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Schwartz JJ, Roske C, Liu Q, Tobe RH, Ely BA, Gabbay V. C-Reactive Protein Does Not Predict Future Depression Onset in Adolescents: Preliminary Findings from a Longitudinal Study. J Child Adolesc Psychopharmacol 2024. [PMID: 38669109 DOI: 10.1089/cap.2023.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Introduction: Neuroinflammatory processes have been extensively implicated in the underlying neurobiology of numerous neuropsychiatric disorders. Elevated C-reactive protein (CRP), an indicator of nonspecific inflammation commonly utilized in clinical practice, has been associated with depression in adults. In adolescents, our group previously found CRP to be associated with altered neural reward function but not with mood and anxiety symptoms assessed cross-sectionally. We hypothesized that the distinct CRP findings in adolescent versus adult depression may be due to chronicity, with neuroinflammatory effects on psychiatric disorders gradually accumulating over time. Here, we conducted a longitudinal study to evaluate if CRP levels predicted future onset or progression of depression in adolescents. Methods: Participants were 53 adolescents (age = 14.74 ± 1.92 years, 35 female), 40 with psychiatric symptoms and 13 healthy controls. At baseline, participants completed semistructured diagnostic evaluations; dimensional assessments for anxiety, depression, anhedonia, and suicidality severity; and bloodwork to quantify CRP levels. Clinical assessments were repeated at longitudinal follow-up after ∼1.5 years. Spearman's correlation between CRP levels and follow-up symptom severity were controlled for body mass index, age, sex, and follow-up interval and considered significant at the two-tailed, Bonferroni-adjusted p < 0.05 level. Results: After correction for multiple comparisons, no relationships were identified between baseline CRP levels and follow-up symptom severity. Conclusion: CRP levels were not significantly associated with future psychiatric symptoms in adolescents in this preliminary analysis. This may suggest that CRP is not a useful biomarker for adolescent depression and anxiety. However, future longitudinal studies with larger sample sizes and incorporating additional indicators of neuroinflammation are needed.
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Affiliation(s)
- Joshua J Schwartz
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Chloe Roske
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Qi Liu
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Russel H Tobe
- The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, USA
| | - Benjamin A Ely
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Vilma Gabbay
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
- The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, USA
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Lange S, Kim KV, Lasserre AM, Orpana H, Bagge C, Roerecke M, Rehm J. Sex-Specific Association of Alcohol Use Disorder With Suicide Mortality: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e241941. [PMID: 38470417 PMCID: PMC10933726 DOI: 10.1001/jamanetworkopen.2024.1941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/21/2024] [Indexed: 03/13/2024] Open
Abstract
Importance Despite individual studies suggesting that sex differences exist in the association between alcohol use disorder (AUD) and suicide, most existing systematic reviews and meta-analyses have reported associations across the sexes. Objective To estimate the sex-specific association between AUD and suicide mortality. Data Sources Embase, MEDLINE (including MEDLINE In-Process), PsycINFO, PubMed, and Web of Science were searched from database inception to April 27, 2022. Study Selection Inclusion criteria consisted of the following: (1) original, quantitative study, (2) inclusion of a measure of association and its corresponding measure of variability (or sufficient data to calculate these [eg, 95% CI]), and (3) results stratified by sex. Data Extraction and Synthesis Data extraction was completed by one reviewer and then cross-checked by a second reviewer. Risk of bias was assessed by study design. Categorical random-effects meta-analyses were conducted to obtain sex-specific pooled estimates of the association between AUD and suicide mortality risk. Methodological moderators (ie, study design and comparator group) were assessed using sex-stratified meta-regressions. Main Outcomes and Measures The association between AUD and suicide mortality. Results A total of 16 347 unique records were identified