood experiences of OHC, whereas 525 individuals ( 3.6%) had HSA. A Cox regression analysis showed a substantially higher risk of HSA among those with childhood experiences of OHC (hazard ratio, 3.58; 95% CI, 2.93-4.36) and after adjusting for a range of adverse childhood living conditions (hazard ratio, 2.51; 95% CI, 2.00-3.15). Those with at least 1 HSA were grouped into 4 trajectories: (1) peak in middle adulthood (66 [12.6%]), (2) stable low across adulthood (167 [31.8%]), (3) peak in early adulthood (210 [40.0%]), and (4) peak in emerging adulthood (82 [15.6%]). A multinomial regression analysis suggested that those with experiences of OHC had higher risks of following any of these trajectories (trajectory 1: relative risk ratio [RRR], 2.91; 95% CI, 1.61-5.26; trajectory 2: RRR, 3.18; 95% CI, 2.21-4.59; trajectory 3: RRR, 4.32; 95% CI, 3.18-5.86; trajectory 4: RRR, 3.26; 95% CI, 1.94-5.46). The estimates were reduced after adjusting for adverse childhood living conditions. Conclusions and Relevance The findings suggest that the elevated risk of suicide attempts among former child welfare clients does not cease after young adulthood, indicating the necessity for clinical attention to childhood experiences of OHC as a risk marker for suicidal behavior across the life span.
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Affiliation(s)
- Ylva B. Almquist
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Yerko Rojas
- Södertörn University School of Social Sciences, Huddinge, Sweden
| | - Bo Vinnerljung
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Lars Brännström
- Department of Social Work, Stockholm University, Stockholm, Sweden
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Squassina A, Niola P, Lopez JP, Cruceanu C, Pisanu C, Congiu D, Severino G, Ardau R, Chillotti C, Alda M, Turecki G, Del Zompo M. MicroRNA expression profiling of lymphoblasts from bipolar disorder patients who died by suicide, pathway analysis and integration with postmortem brain findings. Eur Neuropsychopharmacol 2020; 34:39-49. [PMID: 32241689 DOI: 10.1016/j.euroneuro.2020.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 02/26/2020] [Accepted: 03/06/2020] [Indexed: 12/21/2022]
Abstract
Post-mortem brain studies suggest that miRNAs may be involved in suicide, but their role as peripheral biomarkers or targets of preventive pharmacological treatments in suicide has yet to be elucidated. We used nCounter miRNA Expression assay to measure miRNAs expression in lymphoblastoid cell lines (LCLs) from patients with Bipolar Disorder (BD) who died by suicide (SC, n = 7) and with low risk of suicide (LR, n = 11). Five miRNAs were differentially expressed in SC compared to LR (false discovery rate p<0.05). The two most significant miRNAs were measured with RT-qPCR in the same sample and in 12 healthy controls (HC): miR-4286 was increased while miR-186-5p was decreased in SC compared to LR and HC (ANOVA F = 14.92, p = 0.000043 and F = 3.95, p = 0.032 respectively). miR-4286 was also decreased in postmortem brains from 12 patients with BD who died by suicide compared to 13 controls, even though it did not reach statistical significance (FC=0.51, p = 0.07). Treatment with lithium of human neural progenitor cells reduced the expression of miR-4286 (FC=0.30, p = 0.038). Pathway analysis on predicted miR-4286 targets showed that "insulin resistance" was significantly enriched after correction for multiple testing. This pathway comprised 17 genes involved in lipid and glucose metabolism, several of which were also dysregulated in postmortem brains from patients with BD who died by suicide from the Stanley-foundation array collection. In conclusion, our study suggests that miR-4286 could be a biomarker of suicide but further studies are warranted to investigate its targeted genes and how these could be involved in the neurobiology of suicide.
