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Chang Q, Shi Y, Yao S, Ban X, Cai Z. Prevalence of Suicidal Ideation, Suicide Plans, and Suicide Attempts Among Children and Adolescents Under 18 years of Age in Mainland China: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:2090-2102. [PMID: 37902618 DOI: 10.1177/15248380231205828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Despite suicide in younger population having become a severe public health issue, information on the prevalence of suicidality among Chinese children and adolescents is still limited. This study aims to estimate the prevalence of suicidal ideation, suicide plans, and suicide attempts in Chinese children and adolescents aged under 18 years. A meta-analysis was conducted based on English and Chinese publications from January 1, 2010 to December 31, 2020 using random-effects models. Based on 132 eligible studies with a combined total of 1,103,309 Chinese children and adolescents below 18 years old, the pooled prevalence of the overall suicidal ideation, suicide plans, and suicide attempts were 15.4% (95% CI [14.3, 16.6]), 6.4% (95% CI [5.5, 7.4]) and 3.5% (95% CI [3.1, 4.1]), respectively. The subgroup analyses showed that there were significant variations of prevalence of suicidal risks across genders, school stages, and geographical areas in mainland China. It was the first systematic review and meta-analysis to show suicidality among younger population aged below 18 years is prevalent in mainland China. This study suggests that gender-age-region-specific prevention and intervention programs should be urgently needed to reduce suicidal risks among Chinese children and adolescents.
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Affiliation(s)
| | - Yu Shi
- Xiamen University, Fujian, China
| | | | | | - Ziyi Cai
- University of Hong Kong, Hong Kong, China
- Newcastle University, UK
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2
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Hawton K, Pirkis J. Suicide prevention: reflections on progress over the past decade. Lancet Psychiatry 2024; 11:472-480. [PMID: 38754457 DOI: 10.1016/s2215-0366(24)00105-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/25/2024] [Accepted: 03/25/2024] [Indexed: 05/18/2024]
Abstract
Interest in preventing suicides has increased greatly in recent years. In this Personal View, we consider the general global developments related to suicide prevention that have occurred in the decade since The Lancet Psychiatry was first published in 2014. We then review specific advances during this period, first, in relation to public health initiatives, and second, with regard to clinical developments. Finally, we examine some of the challenges that currently confront individuals and organisations responsible for designing and implementing suicide prevention measures.
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Affiliation(s)
- Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK.
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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3
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Causer H, Spiers J, Chew-Graham CA, Efstathiou N, Gopfert A, Grayling K, Maben J, van Hove M, Riley R. Filling in the gaps: A grounded theory of the experiences and needs of healthcare staff following a colleague death by suicide in the UK. DEATH STUDIES 2024:1-12. [PMID: 38602818 DOI: 10.1080/07481187.2024.2337202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Health-workers are more likely to die by suicide than their counterparts in other occupational groups. The suicide of a staff member can be widely felt by colleagues, leading to complex emotional and cognitive responses. Exposure to suicide heightens the risk of dying by suicide. We investigated the impact of a colleague suicide on National Health Service (NHS) staff. Twenty-nine staff were interviewed; all participants were white British, and so not representative of the ethnic make-up of the NHS. Data were analyzed using grounded theory methods. A theory, "filling in the gaps" was developed. Staff experiences gave rise to needs that were not always met. Staff endeavored to "fill in the gaps" in support; however, sometimes fell through those gaps. Organizational and professional contexts shaped their experiences and responses. Recommendations include skilled and targeted support and compassion for affected staff. Cultural change is needed to challenge suicide stigma and unhelpful narratives.
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Affiliation(s)
- Hilary Causer
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Johanna Spiers
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Nikolaos Efstathiou
- School of Nursing and Midwifery, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Anya Gopfert
- Department of Public Health and Sports Sciences, University of Exeter, Exeter, UK
| | | | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Maria van Hove
- Department of Public Health and Sports Sciences, University of Exeter, Exeter, UK
| | - Ruth Riley
- School of Health Sciences, University of Surrey, Guildford, UK
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Sourander A, Silwal S, Osokina O, Hinkka-Yli-Salomäki S, Hodes M, Skokauskas N. Suicidality and Self-Harm Behavior of Adolescents During the Early Phase of the War in Ukraine. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00177-1. [PMID: 38575059 DOI: 10.1016/j.jaac.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/13/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE War profoundly impacts people's lives, causing death, displacement, and psychological trauma, but research investigating suicidality of adolescents in this context has been limited. We compared suicidality or self-harm behavior among adolescents in regions that were, and were not, affected by Russia's initial invasion of Ukraine in 2014. METHOD This cross-sectional study comprised 2,752 school students aged 11 to 17 years from the war-affected Donetsk region and non-war Kirovograd region. Data collection occurred in 2016 and 2017 using self-report tools to assess suicidality or self-harm behavior; psychopathology including posttraumatic stress disorder (PTSD), depression, and anxiety; and war trauma exposure. RESULTS Adolescent girls in the war-affected region reported more suicide attempts (9.5% vs 5.1%; adjusted odds ratio [aOR] 1.8, 95% CI 1.2-2.8), suicidal ideation (39.3% vs 19.6%; aOR 2.6, 95% CI 2.01-3.3), or self-harm behavior (19.6% vs 13.1%; aOR 1.6, 95% CI 1.2-2.1), and boys reported more suicidal ideation (17.0% vs 9.8%; aOR 1.7, 95% CI 1.2-2.4). Boys and girls with PTSD, depression, or anxiety showed increased risks for any suicidality or self-harm. A dose-effect relation was observed between war trauma exposure and suicidality or self-harm. The association was strongest for adolescents who had experienced 5 or more different war trauma exposures (aOR 3.2, 95% CI 2.2-4.8). CONCLUSION War trauma exposure and psychopathology were strongly associated with suicidality or self-harm behavior, with a greater impact in girls than boys. The high prevalence of suicidality found in this study emphasizes the need for intervention on a large scale for adolescents living in war situations.
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Affiliation(s)
- Andre Sourander
- Research Centre for Child Psychiatry, INVEST Flagship, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland.
| | - Sanju Silwal
- Research Centre for Child Psychiatry, INVEST Flagship, University of Turku, Turku, Finland
| | - Olga Osokina
- Donetsk National Medical University, Kropyvnitskyi, Ukraine; Kyiv Medical University, Kyiv, Ukraine
| | | | | | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare, IPH, Norwegian University of Science and Technology, Trondheim, Norway
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Ellison K, Schleicher H, Sale E. Effectiveness of a Suicide Prevention Lethal Means Training Program for the General Public. Community Ment Health J 2024; 60:552-561. [PMID: 38064038 DOI: 10.1007/s10597-023-01206-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/01/2023] [Indexed: 03/05/2024]
Abstract
To evaluate the effectiveness of Conversations on Access to Lethal Means for the General Public (CALM-GP), a training for the public focusing on reducing access to lethal means during a crisis. The program adapted Counseling on Access to Lethal Means (CALM), developed for mental health practitioners and physicians. Participants completed pre/post surveys and follow-up surveys three months afterward. Measures included comfort and confidence in talking to a suicidal individual about access to lethal means, the likelihood of follow-up, and the number of lethal means conversations before and after the program. Surveys showed improvement in comfort and confidence talking about safely storing firearms and other lethal means and the likelihood of follow-up with that individual regarding access to lethal means. Results also indicated increased conversations participants had regarding suicide and lethal means at three-month follow-up. This evaluation suggests that CALM-GP is an effective suicide prevention and lethal means program for the public.
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Affiliation(s)
- Kathleen Ellison
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO, USA.
| | - Hannah Schleicher
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Elizabeth Sale
- Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO, USA
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Peterson A, Chen J, Bozzay M, Bender A, Chu C. Suicide risk profiles among service members and veterans exposed to suicide. J Clin Psychol 2024; 80:65-85. [PMID: 37659101 DOI: 10.1002/jclp.23592] [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: 02/01/2023] [Revised: 08/10/2023] [Accepted: 08/24/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVES Rates of suicide exposure are high among service members and Veterans and are especially concerning given the link between suicide exposure and subsequent suicide risk. However, to date, it is unclear which individuals who are exposed to suicide are subsequently at high risk for suicide. Latent profile analysis (LPA) can provide information on unique risk profiles and subgroups of service members and Veterans who have higher suicide risk after suicide exposure, which has not yet been empirically studied. The purpose of this study was to utilize LPA to identify subgroups of service members and Veterans who are at the highest risk for suicidal thoughts and behaviors following suicide exposure. METHODS We analyzed data using LPA from 2570 service members and Veterans (82.1% male, 69.5% White, and 12.1% Latino/a/x) who completed the Military Suicide Research Consortium's Common Data Elements, a battery of self-report suicide-related measures. Psychopathology, substance use, mental health service utilization, interpersonal theory of suicide, and suicide exposure variables were used to validate classes. RESULTS Three latent classes emerged from analyses, one low-risk class and two-high risk classes with differing profile compositions (one primarily differentiated by anxiety symptoms and one differentiated by substance use). CONCLUSION Class-specific recommendations for suicide prevention efforts will be discussed.