in the systematic search; 24 studies were ultimately included for 37 870 699 participants (59.7% male and 40.3% female) (23 risk estimates for male and 17 for female participants). Participants ranged in age from 15 years to 65 years or older. Sex-specific meta-regression models indicated that study design (ie, longitudinal vs cross-sectional study design) affected the observed association between AUD and suicide mortality for both male participants (log odds ratio, 0.68 [95% CI, 0.08-1.28]; P = .03) and female participants (log odds ratio, 1.41 [95% CI, 0.57-2.24]; P < .001). For males and females, among longitudinal studies, the pooled odds ratios were 2.68 (95% CI, 1.86-3.87; I2 = 99% [n = 14]) and 2.39 (95% CI, 1.50-3.81; I2 = 90% [n = 11]), respectively. Conclusions and Relevance This systematic review and meta-analysis yielded substantive evidence that AUD was associated with suicide mortality and that the association was similar across the sexes. The findings underscore the importance of identifying and treating AUD as part of a comprehensive suicide prevention strategy.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Kawon V. Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Aurélie M. Lasserre
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Heather Orpana
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Courtney Bagge
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
- Center for Clinical Management Research, Department of Veterans Affairs, Ann Arbor, Michigan
| | - Michael Roerecke
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Program on Substance Abuse and World Health Organization European Region Collaboration Centre, Public Health Agency of Catalonia, Barcelona, Spain
- Zentrum für Interdisziplinäre Suchtforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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Cambron C, Jaggers JW. Examining area- and individual-level differences in suicide ideation severity and suicide attempt among youth. J Res Adolesc 2024; 34:35-44. [PMID: 37873580 DOI: 10.1111/jora.12894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023]
Abstract
Youth suicide is a pressing problem and suicide rates are not equally distributed across geographic areas or socioeconomic status (SES). Death by suicide is often preceded factors including hopelessness and suicide ideation, planning, and attempt. The current study examined area- and individual-level differences in suicide ideation severity and suicide attempt in a state-representative sample of youth from 2019 (N = 78,740) and 2021 (N = 61,396). Youth from higher SES and rural areas showed lower suicide ideation severity and odds of suicide attempt. After including individual-level covariates, SES differences in ideation severity and suicide attempt persisted for 2019 but not 2021. Rural differences for ideation severity persisted across years but not for suicide attempt. Further research on geographic variation in suicide risk is needed.
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Bai S, Asarnow JR, Babeva KN, Irwin MR. IL-6 predicts non-suicidal self-injury over 3 months in high-risk adolescents. BJPsych Open 2024; 10:e51. [PMID: 38406835 PMCID: PMC10897689 DOI: 10.1192/bjo.2023.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/04/2023] [Accepted: 12/29/2023] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Suicide is the second leading cause of death in 12- to 17-year-old adolescents in the USA. Research on biological mechanisms contributing to self-harm risk that could be targeted in treatment could help to prevent suicide and self-harm episodes. AIMS We aimed to evaluate whether markers of inflammation, interleukin-6 (IL-6) and C-reactive protein (CRP), predict self-harm over 3 months within a sample selected for elevated suicide/self-harm risk at project entry. METHOD Fifty-one adolescents aged 12-19 years selected for elevated suicide/self-harm risk completed three clinical interviews about suicide attempts and non-suicidal self-injury, 3 months apart. At baseline and 3 months, youth also provided blood samples, from which we assayed levels of IL-6 and CRP. RESULTS Using generalised mixed models, we found that greater levels of IL-6 predicted more self-harm episodes (odds ratio [OR] = 3.3, 95% CI: 1.1, 10.0) and specifically, non-suicidal self-injury (OR = 3.5, 95% CI: 1.1, 11.2), over 3 months. CONCLUSIONS The study findings increase our understanding of whether and how inflammation may be implicated in risk of self-harm. IL-6 may be a viable biological marker of short-term risk for self-harm.