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Affiliation(s)
- Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy.
| | - Paola Niola
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy; UCL Genomics, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Juan Pablo Lopez
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Canada
| | - Cristiana Cruceanu
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Canada
| | - Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Donatella Congiu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Giovanni Severino
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Raffaella Ardau
- Unit of Clinical Pharmacology of the University Hospital of Cagliari, Italy
| | - Caterina Chillotti
- Unit of Clinical Pharmacology of the University Hospital of Cagliari, Italy
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Canada
| | - Maria Del Zompo
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy; Unit of Clinical Pharmacology of the University Hospital of Cagliari, Italy
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Suicide amongst the Inuit of Nunavut: An Exploration of Life Trajectories. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061812. [PMID: 32168793 PMCID: PMC7143601 DOI: 10.3390/ijerph17061812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 11/17/2022]
Abstract
This article reports results of the life trajectories from 92 Inuit who died by suicide, matched for age and gender with 92 living-controls. A proxy-based procedure and semi-structured interviews with informants were conducted to obtain trajectories of developmental events occurring over the life course for suicide and community-matched controls. Results from this research indicate two different trajectories that differentiate the control-group from the suicide-group throughout the life course. Even though the number of suicide attempts are similar between both groups, the suicide-group had a more important burden of adversity, which seemed to create a cascading effect, leading to suicide.
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Ligier F, Giguère CE, Notredame CE, Lesage A, Renaud J, Séguin M. Are school difficulties an early sign for mental disorder diagnosis and suicide prevention? A comparative study of individuals who died by suicide and control group. Child Adolesc Psychiatry Ment Health 2020; 14:1. [PMID: 31956339 PMCID: PMC6958641 DOI: 10.1186/s13034-019-0308-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/30/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Suicide is the third leading cause of death worldwide among youth aged 10- to 19, and mental disorders are often associated in the etiology of suicidal behavior. Mental disorders are often under-diagnosed and under-treated in young people, a situation likely to increase the severity of the disorder and suicide risk. Presence of school difficulties may, in some cases, be a consequence of mental disorder, and theses difficulties are observable. Therefore, early detection and early intervention of school difficulties may alleviate the development of mental disorders and suicide vulnerability. The aim of this study is to understand the link between school difficulties and suicide risk. METHODS We used the data bank gathered by the McGill Group on Suicide Studies over the past two decades through interviews with the relatives of individuals who died by suicide and with individuals from the community as a control group. We included data on common sociodemographic characteristics, life events and mental health characteristics identified before age 18, among individuals who died before the age of 35 or were interviewed before the age of 35. We identified 200 individuals who died by suicide and 97 living controls. We compared groups according to gender and characteristics. RESULTS Within the total sample, 74% were male, 13% had met with academic failure, 18% had engaged in inappropriate behavior at school, and 18% presented combined school difficulties. Combined school difficulties (academic failure and inappropriate behavior) for both sexes and academic failure alone for males were associated with higher suicide risk before the age of 35. School difficulties generally began in early childhood and were linked to mental disorders/difficulties and substance abuse before age 18. CONCLUSIONS This study underlines the importance for parents, teachers, and educators to identify children with school difficulties-academic failure and behavioral difficulties at school-as early as possible in order to be able to propose adapted interventions. Early identification and proper diagnosis may prevent chronicity of some disorders, accumulation of adverse events, and even suicide.