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Affiliation(s)
- Amanda Peterson
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Jason Chen
- Portland VA Health Care System, Portland, Oregon, USA
| | - Melanie Bozzay
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA
| | - Ansley Bender
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Carol Chu
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
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Hart RK, Christiansen SG, Reneflot A, Hauge LJ. Adolescents' primary care consultations before and after parental suicide: evidence from population-wide data. Eur Child Adolesc Psychiatry 2023; 32:2453-2462. [PMID: 36175569 PMCID: PMC10682049 DOI: 10.1007/s00787-022-02095-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 09/23/2022] [Indexed: 11/03/2022]
Abstract
Parental bereavement is associated with distress and poorer long-term outcomes among adolescents. Adolescents who lose a parent to suicide fare worse than their peers even before bereavement. Based on the current literature, we cannot distinguish such initial differences from the medium and long-term effect of parental suicide. We study the impact of parental suicide on adolescents' General Practitioner visits for mental health or psychosocial reasons. Within-individual models account for time-invariant differences between the bereaved and non-bereaved. We investigate if effects differ from the impact of parental death from other causes, and vary with sex and socioeconomic background. Full population data on Norwegian residents aged 10-19 in the period 2006-2015 are drawn from registers (N = 1 405 suicide bereaved, 12 982 bereaved by other causes, and 1 182 819 non-bereaved controls). Records include data on use of health services, parental mortality, and sociodemographic characteristics of parent and child. Mental health consultations increase gradually in the quarters leading up to the parental suicide, significantly more for girls than for boys. Two years prior to bereavement, 2.4% of the subsequently suicide bereaved have a mental health consultation in any given quarter. In the year of bereavement, this increases with 6% points. Health care workers should be aware that boys are less likely to turn to their GP for support before parental bereavement from suicide.
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Affiliation(s)
- Rannveig K Hart
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway.
| | | | - Anne Reneflot
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway
| | - Lars Johan Hauge
- Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213, Oslo, Norway
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8
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Jiang C, Huang Z, Zhou Z, Chen L, Zhou H. Decreased beta 1 (12-15 Hertz) power modulates the transfer of suicidal ideation to suicide in major depressive disorder. Acta Neuropsychiatr 2023; 35:362-371. [PMID: 37605898 DOI: 10.1017/neu.2023.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
BACKGROUND Suicide prevention for major depressive disorder (MDD) is a worldwide challenge, especially for suicide attempt (SA). Viewing suicide as a state rather than a lifetime event provided new perspectives on suicide research. OBJECTIVE This study aimed to verify and complement SAs biomarkers of MDD with a recent SA sample. METHODS This study included 189 participants (60 healthy controls; 47 MDD patients with non-suicide (MDD-NSs), 40 MDD patients with suicide ideation (MDD-SIs) and 42 MDD patients with SA (MDD-SAs)). MDD patients with an acute SA time was determined to be within 1 week since the last SA. SUICIDALITY Part in MINI was applied to evaluate suicidality. Absolute powers in 14 frequency bands were extracted from subject's resting-state electroencephalography data and compared within four groups. The relationship among suicidality, the number of SA and powers in significant frequency bands were investigated. RESULTS MDD-SIs had increased powers in delta, theta, alpha and beta band on the right frontocentral channels compared to MDD-NSs, while MDD-SAs had decreased powers in delta, beta and gamma bands on widely the right frontocentral and parietooccipital channels compared to MDD-SIs. Beta 1 power was the lowest in MDD-SAs and was modulated by the number of SA. The correlation between suicidality and beta 1 power was negative in MDD-SAs and positive in MDD-SIs. CONCLUSION Reduced beta 1 (12-15 Hz) power could be essential in promoting suicidal behaviour in MDD. Research on recent SA samples contributes to a better understanding of suicide mechanisms and preventing suicidal behaviour in MDD.
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Affiliation(s)
- Chenguang Jiang
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zixuan Huang
- Department of Music and Wellbeing, School of Music, University of Leeds, Leeds, UK
| | - Zhenhe Zhou
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Limin Chen
- Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi, Jiangsu Province, China
| | - Hongliang Zhou
- Department of Clinical Psychology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China
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Sayer NA, Nelson DB, Gradus JL, Sripada RK, Murdoch M, Teo AR, Orazem RJ, Cerel J. The Effects of Suicide Exposure on Mental Health Outcomes Among Post-9/11 Veterans: Protocol for an Explanatory, Sequential, Mixed Methods Study. JMIR Res Protoc 2023; 12:e51324. [PMID: 37751271 PMCID: PMC10565621 DOI: 10.2196/51324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The toll associated with suicide goes well beyond the individual who died. This study focuses on a risk factor for veteran suicide that has received little previous empirical attention-exposure to the suicide death of another person. OBJECTIVE The study's primary objective is to describe the mental health outcomes associated with suicide exposure among veterans who served on active duty after September 2001 ("post-9/11"). The secondary objective is to elucidate why some veterans develop persistent problems following suicide exposure, whereas others do not. METHODS This is an explanatory, sequential, mixed methods study of a nationally representative sample of post-9/11 veterans enrolled in Department of Veterans Affairs (VA) health care. Our sampling strategy was designed for adequate representation of female and American Indian and Alaska Native veterans to allow for examination of associations between suicide exposure and outcomes within these groups. Primary outcomes comprise mental health problems associated with trauma and loss (posttraumatic stress disorder and prolonged grief disorder) and suicide precursors (suicidal ideation, attempts, and planning). Data collection will be implemented in 3 waves. During wave 1, we will field a brief survey to a national probability sample to assess exposure history (suicide, other sudden death, or neither) and exposure characteristics (eg, closeness with the decedent) among 11,400 respondents. In wave 2, we will include 39.47% (4500/11,400) of the wave-1 respondents, stratified by exposure history (suicide, other sudden death, or neither), to assess health outcomes and other variables of interest. During wave 3, we will conduct interviews with a purposive subsample of 32 respondents exposed to suicide who differ in mental health outcomes. We will supplement the survey and interview data with VA administrative data identifying diagnoses, reported suicide attempts, and health care use. RESULTS The study began on July 1, 2022, and will end on June 30, 2026. This is the only national, population-based study of suicide exposure in veterans and the first one designed to study differences based on sex and race. Comparing those exposed to suicide with those exposed to sudden death for reasons other than suicide (eg, combat) and those unexposed to any sudden death may allow for the identification of the common and unique contribution of suicide exposure to outcomes and help seeking. CONCLUSIONS Integrating survey, qualitative, and VA administrative data to address significant knowledge gaps regarding the effects of suicide exposure in a national sample will lay the foundation for interventions to address the needs of individuals affected by a suicide death, including female and American Indian and Alaska Native veterans. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51324.
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Affiliation(s)
- Nina A Sayer
- Center for Care Delivery and Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, United States
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - David B Nelson
- Center for Care Delivery and Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, United States
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Jaimie L Gradus
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, United States
| | - Rebecca K Sripada
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Maureen Murdoch
- Center for Care Delivery and Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, United States
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
- Section of General Internal Medicine, Minneapolis VA Health Care System, Minneapolis, MN, United States
| | - Alan R Teo
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, United States
| | - Robert J Orazem
- Center for Care Delivery and Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, United States
| | - Julie Cerel
- College of Social Work, University of Kentucky, Lexington, KY, United States
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10
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Alshutwi M, Alawad M, Alammari M, Almanea M, Alhumaid R, Alkhalifah AS, Alosaimi FD. Perceived impact of patients' suicide and serious suicidal attempts on their treating psychiatrists and trainees: a national cross-sectional study in Saudi Arabia. BMC Psychiatry 2023; 23:607. [PMID: 37596547 PMCID: PMC10439610 DOI: 10.1186/s12888-023-05042-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/21/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Patient suicides are significant events that tremendously affect psychiatrists- personally and professionally. Very few studies have focused on studying the impact of both serious suicidal attempts and completed suicide on psychiatrists and psychiatry trainees. AIM This study assessed the prevalence and impact of patient suicide and serious suicidal attempts on psychiatrists and psychiatry trainees in Saudi Arabia. METHODS This national cross-sectional study of psychiatrists and psychiatry trainees was conducted in Saudi Arabia. Participants completed an online self-administered questionnaire to assess emotional and professional impacts and the traumatic impact of patient suicide using the Impact of Event Scale-Revised (IES-R). RESULTS 178 psychiatrists were enrolled in this study. The prevalence rate of patient suicide among participants was 38.8%, and they experienced adverse emotional reactions. Additionally, among those who were not exposed to patient suicide, 12.9% reported exposure to serious suicide attempts, and almost all of them experienced related negative emotions. The most frequently reported emotions were sadness (61.95%), shock (48.91%), and guilt (25%), and these emotions lasted longer in completed patient suicide cases than attempted suicide. Nearly 84% of participants who experienced suicide reported its impact on their profession. The most reported professional impacts were increased focus on suicide cues, attention to legal aspects, and a tendency to hospitalize. Of participants who experienced suicide, 75.4% reported that the overall impact of suicidal events on their professional practice had improved. Of the total number of respondents who experienced either suicide or serious suicidal attempts, 10.9% reported symptoms of PTSD. CONCLUSIONS The study highlighted the emotional and professional burden that psychiatrists and psychiatry trainees experience due to patient's completed suicides and serious suicidal attempts. Additionally, it emphasized the need for further research to study the benefits of implementing preparatory and training programs to help trainees and psychiatrists in such instances.
