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Rajkumar RP. The association between nation-level social and economic indices and suicide rates: A pilot study. FRONTIERS IN SOCIOLOGY 2023; 8:1123284. [PMID: 37066069 PMCID: PMC10102579 DOI: 10.3389/fsoc.2023.1123284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
Ever since the pioneering work of Emile Durkheim, it has been known that regional or national suicide rates can be influenced by a variety of social and economic factors. Recent research has found a robust association between two country-level economic indices-gross national product and unemployment rate-and suicide rates, particularly in men. However, the association between other country-level social indices-such as measures of social integration, inequality, environmental preservation and political freedom-and suicide rates has not been studied at the cross-national level. In the current study, national suicide rates for men and women were examined in relation to seven indices measuring subjective wellbeing, sustainable development, type of political regime, economic and gender inequality, and social capital. It was found that the Happy Planet Index, a composite measure of subjective wellbeing and sustainable development, was negatively associated with suicide rates independent of gender, and even after adjusting for possible confounding factors. Economic inequality was associated with suicide in men, and social capital was associated with suicide in women. Moreover, the strength and direction of the associations observed between socioeconomic indices and suicide varied across income groups. These results highlight the need for a closer evaluation of the link between large-scale ("macro") social factors and individual ("micro") psychological factors, as well as the importance of integrating these factors into suicide prevention programmes at the national level.
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2
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Karnecki K, Gos T, Steiner J, Mańkowski D, Kaliszan M. Epidemiology of suicide in the Tri-City metropolitan area in Poland in 2010-2019. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01548-9. [PMID: 36583739 DOI: 10.1007/s00406-022-01548-9] [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: 10/18/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
The paper, which is a continuation of our previous epidemiological studies on the phenomenon of suicide in the Tri-City metropolitan area, presents the results of statistical analyses of suicides in the autopsy material of the Department of Forensic Medicine of the Medical University of Gdańsk in the years 2010-2019. The purpose of the study was to analyse in detail demographic data of suicides (age, sex, place of death), as well as to assess suicide methods and the impact of alcohol on suicides in the study area. During the 10-year study period, 8495 autopsies were performed, of which 1261 were suicides (14.8%). Statistical analyses were conducted using the statistical data analysis software system STATISTICA, version 13 (StatSoft, Tulsa, Oklahoma, USA). The results of the study indicate a continuing downward trend in the number of suicides since the beginning of the 21th century, with the number of suicides in rural areas increasing over the same period. In the analysed cohort, suicides were committed in particular by middle-aged men and the number of suicides among older people (65 +) increased at the same time. The increase in suicide occurred in late autumn and early spring. The most common method of suicide was hanging. There was a high percentage of inebriated victims (45%), and a comparison of the present studies with previous ones indicates the increasing impact of alcohol on suicide.
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Affiliation(s)
- Karol Karnecki
- Department of Forensic Medicine, Faculty of Medicine, Medical University of Gdańsk, 23 Dębowa St, 80-204, Gdańsk, Poland.
| | - Tomasz Gos
- Department of Forensic Medicine, Faculty of Medicine, Medical University of Gdańsk, 23 Dębowa St, 80-204, Gdańsk, Poland
| | - Johann Steiner
- Department of Psychiatry, Otto-Von-Guericke University, 44 Leipziger St, 39120, Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Otto-Von-Guericke University, Universitätsplatz 2, 39106, Magdeburg, Germany
| | - Dobrosław Mańkowski
- Institute of Sociology, Faculty of Social Sciences, University of Gdańsk, Gdańsk, Poland
| | - Michał Kaliszan
- Department of Forensic Medicine, Faculty of Medicine, Medical University of Gdańsk, 23 Dębowa St, 80-204, Gdańsk, Poland
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3
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Kearns JC, Kittel JA, Schlagbaum P, Pigeon WR, Glenn CR. Worry-related sleep problems and suicidal thoughts and behaviors among adolescents in 88 low-, middle-, and high-income countries: an examination of individual- and country-level factors. Eur Child Adolesc Psychiatry 2022; 31:1995-2011. [PMID: 34213638 DOI: 10.1007/s00787-021-01838-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/25/2021] [Indexed: 01/26/2023]