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Affiliation(s)
- Sunhye Bai
- Prevention Research Center, The Pennsylvania State University, USA; and The Ballmer Institute for Children's Behavioral Health, University of Oregon, USA
| | - Joan R. Asarnow
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Kalina N. Babeva
- Child Psychiatry and Behavioral Medicine, Seattle Children's Hospital, USA
| | - Michael R. Irwin
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, USA; and Cousins Center for Psychoneuroimmunology, David Geffen School of Medicine, University of California Los Angeles, USA
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Zafar M, Alhelali AYS, Alfuwis MSM, Alshammari WZAL. Relationship between attention deficit hyperactive disorders with life satisfaction among medical students in city of Hail, KSA. J Educ Health Promot 2024; 12:437. [PMID: 38464643 PMCID: PMC10920718 DOI: 10.4103/jehp.jehp_334_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/30/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND Attention deficit hyperactive disorder (ADHD) begins in childhood, and its symptoms persist into adulthood. Students with ADHD symptoms will be at increased risk of antisocial behavior, depression, and loss of inhibition. This study determines the relationship between ADHD and life satisfaction level among medical students in the city of Hail, KSA. MATERIALS AND METHODS This is a cross-sectional study that was conducted in a public-sector medical college. A total of 200 students were recruited through stratified cluster sampling. Validated, structured scales of ADHD and life satisfaction were used, and known psychiatric disorders among students were excluded from the study. Correlation and linear regression analyses were used to determine the relationship between ADHD and life satisfaction and identify the determinants of ADHD. P value < 0.05 was considered statistically significant. RESULT The prevalence rate of ADHD among medical students was 33.3%. Female gender, third-year academic year student, and 21-26-year-old age group were the high-risk groups of ADHD. Inattention (r = -0.263, P value -0.000) and hyperactivity (r = -0.260, P value 0.000) were significantly correlated with life satisfaction level, with 92% of the variability in life satisfaction determined by inattention and hyperactivity. CONCLUSION The burden of ADHD is high among medical students, and it negatively correlates with life satisfaction level. Students' academic and social functioning was affected due to ADHD. There is a need to address this issue with early diagnosis and management of this disorder.
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Affiliation(s)
- Mubashir Zafar
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, KSA
| | - Alaa Y. S. Alhelali
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, KSA
| | - Mohamed S. M. Alfuwis
- Department of Family and Community Medicine, College of Medicine, University of Hail, Hail, KSA
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Uno A, Nagaoka D, Usami S, Yamaguchi S, Minami R, Tanaka R, Sawai Y, Okuma A, Yamasaki S, Miyashita M, Nishida A, Kasai K, Ando S. Suicidal Thoughts and Trajectories of Psychopathological and Behavioral Symptoms in Adolescence. JAMA Netw Open 2024; 7:e2353166. [PMID: 38270951 PMCID: PMC10811562 DOI: 10.1001/jamanetworkopen.2023.53166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/04/2023] [Indexed: 01/26/2024] Open
Abstract
Importance The suicidal risk of psychopathology in adolescence is suggested to differ based on its longitudinal trajectory, but the comorbidity of these symptom trajectories has not been well examined. This study comprehensively clustered trajectories of multiple psychopathological and behavioral symptoms and examined their associations with suicidal thoughts in adolescence. Objective To determine which categories and trajectories of psychopathological and behavioral symptoms are associated with suicidal thoughts in adolescence, accounting for comorbid symptoms. Design, Setting, and Participants This population-based cohort study in Japan used data from the Tokyo Teen Cohort (TTC) study, which was established in 2012 and is currently ongoing. Data from 3 waves of surveys conducted at ages 10, 12, and 16 years from October 2012 to September 2021 were used. Of the adolescents in the cohort, participants with at least 2 evaluations of psychopathological and behavioral symptoms were included. Data were analyzed from December 2022 to March 2023. Exposure Latent class growth analysis was used to cluster the trajectory of each psychopathological and behavioral symptom. Main Outcomes and Measures The associations between symptom trajectories and suicidal thoughts at age 16 were examined. Suicidal thoughts were assessed using a self-report questionnaire. Psychopathological and behavioral symptoms were assessed using the 8 subscale scores of the caregiver-report Child Behavior Checklist. Results This study included 2780 adolescents (1306 female participants [47.0%]). Of the 1920 adolescents with data on suicidal thoughts, 158 (8.2%) had suicidal thoughts. The median (IQR) age was 10.2 (10.0-10.3) years at the first evaluation, 11.9 (11.8-12.1) years at the second evaluation, and 16.3 (16.1-16.5) years at the last evaluation. The clustering pattern of trajectories varied depending on symptom categories. After adjusting for each symptom trajectory and confounders, adolescents with persistent high withdrawn symptoms (odds ratio [OR], 1.88; 95% CI, 1.10-3.21) and those with increasing somatic symptoms (OR, 1.97; 95% CI, 1.16-3.34) had a significantly higher risk of suicidal thoughts than adolescents without these symptoms. There was no interaction between these symptom trajectories and the risk of suicidal thoughts. Conclusions and Relevance This cohort study found that persistent withdrawn symptoms and increasing somatic symptoms during early to midadolescence were associated with an increased risk of suicidal thoughts in midadolescence, even after accounting for comorbid symptoms and confounders. Attention should be paid to the suicidal risk associated with these symptoms, particularly when they persist or increase in the longitudinal follow-up.