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Affiliation(s)
- Maha Alshutwi
- Saudi Commission for Health Specialties, Riyadh, Saudi Arabia.
| | - Moayad Alawad
- Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | | | | | - Rayan Alhumaid
- College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | | | - Fahad D Alosaimi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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11
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Mitchell KJ, Banyard V, Ybarra M. Overlap Between Exposure to Suicidal Behavior and Indirect Interpersonal Violence: Evidence for a More Integrated Approach to Violence Research. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231163238. [PMID: 37070812 DOI: 10.1177/08862605231163238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This study examines the overlap between indirect exposure to forms of interpersonal violence and suicidal behavior, and the impact of the co-occurrence of these exposures on indicators of depressed mood and substance use among adolescents. Participants were a national sample of 3,917 youth aged 14-15 years, recruited online between June 2018 and March 2020, including an oversample of sexual and gender minority youth. Eight in ten (81.3%) youth reported exposure to indirect interpersonal violence and/or suicidal behavior in their lifetimes: 39.5% reported only interpersonal violence exposure, 5.9% only suicidal behavior exposure, and 35.9% reported both. Youth who reported exposure to interpersonal violence were almost three times more likely (adjusted odds ratio [OR] = 2.78, p < .001) to also report suicidal behavior exposure. Compared with youth having no indirect violence exposure, those with only interpersonal violence exposure were 2.25 times more likely (p < .001), those with only exposure to suicidal behavior 2.93 times more likely (p < .001), and those with both were 5.63 times more likely to report recent depressed mood. The unadjusted odds of any substance use was significantly elevated for each type of indirect violence exposure, with the highest odds seen among youth with dual interpersonal violence and suicide exposure (OR = 4.87, p < .001). For both outcomes, significant findings remained but were attenuated after adjusting for demographic characteristics, non-victimization adversity exposure, and cumulative direct victimization. Findings suggest that the combination of exposure to interpersonal violence and suicidal behavior appears to be particularly impactful. Results highlight that assessment of trauma exposure among adolescents needs to be more comprehensive and include not only direct and indirect interpersonal violence, but also knowledge of other people's suicidal thoughts and behaviors.
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Affiliation(s)
| | | | - Michele Ybarra
- Center for Innovative Public Health Research, San Clemente, CA, USA
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12
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Pitkänen J, Remes H, Aaltonen M, Martikainen P. Moderating role of sociodemographic factors in parental psychiatric treatment before and after offspring severe self-harm. J Affect Disord 2023; 327:145-154. [PMID: 36758868 DOI: 10.1016/j.jad.2023.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Parental psychiatric disorders are known risk factors for adolescent self-harm. Although this association is likely to have a bidirectional element, evidence on changes in parental psychiatric treatment following offspring self-harm is scarce. METHODS Finnish children born in 1987-1996 with a hospital-treated episode of self-harm between the ages 13 and 19 years (N = 3636) were identified using administrative register data, and their biological mothers (N = 3432) and fathers (N = 3167) were followed two years before and after the episode. Data on purchases of psychotropic medication, specialized psychiatric treatment and psychiatric sickness allowances were used to examine psychiatric treatment among parents. Differences by parental education, employment and living arrangements were assessed, and offspring self-harm was compared with offspring accidental poisonings and traffic accidents. RESULTS Psychiatric treatment peaked among mothers during the three-month period after offspring self-harm, after which the treatment prevalence decreased but remained slightly elevated relative to the time preceding offspring self-harm. Higher levels of education and being employed increased the likelihood of treatment right after the episode. Among fathers, changes in treatment were negligible. Treatment trajectories around the comparison events of accidents were similar in shape but more muted than among the parents whose children had self-harmed. LIMITATIONS General practitioner visits or other data from primary health care were not available. CONCLUSION Mothers receive increased psychiatric treatment after stressful offspring events. Our results indicate that prevention of self-harm and accidents would be beneficial not only for those directly concerned but also for their family members.
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Affiliation(s)
- Joonas Pitkänen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland; International Max Planck Research School for Population, Health and Data Science, Rostock, Germany.
| | - Hanna Remes
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland
| | - Mikko Aaltonen
- Institute of Criminology and Legal Policy, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland; Law School, University of Eastern Finland, Joensuu, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland; Max Planck Institute for Demographic Research, Rostock, Germany; Department of Public Health Sciences, Stockholm University, Sweden
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Hill NTM, Walker R, Andriessen K, Bouras H, Tan SR, Amaratia P, Woolard A, Strauss P, Perry Y, Lin A. Reach and perceived effectiveness of a community-led active outreach postvention intervention for people bereaved by suicide. Front Public Health 2022; 10:1040323. [PMID: 36620290 PMCID: PMC9815599 DOI: 10.3389/fpubh.2022.1040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Postvention is a core component of suicide prevention strategies, internationally. However, the types of supports provided to people impacted by suicide vary widely. This study examines the perceived effectiveness of the Primary Care Navigator (PCN) model for people bereaved by suicide. The PCN model was implemented in response to a suicide cluster. It is an active outreach postvention intervention, initiated by police in response to a suspected suicide and links individuals to support in the immediate aftermath of their loss. Methods A retrospective cross-sectional mixed methods approach was used to (1) identify the reach of the PCN model, (2) describe the type of support provided to people bereaved by a suspected suicide and (3) identify the perceived effectiveness of the PCN model from the perspective of WA police, postvention stakeholders and individuals bereaved by suicide. Quantitative data was used to examine the characteristics of suicide in the region, the characteristics of people who received bereavement support, and the types of support that were provided. Interviews with police, postvention stakeholders, and people bereaved by a suspected suicide were conducted to identify the perceived effectiveness of the intervention. Results Between 1 January 2019 and 31 March 2021 there were 80 suspected suicides. Active outreach was provided to 347 bereaved individuals via the PCN model. Just under half of those who were offered outreach accepted further support (N = 164) in the form of suicide bereavement information (98%), mental health or clinical support (49.6%), specialized postvention counseling (38.4%), financial assistance (16%) and assistance with meals (16%), followed by housing assistance (14%) and referral to community services (11%). Police, stakeholders, and people with lived experience of a suspected suicide perceived the PCN model to be effective at connecting them to the community, linking people to support, and preventing suicide. Conclusion The results provide evidence supporting the perceived effectiveness of an active outreach approach to postvention that provides acute support to people bereaved by suicide. Findings highlight important practical areas of support such as providing referral pathways and information on grief and suicide loss in the immediate aftermath of a suicide loss.
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Affiliation(s)
- Nicole T. M. Hill
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia,School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia,*Correspondence: Nicole T. M. Hill
| | - Roz Walker
- School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia,Ngangk Yira Institute for Change, Murdoch University, Murdoch, WA, Australia,School of Indigenous Studies, University of Western Australia, Perth, WA, Australia
| | - Karl Andriessen
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Hamza Bouras
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Shawn R. Tan
- Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Alix Woolard
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
| | - Penelope Strauss
- Telethon Kids Institute, Nedlands, WA, Australia,School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia
| | - Yael Perry
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Nedlands, WA, Australia,Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
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14
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Pitman A, McDonald K, Logeswaran Y, Lewis G, Cerel J, Erlangsen A. Proportion of suicides in Denmark attributable to bereavement by the suicide of a first-degree relative or partner: Nested case-control study. Acta Psychiatr Scand 2022; 146:529-539. [PMID: 35999652 PMCID: PMC9826113 DOI: 10.1111/acps.13493] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/21/2022] [Accepted: 08/16/2022] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To provide the first estimates of the risk of suicide after bereavement by the suicide of any first-degree relative and the proportion of suicides in Denmark attributable to suicide bereavement. METHODS We conducted a nationwide nested case-control study defining cases as all Danish-born individuals who died by suicide in Denmark between 01 January 1980 and 31 December 2016 (n = 32,248), age-matched to four living controls. Using three exposure categories (bereavement by the suicide of a relative [parent, offspring, sibling, and spouse/cohabitee]; non-suicide bereavement; no bereavement) and conditional logistic regression adjusted for pre-specified covariates we estimated the odds of exposure to suicide bereavement in cases versus controls. We tested whether associations differed for men and women, estimated the population attributable fraction (PAF) of suicides in our population at risk that could be attributed to a first-degree relative's suicide loss, and estimated the attributable fraction among the exposed (AFe). RESULTS Suicide bereavement was associated with an increased odds of suicide when compared with no bereavement (ORadj2 = 2.90, 95% CI: 2.46-3.40) or non-suicide bereavement (ORadj2 = 1.48, 95% CI: 1.25-1.74). There was no evidence to support any interaction with sex. PAF (0.69%; 95% CI: 0.62%-0.77%) and AFe (60.12%; 95% CI: 53.19%-66.03%) estimates suggested that in Denmark 0.69% of suicides, and 60% of suicides among suicide-bereaved relatives, could be prevented if it was possible to address all factors increasing suicide risk in suicide-bereaved relatives. CONCLUSION Suicide bereavement in relatives and partners contributes to at least one in 145 suicides in Denmark.
