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Ricciardelli R, Carleton RN, Johnston MS, Dorniani S, Taillieu TL, Afifi TO. A Canadian national study of provincial and territorial correctional workers' suicidal ideation, plans, and attempts. Stress Health 2024:e3476. [PMID: 39276313 DOI: 10.1002/smi.3476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 07/23/2024] [Accepted: 09/01/2024] [Indexed: 09/16/2024]
Abstract
Correctional workers (CWs) endure several operational stressors (e.g., exposures to potentially psychologically traumatic events) and organisational stressors (e.g., shift work, staff shortages), which are associated with positive screens for mental disorders and self-reports of suicidal behaviours and thus urgently warrant further inquiry. The Canadian Provincial and Territorial Correctional Worker Mental Health and Well-Being Study (CWMH) used an online survey to collect data from Canadian correctional service organisations across all 13 provinces and territories. This national Canadian study investigates suicidal behaviours among CWs across diverse occupational roles and provincial and territorial jurisdictions (n = 3740, 50.1% female). The results estimated prevalence proportions for self-reported past-year and lifetime suicidal thoughts, planning, and attempts across the 13 Canadian provincial and territorial correctional systems, with the exceptions of past-year suicidal planning in Alberta, Newfoundland and Labrador, New Brunswick, and Yukon where jurisdictional considerations and requests precluded the inclusion of select questions. Substantial proportions of participants reported past-year or lifetime suicidal ideation (i.e., 9.1%, 29.2%, respectively), planning (i.e., 4.1%, 14.7%, respectively), or attempts (i.e., 0.8%, 7.2%, respectively). Sociodemographic variables (i.e., sex, age, marital status, total years of service, occupational category) were associated with past-year and lifetime suicidal behaviours. Findings provide opportunities for future research and can inform tailored efforts by clinicians, service providers, and organisational leaders to support proactive interventions and treatments, including supporting the partners and families of CWs, fostering social support networks, and improving access to timely mental health treatment.
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Affiliation(s)
- R Ricciardelli
- Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - R N Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - M S Johnston
- Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - S Dorniani
- Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - T L Taillieu
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - T O Afifi
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Kim E, Kim S. Spatially clustered patterns of suicide mortality rates in South Korea: a geographically weighted regression analysis. BMC Public Health 2024; 24:2380. [PMID: 39223483 PMCID: PMC11367767 DOI: 10.1186/s12889-024-19899-4] [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: 02/26/2024] [Accepted: 08/27/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Suicide mortality remains a global health concern, and community characteristics affect regional variations in suicide. This study investigated spatially clustered patterns of suicide mortality rates in South Korea and evaluated the impact of community factors on suicide. METHODS Suicide mortality rates were estimated by sex, age group, and district, using the 2021 Cause of Death Statistics in South Korea from the MicroData Integrated Service. Community-determinant data for 2021 or the nearest year were collected from the Korean Statistical Information Service. The spatial autocorrelation of suicide by sex and age was examined based on Global Moran's I index. Geographically weighted regression (GWR) was used to discern the influence of community determinants on suicide. RESULTS Suicide mortality rates were significantly higher among men (40.64 per 100,000) and adults over the age of 65 years (43.18 per 100,000). The male suicide mortality rates exhibited strong spatial dependence, as indicated by a high global Moran's I with p < 0.001, highlighting the importance of conducting spatial analysis. In the GWR model calibration, a subset of the community's age structure, single-person household composition, access to mental healthcare centers, and unmet medical needs were selected to explain male suicide mortality. These determinants disproportionately increased the risk of male suicide, varying by region. The GWR coefficients of each variable vary widely across 249 districts: aging index (Q1:0.06-Q3:0.46), single-person households (Q1:0.22-Q3:0.35), psychiatric clinics (Q1:-0.20-Q3:-0.01), and unmet medical needs (Q1:0.09-Q3:0.14). CONCLUSIONS Community cultural and structural factors exacerbate regional disparities in suicide among men. The influencing factors exhibit differential effects and significance depending on the community, highlighting the need for efficient resource allocation for suicide. A regionally tailored approach is crucial for the effective control of the community's mental health management system.
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Affiliation(s)
- Eunah Kim
- Institute of Health and Environment, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.
- Institute of Health Policy and Management, Seoul National University Medical Research Center, 71 Ihwajang-gil, Jongno-gu, Seoul, 03087, Republic of Korea.
| | - Seulgi Kim
- Institute of Health and Environment, Seoul National University, 1, Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea.
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Kleiman EM, Bentley KH, Jaroszewski AC, Maimone JS, Fortgang RG, Zuromski KL, Kilbury EN, Stein MB, Beck S, Huffman JC, Nock MK. Acceptability and Feasibility of an Ecological Momentary Intervention for Managing Emotional Distress Among Psychiatric Inpatients at Risk for Suicide. Arch Suicide Res 2024:1-18. [PMID: 39185950 DOI: 10.1080/13811118.2024.2391293] [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: 08/27/2024]
Abstract
The weeks following an inpatient psychiatric hospitalization are known to be the highest-risk time for suicide. Interventions are needed that are well-matched to the dynamic nature of suicidal thoughts and easily implementable during this high-risk time. We sought to determine the feasibility and acceptability of a novel registered clinical trial that combined three brief in-person sessions to teach core cognitive-behavioral therapy (CBT) skills during hospitalization followed by smartphone-based ecological momentary intervention (EMI) to facilitate real-time practice of the emotion management skills during the 28 days after hospital discharge. Results from this pilot study (N = 26) supported some aspects of feasibility and acceptability. Regarding feasibility, 14.7% of all screened inpatients met study eligibility criteria. Half (50.3%) of those who were ineligible were ineligible because they were not part of the population for whom this treatment was designed (e.g., symptoms such as psychosis rendered them ineligible for the current study). Those who were otherwise eligible based on symptoms were primarily ineligible due to inpatient stays that were too short. Nearly half (48%) of study participants did not receive all three in-person sessions during their hospitalization. Among enrolled participants, rates of engagement with the smartphone-based assessment and EMI prompts were 51.47%. Regarding acceptability, quantitative and qualitative data supported the perceived acceptability of the intervention, and provided recommendations for future iterations. Well-powered effectiveness (and effectiveness-implementation) studies are needed to determine the effects of this promising and highly scalable intervention approach.
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Wolf PM, Dettmeyer R, Holz F, Birngruber CG. Complex suicides involving the use of firearms and hanging: A retrospective study and review of the literature. Leg Med (Tokyo) 2024; 69:102337. [PMID: 37926655 DOI: 10.1016/j.legalmed.2023.102337] [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: 06/25/2022] [Revised: 09/03/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Suicides are the second most common cause of non-natural death in Germany after accidents. Most common is death by hanging, followed by the use of firearms. More frequent "simple" suicides in which one suicide method is used are distinguished from rare "complex" suicides, in which several methods are applied, whereby the combination of gunshot and strangulation is frequently chosen. Such cases require a thorough criminalistic and forensic medical examination to check the plausibility of assumed sequences of events and to detect covered-up homicides. MATERIAL AND METHODS A retrospective analysis of 5,400 post-mortem examinations at the Institute of Legal Medicine Giessen (2009-2018) revealed three cases in which gunshot and hanging were used to commit a planned complex suicide. RESULTS Case 1: The body of a 66-year-old carcinoma patient was found hanging from a tree in a kneeling position with a bullet through the head. The post-mortem examination revealed a penetrating head shot, uninjured soft tissues of the neck, no injuries to the hyoid bone or larynx and no signs of congestion. After autopsy, the gunshot through the head was considered as cause of death. Case 2: An 82-year-old man was found dead with two bullet wounds in the chest, hanging in free suspension in a factory hall. The necropsy showed two chest entry wounds with injuries to the heart and lungs as well as a vital ligature mark and fractures of the hyoid bone and larynx without signs of congestion. The combination of hanging and the gunshot wounds was concluded as cause of death. Case 3: The body of an 81-year-old pain patient was found in his home next to a small-caliber rifle, with a noose around his neck, attached to a suspension torn from the wall. The autopsy revealed a tangential shot through the skull with superficial injury to the frontal brain and a vital cord mark on the neck with fractures of the hyoid bone and larynx without signs of strangulation. In this case, hanging was identified as cause of death. CONCLUSION Complex suicides are rare events, that require a thorough criminalistic and forensic medical examination Although being called complex suicides and one of the methods usually being suitable to cause death, the cause of death is not always a combined one.
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Affiliation(s)
- P M Wolf
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe University, Kennedyallee 104, 60596 Frankfurt am Main, Germany
| | - R Dettmeyer
- Institute of Legal Medicine, University Hospital Giessen and Marburg, Justus Liebig University, Frankfurter Str. 58, 35392 Giessen, Germany
| | - F Holz
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe University, Kennedyallee 104, 60596 Frankfurt am Main, Germany
| | - C G Birngruber
- Institute of Legal Medicine, University Hospital Frankfurt, Goethe University, Kennedyallee 104, 60596 Frankfurt am Main, Germany.
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Hamdan-Mansour AM, Hamdan-Mansour RA, Allaham DM, Alrashidi M, Alhaiti A, Mansour LAH. Academic procrastination, loneliness, and academic anxiety as predictors of suicidality among university students. Int J Ment Health Nurs 2024. [PMID: 38797963 DOI: 10.1111/inm.13366] [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: 03/26/2024] [Revised: 05/06/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
Suicide is a major public health concern, and university students are at higher risk of suicide than any other age group. The purpose of this study was to examine the prediction power of loneliness, academic anxiety, and academic procrastination on suicidality among university students. A cross-sectional, correlational design was used to recruit 403 university students using the electronic survey format in Jordan. Data were collected regarding loneliness, academic anxiety, academic procrastination, and suicidality. A two-step multiple hierarchical regression analysis was performed. Only 17.1% (n = 69) of students were at risk of suicide, low to moderate level of loneliness, moderate level and moderate to high level of academic procrastination of academic anxiety. The model that included the sociodemographic and the psychological factors was significant (F18,390 = 12.3, p < 0.001) where the total variance in suicidality was 37.3% (R2 = 0.373). Being a working student, being on psychotropic medication, romantic and family relationships domains of loneliness, and academic anxiety were found to be predictors of suicidality (p < 0.05). Suicide is a significant problem among university students. Mental health professionals and policymakers need to enhance the use and access to mental health services and seek psychological counselling to combat the increasingly observed phenomenon of suicide among young people.