Abstract
A strong association between sleep problems and suicidal thoughts and behaviors (STBs) has been demonstrated in high-income countries. The sleep-STB relationship, however, is minimally understood among youth in low and middle-incomes countries. There also is a limited understanding of how individual- (i.e., age, sex) and country-level (i.e., economic inequality, economic quality) factors may moderate the magnitude of the sleep-STB association among youth. Data were analyzed from the cross-national Global School-based Health Survey 2003-2017, which assessed a range of health behaviors among school-enrolled adolescents aged 11-18 years from 88 low-, lower-middle, upper-middle, and high-income countries. Multilevel models were used to examine the influence of individual- and country-level factors on the association between past-year worry-related sleep problems and past-year suicide ideation, suicide plans, and suicide attempts. Worry-related sleep problems were significantly associated with suicide ideation, plans, and attempts. Adolescent sex, country economic quality (income group designation), and country economic inequality moderated the sleep-STB association, but age did not. The sleep-STB relationship was stronger for males and across macroeconomic indices, the relationship was generally strongest among upper-middle income countries (economic quality) and countries with a big income gap (economic inequality). When examining how individual-level factors differentially affected the sleep-STB relationship within economic quality (income group designation), the effects were driven by older adolescents in high-income countries for suicide ideation and suicide plans. Study findings suggest an important role for global macroeconomic factors, for males, and older adolescents in high-income countries in the sleep-STB relationship. Future directions include expanding worldwide coverage of countries, assessing a wider range of sleep problems, and longitudinal work to understand potential mechanisms in the sleep-STB relationship.
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Affiliation(s)
- Jaclyn C Kearns
- Department of Psychology, University of Rochester, 180 Meliora Hall, Box 270266, Rochester, NY, 14627, USA.
| | - Julie A Kittel
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Paige Schlagbaum
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Wilfred R Pigeon
- VA Center for Excellence for Suicide Prevention, Finger Lakes Healthcare System, Canandaigua, NY, USA.,Sleep and Neurophysiology Research Lab, University of Rochester Medical Center Rochester, Rochester, NY, USA
| | - Catherine R Glenn
- Department of Psychology, Old Dominion University, Norfolk, VA, USA.,Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
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Pajić V, Orešković S. An Exploratory Analysis of Fifteen Years Suicide Trends Using Population-Level Data From Croatian Committed Suicides Registry. Front Public Health 2022; 10:857284. [PMID: 35757608 PMCID: PMC9215280 DOI: 10.3389/fpubh.2022.857284] [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: 01/18/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The provide a descriptive analysis of the available population-level aggregated data on committed suicides in the Republic of Croatia, in the 2004-2018 period, showing emerging trends in suicide incidence focusing on sex/age/geographical distribution of suicides and the primary and secondary causes of suicide mortality, as well as making comparisons with similar neighboring neighboring countries. Methods The aggregated suicide data were obtained from the Croatian Committed Suicides Registry, a national registry maintained by the public health authority. The raw data extract was organized into tables according to several variables (age, sex, place of birth, place of residence, and cause of death). Simple descriptive statistics were performed on the structured data. Results Despite being among the highest in the world and EU, the number of committed suicides in Croatia is in decline since 2004. A higher number of suicides by males was observed when compared to females. Most of the suicides occur during spring and summer. The wealthier, northern continental region of the country had the highest average rate of committed suicides per 1,00,000 population, contrary to some of the findings in the published literature associating economic instability with suicide. The most common way to commit suicide for both sexes in all age groups is self-harm by hanging, strangulation and suffocation. Suicide by firearm and explosive devices discharge remains higher than the global average. Conclusions Despite its steadily declining incidence rates in the past 20 years, suicides remain a major public health challenge in Croatia. Results may bolster the Ugro-Finnish suicide hypothesis, linking higher suicide rates to regions with populations of Hungarian descent.