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Affiliation(s)
- Akito Uno
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daiki Nagaoka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Usami
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Satoshi Yamaguchi
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Rin Minami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Riki Tanaka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Sawai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayako Okuma
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Syudo Yamasaki
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Atsushi Nishida
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Zapata-Ospina JP, Jiménez-Benítez M, Fierro M. "I was very sad, but not depressed": phenomenological differences between adjustment disorder and a major depressive episode. Front Psychiatry 2023; 14:1291659. [PMID: 38146279 PMCID: PMC10749326 DOI: 10.3389/fpsyt.2023.1291659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/21/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction Adjustment disorder (AD) is a diagnosis that must be differentiated from major depressive episode (MDE) because of the therapeutic implications. The aim of this study is to understand the experience of patients who in their lifetime have been diagnosed with AD as well as MDE to establish the characteristics of each disorder. Methods A descriptive phenomenological approach was used with in-depth interviews to four patients and the method proposed by Colaizzi to understand the experiences and reach the description of both disorders. Results Three women and one man, with advanced schooling were interviewed. The participants emphasized the existence of differences that were grouped in: the attribution made by the individual, the theme of cognitions, the variability in the course, the possibility of mood modulation, the syndrome severity, the presence of hopelessness and the perceived course. Conclusion Phenomenological differences were found in the subjective experience of MDE and AD. The MDE would be described as an intense state of generalized shutdown of the subject's own life, with little response to events, and the AD, as a dynamic reaction attributed to a stressful event, with high variability in the course of symptoms due to the dependence on such event, with the preserved hope that it will end.
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Affiliation(s)
- Juan Pablo Zapata-Ospina
- Institute of Medical Research, School of Medicine, Universidad de Antioquia, Academic Group of Clinical Epidemiology (GRAEPIC), Medellín, Colombia
- Hospital Alma Máter de Antioquia, Medellín (Antioquia), Medellín, Colombia
| | - Mercedes Jiménez-Benítez
- Department of Psychology, Faculty of Social and Human Sciences, University of Antioquia, Medellín, Colombia
| | - Marco Fierro
- Department of Psychiatry, School of Medicine, Fundación Universitaria Sanitas, Psychopathology and Society Research Group, Bogotá, Colombia
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Myerson JT, Thomas JK, Rufino KA, Noor N, Patriquin MA. Relationship between parental attachment styles and suicide in adolescents and adults admitted to an inpatient psychiatric hospital. J Affect Disord 2023; 341:170-175. [PMID: 37633528 DOI: 10.1016/j.jad.2023.08.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Suicide is among one of the leading causes of death in the United States affecting individuals of all ages. METHODS We examined the relationship between suicide risk and parental attachment among an inpatient psychiatric sample of 690 adolescents and 1000 adults. Participants completed self-report measures of suicide risk and attachment. RESULTS We found that both adolescents and adults with insecure (i.e., preoccupied, dismissive, fearful) maternal and paternal attachment are at a significantly higher risk of suicide compared to those with secure maternal and paternal attachment. Adolescents who endorsed a previous suicide attempt (27.2 %) were less likely to have a secure maternal attachment, while adults who endorsed a previous suicide attempt (28.9 %) were less likely to have secure paternal attachment. LIMITATIONS Our sample had limited racial and ethnic diversity which may limit the generalizability of the results to a broader population. CONCLUSIONS The present study provides evidence of the importance of parental attachment styles as a predictor of suicide-related behaviors across both adolescents and adults who are admitted inpatient. This suggests the importance of utilizing family-based interventions in order to reduce the risk of suicide.