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Affiliation(s)
- Fabienne Ligier
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,grid.498824.bQuébec Network on Suicide Research, Mood Disorders and Related Disorders (RQSHA), Montreal, QC Canada ,0000 0001 2194 6418grid.29172.3fEA 4360 APEMAC, Faculty of Medicine, Université de Lorraine, 54500 Vandoeuvre-lès-Nancy, France ,Centre Psychothérapique de Nancy, PUPEA, rue du Dr Archambault, 54520 Laxou, France ,0000 0004 1765 1301grid.410527.5Département Pédopsychiatrie, CHRU Nancy, Rue du Morvan, 54500 Vandoeuvre-lès-Nancy, France
| | - Charles-Edouard Giguère
- 0000 0001 2292 3357grid.14848.31Banque Signature, Research Center, Institut Universitaire en Santé Mentale de Montréal, 7401 Rue Hochelaga, Unit 218, Montreal, QC H1N 3M5 Canada
| | - Charles-Edouard Notredame
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,0000 0004 0471 8845grid.410463.4Centre Hospitalier Régional Universitaire de Lille, 2 Avenue Oscar Lambret, 59037 Lille Cedex, France
| | - Alain Lesage
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,grid.498824.bQuébec Network on Suicide Research, Mood Disorders and Related Disorders (RQSHA), Montreal, QC Canada ,0000 0001 2292 3357grid.14848.31Department of Psychiatry, Université de Montréal, Montreal, QC Canada ,0000 0001 2292 3357grid.14848.31Institut Universitaire en Santé Mentale de Montréal, 7401 Rue Hochelaga, Unit 218, Montreal, QC H1N 3M5 Canada
| | - Johanne Renaud
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,grid.498824.bQuébec Network on Suicide Research, Mood Disorders and Related Disorders (RQSHA), Montreal, QC Canada ,0000 0004 4910 4652grid.459278.5Manulife Centre for breackthroughs in Teen Depression and Suicide Prevention, Douglas Institute, 7070, Boulevard Champlain, Montreal, QC H4H 1R3 Canada
| | - Monique Séguin
- 0000 0001 2353 5268grid.412078.8McGill Group on Suicide Studies, Douglas Hospital, 6875, Boulevard LaSalle, Montreal, QC H4H 1R3 Canada ,grid.498824.bQuébec Network on Suicide Research, Mood Disorders and Related Disorders (RQSHA), Montreal, QC Canada ,0000 0001 2112 1125grid.265705.3Department of Psychoeducation and Psychology, Université du Québec en Outaouais, 283 Boulevard Alexandre-Taché, Gatineau, QC J8X 3X7 Canada ,Centre intégré de santé et service social de l’Outaouais (CISSSO), Outaouais, Canada
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Fehling KB, Selby EA. Suicide in DSM-5: Current Evidence for the Proposed Suicide Behavior Disorder and Other Possible Improvements. Front Psychiatry 2020; 11:499980. [PMID: 33613330 PMCID: PMC7891495 DOI: 10.3389/fpsyt.2020.499980] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
Suicide continues to be one of the greatest challenges faced by mental health clinicians and researchers, an issue made worse by increasing trends in the global suicide rate. Suicide behavior disorder (SBD) was introduced in DSM-5 as a disorder for further consideration and potential acceptance into the diagnostic system. There are numerous positive developments that would arise from the addition of a suicide-related diagnosis. Utilizing the 2009 guidelines established by Kendler and colleagues, the present review examines the evidence for SBD's validity and discusses the diagnosis' potential clinical benefits and limitations. Altogether, growing evidence indicates that SBD has preliminary validity and benefit. SBD presents with several significant limitations, however, and possible alternative additions to future DSMs are highlighted.
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Affiliation(s)
| | - Edward A Selby
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
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Abstract
Although recent years have seen large decreases in the overall global rate of suicide fatalities, this trend is not reflected everywhere. Suicide and suicidal behaviour continue to present key challenges for public policy and health services, with increasing suicide deaths in some countries such as the USA. The development of suicide risk is complex, involving contributions from biological (including genetics), psychological (such as certain personality traits), clinical (such as comorbid psychiatric illness), social and environmental factors. The involvement of multiple risk factors in conveying risk of suicide means that determining an individual's risk of suicide is challenging. Improving risk assessment, for example, by using computer testing and genetic screening, is an area of ongoing research. Prevention is key to reduce the number of suicide deaths and prevention efforts include universal, selective and indicated interventions, although these interventions are often delivered in combination. These interventions, combined with psychological (such as cognitive behavioural therapy, caring contacts and safety planning) and pharmacological treatments (for example, clozapine and ketamine) along with coordinated social and public health initiatives, should continue to improve the management of individuals who are suicidal and decrease suicide-associated morbidity.