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Affiliation(s)
- Vanja Pajić
- Independent Researcher, Zagreb, Croatia.,Department of Medical Sociology and Health Economics, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Stjepan Orešković
- Department of Medical Sociology and Health Economics, School of Medicine, University of Zagreb, Zagreb, Croatia
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5
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Shaw C, Stuart J, Thomas T, Kõlves K. Suicidal behaviour and ideation in Guyana: A systematic literature review. LANCET REGIONAL HEALTH. AMERICAS 2022; 11:100253. [PMID: 36778929 PMCID: PMC9903603 DOI: 10.1016/j.lana.2022.100253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background The suicide rate in Guyana has consistently ranked as one of the highest in the world. This systematic review synthesises and critically analyses the existing literature on suicidal behaviours and ideation in Guyana. Methods Systematic review with narrative synthesis was conducted following PRISMA guidelines. PubMed, PsychInfo, CINAHL and SCOPUS databases were searched until 31st March 2021. Articles which included the analysis of suicidal behaviour or suicidal ideation using data collected in Guyana were eligible for inclusion. Articles relating to the Jonestown mass murder-suicide event were excluded. This review was pre-registered with PROSPERO [CRD42021247669]. Findings The search resulted in 318 articles, of which 24 met eligibility for inclusion. The majority were quantitative (n=18), relating to suicide mortality (n=9), and suicide attempt and suicidal ideation (n=9). Additionally, qualitative (n=5) and mixed-method (n=1) papers investigated the experiences of those bereaved by suicide, gatekeepers of suicidality, and adolescent students. Eleven studies were multinational, whilst 13 focused on Guyana. The quality of the publications varied. Interpretation Despite high annual suicide rates in Guyana, published research is very limited. This review found preliminary evidence for key risk groups; males, female youth, and Indo-Guyanese ethnicity. Pesticide poisoning was identified as the most common method for suicide in Guyana. There is a need for local research investigating the context and narrative of suicide to inform culturally tailored prevention strategies. This study was limited to a narrative synthesis and may be impacted by publication bias. Funding This research was supported by an Australian Government Research Training Program Scholarship through Griffith University Australia. Registration Pre-registered in PROSPERO [CRD42021247669].
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Affiliation(s)
- Charlotte Shaw
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Level 1, Building M24 Psychology, 176 Messines Ridge Road, Mt Gravatt Campus, Brisbane, QLD 4122, Australia,Corresponding author.
| | - Jaimee Stuart
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Troy Thomas
- Faculty of Natural Sciences, University of Guyana, Guyana
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Level 1, Building M24 Psychology, 176 Messines Ridge Road, Mt Gravatt Campus, Brisbane, QLD 4122, Australia
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6
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Fox V, Dalman C, Dal H, Hollander AC, Kirkbride JB, Pitman A. Suicide risk in people with post-traumatic stress disorder: A cohort study of 3.1 million people in Sweden. J Affect Disord 2021; 279:609-616. [PMID: 33190111 PMCID: PMC7758737 DOI: 10.1016/j.jad.2020.10.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/28/2020] [Accepted: 10/04/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND It is unclear whether post-traumatic stress disorder [PTSD] is associated with suicide risk in the general population, whether this differs by sex, or what the population impact of PTSD is for suicide. METHODS We constructed a nationwide cohort of all people living in Sweden, born 1973-1997, followed from their 14th birthday (or immigration, if later) until suicide, other death, emigration or 31 December 2016. We used Cox proportional hazards regression to estimate hazard ratios [HR], and calculated the population impact of PTSD on suicide. We included sensitivity analyses to explore effects of outcome and exposure definitions, and to account for potential competing risks. RESULTS Of 3,177,706 participants, 22,361 (0•7%) were diagnosed with PTSD, and 6,319 (0•2%) died by suicide over 49•2 million person-years. Compared with women and men without PTSD, suicide rates were 6•74 (95%CI: 5•61-8•09) and 3•96 (95%CI: 3•12-5•03) times higher in those with PTSD, respectively, after sociodemographic adjustment. Suicide rates remained elevated in women (HR: 2•61; 95%CI: 2•16-3•14) and men (HR: 1•67; 95%CI: 1•31-2•12) after adjustment for previous psychiatric conditions; attenuation was driven by previous non-fatal suicide attempts. Findings were insensitive to definitions or competing risks. If causal, 1•6% (95%CI: 1•2-2•1) of general population suicides could be attributed to PTSD, and up to 53.7% (95%CI: 46.1-60.2) in people with PTSD. LIMITATIONS Residual confounding remains possible due to depressive and anxiety disorders diagnosed in primary care but unrecorded in these registers. CONCLUSIONS Clinical guidelines for the management of people with PTSD should recognise increased suicide risks.
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Affiliation(s)
- Verity Fox
- Division of Psychiatry, UCL, London, W1T 7NF, United Kingdom
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Sweden; Centre for Epidemiology and Social Medicine, The Region Stockholm, Sweden
| | - Henrik Dal
- Department of Global Public Health, Karolinska Institutet, Sweden
| | | | | | - Alexandra Pitman
- Division of Psychiatry, UCL, London, W1T 7NF, United Kingdom; Camden and Islington NHS Foundation Trust, London, NW1 0PE, United Kingdom.