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Affiliation(s)
| | | | | | | | - Ali Alhaiti
- Department of Nursing, College of Applied Sciences, Almaarefa University, Riyadh, Saudi Arabia
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Marco M, López-Quílez A, Sánchez-Sáez F, Escobar-Hernández P, Montagud-Andrés M, Lila M, Gracia E. The Spatio-Temporal Distribution of Suicide-related Emergency Calls in a European City: Age and Gender Patterns, and Neighborhood Influences. PSYCHOSOCIAL INTERVENTION 2024; 33:103-115. [PMID: 38706710 PMCID: PMC11066811 DOI: 10.5093/pi2024a8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/14/2024] [Indexed: 05/07/2024]
Abstract
Objective: The aim of this study was to conduct a comprehensive spatio-temporal analysis of suicide-related emergency calls in the city of Valencia (Spain) over a six-year period. To this end we first examined age and gender patterns and, second, the influence of neighborhood characteristics on general and gender-specific spatio-temporal patterns of suicide-related emergency calls. Method: Geocoded data on suicide-related emergency calls between 2017 and 2022 (N = 10,030) were collected from the 112 emergency service in Valencia. Data were aggregated at the census block group level, used as a proxy for neighborhoods, and trimesters were considered as the temporal unit. Two set of analyses were performed: (1) demographic (age and gender) and temporal descriptive analyses and (2) general and gender-specific Bayesian spatio-temporal autoregressive models. Results: Descriptive analyses revealed a higher incidence of suicide-related emergency calls among females and an increase in calls among the 18-23 age group from 2020 onwards. The general spatio-temporal model showed higher levels of suicide-related emergency calls in neighborhoods characterized by lower education levels and population density, and higher residential mobility, aging population, and immigrant concentration. Relevant gender differences were also observed. A seasonal effect was noted, with a peak in calls during spring for females and summer for males. Conclusions: These findings highlight the need for comprehensive mental health targeted interventions and preventive strategies that account for gender-specific disparities, age-related vulnerabilities, and the specific characteristics of neighborhoods.
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Affiliation(s)
- Miriam Marco
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
| | - Antonio López-Quílez
- University of ValenciaDepartment of Statistics and Operational ResearchValenciaSpainDepartment of Statistics and Operational Research, University of Valencia, Spain;
| | - Francisco Sánchez-Sáez
- Universidad Internacional de La RiojaSchool of Engineering and TechnologySpainSchool of Engineering and Technology (ESIT), Universidad Internacional de La Rioja, Spain
| | - Pablo Escobar-Hernández
- University of ValenciaDepartment of Statistics and Operational ResearchValenciaSpainDepartment of Statistics and Operational Research, University of Valencia, Spain;
| | - María Montagud-Andrés
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
| | - Marisol Lila
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
| | - Enrique Gracia
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
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Landa-Blanco M, Romero K, Caballero I, Gálvez-Pineda E, Fúnes-Henríquez MJ, Romero R. Exploring suicide ideation in university students: sleep quality, social media, self-esteem, and barriers to seeking psychological help. Front Psychiatry 2024; 15:1352889. [PMID: 38645419 PMCID: PMC11027559 DOI: 10.3389/fpsyt.2024.1352889] [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: 12/15/2023] [Accepted: 03/18/2024] [Indexed: 04/23/2024] Open
Abstract
The purpose of the current study is to analyze how variations in suicidal ideation scores can relate to sleep quality, social media consumption, self-esteem, and perceived barriers to seeking psychological help in a sample of university students in Honduras. A quantitative cross-sectional design was used. Self-reported data was collected from a non-random sample of 910 university students in Honduras; their average age was 24.03 years (SD=6.05). Most respondents were women (67%) with men accounting for 33% of the sample. Measurements included item 9 of the Patient Health Questionnaire-9, the Single-Item Sleep Quality Scale, Rosenberg's Self-Esteem Scale, Barriers to Seeking Psychological Help Scale for College Students, and a self-reported questionnaire on social media. In response to the query, "Over the past two weeks, how frequently have you experienced thoughts that you would be better off dead or of hurting yourself?" 54% (n=495) of participants indicated "not at all" 18% (n=168) reported "several days" 14% (n=129) responded "more than half of the days" and 13% (n=118) stated "nearly every day". The results from the ordinal logistic regression model indicate that sleep quality and self-esteem serve as protective factors associated with decreased suicide ideation. At the same time, a higher number of social media platforms used per week and perceived barriers to seeking psychological help increase suicide ideation. Altogether, these variables explained 19% of the variance in suicidal ideation scores. Suicidal ideation is highly prevalent among the sampled university students.
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Affiliation(s)
- Miguel Landa-Blanco
- School of Psychological Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
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Godinho A, Schell C, Cunningham JA. Remaining Between the Cracks - The Long-Term Effect of Different Suicide Risk Exclusion Criterion on Outcomes of an Online Intervention for Depression. CRISIS 2024; 45:100-107. [PMID: 37605900 DOI: 10.1027/0227-5910/a000923] [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: 08/23/2023]
Abstract
Background: Previous studies have demonstrated that excluding individuals at risk of suicide from online depression interventions can impact recruited sample characteristics. Aim: To determine if a small change in suicide risk exclusion criterion led to differences in the usage and effectiveness of an Internet depression intervention at 6 months of follow-up. Method: A partial sample of a recently completed online depression intervention trial was divided into two groups: those with no risk of suicide versus those with some risk. The two groups were compared for baseline demographic and clinical measures, as well as intervention uptake and treatment success across 6 months. Results: Overall, individuals with less risk of suicide at baseline reported significantly less severe clinical symptoms. Both groups interacted with the intervention at the same rate, but specific use of modules was different. Finally, the impact of intervention usage on outcomes over time did not vary by group. Limitations: While different suicide risk exclusion criteria can change recruited sample characteristics, it remains unclear how these differences impact intervention uptake and success. Conclusion: Overall, the findings suggest that researchers should exercise caution when excluding individuals at risk of suicide, as they greatly benefit from web-based interventions.
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Affiliation(s)
- Alexandra Godinho
- Humber River Health Research Institute, Humber River Health, Toronto, ON, Canada
| | - Christina Schell
- Centre for Addiction and Mental Health, Institute of Mental Health and Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - John A Cunningham
- Centre for Addiction and Mental Health, Institute of Mental Health and Policy Research, Toronto, ON, Canada
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
- Department of Psychiatry, University of Toronto, ON, Canada
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Akinyemi O, Ogundare T, Weldeslase T, Andine T, Fasokun M, Odusanya E, Hughes K, Mallory W, Luo G, Cornwell E. The association between community-level economic deprivation and incidences of emergency department visits on account of attempted suicides in Maryland. Front Public Health 2024; 12:1353283. [PMID: 38384877 PMCID: PMC10879598 DOI: 10.3389/fpubh.2024.1353283] [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: 12/10/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024] Open
Abstract
Background Suicide is a major cause of mortality in the United States, accounting for 14.5 deaths per 100,000 population. Many emergency department (ED) visits in the United States are due to attempted suicides. Suicide attempts predict subsequent completed suicides. Socioeconomic factors, such as community-level socioeconomic deprivation, significantly affect many traditional risk factors for attempted suicides and suicides. Aim To determine the association between community-level socioeconomic deprivation and ED visits for attempted suicide in Maryland. Methods A retrospective analysis of attempted suicides in the Maryland State Emergency Department Database from January 2018 to December 2020. Community-level socioeconomic deprivation was measured using the Distress Community Index (DCI). Multivariate regression analyses were conducted to identify the association between DCI and attempted suicides/self-harm. Results There were 3,564,987 ED visits reported in the study period, with DCI data available for 3,236,568 ED visits; 86.8% were younger than 45 years, 64.8% were females, and 54.6% non-Hispanic Whites. Over the study period, the proportion of ED visits due to attempted suicide was 0.3%. In the multivariate logistic regression, compared to prosperous zones, those in comfortable (OR = 0.80, 95% CI: 0.73-0.88, p < 0.01), Mid-Tier (OR = 0.76, 95%CI:0.67-0.86, p < 0.01), At-Risk (OR = 0.77; 95%CI: 0.65-0.92, p < 0.01) and Distressed zones (OR = 0.53; 95% CI:0.42-0.66, p < 0.01) were less likely to visit the ED for attempted suicide. Conclusion Prosperous communities had the highest rate of attempted suicides, with the risk of attempted suicide increasing as individuals move from the least prosperous to more prosperous areas.
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Affiliation(s)
- Oluwasegun Akinyemi
- Clive O Callender Department of Surgery, Howard University College of Medicine, Washington, DC, United States
| | - Temitope Ogundare
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Terhas Weldeslase
- Department of Surgery, Howard University College of Medicine, Washington, DC, United States
| | - Tsion Andine
- Department of Surgery, Howard University College of Medicine, Washington, DC, United States
| | - Mojisola Fasokun
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Eunice Odusanya
- Department of Surgery, Howard University College of Medicine, Washington, DC, United States
| | - Kakra Hughes
- Department of Surgery, Howard University College of Medicine, Washington, DC, United States
| | - Williams Mallory
- Department of Surgery, Howard University College of Medicine, Washington, DC, United States
| | - Guoyang Luo
- Department of Obstetrics and Gynecology, Howard University College of Medicine, Washington, DC, United States
| | - Edward Cornwell
- Department of Surgery, Howard University College of Medicine, Washington, DC, United States
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Eom YJ, Lee H, Choo S, Kim R, Yi H, Kim R, Kim SS. Situational Avoidance and Its Association with Mental Health Among Transgender Adults in South Korea: A Nationwide Cohort Study. LGBT Health 2024; 11:122-130. [PMID: 37831924 DOI: 10.1089/lgbt.2023.0060] [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] [Indexed: 10/15/2023] Open
Abstract
Purpose: In fear of discrimination or unwanted disclosure of their transgender identity, transgender and nonbinary (TGNB) people may commonly avoid daily activities. We assessed the prevalence of situational avoidance among TGNB people and examined its associations with mental health outcomes. Methods: We analyzed data from a longitudinal survey conducted at baseline (2020) and follow-up (2021) among 268 TGNB people in South Korea. Situational avoidance due to transgender identity within the past 12 months was assessed based on 12 kinds of daily activities (e.g., public bathroom use, job applications, and hospital visits). Past-week depressive symptoms and past 2-week anxiety symptoms were measured with the Center for Epidemiologic Studies-Depression Scale and General Anxiety Disorder Scale, respectively. Results: Of 268 participants, 135 (50.4%) have ever avoided daily activities. The most frequently reported situational avoidance was public bathroom use (32.1%), followed by job applications (24.3%) and hospital visits (12.3%). After adjusting for confounders including baseline depressive symptoms and experience of anti-transgender discrimination, participants with any situational avoidance experience were 1.30 times (95% confidence intervals [CI] = 1.01-1.69) more likely to have anxiety symptoms compared with those without situational avoidance experience. In particular, participants who avoided three or more kinds of daily activities were 1.40 times (95% CI = 1.02-1.93) more likely to have anxiety symptoms than those without any experience of situational avoidance. No association was observed with depressive symptoms. Conclusion: Multilateral interventions including anti-discrimination law enactment are necessary to reduce transphobia and provide support for TGNB people in Korea, thus reducing their fear of participating in daily activities and promoting their mental well-being.