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28
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Trajectories of Suicide Ideation and Attempts from Early Adolescence to Mid-Adulthood: Associations with Race/Ethnicity. J Youth Adolesc 2019; 48:1796-1805. [DOI: 10.1007/s10964-019-01074-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/28/2019] [Indexed: 02/03/2023]
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Robert M, Desgranges A, Séguin M, Beauchamp G. Risk factors reduction in suicidal youth through social connectedness opportunities provided by community services. PSYCHOLOGY, COMMUNITY & HEALTH 2018. [DOI: 10.5964/pch.v7i1.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim
This study examined the trajectory (life course) of youths, referred to community services following their suicidal behavior, in order to measure the extent to which these young people have taken this opportunity to modify connectedness with family, school, and workplace, and to change high-risk factors related to suicidal behaviors (mental health problems, delinquency, drug consumption).
Method
Fifteen youths (aged 16-19), who made one or more suicide attempts or had serious ideation in the previous 24 to 48 months, were referred to community services (Vallée-Jeunesse). They were interviewed using an intensive personal interview measures (Trajectory Instrument Measure, TIM) in order to document significant life events and adversities that occured during different periods of their life.In addition, we administered the Structured Clinical Interview for DSM-IV Axis-I and Axis-II disorders (SCID-I and SCID-II) to identify past and current psychopathologies.
Results
Several important changes took place following their entry into the community services: a reduction in delinquency and substance abuse/dependence, and positive changes in occupational status and suicidal behaviors (ideation and suicide attempt).
Conclusion
Our findings can inform policies and strategies that support the prevention of suicidal behavior among young adults. Community services providers can play a role in the prevention of suicidal behaviors for the most vulnerable youths. These types of services could complement traditional suicide prevention strategies, which are mostly mental-health based.
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Kapusta ND, Jankowski KS, Wolf V, Chéron-Le Guludec M, Lopatka M, Hammerer C, Schnieder A, Kealy D, Ogrodniczuk JS, Blüml V. Measuring the Capacity to Love: Development of the CTL-Inventory. Front Psychol 2018; 9:1115. [PMID: 30087627 PMCID: PMC6066550 DOI: 10.3389/fpsyg.2018.01115] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/11/2018] [Indexed: 11/23/2022] Open
Abstract
Objective: The individual capacity to love (CTL) has been linked to various mental health parameters and is considered to be an important outcome parameter of psychotherapeutic treatment. However, empirical examinations of the concept have not been conducted up to now. The aim of this study was to develop a valid and reliable instrument for the assessment of CTL [Capacity to Love Inventory (CTL-I)] as a trait of personality, which is shown to be related to clinically relevant symptoms and conditions. Method: Four independent healthy samples in Austria (n = 547, n = 174, and n = 85) and Poland (n = 240) were assessed by a prototype of the CTL-I and its final shorter version in a confirmatory factor analysis (CFA). Internal consistency of the total questionnaire and each subscale was assessed by Cronbach alpha. External validity was measured against Beck Depression Inventory, Quality of Relationship Inventory, Sociosexual Orientation Inventory, Pathological Narcissism Inventory, and Narcissistic Personality Inventory according to the theoretical framework of the CTL concept. Further test–retest reliability was assessed. Results: The CFA confirmed 41 items in six dimensions: Interest in the life project of the other, Basic trust, Humility and gratitude, Common ego ideal, Permanence of sexual passion, and Acceptance of loss/jealousy/mourning. The Cronbach alphas of the total CTL-I and its subscales ranged between 0.67 and 0.90 in all samples, suggesting a valid construct. The CTL-I was moderately positively associated with quality of relationship (Support r = 0.63, Conflict r = -0.66, and Depth r = 0.66) and inversely associated with symptoms of depression (r = -0.37), pathological narcissism (r = -0.29) and promiscuity (r = -0.42). The test–retest reliability of the total CTL-I was high with r = 0.81, suggesting the stability of answers over time. Conclusion: The proposed 41-item version of the CTL-I is a psychometrically sound and validated instrument measuring six dimensions of the concept of the CTL. The reported negative associations with clinically relevant parameters such as depression, pathological narcissism and promiscuity as well as associations with relationship qualities such as conflicts, support, and depth warrant its future use in burdened populations including couples in clinical settings.