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Affiliation(s)
- Alexandra Pitman
- Division of PsychiatryUCLLondonUK
- Camden and Islington NHS Foundation TrustSt. Pancras HospitalLondonUK
| | | | | | | | - Julie Cerel
- College of Social WorkUniversity of KentuckyLexingtonKentuckyUSA
| | - Annette Erlangsen
- Danish Research Institute for Suicide PreventionPsychiatric Centre CopenhagenCopenhagenDenmark
- Copenhagen Research Centre for Mental Health, Mental Health Center CopenhagenMental Health ServicesCopenhagenDenmark
- Department of Mental HealthJohns Hopkins School of Public HealthHamptonMarylandUSA
- Centre for Mental Health ResearchThe Australian National UniversityCanberraAustralia
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15
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Groves S, Hawley M, Lascelles KM, Hawton K. News reporting of suicide in nurses: A content analysis study. Int J Ment Health Nurs 2022; 31:1513-1522. [PMID: 36008915 PMCID: PMC9804535 DOI: 10.1111/inm.13057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2022] [Indexed: 01/05/2023]
Abstract
Media impact on suicide is well-established. Groups at heightened risk of suicide, such as nurses, may be particularly influenced by poor news reporting. This study aimed to examine UK newspaper reporting of suicide of nurses and student nurses, including during the COVID-19 pandemic. Print and online newspaper reports about suicide in nurses (including students) published in the UK between January 2018 and August 2021 were obtained and data extracted for analysis in collaboration with Samaritans' media advisory team. Content and quality of newspaper reports were examined using a content analysis approach. The study was compliant with the STROBE checklist. Nurse or student nurse suicides were reported in 134 articles, including 50 individual suicides. Most articles were acceptable against Samaritans' media guidelines. However, common problems included absence of signposting to support organizations and lack of suicide prevention messages. A minority of articles included methods of suicide within article headlines (18, 13.4%) and sensationalist or romanticizing language (14, 10.7%). Most contained occupation-related content. Many named the individual's specific hospital or university and a substantial proportion included occupation-related images. Working on the frontline was the most reported link between COVID-19 and nurse suicide. While reporting on suicide among nurses and students was largely acceptable, quality of reporting was variable. Occupation was often discussed, and most articles published during COVID-19 linked suicide to the pandemic. The research findings can help shape guidance on reporting of suicide in specific professions and occupations, including nursing, to encourage responsible reporting and reduce inadvertent promotion of suicide.
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Affiliation(s)
- Samantha Groves
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | | | | | - Keith Hawton
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.,Centre for Suicide Research, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
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16
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Aboagye RG, Ahinkorah BO, Seidu AA, Okyere J, Frimpong JB, Kumar M. In-school adolescents’ loneliness, social support, and suicidal ideation in sub-Saharan Africa: Leveraging Global School Health data to advance mental health focus in the region. PLoS One 2022; 17:e0275660. [PMID: 36350793 PMCID: PMC9645589 DOI: 10.1371/journal.pone.0275660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 09/21/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction Adolescent and youth mental health problems are increasingly becoming an area of concern in global health. Young people in sub-Saharan Africa experience significant adversities and systemic challenges despite technological advancements and demographic transition that the region is experiencing. We examined the nexus between experiences of loneliness, low social support, and presence of suicidal ideation among in-school adolescents in sub-Saharan Africa. Method A total of 19,119 in-school adolescents from eight countries in sub-Saharan Africa were included in this study. Suicidal ideation was the main outcome variable and loneliness, and social support were the explanatory variables. Percentages were used to summarise the prevalence of suicidal ideation, loneliness, and social support among the in-school adolescents. A multivariable binary logistic regression analysis was later used to determine the association between suicidal ideation and the explanatory variables and covariates using Stata v16. Four models were tested using the regression analysis. We presented the regression results using adjusted odds ratios (aOR), with their respective 95% confidence intervals (CIs). Results Overall, the past year prevalence of loneliness, peer support, one or more close friends, and suicidal ideation were 10%, 33.4%, 90.1%, and 14.5%, respectively. In-school adolescents who felt lonely (aOR = 1.88, 95% CI = 1.69, 2.09) were more likely to experience suicidal ideation. However, those who received peer support (aOR = 0.89, 95% CI = 0.82, 0.97) and had one or more close friends (aOR = 0.77, 95% CI = 0.68, 0.86) were less likely to experience suicidal ideation. Conclusion These results point to the significant roles of loneliness, and lack of social support, in understanding suicidal ideations. Countries in sub-Saharan Africa need to improve child and adolescent mental health policies and programmes to respond to these risk factors and mental health challenges. Programmes with a differential focus on the needs of males and females, younger and older adolescents will be important in the future.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Douglas, Australia
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Department of Kinesiology, New Mexico State University, Las Cruces, NM, United States of America
- * E-mail:
| | - Manasi Kumar
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
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17
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Mathieu S, Todor R, De Leo D, Kõlves K. Coping Styles Utilized during Suicide and Sudden Death Bereavement in the First Six Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192214709. [PMID: 36429427 PMCID: PMC9690721 DOI: 10.3390/ijerph192214709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/03/2022] [Accepted: 11/07/2022] [Indexed: 05/13/2023]
Abstract
Individuals bereaved by suicide experience substantial emotional distress and are at risk for poorer mental health, substance use concerns, and suicidal behaviors. This study aimed to explore whether those bereaved by suicide reported different coping styles compared to those bereaved by sudden death in the first six months. It also aimed to determine whether a previous mental health diagnosis (PMHD) and experiencing stigma and/or shame impacted the utilization of adaptive and maladaptive coping. The sample was constituted by individuals bereaved by suicide (n = 142) compared to those bereaved by sudden death (n = 63), six months after loss. The study included immediate family members who were 18 years or older and understood the English language. After controlling for demographics there were no significant differences in coping styles between bereavement types. Regardless of bereavement type, having a PMHD was associated with increased avoidant and problem-focused coping, and stigma and shame were each associated with increased avoidant coping. Women were also more likely to report using adaptive coping. Findings demonstrate no difference by bereavement type and have implications for the tailoring of grief/postvention supports that are sensitive to perceived stigma/shame to better facilitate utilization of adaptive emotion-focused coping, particularly for men and those with pre-existing mental health problems.
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Affiliation(s)
- Sharna Mathieu
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Suicide Research and Training, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
| | - Racquel Todor
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Suicide Research and Training, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
| | - Diego De Leo
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Suicide Research and Training, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
- Slovene Centre for Suicide Research, Primorska University, 6000 Koper, Slovenia
- De Leo Fund, 35137 Padua, Italy
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Suicide Research and Training, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
- Correspondence:
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18
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Weiss SJ, Simeonova DI, Koleva H, Muzik M, Clark KD, Ozerdem A, Cooper B, Ammerman RT. Potential paths to suicidal ideation and suicide attempts among high-risk women. J Psychiatr Res 2022; 155:493-500. [PMID: 36183603 DOI: 10.1016/j.jpsychires.2022.09.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 08/22/2022] [Accepted: 09/16/2022] [Indexed: 10/31/2022]
Abstract
Although men are more likely to die by suicide, women experience a greater and more rapidly increasing rate of suicidal ideation (SI) and are 3 times more likely to attempt suicide than men. Despite this increased risk, little is known about factors that contribute to SI or suicide attempts (SA) among women. We examined factors associated with SI and SA among women and identified mood-related symptoms that differentiate women who reported attempting suicide from those who did not. Women at elevated risk for depression from across the U.S. (N = 3372; age 18 to 90) completed a survey regarding depression, anxiety, sociodemographic and reproductive status, behavioral/mental health history, and exposure to adversity. Structural equation modeling and logistic regression were used to analyze the data. Variables with the most significant relationships to SI were severity of depression (OR = 5.2, p = 0.000) and perceived stress (OR = 1.18, p = 0.000) while frequency of suicidal thoughts (OR = 3.3, p = 0.000), family history of a depression diagnosis (OR = 1.6, p = 0.000) and exposure to violence (OR = 1.9, p = 0.000) had the strongest association with SA. Childhood abuse/trauma was associated with SA (OR = 1.13, p = 0.000) but not SI. 'Feeling bad about themselves, a failure, or having let themselves or their family down' was the symptom that most clearly differentiated women who attempted suicide from women who reported suicidal ideation but no SA. The salience of childhood abuse and domestic/community violence to women's risk for a suicide attempt reinforces previous findings that these adversities may differentiate suicide risk for women versus men. Continued research is essential to understand varied paths that may lead to suicidal behavior among women, some which appear unrelated to the frequency or intensity of their suicidal thoughts.
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Affiliation(s)
- Sandra J Weiss
- University of California, 2 Koret Way, Box 0608, San Francisco, CA, 94143, USA.
| | - Diana I Simeonova
- Emory University, 12 Executive Park Drive NE, Atlanta, GA, 30329, USA.
| | - Hristina Koleva
- University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
| | - Maria Muzik
- University of Michigan, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA.
| | - Kristen D Clark
- University of New Hampshire, 4 Library Way, Hewitt Hall, Durham, NH, 03824, USA.
| | - Aysegul Ozerdem
- Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Bruce Cooper
- University of California, 2 Koret Way, Box 0610, San Francisco, CA, 94143, USA.
| | - Robert T Ammerman
- University of Cincinnati, Cincinnati Children's Hospital, 333 Burnet Avenue, ML7039, Cincinnati, OH, 45229, USA.