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Affiliation(s)
- Yun-Jung Eom
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Hyemin Lee
- Jeju Institute of Public Health & Health Policy, Jeju, South Korea
| | - Sungsub Choo
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Ranyeong Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Horim Yi
- Solidarity for LGBT Human Rights of Korea, Seoul, South Korea
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
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Ahuja M, Jain M, Mamudu H, Al Ksir K, Sathiyaseelan T, Zare S, Went N, Fernandopulle P, Schuver T, Pons A, Dooley M, Nwanecki C, Dahal K. Substance Use Disorder and Suicidal Ideation in Rural Maryland. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2024; 8:24705470241268483. [PMID: 39113832 PMCID: PMC11304480 DOI: 10.1177/24705470241268483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Background Rural areas in the United States have been disproportionately burdened with high rates of substance use, mental health challenges, chronic stress, and suicide behaviors. Factors such as a lack of mental health services, decreased accessibility to public health resources, and social isolation contribute to these disparities. The current study explores risk factors to suicidal ideation, using emergency room discharge data from Maryland. Methods The current study used data from the Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) from the State of Maryland. Logistic regression was used to assess the association between ICD-10 coded opioid use disorder, alcohol use disorder, cannabis use disorder, major depressive disorder, and the outcome variable of suicidal ideation discharge. We controlled for income, race, age, and gender. Results Lifetime major depressive disorder diagnosis (odds ration [OR] = 79.30; 95% confidence interval [CI] 51.91-121.15), alcohol use disorder (OR = 6.87; 95% CI 4.97-9.51), opioid use disorder (OR = 5.39; 95% CI 3.63-7.99), and cannabis use disorder (OR = 2.67; 95% CI 1.37-5.18) were all positively associated with suicidal ideation. Conclusions The study highlights the strong link between prior substance use disorder, depression, and suicidal ideation visit to the emergency room, indicating the need for prevention and intervention, particularly among those in rural areas where the burden of suicidal ideation and chronic stress are high. As health disparities between rural and urban areas further widened during the COVID-19 pandemic, there is an urgent need to address these issues.
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Affiliation(s)
- Manik Ahuja
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Monika Jain
- Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Hadii Mamudu
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Kawther Al Ksir
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | | | - Shahin Zare
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Nils Went
- Department of Psychiatry, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Praveen Fernandopulle
- Psychiatry and Behavioral Sciences Department, East Tennessee State University, Johnson City, TN, USA
| | - Trisha Schuver
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Amanda Pons
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - McKenzie Dooley
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Chisom Nwanecki
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Kajol Dahal
- College of Public Health, East Tennessee State University, Johnson City, TN, USA
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Torales J, Barrios I, Melgarejo O, Tullo-Gómez JE, Díaz NR, O'Higgins M, Maggi C, Adorno V, Medina A, Villalba-Arias J, González-Urbieta I, Caycho-Rodríguez T, Castaldelli-Maia JM, Ventriglio A. Suicides among adults in Paraguay: An 18-year national exploratory study (2004-2022). Int J Soc Psychiatry 2023; 69:1641-1648. [PMID: 37113070 DOI: 10.1177/00207640231169650] [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: 04/29/2023]
Abstract
BACKGROUND The number of suicides has been increasing worldwide, year after year, becoming the fourth leading cause of death among young people between 15 and 29 years of age. AIM In this study, we explored the frequency and characteristics of suicides among the adult general population in Paraguay between 2004 and 2022, considering that suicide attempts and suicidal risk/ideation are frequent and relevant issues in the consultation activity, even if epidemiological evidence on the national rates of suicide is scarce. METHODS In this observational, descriptive, and exploratory study, official records of all deaths by suicide were reviewed and information analyzed. In addition, an attempt was made to predict the number of suicides in the next 5 years according to a mathematical modeling. RESULTS In the 18-year period, 5,527 suicides of adults were recorded. Patients' mean age was 36.8 ± 17 years old. A 76.77% of them were males, 77.44% were from an urban area and 25.98% from the Greater Asunción and Central Department of Paraguay. The most frequently used method of suicide was intentional self-inflicted injury by hanging, strangulation, or suffocation (all 67.6%). The expected number of national suicides in the following years from 2023 to 2027 will range between 462 and 530. Limitations include the lack of information regarding diagnoses and personal history in the suicide reports as well as the possibility of underreporting of national suicide cases. CONCLUSION Our results represent the first large national epidemiological report of suicides in Paraguay and may be of interest for mental health professionals and health authorities in order to reduce the suicide mortality rate within the country.
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Affiliation(s)
- Julio Torales
- Department of Medical Psychology, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Iván Barrios
- Department of Statistics, School of Medical Sciences, Santa Rosa Campus, National University of Asunción, Santa Rosa del Aguaray, Paraguay
| | - Osvaldo Melgarejo
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Juan Edgar Tullo-Gómez
- General Directorate of Strategic Health Information, Ministry of Public Health and Social Welfare, Asunción, Paraguay
| | - Noelia Ruiz Díaz
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Marcelo O'Higgins
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Carol Maggi
- Department of Medical Psychology, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Víctor Adorno
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Alicia Medina
- Department of Medical Psychology, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Jorge Villalba-Arias
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
- Department of Psychiatry, School of Medical Sciences, Santa Rosa Campus, National University of Asunción, Santa Rosa del Aguaray, Paraguay
| | | | | | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Fundação do ABC, Santo André, Brazil
- Department of Psychiatry, University of São Paulo, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Italy
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Ramalle-Gómara E, Palacios-Castaño MI, Martínez-Ochoa E, Quiñones-Rubio C. Trends in suicide mortality in Spain from 1998 to 2021 and its relationship with the COVID-19 pandemic: A joinpoint regression analysis. Psychiatry Res 2023; 329:115520. [PMID: 37797441 DOI: 10.1016/j.psychres.2023.115520] [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: 07/11/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/07/2023]
Abstract
In the European Union, a rate of 11.9 cases per 100,000 was estimated in 2019.In Spain, suicide is the leading cause of external death. Social crises can have an impact on suicide rates. We analyzed changes in suicide mortality trends in Spain following the COVID-19 pandemic. We used statistical data from the National Institute of Statistics of Spain (1998-2021). We calculated age-specific rates, age and sex-adjusted rates, and analyzed trends and changes using joinpoint-regression models. Rates decrease in both sexes at the ages of 65 and older. In women, they increase in the ages of 1-29 years and 45-59 years. In men, they decrease in the ages of 15-39 years. Among women, age-adjusted rates remained stable between 1998 and 2021, with a non-significant annual decrease of 0.4 %. Among men, there was a significant annual decrease of 0.7 %. The years 2020 and 2021 had 8 % higher mortality compared to the two years prior to the COVID-19 pandemic. Suicide mortality in Spain slightly decreased among men and remained stable among women between 1998 and 2021, but there seems to be an increase following the COVID-19 pandemic.
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Affiliation(s)
- Enrique Ramalle-Gómara
- Epidemiology and Health Promotion Department, Directorate General of Public Health, Vara de Rey, 8, 26071 Logroño, La Rioja, Spain.
| | - María-Isabel Palacios-Castaño
- Epidemiology and Health Promotion Department, Directorate General of Public Health, Vara de Rey, 8, 26071 Logroño, La Rioja, Spain
| | - Eva Martínez-Ochoa
- Epidemiology and Health Promotion Department, Directorate General of Public Health, Vara de Rey, 8, 26071 Logroño, La Rioja, Spain
| | - Carmen Quiñones-Rubio
- Epidemiology and Health Promotion Department, Directorate General of Public Health, Vara de Rey, 8, 26071 Logroño, La Rioja, Spain
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14
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McCarthy M, Saini P, Nathan R, McIntyre J. Predictors of self-harm and emergency department attendance for self-harm in deprived communities. Int J Inj Contr Saf Promot 2023; 30:403-409. [PMID: 37126426 DOI: 10.1080/17457300.2023.2204474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 03/07/2023] [Accepted: 04/16/2023] [Indexed: 05/02/2023]
Abstract
Emergency departments (EDs) are often the first point of contact for individuals following self-harm. The majority of previous research relies on hospital-based data, yet only a minority of individuals who self-harm in the community present to healthcare services. The study design is cross-sectional survey design. Data from the National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC) Household Health Survey, a community-based public health survey in North West England, was collected using stratified random sampling. Three thousand four hundred twelve people were recruited in 2018 from relatively disadvantaged areas. The sample included 1490 men and 1922 women aged 18 to 100 years (M = 49.37, SD = 18.91). Logistic regression analysis was employed to examine demographic, health and socioeconomic predictors of self-harm and ED attendance for self-harm. Age (18-24 years), lower financial status, depression, anxiety and physical and mental health co-morbidity was associated with significantly higher levels of self-harm. People aged 18-24 years, with physical and mental health co-morbidity and lower levels of social support had significantly higher levels of attending EDs for self-harm. Improving people's financial situations, social connectivity, mental and physical health may help to reduce individual risk for self-harm and strain on health services.
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Affiliation(s)
- Molly McCarthy
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, England
| | - Pooja Saini
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, England
| | - Rajan Nathan
- Cheshire & Wirral Partnership NHS Foundation Trust, Chester, England
| | - Jason McIntyre
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, England
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15
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Lima CNC, Kovács EHC, Mirza S, Del Favero-Campbell A, Diaz AP, Quevedo J, Argue BMR, Richards JG, Williams A, Wemmie JA, Magnotta VA, Fiedorowicz JG, Soares JC, Gaine ME, Fries GR. Association between the epigenetic lifespan predictor GrimAge and history of suicide attempt in bipolar disorder. Neuropsychopharmacology 2023; 48:954-962. [PMID: 36878995 PMCID: PMC10156727 DOI: 10.1038/s41386-023-01557-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/07/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023]
Abstract
Bipolar disorder (BD) has been previously associated with premature mortality and aging, including acceleration of epigenetic aging. Suicide attempts (SA) are greatly elevated in BD and are associated with decreased lifespan, biological aging, and poorer clinical outcomes. We investigated the relationship between GrimAge, an epigenetic clock trained on time-to-death and associated with mortality and lifespan, and SA in two independent cohorts of BD individuals (discovery cohort - controls (n = 50), BD individuals with (n = 77, BD/SA) and without (n = 67, BD/non-SA) lifetime history of SA; replication cohort - BD/SA (n = 48) and BD/non-SA (n = 47)). An acceleration index for the GrimAge clock (GrimAgeAccel) was computed from blood DNA methylation (DNAm) and compared between groups with multiple general linear models. Differences in epigenetic aging from the discovery cohort were validated in the independent replication cohort. In the discovery cohort, controls, BD/non-SA, and BD/SA significantly differed on GrimAgeAccel (F = 5.424, p = 0.005), with the highest GrimAgeAccel in BD/SA (p = 0.004, BD/SA vs. controls). Within the BD individuals, BD/non-SA and BD/SA differed on GrimAgeAccel in both cohorts (p = 0.008) after covariate adjustment. Finally, DNAm-based surrogates revealed possible involvement of plasminogen activator inhibitor 1, leptin, and smoking pack-years in driving accelerated epigenetic aging. These findings pair with existing evidence that not only BD, but also SA, may be associated with an accelerated biological aging and provide putative biological mechanisms for morbidity and premature mortality in this population.