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Affiliation(s)
- Nestor D Kapusta
- Department for Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Viktoria Wolf
- Department for Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Madlen Lopatka
- Department for Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Christopher Hammerer
- Department for Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Alina Schnieder
- Department for Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Victor Blüml
- Department for Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Pitman A, De Souza T, Khrisna Putri A, Stevenson F, King M, Osborn D, Morant N. Support Needs and Experiences of People Bereaved by Suicide: Qualitative Findings from a Cross-Sectional British Study of Bereaved Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040666. [PMID: 29614053 PMCID: PMC5923708 DOI: 10.3390/ijerph15040666] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 03/29/2018] [Accepted: 03/29/2018] [Indexed: 11/16/2022]
Abstract
People bereaved by suicide are at increased risk of suicide, but evidence is lacking that available interventions reduce suicide risk. Few large-scale studies have described the views of suicide-bereaved people regarding their needs for support. Our objective was to explore the nature of young adults' experiences of support after bereavement by suicide and their views on valued and unhelpful aspects. We conducted a cross-sectional study of staff and students aged 18-40 at 37 United Kingdom (UK) higher educational institutions in 2010, eliciting qualitative responses to two questions probing experiences of support and unmet needs after the suicide of a close contact. We conducted thematic analysis of responses from 420 adults bereaved by suicide, of whom 75% had received support after the loss. We identified three broad descriptive areas corresponding to important aspects of support: value and experiences of the support received; views on specific support needs; and reasons for not seeking support. We found that needs for emotional support exist throughout the social networks of people who die by suicide but are often hidden. Our findings suggest a need for proactive offers of support from family, friends, and professionals after suicide, repeated regularly in case a bereaved person does not feel ready for support early on.
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Affiliation(s)
- Alexandra Pitman
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK.
| | - Tanisha De Souza
- North East London NHS Foundation Trust, Memory Service, Broad Street Health Centre, Morland Road, Dagenham, Essex RM10 9HU, UK.
| | - Adelia Khrisna Putri
- UGM Faculty of Psychology, Jl. Sosio Humaniora 1, Sleman, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
| | - Fiona Stevenson
- UCL Research Department of Primary Care & Population Health, Rowland Hill St, London NW3 2PF, UK.
| | - Michael King
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
| | - David Osborn
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, UK.
| | - Nicola Morant
- UCL Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London W1T 7NF, UK.
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32
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Lewis KC. The Treacherous Path: Developmental Psychopathology and the Evolution of Risk for Suicide. PSYCHOANALYTIC STUDY OF THE CHILD 2018. [DOI: 10.1080/00797308.2017.1415070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Katie C. Lewis
- Erikson Institute for Education and Research, Austen Riggs Center
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33
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Séguin M, Robert M, Beauchamp G. Temperament and Character Profiles of Group-Based Suicide Cases. CRISIS 2017; 38:177-185. [DOI: 10.1027/0227-5910/a000430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Personality and character traits may be a key predisposing factor to consider in the life course of people who are vulnerable to suicide. Aims: The aim of this study is first to explore the possible presence of different subgroups of suicide decedents based on developmental profiles of adversity, and secondly to examine the association of personality and character dimensions (covariates) with the trajectory outcome. Method: A total of 90 cases of suicide decedents were analyzed using growth mixture modeling (GMM). Results: Results generated two different life trajectories and identified specific temperament profiles. Subjects assigned to the trajectory of high burden of adversity demonstrated a greater predisposition for harm avoidance and those in the trajectory characterized by low burden of adversity displayed greater predisposition for self-directedness. Conclusion: Our results add to the literature by suggesting that different subgroups of suicide completers show a predisposition for either harm avoidance or self-directedness.