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19
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McDonnell S, Flynn S, Shaw J, Smith S, McGale B, Hunt I. Suicide bereavement in the UK: Descriptive findings from a national survey. Suicide Life Threat Behav 2022; 52:887-897. [PMID: 35611626 PMCID: PMC9790485 DOI: 10.1111/sltb.12874] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/12/2022] [Accepted: 05/05/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Those bereaved by suicide are a high-risk group of adverse health outcomes and suicidal behavior, yet little is known about the experiences and support needs of these individuals in the UK. METHODS We conducted a national cross-sectional study using an online survey and analyzed the experiences of 7158 participants who had been bereaved or affected by suicide. RESULTS Suicide had a major impact on 77% of participants, including those who had lost a friend and those exposed to suicide at a professional level. Mental and physical health problems linked to the suicide were reported in half. Adverse social outcomes and engaging in high-risk behaviors following the suicide were common. Over a third reported suicidal ideation and 8% had attempted suicide as a direct result of the suicide loss. Most had not accessed support services, with the majority viewing provision of local suicide bereavement support as inadequate. CONCLUSIONS Our results highlight the need for a multi-disciplinary approach in postvention and the provision of proactive outreach to support those bereaved by suicide. Postvention efforts need to acknowledge the death of a friend by suicide as a significant loss.
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Affiliation(s)
- Sharon McDonnell
- Faculty of Biology, Medicine and HealthCentre for Mental Health and SafetyUniversity of ManchesterManchesterUK,Suicide BereavementRamsbottomUK
| | - Sandra Flynn
- Faculty of Biology, Medicine and HealthCentre for Mental Health and SafetyUniversity of ManchesterManchesterUK
| | - Jenny Shaw
- Faculty of Biology, Medicine and HealthCentre for Mental Health and SafetyUniversity of ManchesterManchesterUK,Greater Manchester Mental Health NHS Foundation TrustManchesterUK,Independent Advisory Panel on Deaths in CustodyLondonUK
| | - Shirley Smith
- If U Care Share FoundationChesterUK,Support After Suicide PartnershipLondonUK
| | - Barry McGale
- Suicide BereavementRamsbottomUK,Support After Suicide PartnershipLondonUK
| | - Isabelle M. Hunt
- Faculty of Biology, Medicine and HealthCentre for Mental Health and SafetyUniversity of ManchesterManchesterUK
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20
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Maple M, Cerel J, Sanford R, Shand F, Batterham PJ, Bhullar N. Suicide exposure experience screener for use in therapeutic settings: A validation report. Suicide Life Threat Behav 2022; 52:975-982. [PMID: 35713122 PMCID: PMC9796633 DOI: 10.1111/sltb.12894] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/20/2022] [Accepted: 06/02/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION A brief screener assessing experience of exposure to suicide for use in therapeutic settings is warranted. To examine the concurrent validity of such a screening tool, labeled as the Suicide Exposure Experience Screener (SEES), the associations of the two SEES items: (i) reported closeness with the person who died by suicide and (ii) perceived impact of suicide death with psychological distress are presented. METHODS Five separate datasets comprising surveys from Australia, Canada, and the United States (Ncombined = 7782) were used to provide evidence of concurrent validity of closeness and impact of suicide exposure. RESULTS Overall, closeness and impact were significantly correlated with measures of global distress across five different datasets, showing small to medium effect sizes. Closeness and impact were also intercorrelated demonstrating a large effect size across all surveys. This report used cross-sectional data and comprised varied sample sizes across different datasets that influenced statistical significance of obtained effects and did not tease apart the roles of cumulative exposure of suicide and prolonged bereavement in experiencing global distress. CONCLUSION The SEES has clinical utility in determining psychological distress in bereaved individuals and is recommended for use in therapeutic settings.
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Affiliation(s)
- Myfanwy Maple
- School of HealthUniversity of New EnglandArmidaleNew South WalesAustralia
| | - Julie Cerel
- College of Social WorkUniversity of KentuckyLexingtonKentuckyUSA
| | - Rebecca Sanford
- School of Social Work and Human ServiceThompson Rivers UniversityKamloopsBritish ColumbiaCanada
| | - Fiona Shand
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Philip J. Batterham
- Centre for Mental Health ResearchThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Navjot Bhullar
- Discipline of PsychologyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
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21
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Framework for successful school reintegration after psychiatric hospitalization: A systematic synthesis of expert recommendations. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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22
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Soberay KA, Cerel J, Brown MM, Maple M. An Examination of Suicide Exposure and Fearlessness about Death on Suicide Risk among Active Duty Service Members, Veterans, and Civilians. Arch Suicide Res 2022; 26:1198-1218. [PMID: 33465319 DOI: 10.1080/13811118.2020.1868365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Suicide exposure is associated with an increased risk for suicide. There is limited research on the mechanisms that increase this risk. This study aims to: (1) compare suicide exposure and associated variables in veteran, active duty, and civilian participants, (2) examine the extent to which fearlessness about death and suicide risk factors differ as a function of group membership and suicide exposure, and (3) determine the degree to which relationship to the decedent, perceived closeness, and reported impact of the death are associated with fearlessness about death and suicide-related outcomes. 1,533 participants were included, of whom 48% of active duty service members, 65% of veterans, and 58% of civilians reported knowing someone who died by suicide. A series of regressions were conducted. There were group differences by military service on the suicide exposure variables. Furthermore, there were significant main effects for military service group and suicide exposure on the outcome variables. In general, civilians reported greater suicide risk and active duty service members reported greater fearlessness about death. Fearlessness about death mediated the associations between perceived closeness and a history of suicide attempts. The loss of a military colleague to suicide was found to be unique and distinguishable from other important relationships. Results suggest the need to consider suicide exposure and closeness as salient variables associated with fearlessness about death and suicide risk factors. Inquiring about suicide exposure, closeness to the decedent, fearlessness about death, and beyond familial losses to suicide may indicate important avenues of intervention.
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23
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da Fonsêca JR, de Oliveira CM, de Castro CCL, da Costa HVV, Galvão PVM, da Costa Ceballos AG, do Bonfim CV. Analysis of the completeness of self-harm and suicide records in Pernambuco, Brazil, 2014-2016. BMC Public Health 2022; 22:1154. [PMID: 35681172 PMCID: PMC9178859 DOI: 10.1186/s12889-022-13455-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Suicides and suicide attempts are major public health problems, and coping strategies are hampered by insufficient or inadequate notifications. Data accuracy influences the formulation of public and mental health policies and suicide prevention strategies. The objective of this study was to analyze the completeness of self-harm and suicide records in the state of Pernambuco, Brazil, 2014-2016. METHODS This is an evaluative study with a descriptive design. The data were collected from suicide attempt records from the Notifiable Diseases Information System and suicide records from the Mortality Information System. Probabilistic linkage was used to relate these databases, and the degree of completeness of the variables was calculated. Completeness was classified into the following categories: good (≥ 75.1%), regular (50.1%-75.0%), low (25.1%-50.0%), and very low (≤ 25.0%). RESULTS In the analyzed period, 1,404 notifications of self-harm were studied, with an overall mean completeness of 86.2%. In addition, 1,050 suicide records were analyzed, with an overall mean completeness of 95.8%. Most variables referring to suicide attempts had good completeness, with the exception of the variables "occupation" and "education." The completeness of all suicide-related variables was rated as good. After linkage, a significant improvement was observed in the degree of completeness of the variable "occupation". CONCLUSION The results of this study showed that the completeness of self-harm and suicide variables improved from the first to the last year. The integration of data from different information systems provides an opportunity to improve suicide prevention programs and the quality of available information. Continuous efforts to increase the completeness and reliability of suicide surveillance systems are fundamental to describe the epidemiological profile and, consequently, plan preventive actions, in addition to contributing to the development and reformulation of strategies aimed at reducing morbidity and mortality related to suicidal behavior.
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Affiliation(s)
| | | | | | | | | | | | - Cristine Vieira do Bonfim
- Directorate of Social Research, Joaquim Nabuco Foundation, Rua Dois Irmãos, 92 - Ed. Anexo Anísio Teixeira - Apipucos, Recife, PE, CEP 52071-440, Brazil.
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24
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Demesmaeker A, Chazard E, Hoang A, Vaiva G, Amad A. Suicide mortality after a nonfatal suicide attempt: A systematic review and meta-analysis. Aust N Z J Psychiatry 2022; 56:603-616. [PMID: 34465221 DOI: 10.1177/00048674211043455] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Deliberate self-harm and suicide attempts share common risk factors but are associated with different epidemiological features. While the rate of suicide after deliberate self-harm has been evaluated in meta-analyses, the specific rate of death by suicide after a previous suicide attempt has never been assessed. The aim of our study was to estimate the incidence of death by suicide after a nonfatal suicide attempt. METHOD We developed and followed a standard meta-analysis protocol (systematic review registration-PROSPERO 2021: CRD42021221111). Randomized controlled trials and cohort studies published between 1970 and 2020 focusing on the rate of suicide after suicide attempt were identified in PubMed, PsycInfo and Scopus and qualitatively described. The rates of deaths by suicide at 1, 5 and 10 years after a nonfatal suicide attempt were pooled in a meta-analysis using a random-effects model. Subgroup analysis and meta-regressions were also performed. RESULTS Our meta-analysis is based on 41 studies. The suicide rate after a nonfatal suicide attempt was 2.8% (2.2-3.5) at 1 year, 5.6% (3.9-7.9) at 5 years and 7.4% (5.2-10.4) at 10 years. Estimates of the suicide rate vary widely depending on the psychiatric diagnosis, the method used for the suicide attempt, the type of study and the age group considered. CONCLUSION The evidence of a high rate of suicide deaths in the year following nonfatal suicide attempts should prompt prevention systems to be particularly vigilant during this period.