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Affiliation(s)
- Camila N C Lima
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
| | - Emese H C Kovács
- Department of Neuroscience and Pharmacology, The University of Iowa, 51 Newton Rd, 52242, Iowa City, IA, USA
| | - Salahudeen Mirza
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Institute of Child Development, University of Minnesota, 51 E River Rd, 55455, Minneapolis, MN, USA
| | - Alexandra Del Favero-Campbell
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
| | - Alexandre Paim Diaz
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Joao Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Ave, 77030, Houston, TX, USA
| | - Benney M R Argue
- Pharmaceutical Sciences and Experimental Therapeutics, The University of Iowa, 180 South Grand Ave, 52242, Iowa City, IA, USA
| | - Jenny Gringer Richards
- Department of Radiology, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
| | - Aislinn Williams
- Department of Psychiatry, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, 169 Newton Rd, 52242, Iowa City, IA, USA
| | - John A Wemmie
- Department of Psychiatry, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
| | - Vincent A Magnotta
- Department of Radiology, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
- Department of Psychiatry, The University of Iowa, 200 Hawkins Dr, 52242, Iowa City, IA, USA
| | - Jess G Fiedorowicz
- University of Ottawa Brain and Mind Research Institute, Ottawa Hospital Research Institute, 501 Smyth, K1H 8L6, Ottawa, ON, Canada
| | - Jair C Soares
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Ave, 77030, Houston, TX, USA
| | - Marie E Gaine
- Pharmaceutical Sciences and Experimental Therapeutics, The University of Iowa, 180 South Grand Ave, 52242, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, 169 Newton Rd, 52242, Iowa City, IA, USA
| | - Gabriel R Fries
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA.
- Center of Excellence in Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, 1941 East Rd, 77054, Houston, TX, USA.
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, 6767 Bertner Ave, 77030, Houston, TX, USA.
- Center for Precision Health, School of Biomedical Informatics, The University of Texas Health Science Center at Houston, 7000 Fannin, 77030, Houston, TX, USA.
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16
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Bergmann E, Peso D, Nashashibi L, Grinapol S, Meretyk I, Fruchther E, Harlev D. Association of ethnic concordance between patients and psychiatrists with the management of suicide attempts in the emergency department. Psychiatry Res 2023; 323:115167. [PMID: 36966695 DOI: 10.1016/j.psychres.2023.115167] [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: 12/28/2022] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Suicide attempt is a psychiatric emergency that can be treated with different approaches. Understanding of patient- and physician-related determinants of psychiatric interventions may help to identify sources of bias and improve clinical care. OBJECTIVE To evaluate the demographic predictors of psychiatric intervention in the emergency department (ED) following a suicide attempt. METHODS We analyzed all ED visits in Rambam Health Care Campus following suicide attempts carried out by adults between 2017-2022. Two logistic regression models were built to examine whether patient and psychiatrist's demographic variables can predict 1) the clinical decision to provide a continued psychiatric intervention and 2) the setting for the psychiatric intervention (inpatient or outpatient). RESULTS In total, 1,325 ED visits were evaluated, corresponding to 1,227 unique patients (mean age; 40.47±18.14 years, 550 men [41.51%]; 997 Jewish [75.25%] and 328 Arabs [24.75%]]), and 30 psychiatrists (9 men [30%]; 21 Jewish [70%] and 9 Arabs [30%]). Demographic variables had a limited predictive power for the decision to intervene (R²=0.0245). Yet, a significant effect of age was observed as intervention rates increased with age. In contrast, the type of intervention was strongly associated with demography (R²=0.289), with a significant interaction between patient and psychiatrist's ethnic identities. Further analysis revealed that Arab psychiatrists preferentially referred Arab patients to outpatient over inpatient treatment. CONCLUSIONS The results indicate that while demographic variables, and specifically patient and psychiatrist's ethnicity, do not affect clinical judgement for psychiatric intervention following a suicide attempt, they do play a major role in selecting treatment setting. Further studies are required to better understand the causes underlying this observation and its association with long-term outcomes. Yet, acknowledging the existence of such bias is a first step towards better culturally mindful psychiatric interventions.
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Affiliation(s)
- Eyal Bergmann
- Department of Psychiatry, Rambam Health Care Campus, Haifa, Israel
| | - Dana Peso
- Department of Psychiatry, Rambam Health Care Campus, Haifa, Israel
| | | | | | - Irit Meretyk
- Department of Psychiatry, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Eyal Fruchther
- Department of Psychiatry, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Daniel Harlev
- Department of Psychiatry, Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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17
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Mujica OJ, Zhang D, Hu Y, Espinosa IC, Araneda N, Dragomir A, Luta G, Sanhueza A. Inequalities in Violent Death across Income Levels among Young Males and Females in Countries of the Americas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5256. [PMID: 37047871 PMCID: PMC10094469 DOI: 10.3390/ijerph20075256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/12/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Violent deaths (i.e., those due to road traffic injury, homicide, and suicide) are among the most important causes of premature and preventable mortality in young people. This study aimed at exploring inequalities in violent death across income levels between males and females aged 10 to 24 years from the Americas in 2015, the SDG baseline year. METHODS In a cross-sectional ecological study design, eleven standard summary measures of health inequality were calculated separately for males and females and for each cause of violent death, using age-adjusted mortality rates and average income per capita for 17 countries, which accounted for 87.9% of the target population. RESULTS Premature mortality due to road traffic injury and homicide showed a pro-poor inequality pattern, whereas premature mortality due to suicide showed a pro-rich inequality pattern. These inequalities were statistically significant (p < 0.001), particularly concentrated among young males, and dominated by homicide. The ample array of summary measures of health inequality tended to generate convergent results. CONCLUSIONS Significant inequalities in violent death among young people seems to be in place across countries of the Americas, and they seem to be socially determined by both income and gender. These findings shed light on the epidemiology of violent death in young people and can inform priorities for regional public health action. However, further investigation is needed to confirm inequality patterns and to explore underlying mechanisms, age- and sex-specific vulnerabilities, and gender-based drivers of such inequalities.
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Affiliation(s)
| | - Dihui Zhang
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC 20057, USA
| | - Yi Hu
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC 20057, USA
| | - Isabel C. Espinosa
- T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Nelson Araneda
- Department of Education, University of La Frontera, Temuco 4811230, Chile
| | - Anca Dragomir
- Department of Oncology, Georgetown University, Washington, DC 20057, USA
| | - George Luta
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC 20057, USA
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Lay-Yee R, Matthews T, Moffitt T, Poulton R, Caspi A, Milne B. Are trajectories of social isolation from childhood to mid-adulthood associated with adult depression or suicide outcomes. Soc Psychiatry Psychiatr Epidemiol 2023; 58:373-382. [PMID: 36456781 PMCID: PMC9715405 DOI: 10.1007/s00127-022-02389-6] [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: 02/21/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE Social isolation has been shown to have negative effects on mental health outcomes though little is known about trajectories across the life course. We examined the relationship between trajectory groups and selected mental health outcomes in mid-adulthood. METHODS We previously created a typology of social isolation based on onset during the life course and persistence into adulthood, using group-based trajectory analysis of longitudinal data from a New Zealand birth cohort. The typology comprises four groups: 'never-isolated', 'adult-only', 'child-only', and 'persistent (child-adult) isolation'. We undertook logistic regression analyses of three mental health outcomes with trajectory group as the predictor, adjusting for sex and a range of familial and child-behavioural factors. RESULTS Lifetime suicide attempt, and depression and suicide ideation in mid-adulthood were each associated with adult-only but not child-only social isolation. Depression in mid-adulthood was also associated with persistent child-adult social isolation. CONCLUSION Although our findings are associational and not causal, they indicate that interrupting persistent social isolation may help to prevent adult depression whereas halting adult social isolation may ameliorate both depression and suicide outcomes.
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Affiliation(s)
- Roy Lay-Yee
- Centre of Methods and Policy Application in the Social Sciences, School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand.
| | - Timothy Matthews
- Department of Social Genetic and Developmental Psychiatry, Institute of Psychiatry, King's College London, London, UK
| | - Terrie Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Richie Poulton
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Barry Milne
- Centre of Methods and Policy Application in the Social Sciences, School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand
- Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand
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19
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Snell DT, Lockey PD, Thompson DJ. Socioeconomic status is associated with mechanism and intent of injury in patients presenting to a UK Major Trauma Centre. Injury 2023; 54:497-501. [PMID: 36379740 DOI: 10.1016/j.injury.2022.11.023] [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: 06/30/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Lower socioeconomic status (SES) is linked to poorer health, health outcomes and higher rates of trauma. The aim of this study was to investigate the impact SES had on the mechanism and intent of trauma in patients presenting to a UK regional Major Trauma Centre (MTC). MATERIALS AND METHODS Trauma data from a UK MTC over a five-year period was obtained from the Trauma Audit and Research Network. Deprivation data was obtained from English Indices of Multiple Deprivation 2019 data and the study population classified into quintiles. Odds ratios were calculated, comparing mechanism and intent of trauma with each SES quintile with the least deprived quintile as the baseline for comparison. RESULTS Lower SES was associated with an increased odds ratio of undifferentiated trauma (OR 1.32, P<0.001). Falls from less than 2m constitute most trauma presentations and were not associated with SES (OR 1.09, P=0.114, 58.3% of trauma). The greater odds ratios for trauma in the socially deprived was accounted for by an increase in high-energy mechanisms and injury intents that include falls more than 2m (OR 1.75), stabbing (OR 5.18), blow injury (OR 2.75), high-risk behaviour (OR 4.61), assault (OR 6.63) and self-harm (OR 2.94) (P-values <0.001). CONCLUSION In this large, retrospective analysis of a UK MTC, we have shown that the increased risk of trauma seen with lower SES is not uniform across all mechanisms or intents and is mediated by high-energy and violent mechanisms. Targeted public health education and intervention within these demographics, appropriate to mechanisms observed as over-represented, may prove beneficial in the primary prevention of trauma, and help to guide local health service planning.