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Affiliation(s)
- Monique Séguin
- Département de psychoeducation et psychologie, Université du Québec en Outaouais, Gatineau, Canada
- McGill Group for Suicide Studies, Montréal, Canada
| | - Marie Robert
- Département de psychoeducation et psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Guy Beauchamp
- Département de psychoeducation et psychologie, Université du Québec en Outaouais, Gatineau, Canada
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Berona J, Horwitz AG, Czyz EK, King CA. Psychopathology profiles of acutely suicidal adolescents: Associations with post-discharge suicide attempts and rehospitalization. J Affect Disord 2017; 209:97-104. [PMID: 27894037 PMCID: PMC5473155 DOI: 10.1016/j.jad.2016.10.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 09/21/2016] [Accepted: 10/22/2016] [Indexed: 01/20/2023]
Abstract
BACKGROUND Suicidal adolescents are heterogeneous, which can pose difficulties in predicting suicidal behavior. The Youth Self-Report (YSR) psychopathology profiles predict the future onset of psychopathology and suicide-related outcomes. The present study examined the prevalence and correlates of YSR psychopathology profiles among suicidal adolescents and prospective associations with post-discharge rates of suicide attempts and psychiatric rehospitalization. METHODS Participants were acutely suicidal, psychiatrically hospitalized adolescents (N=433 at baseline; n=355 at follow-up) who were enrolled in a psychosocial intervention trial during hospitalization. Psychopathology profiles were assessed at baseline. Suicide attempts and rehospitalization were assessed for up to 12 months following discharge. RESULTS Latent profile analysis identified four psychopathology profiles: subclinical, primarily internalizing, and moderately and severely dysregulated. At baseline, profiles differed by history of non-suicidal self-injury (NSSI) and multiple suicide attempts (MA) as well as severity of suicide ideation, hopelessness, depressive symptoms, anxiety symptoms, substance abuse, and functional impairment. The dysregulation profiles predicted suicide attempts within 3 months post-discharge. The internalizing profile predicted suicide attempts and rehospitalization at 3 and 12 months. LIMITATIONS This study's participants were enrolled in a randomized trial and were predominantly female, which limit generalizability. Additionally, only a history of NSSI was assessed. CONCLUSIONS The dysregulation profile was overrepresented among suicidal youth and associated with impairment in several domains as well as suicide attempts shortly after discharge. Adolescents with a severe internalizing profile also reported adverse outcomes throughout the study period. Psychopathology profiles warrant further examination in terms of their potential predictive validity in relation to suicide-related outcomes.
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Affiliation(s)
- Johnny Berona
- University of Michigan, Department of Psychology, USA; University of Michigan, Department of Psychiatry, USA.
| | - Adam G. Horwitz
- University of Michigan, Department of Psychology,University of Michigan, Department of Psychiatry
| | - Ewa K. Czyz
- University of Michigan, Department of Psychiatry
| | - Cheryl A. King
- University of Michigan, Department of Psychology,University of Michigan, Department of Psychiatry
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Difficultés professionnelles et suicide : étude comparative de parcours de vie. ANNALES MEDICO-PSYCHOLOGIQUES 2016. [DOI: 10.1016/j.amp.2014.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Suicide is a complex public health problem of global importance. Suicidal behaviour differs between sexes, age groups, geographic regions, and sociopolitical settings, and variably associates with different risk factors, suggesting aetiological heterogeneity. Although there is no effective algorithm to predict suicide in clinical practice, improved recognition and understanding of clinical, psychological, sociological, and biological factors might help the detection of high-risk individuals and assist in treatment selection. Psychotherapeutic, pharmacological, or neuromodulatory treatments of mental disorders can often prevent suicidal behaviour; additionally, regular follow-up of people who attempt suicide by mental health services is key to prevent future suicidal behaviour.