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Affiliation(s)
- Alice Demesmaeker
- U1172-LilNCog-Lille Neuroscience & Cognition, Inserm, CHU Lille, Université de Lille, Lille, France.,Hôpital Fontan, CHU de Lille, Lille, France
| | - Emmanuel Chazard
- ULR 2694 Metrics, CERIM, Public Health Department, CHU Lille, Université de Lille, Lille, France
| | - Aline Hoang
- U1172-LilNCog-Lille Neuroscience & Cognition, Inserm, CHU Lille, Université de Lille, Lille, France
| | - Guillaume Vaiva
- U1172-LilNCog-Lille Neuroscience & Cognition, Inserm, CHU Lille, Université de Lille, Lille, France.,Hôpital Fontan, CHU de Lille, Lille, France.,Centre National de Ressources et de Résilience (CN2R), Lille, France
| | - Ali Amad
- U1172-LilNCog-Lille Neuroscience & Cognition, Inserm, CHU Lille, Université de Lille, Lille, France.,Hôpital Fontan, CHU de Lille, Lille, France
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25
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Punzi G, Ursini G, Chen Q, Radulescu E, Tao R, Huuki LA, Di Carlo P, Collado-Torres L, Shin JH, Catanesi R, Jaffe AE, Hyde TM, Kleinman JE, Mackay TFC, Weinberger DR. Genetics and Brain Transcriptomics of Completed Suicide. Am J Psychiatry 2022; 179:226-241. [PMID: 35236118 PMCID: PMC8908792 DOI: 10.1176/appi.ajp.2021.21030299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to study the transcriptomic and genomic features of completed suicide by parsing the method chosen, to capture molecular correlates of the distinctive frame of mind of individuals who die by suicide, while reducing heterogeneity. METHODS The authors analyzed gene expression (RNA sequencing) from postmortem dorsolateral prefrontal cortex of patients who died by suicide with violent compared with nonviolent means, nonsuicide patients with the same psychiatric disorders, and a neurotypical group (total N=329). They then examined genomic risk scores (GRSs) for each psychiatric disorder included, and GRSs for cognition (IQ) and for suicide attempt, testing how they predict diagnosis or traits (total N=888). RESULTS Patients who died by suicide by violent means showed a transcriptomic pattern remarkably divergent from each of the other patient groups but less from the neurotypical group; consistently, their genomic profile of risk was relatively low for their diagnosed illness as well as for suicide attempt, and relatively high for IQ: they were more similar to the neurotypical group than to other patients. Differentially expressed genes (DEGs) associated with patients who died by suicide by violent means pointed to purinergic signaling in microglia, showing similarities to a genome-wide association study of Drosophila aggression. Weighted gene coexpression network analysis revealed that these DEGs were coexpressed in a context of mitochondrial metabolic activation unique to suicide by violent means. CONCLUSIONS These findings suggest that patients who die by suicide by violent means are in part biologically separable from other patients with the same diagnoses, and their behavioral outcome may be less dependent on genetic risk for conventional psychiatric disorders and be associated with an alteration of purinergic signaling and mitochondrial metabolism.
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Affiliation(s)
- Giovanna Punzi
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Gianluca Ursini
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Qiang Chen
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Eugenia Radulescu
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Ran Tao
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Louise A Huuki
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Pasquale Di Carlo
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Leonardo Collado-Torres
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Joo Heon Shin
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Roberto Catanesi
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Andrew E Jaffe
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Thomas M Hyde
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Joel E Kleinman
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Trudy F C Mackay
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
| | - Daniel R Weinberger
- Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore (Punzi, Ursini, Chen, Radulescu, Tao, Huuki, Di Carlo, Collado-Torres, Shin, Jaffe, Hyde, Kleinman, Weinberger); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (Ursini, Hyde, Kleinman, Weinberger); Section of Forensic Psychiatry and Criminology, Institute of Legal Medicine, D.I.M., University of Bari "Aldo Moro," Bari, Italy (Catanesi); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Jaffe); Department of Neurology, Johns Hopkins School of Medicine, Baltimore (Hyde, Weinberger); Department of Genetics and Biochemistry and Center for Human Genetics, Clemson University, Greenwood, S.C. (Mackay); Departments of Neuroscience and Genetic Medicine, Johns Hopkins School of Medicine, Baltimore (Weinberger)
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26
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Roland L, Höller I, Forkmann T, Glaesmer H, Paashaus L, Schönfelder A, Teismann T, Juckel G, Rath D. Suicidal behavior in the social environment: Does exposure moderate the relationship between an individual's own suicidal ideation and behavior? Clin Psychol Psychother 2022; 29:1309-1320. [PMID: 35005811 DOI: 10.1002/cpp.2709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/13/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Suicidal behavior still cannot be sufficiently predicted. Exposure to suicidal behavior in the personal social environment is assumed to moderate the individual's transition from suicidal ideation to suicidal behavior within the Integrated Motivational-Volitional Model of Suicidal Behavior (IMV-model). This study aimed to investigate this moderating effect in a German high-risk sample. METHODS We interviewed 308 psychiatric inpatients (53% female) aged 18 to 81 years (M = 36.9, SD = 14.30) admitted after attempted suicide (53%) or due to an acute suicidal crisis (47%) regarding exposure events in their social environment. Four types of exposure events were analyzed using moderation analyses: familial suicides/suicide attempts, non-familial suicides/suicide attempts. Additionally, the numbers of reported exposure events were compared between patients with and without a recent suicide attempt as well as between patients with lifetime suicide attempts and lifetime suicidal ideation. RESULTS Neither moderating effects of exposure events on the relationship between lifetime suicidal ideation and recent suicidal behavior nor group differences between suicidal ideators and suicide attempters regarding the exposure events were found. CONCLUSIONS Exposure events might have differential and possibly protective effects on suicidal behavior - depending on type and quality (intensity, personal relevance, and recency) of event - and on the outcome (suicide vs. suicide attempt).
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Affiliation(s)
- Lea Roland
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Inken Höller
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Thomas Forkmann
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Laura Paashaus
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Antje Schönfelder
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, LWL-University Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Dajana Rath
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
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27
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Huang CY, Huang YT, Lin YH, Chi YC, Chang SS, Chen YY. Factors associated with psychological impact of celebrity suicide media coverage: An online survey study. J Affect Disord 2021; 295:839-845. [PMID: 34706454 DOI: 10.1016/j.jad.2021.08.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/16/2021] [Accepted: 08/28/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND We investigated factors associated with vulnerability to the psychological impact of celebrity suicide news reporting after the suicide of an emerging Taiwanese novelist, Ms Yi-Han Lin. METHODS We conducted a cross-sectional online survey. Participants completed a questionnaire which asked whether they were affected by the media coverage of Lin's suicide and whether they would seek help if affected. Logistic regression was used to identify factors associated with being affected by the celebrity suicide media reporting and, among those affected, factors associated with feeling suicidal or not seeking help. RESULTS A total of 1258 respondents (81% females) completed the survey. Affected individuals (n=907; 70%) were more likely to be females, younger (age < 40 years), have past psychiatric treatment, and show increased interest in the incident (e.g., spending more time on reading the celebrity suicide news) than non-affected individuals. Among those affected, negative views of the media reporting impact, pessimistic attitude toward both depression treatment and suicide prevention, and having a history of past psychiatric treatment were associated with feeling suicidal, while low education attainment, increased interest in the celebrity suicide, and permissive attitude toward inappropriate media reporting were additionally associated with not seeking help. LIMITATIONS Selection bias of participants through internet-based surveying should be considered. CONCLUSION Individuals affected by the media coverage of celebrity suicide showed similar demographic and mental health characteristics as those of the deceased celebrity. Poor mental health and suicide prevention literacy may increase the risk of psychological impact and not seeking help. Future interventions could target at enhancing mental health literacy and help seeking intention in vulnerable individuals.
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Affiliation(s)
- Cho-Yin Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yuan-Ting Huang
- Tao Yuan General Hospital, Ministry of Health and Welfare, Taoyuan City, Taiwan
| | - Yu-Hsuan Lin
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Ying-Chen Chi
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences and Global Health Program, College of Public Health, National Taiwan University, Taipei City, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Ying-Yeh Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan; Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei City, Taiwan.