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Affiliation(s)
| | - Professor David Lockey
- Adult Intensive Care Unit, Southmead Hospital Bristol, UK; Severn Major Trauma Network, UK
| | - Dr Julian Thompson
- Adult Intensive Care Unit, Southmead Hospital Bristol, UK; Severn Major Trauma Network, UK
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20
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Chireh B, Essien SK, Novik N, Ankrah M. Long working hours, perceived work stress, and common mental health conditions among full-time Canadian working population: a national comparative study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
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21
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Mofatteh M, Mashayekhi MS, Arfaie S, Chen Y, Malhotra AK, Alvi MA, Sader N, Antonick V, Fatehi Hassanabad M, Mansouri A, Das S, Liao X, McIntyre RS, Del Maestro R, Turecki G, Cohen-Gadol AA, Zadeh G, Ashkan K. Suicidal ideation and attempts in brain tumor patients and survivors: A systematic review. Neurooncol Adv 2023; 5:vdad058. [PMID: 37313501 PMCID: PMC10259251 DOI: 10.1093/noajnl/vdad058] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Background Subsequent to a diagnosis of a brain tumor, psychological distress has been associated with negative effects on mental health as well as suicidality. The magnitude of such impact has been understudied in the literature. We conducted a systematic review to examine the impact of a brain tumor on suicidality (both ideation and attempts). Methods In accordance with the PRISMA guidelines, we searched for relevant peer-reviewed journal articles on PubMed, Scopus, and Web of Science databases from inception to October 20, 2022. Studies investigating suicide ideation and/or attempt among patients with brain tumors were included. Results Our search yielded 1,998 articles which were screened for eligibility. Seven studies consisting of 204,260 patients were included in the final review. Four studies comprising 203,906 patients (99.8%) reported elevated suicidal ideation and suicide attempt incidence compared with the general population. Prevalence of ideation and attempts ranged from 6.0% to 21.5% and 0.03% to 3.33%, respectively. Anxiety, depression, pain severity, physical impairment, glioblastoma diagnosis, male sex, and older age emerged as the primary risk factors associated with increased risk of suicidal ideation and attempts. Conclusion Suicidal ideation and attempts are increased in patients and survivors of brain tumors compared to the general population. Early identification of patients exhibiting these behaviors is crucial for providing timely psychiatric support in neuro-oncological settings to mitigate potential harm. Future research is required to understand pharmacological, neurobiological, and psychiatric mechanisms that predispose brain tumor patients to suicidality.
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Affiliation(s)
- Mohammad Mofatteh
- Corresponding Author: Mohammad Mofatteh, PhD, MPH, MSc, PGCert TLHE, BSc (Hons), School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom ()
| | - Mohammad Sadegh Mashayekhi
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Neuro International Collaboration (NIC), Vancouver, British Columbia, Canada
| | - Saman Arfaie
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- Department of Molecular and Cell Biology, University of California Berkeley, California, USA
- Neuro International Collaboration (NIC), Montreal, Quebec, Canada
| | - Yimin Chen
- Department of Neurology, Foshan Sanshui District People’s Hospital, Foshan, China
- Neuro International Collaboration (NIC), Foshan, China
| | - Armaan K Malhotra
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mohammed Ali Alvi
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
- Neuro International Collaboration (NIC), Toronto, Ontario, Canada
| | - Nicholas Sader
- Division of Neurosurgery, University of Calgary, Alberta, Canada
- Neuro International Collaboration (NIC), Calgary, Alberta, Canada
| | - Violet Antonick
- University of Vermont, Burlington, Vermont, USA
- Neuro International Collaboration (NIC), Vermont, USA
| | | | - Alireza Mansouri
- Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Sunit Das
- Division of Neurosurgery, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Xuxing Liao
- Department of Neurosurgery, Foshan Sanshui District People’s Hospital, Foshan, China
- Department of Surgery of Cerebrovascular Diseases, Foshan First People’s Hospital, Foshan, China
| | - Roger S McIntyre
- Neuro International Collaboration (NIC), Toronto, Ontario, Canada
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
| | - Rolando Del Maestro
- Neuro International Collaboration (NIC), Montreal, Quebec, Canada
- Neurosurgical Simulation and Artificial Intelligence Learning Centre, Department of Neurology & Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Hospital Research Center, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Aaron A Cohen-Gadol
- The Neurosurgical Atlas, Carmel, Indiana, USA
- Department of Neurological Surgery, Indiana University, Indianapolis, Indiana, USA
- Neuro International Collaboration (NIC), Indiana, USA
| | - Gelareh Zadeh
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Keyoumars Ashkan
- Neuro International Collaboration (NIC), London, UK
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
- King’s Health Partners Academic Health Sciences Centre, London, UK
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, UK
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22
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Holman S, Steinberg R, Schaffer A, Fiksenbaum L, Sinyor M. The association of social, economic, and health-related variables with suicidal and/or self-harm thoughts in individuals admitted to a psychiatric inpatient unit during the COVID-19 pandemic: An exploratory study. Psychiatry Res 2023; 319:114998. [PMID: 36535108 PMCID: PMC9737504 DOI: 10.1016/j.psychres.2022.114998] [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: 05/05/2022] [Revised: 07/28/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
Individuals with pre-existing psychiatric diagnoses appear to be vulnerable to worsening mental health symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Furthermore, psychiatric hospitalizations during the pandemic may be complicated by increased risk of SARS-Cov-2 infection and limited social engagement due to changes in hospital policies. The objective of our exploratory study was to determine whether social, economic, and health-related variables were associated with thoughts of suicide and/or self-harm since March 2020 in individuals admitted to a psychiatric inpatient unit during the COVID-19 pandemic. Chi-square tests revealed four variables were significantly associated with thoughts of suicide and/or self-harm: 1) difficulty with cancellation of important events, 2) some form of loneliness, 3) decreased time spent in green spaces, and 4) increased time spent using devices with screens. The logistic regression model showed a significant association between suicidal and/or self-harm thoughts and cancellation of important events. Further investigation of the loneliness variable components revealed a significant association between suicidal and/or self-harm thoughts and feeling a lack of companionship, feeling isolated, and feeling alone. These results suggest that social challenges experienced during the pandemic were associated with negative mental health symptoms of individuals admitted to a psychiatric inpatient unit.
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Affiliation(s)
- Sarah Holman
- Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
| | - Rosalie Steinberg
- Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada,Department of Psychiatry, University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada
| | - Ayal Schaffer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada,Department of Psychiatry, University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada
| | - Lisa Fiksenbaum
- Department of Psychology, York University, 4700 Keele St, Toronto, ON M3J 1P3, Canada
| | - Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada.
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Yarar EZ, Bulut BP, Demirbaş H. Does Gender Really Matter: Childhood Trauma, Trait Anger, and Suicide Risk in Early Adulthood. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1222-NP1238. [PMID: 35435769 DOI: 10.1177/08862605221087704] [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: 06/14/2023]
Abstract
Background: Previous studies have reported mixed findings regarding gender differences in suicidal behavior. This discrepancy may be partly attributable to common predictors of suicide risk, such as childhood trauma and anger, and may also be independent of gender. Objectives: The present study investigated gender differences in the impact of childhood trauma and current trait anger on suicide risk, in a group of young Turkish adults. We hypothesized that trait anger would mediate the association between childhood trauma and suicide risk, independently of gender. Participants and Setting: Participants were 589 university students (84.3% women) aged 18-34 years (M = 21.43, SD = 1.82). Methods: Gender group differences in suicide risk, history of childhood trauma, and trait anger as well as possible covariates (i.e., self-rated socio-economic status and academic performance) were assessed. Possible predictors of suicide risk in gender groups were examined. The role of trait anger as a mediator of the relationship between childhood trauma and suicide risk was also examined. Results: Results showed that men reported a higher suicide risk, history of childhood trauma, and trait anger than women. Early childhood trauma and current trait anger scores were significant predictors of suicide risk in both gender groups. Trait anger significantly mediated the relationship between early trauma history and risk for suicide, independently of gender. Conclusions: Study findings support early reports of the effects of childhood trauma and trait anger on suicide risk. It was suggested that preventive interventions for suicidal behavior and monitoring risk groups with aggressive tendencies and childhood trauma history may be important.
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Affiliation(s)
- Esra Zıvralı Yarar
- Department of Psychology, 390121Social Sciences University of Ankara, Ankara, Turkey
| | - Burcu Pınar Bulut
- Department of Psychology, 523228Ankara Hacı Bayram Veli University, Ankara, Turkey
| | - Hatice Demirbaş
- Department of Psychology, 523228Ankara Hacı Bayram Veli University, Ankara, Turkey
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24
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Pritchard C, Hansen L, Dray R, Sharif J. USA Suicides Compared to Other Western Countries in the 21st Century: Is there a Relationship with Gun Ownership? Arch Suicide Res 2023; 27:135-147. [PMID: 35068366 DOI: 10.1080/13811118.2021.1974624] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Causes of suicide are complex indicating a nation's psycho-socio-economic well-being hence this population-based study explores whether USA suicides worsened compared to nineteen Other Western Countries (OWC) being possibly related to gun ownership in the 21st Century. METHODS Total suicide data are drawn from the latest WHO Age-Standardised-Death-Rates per million (pm) controlled for age, sex, and population, along with suicides in the five age- bands 15-34 years to 75 + years. National gun ownership data from the international Small Arms Survey. Chi-square tests any significant difference between American and OWC suicides during the century. Spearman Rank Order correlations are used to determine comparability of suicides and gun ownership per thousand person rates over the period 2000-15. RESULTS USA had the highest gun ownership, treble the rate of the next highest country. American Total suicides rose 27%, significantly more than eight other countries (p < 0.05). The USA had significantly worse suicide outcomes for Older (75+) people than three OWC; eleven for Mature Adults 55-74; eight for Adults 34-54 and for ten countries for Young Adults 15-34. Young Adult suicides numbered 12,438, 6,702 gun-related in 2015, exceeding recent USA military losses. Only Young Adult suicides positively correlated with gun ownership (<0.025). CONCLUSIONS The key finding is whilst most countries reduced suicides American rates rose substantially this century, raising questions about US society. Importantly the easy access to firearms in the USA makes Young Adult suicide more likely when facing psycho-social stress. This study exposes the vulnerability of distressed young American adults in a permissive gun culture, with its sequel, life-long grieving parents.HighlightsDuring 21st Century USA suicides rose substantially more than other Western nations.Only USA suicides rose >20% amongst Total suicides and in those aged 15-to-74years.USA Young Adult suicides 150,099 in 21st century, 12,438 in 2015, 6,702 were gun-related.
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25
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Randall AB, van der Star A, Pennesi JL, Siegel JA, Blashill AJ. Gender identity-based disparities in self-injurious thoughts and behaviors among pre-teens in the United States. Suicide Life Threat Behav 2022; 53:241-249. [PMID: 36562588 DOI: 10.1111/sltb.12937] [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: 08/08/2022] [Revised: 09/26/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Transgender individuals are at heightened risk for self-injurious thoughts and behaviors (SITBs). Evidence suggests that middle childhood-aged transgender individuals experience elevated rates of non-suicidal self-injury (NSSI) and passive suicidal ideation (SI), compared to cisgender children. Little is known about gender identity-based disparities in SI more broadly and suicidal behavior (SB) in children aged 9 and 10. The aim of this study was to examine gender identity-based disparities in SITBs among children in middle childhood (pre-teens) in a US-based sample. METHODS Using data from the 3.0 baseline release of the Adolescent Brain Cognitive Development (ABCD) study, logistic regression models, unadjusted and adjusted for covariates, were performed to examine gender identity-based disparities in SITBs. RESULTS In a model adjusted for birth sex, race/ethnicity, and household income, transgender children were at significantly higher odds for current (adjusted odds ratio [AOR] = 6.34) but not lifetime NSSI compared with cisgender children. Transgender children were at significantly higher odds for current and lifetime SI (AOR = 13.03; AOR = 5.39, respectively) and SB (AOR = 14.21; AOR = 12.64, respectively) compared with cisgender children. CONCLUSIONS Gender identity-based disparities in SITBs may be present as early as age 9 and 10, demonstrating the need for SITB prevention and intervention efforts specific to transgender children.