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Awan S, Diwan MN, Aamir A, Allahuddin Z, Irfan M, Carano A, Vellante F, Ventriglio A, Fornaro M, Valchera A, Pettorruso M, Martinotti G, Di Giannantonio M, Ullah I, De Berardis D. Suicide in Healthcare Workers: Determinants, Challenges, and the Impact of COVID-19. Front Psychiatry 2021; 12:792925. [PMID: 35185638 PMCID: PMC8850721 DOI: 10.3389/fpsyt.2021.792925] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/21/2021] [Indexed: 12/16/2022] Open
Abstract
The Coronavirus disease-19 (COVID-19), which first appeared in Wuhan, China, and was later declared a pandemic, has caused significant morbidity and mortality worldwide. Numerous efforts have been made worldwide to understand the disease's physical manifestation. However, less emphasis has been placed on the pandemic's mental health challenges for healthcare workers (HCWs) who played a critical role in fighting the disease. Existing literature shows the detrimental psychological impact and increased incidence of depression and anxiety among HCWs. It is expected that the mental health crisis will become a serious issue affecting HCWs, with long-term negative consequences following COVID. Physicians and nurses already represent the highest risk groups of suicide among the general population, and suicide can be regarded as an occupational hazard in the healthcare industry. Increased workload, burnout and fatigue, multifaceted challenges women HCWs, and increased substance abuse are contributing factors to suicide ideation. In this article, we identify the risk factors of suicide among HCWs, discuss mental health challenges exacerbated by the pandemic and its impact on suicide ideation.
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Affiliation(s)
- Sana Awan
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan
| | | | - Alifiya Aamir
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan
| | - Zoha Allahuddin
- Department of Internal Medicine, Dow Medical College, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Alessandro Carano
- Department of Mental Health, Azienda Sanitaria Unica Regionale 5 Marche, San Benedetto Del Tronto, Italy
| | - Federica Vellante
- Department of Mental Health, Mental Health Center of Ortona, Azienda Sanitaria Locale Chieti, Chieti, Italy
| | | | - Michele Fornaro
- Laboratory of Molecular and Translational Psychiatry, Unit of Treatment-Resistant Psychosis, Section of Psychiatry, University of Naples Federico II, Naples, Italy
| | - Alessandro Valchera
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Domenico De Berardis
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy.,Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
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8
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Stoychev K, Dimitrova E, Nakov V, Stoimenova-Popova M, Chumpalova P, Veleva I, Mineva-Dimitrova E, Dekov D. Socio-Demographic and Clinical Characteristics of Psychiatric Patients Who Have Committed Suicide: Analysis of Bulgarian Regional Suicidal Registry for 10 Years. Front Psychiatry 2021; 12:665154. [PMID: 34489748 PMCID: PMC8417357 DOI: 10.3389/fpsyt.2021.665154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Suicide is a major public health problem but factors determining suicide risk are still unclear. Studies in this field in Bulgaria are limited, especially on a regional level. Methods: By a cross-sectional design, we accessed the medical records of all psychiatric patients committed suicide over a 10-year period (2009-2018) in one major administrative region of Bulgaria. A statistical analysis was performed of the association between age of suicide as an indirect yet measurable expression of the underlying suicidal diathesis and a number of socio-demographic and clinical characteristics. Results: Seventy-seven of 281 suicides (28%) had psychiatric records. Most common diagnoses were mood disorders (44%), followed by schizophrenia (27%), anxiety disorders (10%), substance use disorders (9%) and organic conditions (8%). Male gender, single/divorced marital status, early illness onset, co-occurring substance misuse and lower educational attainment (for patients aged below 70) were significantly associated with earlier age of suicide whereas past suicide attempts and psychiatric hospitalizations, comorbid somatic conditions and unemployment showed insignificant association. Substantial proportion of patients (60%) had contacted psychiatric service in the year preceding suicide, with nearly half of these encounters being within 30 days of the accident. Conclusion: Severe mental disorders are major suicide risk factor with additional contribution of certain socio-demographic and illness-related characteristics. Monitoring for suicidality must be constant in chronic psychiatric patients. Registration of suicide cases in Bulgaria needs improvement in terms of information concerning mental health. More studies with larger samples and longitudinal design are needed to further elucidate distal and proximal suicide risk factors.