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Affiliation(s)
- Gustavo Turecki
- McGill Group for Suicide Studies, Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, QC, Canada.
| | - David A Brent
- Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
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Kazan D, Calear AL, Batterham PJ. The impact of intimate partner relationships on suicidal thoughts and behaviours: A systematic review. J Affect Disord 2016; 190:585-598. [PMID: 26583348 DOI: 10.1016/j.jad.2015.11.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 10/13/2015] [Accepted: 11/01/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND A systematic review was conducted to identify the impact of intimate partner relationships on suicidality. The aim of the review was to identify factors within intimate partner relationships that influence suicidal ideation, attempts and completion. METHOD Fifty-one articles were identified through Scopus, PubMed and PsycINFO databases. Due to the high heterogeneity of the included studies, a narrative data synthesis was conducted. RESULTS The research drew attention to specific contingents of the population, for example examining suicide risk in individuals under the age of 35 or lesbian, gay, bisexual and transgender (LGBT) individuals who are experiencing relationship discord, and in males who have recently separated. LIMITATIONS Interpretation of these findings is constrained by methodological limitations prevalent in much of the literature. Limitations of the existing literature and corresponding directions for future research are discussed. CONCLUSIONS Relationship separation and poor quality relationships are likely to be important risk factors for suicidal thoughts and behaviours and are frequent triggers for a suicide attempt. This review highlights intimate partner relationships as a significant component in a suicide risk assessment, regardless of the clinical setting. Consequently, clinicians should be aware that individuals reporting relationship problems are likely to be at increased risk of suicidal thoughts and behaviours.
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Affiliation(s)
- Dominique Kazan
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia.
| | - Alison L Calear
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- National Institute for Mental Health Research, The Australian National University, Canberra, Australia
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Gesi C, Carmassi C, Miniati M, Benvenuti A, Massimetti G, Dell'Osso L. Psychotic spectrum symptoms across the lifespan are related to lifetime suicidality among 147 patients with bipolar I or major depressive disorder. Ann Gen Psychiatry 2016; 15:15. [PMID: 27330540 PMCID: PMC4915160 DOI: 10.1186/s12991-016-0101-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 05/31/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Conflicting evidence exists about the relationship between psychotic symptoms and suicidality in mood disorders. We aimed to investigate the lifetime suicidality and its relationship with dimensions of the psychotic spectrum over the lifespan among subjects with bipolar I (BD I) or major depressive disorder (MDD). METHODS 147 Consecutive out- and inpatients with BD I or MDD presenting for treatment at 11 Italian Departments of Psychiatry were administered the Structured Clinical Interview for DSM-IV Axis I Disorders, the Structured Clinical Interview for the Psychotic Spectrum (SCI-PSY, lifetime version) and the Mood Spectrum Self-Report (MOODS-SR, lifetime version). RESULTS Subjects with psychotic features did not differ from those without for MOODS-SR suicidality score. Controlling for age, gender and diagnosis (MDD/BD I), the SCI-PSY total score (p = .007) and Paranoid (p = .042), Schizoid (p = .007) and Interpersonal Sensitivity (p < .001) domain scores independently predicted lifetime MOODS-SR suicidality score in the overall sample. CONCLUSIONS Psychotic features, as evaluated upon the presence of delusions or hallucinations, are not associated with suicidality among subjects with BD I or MDD. However, more subtle dimensions of the psychotic spectrum, such as Interpersonal Sensitivity, Paranoid and Schizoid symptoms, show a significant relationship with lifetime suicidality. Our findings highlight the potential usefulness of a spectrum approach in the assessment of psychotic symptoms and suicide risk among subjects with BD I or MDD.