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Affiliation(s)
- Alyson B Randall
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Arjan van der Star
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Jamie-Lee Pennesi
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Jaclyn A Siegel
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Aaron J Blashill
- Department of Psychology, San Diego State University, San Diego, California, USA.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
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26
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Spatial analysis of mental health and suicide clustering among older adults in North Carolina: An exploratory analysis. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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27
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Perry SW, Rainey JC, Allison S, Bastiampillai T, Wong ML, Licinio J, Sharfstein SS, Wilcox HC. Achieving health equity in US suicides: a narrative review and commentary. BMC Public Health 2022; 22:1360. [PMID: 35840968 PMCID: PMC9284959 DOI: 10.1186/s12889-022-13596-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Suicide rates in the United States (US) reached a peak in 2018 and declined in 2019 and 2020, with substantial and often growing disparities by age, sex, race/ethnicity, geography, veteran status, sexual minority status, socioeconomic status, and method employed (means disparity). In this narrative review and commentary, we highlight these many disparities in US suicide deaths, then examine the possible causes and potential solutions, with the overarching goal of reducing suicide death disparities to achieve health equity.The data implicate untreated, undertreated, or unidentified depression or other mental illness, and access to firearms, as two modifiable risk factors for suicide across all groups. The data also reveal firearm suicides increasing sharply and linearly with increasing county rurality, while suicide rates by falls (e.g., from tall structures) decrease linearly by increasing rurality, and suicide rates by other means remain fairly constant regardless of relative county urbanization. In addition, for all geographies, gun suicides are significantly higher in males than females, and highest in ages 51-85 + years old for both sexes. Of all US suicides from 1999-2019, 55% of male suicides and 29% of female suicides were by gun in metropolitan (metro) areas, versus 65% (Male) and 42% (Female) suicides by gun in non-metro areas. Guns accounted for 89% of suicides in non-metro males aged 71-85 + years old. Guns (i.e., employment of more lethal means) are also thought to be a major reason why males have, on average, 2-4 times higher suicide rates than women, despite having only 1/4-1/2 as many suicide attempts as women. Overall the literature and data strongly implicate firearm access as a risk factor for suicide across all populations, and even more so for male, rural, and older populations.To achieve the most significant results in suicide prevention across all groups, we need 1) more emphasis on policies and universal programs to reduce suicidal behaviors, and 2) enhanced population-based strategies for ameliorating the two most prominent modifiable targets for suicide prevention: depression and firearms.
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Affiliation(s)
- Seth W Perry
- Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.
- Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.
- Department of Neurosurgery, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.
- Department of Public Health and Preventive Medicine, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA.
| | - Jacob C Rainey
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Stephen Allison
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Tarun Bastiampillai
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Mind and Brain Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
- Department of Psychiatry, Monash University, Clayton, Australia
| | - Ma-Li Wong
- Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Julio Licinio
- Department of Psychiatry and Behavioral Sciences, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Neuroscience & Physiology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Department of Medicine, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
- Department of Pharmacology, College of Medicine, State University of New York (SUNY, Upstate Medical University, Syracuse, NY, USA
| | - Steven S Sharfstein
- Sheppard Pratt Health System, Baltimore, MD, USA
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Association between Suicide Rate and Human Development Index, Income, and the Political System in 46 Muslim-Majority Countries: An Ecological Study. Eur J Investig Health Psychol Educ 2022; 12:754-764. [PMID: 35877455 PMCID: PMC9318836 DOI: 10.3390/ejihpe12070055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 11/28/2022] Open
Abstract
Very little has been researched assessing the relationship between the suicide rate and the ecological perspectives of the country, especially in the Muslim majority countries. We aimed to determine the association between suicide rate and the ecological parameters of 46 Muslim majority countries. We extracted the Muslim majority countries and their suicide rate, income distribution, distribution of the WHO region and continents, and Human Development Index (HDI). We assessed the correlation of the proportion of Muslim populations, the total population of the countries, number of suicides, continent, income group, political system, and HDI score with the suicide rate. The median suicide rate was 5.45 (IQR = 4.8); 2.9 (IQR = 4) in females and 7.45 (IQR = 8.2) in males per 100,000 population. The males had a significantly higher rate and the highest suicide rate was found in Africa. There are inverse associations between the total suicide rate, the rate in males, and females with HDI, and the income of the country. Furthermore, the suicide rate was significantly higher in countries with democratic systems compared to non-democratic countries. The findings suggest that ecological parameters may have an etiological role on suicides in Muslim countries where HDI and income are inversely associated with suicide rates.
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29
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Asri AK, Tsai HJ, Wong PY, Lee HY, Pan WC, Guo YL, Wu CS, Su HJ, Wu CD, Spengler JD. Examining the Benefits of Greenness on Reducing Suicide Mortality Rate: A Global Ecological Study. Front Public Health 2022; 10:902480. [PMID: 35865246 PMCID: PMC9294351 DOI: 10.3389/fpubh.2022.902480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
Objective This study applied an ecological-based analysis aimed to evaluate on a global scale the association between greenness exposure and suicide mortality. Methods Suicide mortality data provided by the Institute for Health Metrics and Evaluation and the Normalized Difference Vegetation Index (NDVI) were employed. The generalized additive mixed model was applied to evaluate with an adjustment of covariates the association between greenness and suicide mortality. Sensitivity tests and positive-negative controls also were used to examine less overt insights. Subgroup analyses were then conducted to investigate the effects of greenness on suicide mortality among various conditions. Results The main finding of this study indicates a negative association between greenness exposure and suicide mortality, as greenness significantly decreases the risk of suicide mortality per interquartile unit increment of NDVI (relative risk = 0.69, 95%CI: 0.59–0.81). Further, sensitivity analyses confirmed the robustness of the findings. Subgroup analyses also showed a significant negative association between greenness and suicide mortality for various stratified factors, such as sex, various income levels, urbanization levels, etc. Conclusions Greenness exposure may contribute to a reduction in suicide mortality. It is recommended that policymakers and communities increase environmental greenness in order to mitigate the global health burden of suicide.
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Affiliation(s)
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Pei-Yi Wong
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Hsiao-Yun Lee
- Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Wen-Chi Pan
- Institute of Environmental and Occupational Health Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yue-Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Huey-Jen Su
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
- *Correspondence: Chih-Da Wu
| | - John D. Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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30
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Collados-Ros A, Torres-Sánchez C, Pérez-Cárceles MD, Luna A, Legaz I. Suicidal Behavior and Its Relationship with Postmortem Forensic Toxicological Findings. TOXICS 2022; 10:319. [PMID: 35736927 PMCID: PMC9229491 DOI: 10.3390/toxics10060319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Suicide affects all sociodemographic levels, age groups, and populations worldwide. The factors that can increase the risk of suicidal tendencies are widely studied. The aim of this study was to analyze the types and combinations of toxics found in fatal suicide victims with different suicide mechanisms. A total of 355 autopsies were retrospectively studied, and 26 toxics were determined and related to mechanisms of suicide. Hanging (55%), drug overdose (22.7%), and jumping from a height (17.8%) were most represented suicide mechanisms with positive toxicology. Hanging was the most represented in men (50.3%; p = 0.019), while jumping from a height was more represented in women (29.7%, p = 0.028). Drugs of abuse were the most frequent toxics found in men (55.5%; p < 0.001), while medicines were the most frequent type found in women (70.3%, p < 0.001). Alcohol, nordiazepam, cocaine, and venlafaxine were the most consumed toxics. Benzodiazepines and venlafaxine were found in suicides involving drug overdose, hanging, and jumping from a height. In conclusion, most suicides were associated with drug abuse in men. Hanging was more represented in men and jumping from a height in women. Alcohol was present in combination with other toxics and medicines. The toxicological analysis is fundamental to understanding consumption patterns and establishing strategies and protocols for detecting and preventing suicide.
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Affiliation(s)
- Aurelia Collados-Ros
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
| | - Carmen Torres-Sánchez
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
- Pathology Service, Institute of Legal Medicine and Forensic Sciences, 30100 Murcia, Spain
| | - María Dolores Pérez-Cárceles
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
| | - Aurelio Luna
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
| | - Isabel Legaz
- Department of Legal and Forensic Medicine, Biomedical Research Institute (IMIB), Regional Campus of International Excellence “Campus Mare Nostrum”, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain; (A.C.-R.); (C.T.-S.); (M.D.P.-C.); (A.L.)
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O'Connell KL, Jacobson SV, Ton AT, Law KC. Association between race and socioeconomic factors and suicide-related 911 call rate. Soc Sci Med 2022; 306:115106. [PMID: 35700551 DOI: 10.1016/j.socscimed.2022.115106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/03/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
The American 911 emergency call system fulfills a unique role in preventing suicide and is universally available to all residents suffering a mental health crisis. Previous studies have found disparities between socioeconomic and racial groups in mental health treatment and in help-seeking behaviors. However, very few studies have analyzed disparities in the use of the 911 system for mental health or suicidal crises. The present study conducted negative binomial regression analyses to determine if an increase in suicide-related 911 call rate is associated with race and socioeconomic characteristics in Western King County, Washington. We used the geographic locations of 4823 suicide-related calls from January 2019 to June 2020 to contrast against 2019 demographic data from the Census Bureau. We found increased percentage of Black, Indigenous and People of Color (BIPOC), residents relying on private health insurance, and lower education levels were associated with a decreased suicide-related 911 call rate. We found residents relying on public health insurance to be associated with an increased suicide-related 911 call rate. Future research should explore how residents use 911 in mental health crises to further improve public suicide prevention efforts. Our findings demonstrate how areas with poor health care options may rely more on the 911 system amidst a suicidal crisis.