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28
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Sadanand A, Rangiah S, Chetty R. Demographic profile of patients and risk factors associated with suicidal behaviour in a South African district hospital. S Afr Fam Pract (2004) 2021; 63:e1-e7. [PMID: 34797092 PMCID: PMC8603102 DOI: 10.4102/safp.v63i1.5330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background Suicidal behaviour comprises self-destructive thoughts coupled with attempts at suicide, which negatively impacts the patient, family, friends, and their community. There is a paucity of data on factors influencing suicidal thoughts and behaviour in South Africa. The aim of this study was to evaluate demographic profile and risk factors associated with suicidal behaviour. Methods In this retrospective descriptive and observational study, 282 medical records of patients with suicidal behaviour were studied. The risk factors and age at occurrence were tabulated. Descriptive analyses were undertaken to understand how they were distributed across key socio-demographic groups. Results Suicidal behaviour was particularly prominent amongst the female population. The suicidal ideation, plan and non-fatal suicide were reported by 48.6%, 29.1% and 36.5%, of patients respectively. The prevalence for suicidal ideation was significantly higher in females (54.5% vs. 31.5%; p < 0.0007) but not for suicidal plan (28.7% vs. 30.1%; p < 0.81) and suicidal attempt (37.3% vs. 34.2%; p = 0.63) as compared with males. Suicidal behaviour was positively associated with depression (r = 0.56, p < 0.001) and negatively associated with age (r = −0.16, p = 0.01). Multivariate logistic regression analysis revealed that suicidal behaviour was influenced by female gender, poor social support, depression and a family history of non-fatal suicide. Conclusion This research has confirmed an association between female sex and factors associated with a higher risk of suicidal behaviour.
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Affiliation(s)
- Aneeth Sadanand
- Department of Family Medicine, College of Health Science, University of KwaZulu-Natal, Durban.
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29
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del Carpio L, Paul S, Paterson A, Rasmussen S. A systematic review of controlled studies of suicidal and self-harming behaviours in adolescents following bereavement by suicide. PLoS One 2021; 16:e0254203. [PMID: 34242305 PMCID: PMC8270178 DOI: 10.1371/journal.pone.0254203] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 06/23/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Research suggests that being exposed to the suicide of others increases risk of subsequent suicidal or self-harming thoughts or behaviours. What is less clear is whether this applies to adolescents, and if the risk exceeds that following other causes of death, which has implications on suicide prevention approaches. This study aimed to systematically review the evidence on adolescent bereavement experiences by different causes to address this gap. METHODS A comprehensive literature search using four databases (MEDLINE, PsycInfo, Web of Science, and Embase) identified 21 studies which measured suicidal or self-harm outcomes among bereaved adolescents aged between 12 to 18 years old. The literature was screened, data was extracted using pre-piloted forms, and risk of bias was assessed using versions of the Newcastle-Ottawa Scale; a proportion of papers were double extracted and assessed for bias. The review has been registered with PROSPERO (CRD42016051125). RESULTS A narrative synthesis of the literature demonstrated divergent findings depending on the outcome being measured. Suicide bereavement appears to be strongly associated with suicide mortality among parentally bereaved youth, while self-harm or non-fatal suicide attempts (either presenting to hospital or self-reported) showed mixed evidence. Suicidal ideation was not uniquely associated with suicide bereavement. An exploration of circumstances surrounding the death, characteristics of the person who died, and characteristics of the young person across each outcome measure suggested that earlier experiences of loss, shorter timeframes following the death, and maternal death are associated with particularly elevated risk of suicidal outcomes. CONCLUSIONS Findings suggest that suicide loss is associated with subsequent suicide, and may be associated with non-fatal self-harm. A detailed account of the risk and protective factors surrounding suicide bereavement among young people is crucial to understand the pathways through which suicidal behaviours develop. Researchers, policy makers and practitioners with an interest in suicide prevention will benefit from clarity around the needs of young bereaved individuals.
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Affiliation(s)
- Laura del Carpio
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Sally Paul
- School of Social Work and Social Policy, University of Strathclyde, Glasgow, United Kingdom
| | - Abigail Paterson
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Susan Rasmussen
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
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Causer H, Bradley E, Muse K, Smith J. Bearing witness: A grounded theory of the experiences of staff at two United Kingdom Higher Education Institutions following a student death by suicide. PLoS One 2021; 16:e0251369. [PMID: 33979333 PMCID: PMC8115842 DOI: 10.1371/journal.pone.0251369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/24/2021] [Indexed: 11/21/2022] Open
Abstract
Wider networks of people are affected by a suicide death than originally thought, including those whose job-role brings them into contact with a death by suicide of another person. The impact of student suicide within United Kingdom (UK) Higher Education Institutions (HEIs) is unexplored and the experiences of staff members remain unknown. It is not known whether staff members have specific postvention needs following a student death by suicide. Any postvention support currently offered to staff members within UK HEIs lacks a context-specific evidence base. This study asked 'How is a student suicide experienced by staff members within a UK HEI and what are the features of that experience?' Staff members from diverse job-roles in two UK HEIs responded to a qualitative survey (n = 19) and participated in semi-structured interviews (n = 10). Data were transcribed and subjected to a constructivist grounded theory analysis. Participants' experiences informed the development of a core category: 'Bearing witness', which encompassed six further categories: 'Responding to a student suicide'; 'Experiencing a student suicide'; 'Needs and fears'; 'Experiences of support'; 'Human stories'; and 'Cultural stories'. The resulting grounded theory demonstrates how participants' perceptions of impact are informed by their experiences of undertaking tasks following a student suicide within the community of their HEI. Processes of constructing perceptions of closeness to the student who died are evident amongst participants who did not know the student prior to their death. Tailored postvention support is required to respond to the range and complexity of HEI staff needs following a student death by suicide.
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Affiliation(s)
- Hilary Causer
- School of Allied Health and Community, University of Worcester, Worcestershire, United Kingdom
| | - Eleanor Bradley
- College of Life, Health and Environmental Sciences, University of Worcester, Worcestershire, United Kingdom
| | - Kate Muse
- School of Psychology, University of Worcester, Worcestershire, United Kingdom
| | - Jo Smith
- School of Allied Health and Community, University of Worcester, Worcestershire, United Kingdom
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Morgan ER, DeCou CR, Hill HD, Mooney SJ, Rivara FP, Rowhani-Rahbar A. State earned income tax credits and suicidal behavior: A repeated cross-sectional study. Prev Med 2021; 145:106403. [PMID: 33388334 DOI: 10.1016/j.ypmed.2020.106403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/07/2020] [Accepted: 12/29/2020] [Indexed: 01/28/2023]
Abstract
Suicide is an increasingly common cause of death in the United States and recent increases in suicide rates disproportionately impact low income individuals. We sought to assess the impact of income support in the form of state earned income tax credit policies on suicide-related behaviors. This state-level study used repeated cross-sectional data from vital records and the National Survey of Drug Use and Health data representative at the state-level. The population included adults who either died by suicide or were selected for in-person NSDUH interviews between 2008 and 2018. Exposure was measured as the generosity of a refundable state earned income tax credit policy measured as a percentage of the federal policy. Outcomes assessed were suicidal ideation, suicidal planning, non-fatal suicide attempt, suicide deaths, and combined fatal and non-fatal suicide attempts. Analyses were performed between April and June 2020. A 10 percentage-point increase in the generosity of state earned income tax credit was associated with lower frequency of non-fatal suicide attempts (prevalence ratio [PR] = 0.96; 95% CI: 0.93-0.99), combined fatal and non-fatal suicide attempts (PR = 0.96; 95% CI: 0.93-0.99), and suicide deaths (PR = 0.99; 95% CI: 0.99-1.00). This translates to 4 fewer suicide attempts per 10,000 population each year. Generous state earned income tax credit policies are associated with reductions in the frequency of most severe suicidal behavior. Income support policies may be one way to reduce suicide attempts and death, especially among low-income adults.
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Affiliation(s)
- Erin R Morgan
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States of America; Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, United States of America.
| | - Christopher R DeCou
- Department of Psychiatry & Behavioral Science, School of Medicine, University of Washington, Seattle, WA, United States of America
| | - Heather D Hill
- Daniel J. Evans School of Public Policy and Governance, University of Washington, Seattle, WA, United States of America
| | - Stephen J Mooney
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States of America; Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, United States of America
| | - Frederick P Rivara
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, United States of America
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States of America; Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA, United States of America
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Mitchell KJ, Banyard V, Goodman KL, Strøm IF, Ybarra ML. Exposure to Suicidal Behavior and Social Support Among Sexual- and Gender-Minority Youth. Pediatrics 2021; 147:e2020033134. [PMID: 33722989 PMCID: PMC8015153 DOI: 10.1542/peds.2020-033134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In this study, we examine reports of exposure to suicidal behavior by youth sexual and gender identity. We explore how exposure is related to depressed mood in the context of high social support while accounting for cumulative adversity. METHODS Data from a large national sample of youth aged 14 to 15 years in the United States (N = 3979) were collected online in 2018-2019. RESULTS Sexual- and gender-minority youth were more likely to know someone close to them who attempted suicide, relative to cisgender heterosexual youth. Cisgender heterosexual youth were buffered from recent depressed mood when they endorsed having high social support in the context of exposure to suicidal behavior; less social support did not provide such a buffer. For cisgender sexual-minority male and female youth, exposure to suicidal behavior was related to recent depressed mood regardless of the level of social support. For gender-minority youth assigned female at birth, the combination of exposure and high social support was significantly associated with elevated depressed mood. Cumulative adversity accounted for some but not all of these relationships, indicating the influential role of exposure to suicidal behavior on depressed mood for some youth. CONCLUSIONS These findings illustrate the complexities of social support and raise questions about its potential to magnify stress rather than serve as a buffer for some youth. Although findings need to be replicated, suicide prevention efforts should carefully consider how to promote resilience among these suicide-exposed sexual- and gender-minority youth who may themselves be at risk for suicidal ideation and behavior.