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Affiliation(s)
- Kalyan Stoychev
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Emilia Dimitrova
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Vladimir Nakov
- Department of Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria
| | - Maya Stoimenova-Popova
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Petranka Chumpalova
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | - Ivanka Veleva
- Department of Psychiatry and Medical Psychology, Medical University Pleven, Pleven, Bulgaria.,Department of Psychiatry, 'Dr. Georgi Stranski' University Hospital, Pleven, Bulgaria
| | | | - Dancho Dekov
- Deparment of General Medicine, Forensic Medicine, and Deontology, Medical University Pleven, Pleven, Bulgaria
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9
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Glenn CR, Kleiman EM, Kellerman J, Pollak O, Cha CB, Esposito EC, Porter AC, Wyman PA, Boatman AE. Annual Research Review: A meta-analytic review of worldwide suicide rates in adolescents. J Child Psychol Psychiatry 2020; 61:294-308. [PMID: 31373003 DOI: 10.1111/jcpp.13106] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2019] [Indexed: 12/01/2022]
Abstract
Suicide is a leading cause of death among youth worldwide. The purpose of the current review was to examine recent cross-national trends in suicide mortality rates among 10- to 19-year-olds. This study extracted suicide mortality data from the World Health Organization's (WHO) Mortality Database for the most recent year (since 2010) from any country with available high-quality data (as defined by the WHO's guidelines). Data on access to lethal means (firearms, railways) and measures of economic quality (World Bank Income Group) and inequality (Gini coefficients) were obtained from publicly available data sources. Cross-national suicide mortality rates in youth were heterogeneous. The pooled estimate across all ages, sexes, and countries was 3.77/100,000 people. The highest suicide rates were found in Estonia, New Zealand, and Uzbekistan. Suicide rates were higher among older compared with younger adolescents and higher among males than females. The most common suicide methods were hanging/suffocation and jumping/lying in front of a moving object or jumping from a height. Firearm and railway access were related to suicide deaths by firearms and jumping/lying, respectively. Economic quality and inequality were not related to overall suicide mortality rates. However, economic inequality was correlated with a higher ratio of male:female suicides. This study provides a recent update of cross-national suicide trends in adolescents. Findings replicate prior patterns related to age, sex, geographic region, and common suicide methods. New to this review are findings relating suicide method accessibility to suicide mortality rates and the significant association between income inequality and the ratio of male:female suicide. Future research directions include expanding the worldwide coverage to more low- and middle-income countries, examining demographic groupings beyond binary sex and to race/ethnicity within countries, and clarifying factors that account for cross-national differences in suicide trends.
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Affiliation(s)
- Catherine R Glenn
- Department of Psychology, University of Rochester, Rochester, NY, USA.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Evan M Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - John Kellerman
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Olivia Pollak
- Department of Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Christine B Cha
- Department of Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Erika C Esposito
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Andrew C Porter
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Peter A Wyman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Anne E Boatman
- Department of Psychology, University of Rochester, Rochester, NY, USA
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10
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Wu KK, Armstrong AW. Suicidality among psoriasis patients: a critical evidence synthesis. GIORN ITAL DERMAT V 2019; 154:56-63. [DOI: 10.23736/s0392-0488.18.06112-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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11
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Bachmann S. Epidemiology of Suicide and the Psychiatric Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1425. [PMID: 29986446 PMCID: PMC6068947 DOI: 10.3390/ijerph15071425] [Citation(s) in RCA: 744] [Impact Index Per Article: 106.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 06/28/2018] [Accepted: 07/01/2018] [Indexed: 12/12/2022]
Abstract
Suicide is a worldwide phenomenon. This review is based on a literature search of the World Health Organization (WHO) databases and PubMed. According to the WHO, in 2015, about 800,000 suicides were documented worldwide, and globally 78% of all completed suicides occur in low- and middle-income countries. Overall, suicides account for 1.4% of premature deaths worldwide. Differences arise between regions and countries with respect to the age, gender, and socioeconomic status of the individual and the respective country, method of suicide, and access to health care. During the second and third decades of life, suicide is the second leading cause of death. Completed suicides are three times more common in males than females; for suicide attempts, an inverse ratio can be found. Suicide attempts are up to 30 times more common compared to suicides; they are however important predictors of repeated attempts as well as completed suicides. Overall, suicide rates vary among the sexes and across lifetimes, whereas methods differ according to countries. The most commonly used methods are hanging, self-poisoning with pesticides, and use of firearms. The majority of suicides worldwide are related to psychiatric diseases. Among those, depression, substance use, and psychosis constitute the most relevant risk factors, but also anxiety, personality-, eating- and trauma-related disorders as well as organic mental disorders significantly add to unnatural causes of death compared to the general population. Overall, the matter at hand is relatively complex and a significant amount of underreporting is likely to be present. Nevertheless, suicides can, at least partially, be prevented by restricting access to means of suicide, by training primary care physicians and health workers to identify people at risk as well as to assess and manage respective crises, provide adequate follow-up care and address the way this is reported by the media. Suicidality represents a major societal and health care problem; it thus should be given a high priority in many realms.