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Affiliation(s)
| | | | - Andrew T Ton
- Uniformed Services University of the Health Sciences, USA
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32
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Jang H, Lee W, Kim YO, Kim H. Suicide rate and social environment characteristics in South Korea: the roles of socioeconomic, demographic, urbanicity, general health behaviors, and other environmental factors on suicide rate. BMC Public Health 2022; 22:410. [PMID: 35227243 PMCID: PMC8887086 DOI: 10.1186/s12889-022-12843-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide is a serious worldwide public health concern, and South Korea has shown the highest suicide rate among Organisation for Economic Co-operation and Development (OECD) countries since 2003. Nevertheless, most previous Korean studies on suicide had limitations in investigating various social environment factors using long-term nationwide data. Thus, this study examined how various social environment characteristics are related to the suicide rate at the district-level, using nationwide longitudinal data over 11 years. METHODS We used the district-level age-standardized suicide rate and a total of 12 annual social environment characteristics that represented socioeconomic, demographic, urbanicity, general health behaviors, and other environmental characteristics from 229 administrative districts in South Korea. A Bayesian hierarchical model with integrated Laplace approximations (INLA) was used to examine the spatiotemporal association between the rate of suicide and the social environment indicators selected for the study. RESULTS In the total population, the indicators "% of population aged 65 and older eligible for the basic pension", "% vacant houses in the area", "% divorce", "% single elderly households", "% detached houses", "% current smokers", and "% of population with obesity" showed positive associations with the suicide rate. In contrast, "% of people who regularly participated in religious activities" showed negative associations with suicide rate. The associations between these social environment characteristics and suicide rate were generally more statistically significant in males and more urbanized areas, than in females and less urbanized areas; however, associations differed amongst age groups, depending on the social environment characteristic variable under study. CONCLUSIONS This study investigated the complex role of social environments on suicide rate in South Korea and revealed that higher suicide rates were associated with lower values of socioeconomic status, physical exercise, and religious activities, and with higher social isolation and smoking practice. Our results can be used in the development of targeted suicide prevention policies.
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Affiliation(s)
- Hyemin Jang
- Department of Statistics, Ewha Womans University, Seoul, Korea
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven, CT, USA
| | - Yong-Ook Kim
- Population Research Lab, Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, & Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 151-742, Republic of Korea.
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Hui J, Hilton NZ. The Relation of childhood adversity and antisociality to suicide attempts in men admitted to forensic psychiatric hospital. J Forensic Sci 2022; 67:1132-1139. [PMID: 35119119 DOI: 10.1111/1556-4029.14987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/09/2021] [Accepted: 01/05/2022] [Indexed: 11/27/2022]
Abstract
Suicide is a leading cause of death in custody. Although previous studies with prison inmates suggest a strong relation between childhood adversity and suicidal behavior, as well as between childhood adversity and antisociality, this has not been explored in the forensic psychiatric system. We compared 211 men admitted to a forensic hospital having a lifetime history of suicide attempts with 275 men with no suicide history in the same institution. Data were retrospectively coded from information gathered during their assessment and medical records. We examined associations of adverse childhood events and antisociality with suicide attempt history in a series of regression analyses. Childhood adversity was present in majority of individuals and significantly more common for individuals with a history of suicide attempts (76.8%) than those with no suicide attempts (63.3%). The suicide attempt group also experienced a greater number of adverse childhood events. Physical abuse, parental separation, and parental psychiatric history during childhood were associated with suicide attempts. Men with a suicide attempt history had higher antisociality scores than the comparison group and adult antisocial behavior partially mediated the relationship between adverse childhood experiences and suicide attempts. Men in forensic hospital who have suffered multiple experiences of childhood adversity are at increased risk for exhibiting antisocial behavior and engaging in suicidal attempts. Early interventions targeted toward antisociality and trauma-informed care in the forensic hospital are needed to support the mental health of the forensic population.
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Affiliation(s)
- Jeanette Hui
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - N Zoe Hilton
- Waypoint Research Institute, Penetanguishene, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Investigation of the association between lithium levels in drinking water and suicide mortality in Hungary. J Affect Disord 2022; 298:540-547. [PMID: 34800573 DOI: 10.1016/j.jad.2021.11.041] [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: 06/17/2021] [Revised: 10/13/2021] [Accepted: 11/14/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND In recent decades, a series of ecological studies from various countries have attempted to reveal whether there is an association between trace amounts of lithium in drinking water and suicide mortality. With some notable exceptions, results have indicated that there is an inverse association between these two variables. Since Hungary had extremely high rates of suicide with a persistent spatial pattern, we consider that our country is ideal to investigate this research question. METHODS We carried out our research on Hungarian data at the level of districts (n = 197). The dependent variable was the age- and gender-standardized mortality ratio for suicide (sSMR). Our main explanatory variable was the tap water lithium level (Li) from public drinking water supply systems using their own water source (n = 1 325). Those data, which give full national coverage, were aggregated to the level of districts. Confounding factors were religiosity, alcohol consumption and income. Various regression models were used for statistical calculations. RESULTS Findings from our most appropriate regression model - adjusted for relevant confounding variables and able to handle spatial autocorrelation and heteroscedasticity - suggest a significant (p < 0.05) and a trend-like (p < 0.1) negative association between Li and sSMR in the total population and among males, respectively. However, such an association was not found between these two variables among females. CONCLUSION In line with the majority of findings from other countries, our results indicate that the intake of lithium with drinking water may have a gender-dependent suicide-protective effect.
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Motillon-Toudic C, Walter M, Séguin M, Carrier JD, Berrouiguet S, Lemey C. Social isolation and suicide risk: Literature review and perspectives. Eur Psychiatry 2022; 65:e65. [PMID: 36216777 PMCID: PMC9641655 DOI: 10.1192/j.eurpsy.2022.2320] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Suicide is a major public health problem and a cause of premature mortality. With a view to prevention, a great deal of research has been devoted to the determinants of suicide, focusing mostly on individual risk factors, particularly depression. In addition to causes intrinsic to the individual, the social environment has also been widely studied, particularly social isolation. This paper examines the social dimension of suicide etiology through a review of the literature on the relationship between suicide and social isolation. Methods Medline searches via PubMed and PsycINFO were conducted. The keywords were “suicid*” AND “isolation.” Results Of the 2,684 articles initially retrieved, 46 were included in the review. Conclusions Supported by proven theoretical foundations, mainly those developed by E. Durkheim and T. Joiner, a large majority of the articles included endorse the idea of a causal relationship between social isolation and suicide, and conversely, a protective effect of social support against suicide. Moreover, the association between suicide and social isolation is subject to variations related to age, gender, psychopathology, and specific circumstances. The social etiology of suicide has implications for intervention and future research.
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Pennap DD, Swain RS, Welch EC, Bohn J, Lyons JG, Dutcher S, Mosholder AD. Risk of hospitalized depression and intentional self-harm with brand and authorized generic sertraline. J Affect Disord 2022; 296:635-641. [PMID: 34619154 DOI: 10.1016/j.jad.2021.09.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/16/2021] [Accepted: 09/26/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Recent suggestions of therapeutic inequivalence of brand and generic sertraline have raised concerns about disproportionately higher adverse events among generic users. OBJECTIVE To assess the impact of confounding in a comparison of the risks of worsening depression and intentional self-harm (ISH) between users of brand name sertraline and its pharmaceutically equivalent authorized generic (AG). METHODS Using a retrospective new-user cohort design, we identified patients with a diagnosis code for depression aged ≥12 years who were continuously enrolled in a Sentinel Data Partner health plan for ≥180 days before their first sertraline dispensing between June 30, 2006 and September 30, 2015. New use was defined as no evidence of sertraline dispensing in the 180 days before index date. We matched each brand name user to up to 10 AG users using propensity scores (PS) and conducted case-centered logistic regression to assess the risks of hospitalized depression and ISH. RESULTS Before PS matching, brand name users were significantly less likely to be hospitalized for depression [Hazard Ratio (HR) = 0.70 (95% confidence interval (CI): 0.53-0.94)]. However, in the matched analysis, we observed no statistical difference between brand and AG users [HR = 0.84 (95% CI: 0.59-1.21)]. The risk of ISH did not significantly differ between the exposure groups in unmatched (HR = 0.99 (95% CI: 0.60-1.62) and matched analyses [HR = 0.91 (95% CI: 0.49-1.70). CONCLUSION In depressed patients receiving brand versus AG sertraline, patient characteristics confounded the association with hospitalization. Baseline differences were ameliorated by PS matching resulting in no statistical difference between brand and AG sertraline users.
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Affiliation(s)
- Dinci D Pennap
- U.S. Food and Drug Administration Center for Drug Evaluation and Research, Division of Epidemiology I, Silver Spring MD, United States.
| | - Richard S Swain
- U.S. Food and Drug Administration Center for Drug Evaluation and Research, Division of Epidemiology I, Silver Spring MD, United States
| | - Emily C Welch
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston MA, United States
| | - Justin Bohn
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston MA, United States
| | - Jennifer G Lyons
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston MA, United States
| | - Sarah Dutcher
- U.S. Food and Drug Administration Center for Drug Evaluation and Research, Regulatory Science Staff, Silver Spring MD, United States
| | - Andrew D Mosholder
- U.S. Food and Drug Administration Center for Drug Evaluation and Research, Division of Epidemiology I, Silver Spring MD, United States
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Anand P, Bhurji N, Williams N, Desai N. Comparison of PHQ-9 and PHQ-2 as Screening Tools for Depression and School Related Stress in Inner City Adolescents. J Prim Care Community Health 2021; 12:21501327211053750. [PMID: 34905994 PMCID: PMC8679043 DOI: 10.1177/21501327211053750] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Major depressive disorder is associated with significant morbidity and
mortality in adolescents. Suicide is one of the leading causes of mortality
between 15 and 19 years. Both AAP and USPSTF recommend routine depression
screening of adolescents. Patient Health Questionnaire-2 (PHQ-2) and Patient
Health Questionnaire-9 (PHQ-9) are widely used in primary care practice,
however, PHQ-2 does not screen for suicidality. School-related factors are
known to affect adolescent mental health. Purpose To compare PHQ-2 and PHQ-9 for depression screening in adolescents, with
respect to age, gender, chronic illness over the course of 9 months. Methods As a QI initiative, we compared screening results in our inner-city pediatric
practice using PHQ-2 and PHQ-9 from Jun’18 to Feb’19. EMR of 2364 patients
12 to 21 years were reviewed. We considered the PHQ-2 score of ≥2 and PHQ-9
of ≥10 as positive. Pre-existing chronic medical and mental illnesses were
noted. Results Of these 61.5% of patients were females, 95% were Black/Hispanic, and 96%
were insured by Medicaid. About 10.6% of PHQ-9 tests were positive whereas
7.4% PHQ2 were positive. Logistic regression was performed to ascertain the
effects of age, gender, and chronic illness. Females were more likely to
have a positive screen, as were patients with chronic illness. Age had no
effect on the outcome. The screening yield for both tests was comparable in
the summer months. PHQ9 yield increased while schools were in session while
PHQ 2 remained stable. Conclusion PHQ9 is superior as a screening test compared to PHQ2. Repeat screening
should be targeted toward patients with chronic medical conditions and/or
mental health diagnoses. PHQ9 may be better at screening for school-related
stress.