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Affiliation(s)
- Kimberly J Mitchell
- Crimes Against Children Research Center, University of New Hampshire, Durham, New Hampshire;
| | - Victoria Banyard
- School of Social Work, Rutgers University, New Brunswick, New Jersey
| | - Kimberly L Goodman
- Rape, Abuse & Incest National Network, Washington, District of Columbia; and
| | - Ida F Strøm
- Center for Innovative Public Health Research, San Clemente, California
| | - Michele L Ybarra
- Center for Innovative Public Health Research, San Clemente, California
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Suicidal ideation and associated factors among school-going adolescents in rural Ghana. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01378-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractSuicidal ideation is a critical risk for attempted suicide and eventual suicide. Little is known about suicidal ideation among rural adolescents in most sub-Saharan African countries. We aimed to estimate the 12-month prevalence of suicidal ideation and to describe some of the common and gender-specific associated factors among in-school adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana. The Suicidal Behavior Questionnaire-Revised was used to assess suicidal ideation. Overall, 25.1% participants (95% CI = 22.5–27.7), representing 28.3% females (95% CI = 24.7–32.2) and 21.5% males (95% CI = 18.0–25.2) reported suicidal ideation during the previous 12 months. Females who experienced personal and interpersonal adversities mainly outside the family context were likely to report suicidal ideation, while suicidal ideation among males was associated with conflict with parents. Regardless of gender, adolescents who reported exposure to a friend’s attempted suicide were about two times more likely to report suicidal ideation. The prevalence of suicidal ideation among adolescents in rural Ghana compares with in-school estimates from other countries within sub-Saharan Africa, but also underscores the need for targeted and universal prevention programmes and intervention efforts to mitigate the potential transition from suicidal ideations to suicidal attempts and eventual deaths by suicide among rural adolescents.
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Kirtley OJ, Hussey I, Marzano L. Exposure to and experience of self-harm and self-harm related content: An exploratory network analysis. Psychiatry Res 2021; 295:113572. [PMID: 33333438 DOI: 10.1016/j.psychres.2020.113572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 11/09/2020] [Indexed: 11/19/2022]
Abstract
Exposure to the self-harm behaviour of others plays a role in individuals' own self-harm thoughts and behaviours, but there has been little consideration of the broader range of mediums through which exposure to self-harm related content may occur. N = 477 participants completed an online study, including questions regarding lifetime history of self-harm thoughts and behaviours and the frequency with which they had been exposed to self-harm via various mediums. Gaussian Markov random field network models were estimated using graphical LASSO and extended Bayesian information criterion. Bootstrapping revealed that exposure mediums with a direct connection to self-harm thoughts and behaviours were the internet (rrp = .34, 95% CI [.26, .42]) and in-passing 'miscellaneous' exposure (rrp = .14, 95% CI [.00, .23]). However, stability of the network centrality was low (expected influence stability = 0.52). The node with the greatest increase in expected influence within the network was miscellaneous "in-passing" exposure. In-passing exposure is an understudied exposure medium. Our results may suggest new types of exposure mediums for future research. Data were cross-sectional, so temporal relationships between exposure and behaviour could not be determined. Low stability of the networks suggests that future similar studies would benefit from larger sample sizes.
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Affiliation(s)
- Olivia J Kirtley
- Center for Contextual Psychiatry, KU Leuven, Department of Neuroscience, Campus Sint-Rafael, Kapucijnenvoer 33, Bus 7001 (Blok H), 3000 Leuven, Belgium..
| | - Ian Hussey
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Lisa Marzano
- Psychology Department, Middlesex University, The Burroughs, London NW4 4BT, UK
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Hill NT, Spittal MJ, Pirkis J, Torok M, Robinson J. Risk factors associated with suicide clusters in Australian youth: Identifying who is at risk and the mechanisms associated with cluster membership. EClinicalMedicine 2020; 29-30:100631. [PMID: 33294825 PMCID: PMC7691728 DOI: 10.1016/j.eclinm.2020.100631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/18/2020] [Accepted: 10/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND It is unclear who is at risk of being involved in a suicide cluster and whether suicide clusters are influenced by the social transmission of suicidal behaviour, assortative relating, or a combination of both. METHODS Suicide clusters involving two or more young people were identified from the free text of electronic police and coroners reports in Australia's National Coronial Information System in a nationwide cross-sectional study. The duration of survival among exposed cases were estimated using time-to-event methods. The casewise concordance of demographic, social and clinical characteristics and circumstances of death were examined among index and exposed cases. FINDINGS We identified links between 117 young people (51 suicide clusters). 50% of young people died within 90 days of the index suicide. Individuals exposed to railway suicide had an 80% probability of dying by the same method. Those exposed to the suicide of a person aged 10-18 years had an 86% probability of being from the same age group. Young people had a 67% and 60% probability of sharing the same characteristics as the index suicide when the index suicide resided in a remote community or was of Aboriginal and Torres Strait Islander descent. INTERPRETATION Suicide clusters may be associated with both the social transmission of suicidal behaviour and assortative relating. Individuals who were close to the deceased should be provided with access to postvention support, particularly within the first 90 days of exposure to an index suicide. FUNDING Australian Rotary Health, National Health and Medical Research Council.
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Affiliation(s)
- Nicole T.M. Hill
- Telethon Kids Institute, 15 Hospital Ave, Nedlands, Perth, WA 6008, Australia
- Orygen, Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Jo Robinson
- Orygen, Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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Hill NT, Witt K, Rajaram G, McGorry PD, Robinson J. Suicide by young Australians, 2006-2015: a cross-sectional analysis of national coronial data. Med J Aust 2020; 214:133-139. [PMID: 33236400 DOI: 10.5694/mja2.50876] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/07/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To assess the demographic, social, and clinical characteristics of young Australians who die by suicide. DESIGN Retrospective analysis of National Coronial Information System (NCIS) data. SETTING, PARTICIPANTS People aged 10-24 years who died by suicide in Australia during 2006-2015. MAIN OUTCOME MEASURES Demographic, social, and clinical characteristics of young people who died by suicide; circumstances of death recorded in the NCIS. RESULTS 3365 young people died of suicide during 2006-2015 (including 2473 boys and men, 73.5%); 1292 people (38.4%) lived in areas of greater socio-economic disadvantage. Free text reports were included in the NCIS for 3027 people (90%), of whom 1237 (40.9%) had diagnosed mental health disorders and 475 (15.7%) had possible mental health disorders. Alcohol consumption near the time of death was detected in 1015 of 3027 cases (33.5%); histories of self-harm were recorded in 940 cases (31.1%) and of illicit substance misuse in 852 (28.1%). Adverse life events included history of abuse or neglect (223, 7.4%), suicide of relatives, friends, or acquaintances (202, 6.7%), and financial difficulties (174, 5.8%). CONCLUSIONS Three-quarters of the young people who died by suicide were boys or young men, and 57% had diagnosed or possible mental health disorders, suggesting that the mental health and wellbeing of young Australians should be a key target for youth suicide prevention. To reduce the number of youth suicides, it is imperative that prevention strategies target the mental health and psychosocial stressors that lead to suicidal crises in young people.
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Affiliation(s)
- Nicole Tm Hill
- Telethon Kids Institute, Perth, WA.,Orygen Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC
| | - Katrina Witt
- Orygen Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC
| | - Gowri Rajaram
- Orygen Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC
| | - Patrick D McGorry
- Orygen Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC
| | - Jo Robinson
- Orygen Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC
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Favril L, O’Connor RC, Hawton K, Vander Laenen F. Factors associated with the transition from suicidal ideation to suicide attempt in prison. Eur Psychiatry 2020; 63:e101. [PMID: 33183374 PMCID: PMC7737175 DOI: 10.1192/j.eurpsy.2020.101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although research has identified a wide range of risk factors for suicidal behavior in prisoners, it does not establish who is most likely to act on their suicidal thoughts while incarcerated. METHODS Self-report data were collected from a random sample of 1,203 adult men incarcerated across 15 prisons in Belgium, who represent 12% of all male prisoners nationwide. RESULTS One-third (33%) of participants reported having suicidal thoughts during their incarceration, of whom 26% attempted suicide in prison (9% of all prisoners). Factors independently associated with suicide attempt among prisoners with suicidal ideation were violent offending (adjusted odds ratio [aOR] = 2.64, 95% confidence interval [CI] 1.33-5.23), in-prison drug use (aOR = 2.30, 95% CI 1.25-4.22), exposure to suicidal behavior (aOR = 1.96, 95% CI 1.04-3.68), and a lifetime history of nonsuicidal self-injury (aOR = 1.90, 95% CI 1.08-3.36). While related to suicidal thoughts, markers of psychiatric morbidity and aspects of the prison regime were not associated with the progression to suicide attempt. CONCLUSIONS Many prisoners who think about suicide do not attempt suicide while incarcerated. Factors associated with suicidal ideation are distinct from those that govern the transition to suicidal behavior. Our findings lend support to the hypothesis that behavioral disinhibition might act as a catalyst in the translation of suicidal thoughts into action.
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Affiliation(s)
- Louis Favril
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
| | - Rory C. O’Connor
- Suicidal Behaviour Research Laboratory, Institute of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Freya Vander Laenen
- Institute for International Research on Criminal Policy, Faculty of Law and Criminology, Ghent University, Ghent, Belgium
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