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Affiliation(s)
- Silke Bachmann
- Clienia Littenheid AG, Hauptstrasse 130, 9573 Littenheid, Switzerland.
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, University Halle (Saale), Julius-Kühn-Strasse 7, 6112 Halle (Saale), Germany.
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12
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Psoriasis and suicidality: A systematic review and meta-analysis. J Am Acad Dermatol 2017; 77:425-440.e2. [DOI: 10.1016/j.jaad.2017.05.019] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/15/2017] [Accepted: 05/19/2017] [Indexed: 12/18/2022]
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13
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Campo-Arias A, Herazo E. Asociación entre desigualdad y tasa de suicidio en Colombia (1994-2013). ACTA ACUST UNITED AC 2015; 44:28-32. [DOI: 10.1016/j.rcp.2014.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
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Sublette ME, Galfalvy HC, Fuchs D, Lapidus M, Grunebaum MF, Oquendo MA, Mann JJ, Postolache TT. Plasma kynurenine levels are elevated in suicide attempters with major depressive disorder. Brain Behav Immun 2011; 25:1272-8. [PMID: 21605657 PMCID: PMC3468945 DOI: 10.1016/j.bbi.2011.05.002] [Citation(s) in RCA: 183] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 05/06/2011] [Accepted: 05/09/2011] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Inflammation has been linked to depression and suicide risk. One inflammatory process that has been minimally investigated in this regard is cytokine-stimulated production of kynurenine (KYN) from tryptophan (TRP). Recent data suggest that KYN increases in cerebrospinal fluid (CSF) are associated with depressive symptoms secondary to immune activation. KYN may alter dopaminergic and glutamatergic tone, thereby contributing to increased arousal, agitation and impulsivity - important risk factors in suicide. We hypothesized that patients with major depressive disorder (MDD) and a history of suicide attempt would have higher levels of KYN than depressed nonattempters, who in turn would have higher levels than healthy volunteers. METHODS Plasma KYN, TRP, and neopterin were assayed by high performance liquid chromatography in three groups: healthy volunteers (n=31) and patients with MDD with (n=14) and without (n=16) history of suicide attempt. Analysis of variance tested for group differences in KYN levels. RESULTS KYN levels differed across groups (F=4.03, df=(2,58), and p=0.023): a priori planned contrasts showed that KYN was higher in the MDD suicide attempter subgroup compared with MDD non-attempters (t=2.105, df=58, and p=0.040), who did not differ from healthy volunteers (t=0.418, df=58, and p=0.677). In post hoc testing, KYN but not TRP was associated with attempt status, and only suicide attempters exhibited a positive correlation of the cytokine activation marker neopterin with the KYN:TRP ratio, suggesting that KYN production may be influenced by inflammatory processes among suicide attempters. CONCLUSION These preliminary results suggest that KYN and related molecular pathways may be implicated in the pathophysiology of suicidal behavior.
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Affiliation(s)
- M. Elizabeth Sublette
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute,Department of Psychiatry, Columbia University
| | - Hanga C. Galfalvy
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute,Department of Psychiatry, Columbia University
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocentre, Innsbruck Medical University
| | | | - Michael F. Grunebaum
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute,Department of Psychiatry, Columbia University
| | - Maria A. Oquendo
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute,Department of Psychiatry, Columbia University
| | - J. John Mann
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute,Department of Psychiatry, Columbia University,Department of Radiology, Columbia University
| | - Teodor T. Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland, School of Medicine
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