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Affiliation(s)
- Paridhi Anand
- NYC Health+Hospitals/Kings County, Brooklyn, NY, USA
| | | | | | - Ninad Desai
- NYC Health+Hospitals/Kings County, Brooklyn, NY, USA
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Reddan MC. Recommendations for the Development of Socioeconomically-Situated and Clinically-Relevant Neuroimaging Models of Pain. Front Neurol 2021; 12:700833. [PMID: 34557144 PMCID: PMC8453079 DOI: 10.3389/fneur.2021.700833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
Pain is a complex, multidimensional experience that emerges from interactions among sensory, affective, and cognitive processes in the brain. Neuroimaging allows us to identify these component processes and model how they combine to instantiate the pain experience. However, the clinical impact of pain neuroimaging models has been limited by inadequate population sampling - young healthy college students are not representative of chronic pain patients. The biopsychosocial approach to pain management situates a person's pain within the diverse socioeconomic environments they live in. To increase the clinical relevance of pain neuroimaging models, a three-fold biopsychosocial approach to neuroimaging biomarker development is recommended. The first level calls for the development of diagnostic biomarkers via the standard population-based (nomothetic) approach with an emphasis on diverse sampling. The second level calls for the development of treatment-relevant models via a constrained person-based (idiographic) approach tailored to unique individuals. The third level calls for the development of prevention-relevant models via a novel society-based (social epidemiologic) approach that combines survey and neuroimaging data to predict chronic pain risk based on one's socioeconomic conditions. The recommendations in this article address how we can leverage pain's complexity in service of the patient and society by modeling not just individuals and populations, but also the socioeconomic structures that shape any individual's expectations of threat, safety, and resource availability.
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Affiliation(s)
- Marianne C. Reddan
- Department of Psychology, Stanford University, Stanford, CA, United States
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Wang G, Wu L. Social Determinants on Suicidal Thoughts among Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8788. [PMID: 34444536 PMCID: PMC8394117 DOI: 10.3390/ijerph18168788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The main objective of this study was to investigate the relationship between poverty, religion, and suicidal thoughts among U.S. youth. The disparities regarding gender, race, and ethnicity with regard to suicidal thoughts were also assessed. METHODS A cross-sectional correlational research design was used for this study and a national representative sample of 1945 young adults aged 18 to 25 was selected from the 2014 National Survey on Drug Use and Health. Logistic regression analysis with interaction effects was utilized to determine if poverty and religion were associated with suicidal thoughts. RESULTS About 43 percent of the sample reported having suicidal thoughts when things got worse and this prevalence rate varied by gender and race/ethnicity with white males self-disclosing the highest rate of suicidal thoughts. After adjusting for demographic and socioeconomic characteristics, black males who lived up to two times the poverty line had a higher likelihood of suicidal thoughts (p = 0.011), and religion protected against suicidal thoughts (p = 0.012). Youth with lower education and poor health were more inclined to have suicidal thoughts than their peers. CONCLUSIONS Suicide is the second leading cause of death for American young adults aged 18 to 25. Understanding these differences between social determinants of suicide can help public health researchers strategize how to make evidence-based recommendations for suicide prevention efforts.
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Affiliation(s)
- Gang Wang
- School of Journalism and Communication, Wuhan University, 299 Ba Yi Road, Wuhan 430072, China;
| | - Liyun Wu
- School of Social Work, Norfolk State University, Brown Memorial Hall Suite 335.10, 700 Park Avenue, Norfolk, VA 23504, USA
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Elzinga E, de Beurs D, Beekman A, Berkelmans G, Gilissen R. Who didn't consult the doctor? Understanding sociodemographic factors in relation to health care uptake before suicide. J Affect Disord 2021; 287:158-164. [PMID: 33799033 DOI: 10.1016/j.jad.2021.03.014] [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: 12/04/2020] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study aimed to establish differences between suicide decedents and a reference population across various health care settings. METHODS This population-wide registration study combined death statistics, sociodemographic data and health care data from Statistics Netherlands. From 2010 to 2016, 12,015 suicide cases and a random reference group of 132,504 were included and assigned to one of the three health care settings; mental health (MH) care, primary care or no care. Logistic regression analyses were performed to determine differences in suicide risk factors across settings. RESULTS In the 1-2 year period before suicide, 52% of the suicide decedents received MH care, 41% received GP care only and 7% received neither. Although sociodemographic factors showed significant differences across settings, the suicide risk profiles were not profoundly distinctive. A decreasing trend in suicide risk across health care settings became apparent for male gender, income level and being in a one-person or one-parent household, whereas for other factors (middle and older age, non-Western migration background, couples without children and people living in more sparsely populated areas), risk of suicide increased when health care setting became more specialized. LIMITATIONS Because of the data structure, 18 months of suicide decedents' health care use were compared with two years health care use of the reference group, which likely led to an underestimation of the reported differences. CONCLUSION Although there are differences between suicide decedents and a reference group across health care settings, these are not sufficiently distinctive to advocate for a setting-specific approach to suicide prevention.
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Affiliation(s)
- Elke Elzinga
- Research department, 113 Suicide Prevention, Amsterdam, Netherlands; Psychiatry, Amsterdam Public Health (research institute), Amsterdam UMC VU University, Amsterdam, Netherlands.
| | - Derek de Beurs
- Department of epidemiology, Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, Netherlands
| | - Aartjan Beekman
- Department of Research & Innovation, GGZ inGeest Specialized Mental Health Care, Amsterdam, Netherlands; Psychiatry, Amsterdam Public Health (research institute), Amsterdam UMC VU University, Amsterdam, Netherlands
| | - Guus Berkelmans
- Research department, 113 Suicide Prevention, Amsterdam, Netherlands; National research institute for mathematics and computer science, Centrum Wiskunde & Informatica; CWI, Amsterdam, Netherlands
| | - Renske Gilissen
- Research department, 113 Suicide Prevention, Amsterdam, Netherlands
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The effect of income level on all-cause mortality and suicide among patients using antidepressants: A population-based cohort study. Psychiatry Res 2021; 299:113838. [PMID: 33756205 DOI: 10.1016/j.psychres.2021.113838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/23/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND To investigate whether household income levels are associated with all-cause mortality and suicide in patients using antidepressant agents. METHODS We analyzed data from 75,782 patients using antidepressants, acquired from the Korean National Health Insurance claims database (2002-2013). Each patient was monitored until December 2013 or until death, whichever occurred sooner. Cox proportional hazard models were used to compare all-cause and suicide mortalities between different income groups after adjusting for possible confounding covariates and risk factors. RESULTS The mid-low income group had a significantly higher suicide rate than the high-income group (hazard ratio [HR] 1.379; 95% confidence interval [CI] 1.102-1.762). Male patients in the low and mid-low income groups had a higher risk of suicide (HR 1.449; 95% CI, 1.006-2.087 and HR 1.410; 95% CI, 1.036-1.918, respectively), whereas there was no significant difference in suicide risk between income groups among female patients. CONCLUSION Promotion of targeted policies and priority health services for low-income patients on antidepressants may help reduce the risk of suicide in this high-risk group.
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Assessing the Determinants of the Wish to Die among the Elderly Population in Ghana. Geriatrics (Basel) 2021; 6:geriatrics6010032. [PMID: 33807000 PMCID: PMC8006009 DOI: 10.3390/geriatrics6010032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/01/2021] [Accepted: 03/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background: A wish to die is common in elderly people. Concerns about death wishes among the elderly have risen in Ghana, where the ageing transition is comparable to other low-and middle-income countries. However, nationally representative research on death wishes in the elderly in the country is not readily available. Our study aimed to assess the determinants of the wish to die among the elderly in Ghana. Methods: We analysed data from the World Health Organisation Global Ageing and Adult Health Survey, Wave 1 (2007–2008) for Ghana. Data on the wish to die, socio-demographic profiles, health factors and substance abuse were retrieved from 2147 respondents aged 65 and above. Ages of respondents were categorised as 65–74 years; 75–84 years; 85+ to reflect the main stages of ageing. Logistic regression models were fitted to assess the association between these factors and the wish to die. Results: Age, sex, place of residence, education, body mass index, hypertension, stroke, alcohol consumption, tobacco use, income, diabetes, visual impairment, hopelessness and depression had statistically significant associations with a wish to die. Older age cohorts (75–84 and 85+) were more likely to have the wish to die (AOR = 1.05, CI = 1.02–1.16; AOR = 1.48, CI = 1.22–1.94), compared to younger age cohorts (65–74 years). Persons who felt hopeless had higher odds (AOR = 2.15, CI = 2.11–2.20) of experiencing the wish to die as compared to those who were hopeful. Conclusions: In view of the relationship between socio-demographic (i.e., age, sex, education and employment), hopelessness, anthropometric (body mass index), other health factors and the wish to die among the elderly in Ghana, specific biopsychosocial health promotion programmes, including timely identification of persons at risk, for appropriate intervention (e.g., psychotherapy, interpersonal support, alcohol-tobacco cessation therapy, clinical help) to promote their wish for a longer life is needed.
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Kahil K, Cheaito MA, El Hayek R, Nofal M, El Halabi S, Kudva KG, Pereira-Sanchez V, El Hayek S. Suicide during COVID-19 and other major international respiratory outbreaks: A systematic review. Asian J Psychiatr 2021; 56:102509. [PMID: 33418284 PMCID: PMC7764387 DOI: 10.1016/j.ajp.2020.102509] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 10/22/2020] [Accepted: 12/08/2020] [Indexed: 12/01/2022]
Abstract
Coronavirus disease 2019 (COVID-19) was recently declared a pandemic by the WHO. This outbreak threatens not only physical health but also has significant repercussions on mental health. In recent world history, major infectious outbreaks were associated with severe mental health sequelae, including suicide. In this study, we systematically review the literature on suicidal outcomes during major international respiratory outbreaks, including COVID-19. We reviewed descriptive and analytic articles addressing suicide during major international respiratory outbreaks. We searched PubMed, Medline, Embase, Scopus, and PsycInfo databases and then utilized an independent method for study selection by a pair of reviewers. Two reviewers completed data abstraction and conducted a narrative summary of the findings. Our search generated 2,153 articles. Nine studies (three descriptive, five analytical, and one with mixed methodology) were eligible. The included studies were heterogeneous, divergent in methods, and with a low degree of evidence. Deducing an association between pandemics, suicide, and suicide-related outcomes remains thus poorly supported. Future research with better methodological characteristics, the use of longitudinal studies, and a focus on suicide as the primary outcome would allow for an in-depth understanding and formulation of the scope of this problem.
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Affiliation(s)
- Karine Kahil
- Department of Psychiatry, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Mohamad Ali Cheaito
- Department of Emergency Medicine, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Rawad El Hayek
- Faculty of Medicine, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Marwa Nofal
- Helwan Mental Health Hospital, Extension of Mansour St., Behind Kbretaj Helwan Club, Helwan, 25562198, Cairo, Egypt
| | - Sarah El Halabi
- Columbia University Program in Narrative Medicine, Columbia University, New York, NY, 10033, USA
| | - Kundadak Ganesh Kudva
- Early Psychosis Intervention Programme and East Region, Institute of Mental Health, 10 Buangkok View, Buangkok Green, Medical Park, 539747, Singapore
| | - Victor Pereira-Sanchez
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, One Park Avenue, New York, NY, 10016, USA
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon.
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