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Affiliation(s)
- Camilla Gesi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Antonella Benvenuti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
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Mok PLH, Antonsen S, Pedersen CB, Appleby L, Shaw J, Webb RT. National cohort study of absolute risk and age-specific incidence of multiple adverse outcomes between adolescence and early middle age. BMC Public Health 2015; 15:920. [PMID: 26386672 PMCID: PMC4575432 DOI: 10.1186/s12889-015-2249-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 09/08/2015] [Indexed: 12/17/2022] Open
Abstract
Background Psychiatric illness, substance misuse, suicidality, criminality and premature death represent major public health challenges that afflict a sizeable proportion of young people. However, studies of multiple adverse outcomes in the same cohort at risk are rare. In a national Danish cohort we estimated sex- and age-specific incidence rates and absolute risks of these outcomes between adolescence and early middle age. Methods Using interlinked registers, persons born in Denmark 1966–1996 were followed from their 15th until 40th birthday or December 2011 (N = 2,070,904). We estimated sex- and age-specific incidence rates of nine adverse outcomes, in three main categories: Premature mortality (all-causes, suicide, accident); Psychiatric morbidity (any mental illness diagnosis, suicide attempt, alcohol or drug misuse disorder); Criminality (violent offending, receiving custodial sentence, driving under influence of alcohol or drugs). Cumulative incidences were also calculated using competing risk survival analyses. Results For cohort members alive on their 15th birthday, the absolute risks of dying by age 40 were 1.99 % for males [95 % confidence interval (CI) 1.95–2.03 %] and 0.85 % for females (95 % CI 0.83–0.88 %). The risks of substance misuse and criminality were also much higher for males, especially younger males, than for females. Specifically, the risk of a first conviction for a violent offence was highest amongst males aged below 20. Females, however, were more likely than males to have a hospital-treated psychiatric disorder. By age 40, 13.25 % of females (95 % CI 13.16–13.33 %) and 9.98 % of males (95 % CI 9.91–10.06 %) had been treated. Women aged below 25 were also more likely than men to first attempt suicide, but this pattern was reversed beyond this age. The greatest gender differentials in incidence rates were in criminality outcomes. Conclusions This is the first comprehensive assessment of the incidence rates and absolute risks of these multiple adverse outcomes. Approximately 1 in 50 males and 1 in 120 females who are alive on their 15th birthday will die by age 40. By examining the same cohort at risk, we compared risks for multiple outcomes without differential inter-cohort biases. These epidemiological profiles will inform further research into the pathways leading to these adverse events and future preventive strategies.
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Affiliation(s)
- Pearl L H Mok
- Centre for Mental Health and Safety, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Sussie Antonsen
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark. .,National Centre for Register-Based Research, Aarhus University, Business and Social Sciences, Aarhus, Fuglesangs Alle 4, 8210, Aarhus V, Denmark.
| | - Carsten Bøcker Pedersen
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark. .,National Centre for Register-Based Research, Aarhus University, Business and Social Sciences, Aarhus, Fuglesangs Alle 4, 8210, Aarhus V, Denmark.
| | - Louis Appleby
- Centre for Mental Health and Safety, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Jenny Shaw
- Centre for Mental Health and Safety, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Roger T Webb
- Centre for Mental Health and Safety, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
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Okoro DC. Posttraumatic Stress Disorder: The Misappropriation of Military Suicide Causation and Medication Treatment of Posttraumatic Stress Disorder. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2015; 60:201. [PMID: 26174221 PMCID: PMC4459248 DOI: 10.1177/070674371506000408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Brunet A, Sareen J. Posttraumatic Stress Disorder: The Misappropriation of Military Suicide Causation and Medication Treatment of Posttraumatic Stress Disorder. Reply. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2015. [PMID: 26203476 DOI: 10.1177/070674371506000409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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