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Affiliation(s)
| | | | - Katrina A Rufino
- The Menninger Clinic, Houston, TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA; The University of Houston Downtown, Houston, TX 77002, USA
| | - Nausheen Noor
- The Menninger Clinic, Houston, TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA
| | - Michelle A Patriquin
- The Menninger Clinic, Houston, TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.
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Hung YA, Liao SC, Chang CM, Chang SS, Yang AC, Chien YL, Wu CS, Gau SSF. Population-attributable risk of psychiatric disorders for suicide among adolescents and young adults in Taiwan. Psychol Med 2023; 53:6161-6170. [PMID: 36349368 PMCID: PMC10520582 DOI: 10.1017/s0033291722003361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/20/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Youth suicide rates have increased markedly in some countries. This study aimed to estimate the population-attributable risk of psychiatric disorders associated with suicide among Taiwanese youth aged 10-24 years. METHODS Data were obtained from the National Death Registry and National Health Insurance (NHI) claims database between 2007 and 2019. Youth who died by suicide were included, and comparisons, 1:10 matched by age and sex, were randomly selected from the Registry for NHI beneficiaries. We used multivariable logistic regression to estimate suicide odds ratios for psychiatric disorders. The population-attributable fractions (PAF) were calculated for each psychiatric disorder. RESULTS A total of 2345 youth suicide and 23 450 comparisons were included. Overall, 44.8% of suicides had a psychiatric disorder, while only 7.9% of the comparisons had a psychiatric disorder. The combined PAF for all psychiatric disorders was 55.9%. The top three psychiatric conditions of the largest PAFs were major depressive disorder, dysthymia, and sleep disorder. In the analysis stratified by sex, the combined PAF was 45.5% for males and 69.2% for females. The PAF among young adults aged 20-24 years (57.0%) was higher than among adolescents aged 10-19 years (48.0%). CONCLUSIONS Our findings of high PAF from major depressive disorder, dysthymia, and sleep disorder to youth suicides suggest that youth suicide prevention that focuses on detecting and treating mental illness may usefully target these disorders.
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Affiliation(s)
- Yi-An Hung
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei City, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu Hospital, Hsin-Chu City, Taiwan
| | - Chia-Ming Chang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan
| | - Albert C. Yang
- Digital Medicine Center / Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei City, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei City, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei City, Taiwan
- Department of Psychology, Graduate Institute of Epidemiology, and Preventive Medicine, and Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan
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Melvin G, Hofmann JL, Pavlou C, Lu S, Verstandig S, Taylor A, Desilva D, Cameron L, Evans S. The Impacts of a Clown Doctor Program on an Adolescent Psychiatric Unit: A Mixed Methods Investigation. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01545-6. [PMID: 37227620 DOI: 10.1007/s10578-023-01545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 05/26/2023]
Abstract
Inpatient psychiatric care may be required to manage adolescents with severe mental health problems. As the ward can be a challenging environment, this study explored the influence of clown doctors on adolescents. Seventy-seven adolescents (13-18 years) and 22 staff from the Monash Health Stepping Stones Adolescent Unit, and 11 clown doctors from The Humour Foundation participated in the study. Bespoke surveys were developed by the research team to collect quantitative self-report data and qualitative responses. Descriptive statistics and thematic analysis suggested that adolescents experienced high levels of fun as well as positive mood during a clown doctor session. Clown doctor programs show promise within an inpatient unit with opportunities for further development being identified. With considerations of the findings, future clown doctor training could include tailoring sessions to the developmental needs of adolescents and developing strategies on how to interact with adolescents who have a mental health disorder.
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Affiliation(s)
- Glenn Melvin
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Jovell Ling Hofmann
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Christine Pavlou
- Early in Life Mental Health Service, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Sinh Lu
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia
| | - Stephanie Verstandig
- Early in Life Mental Health Service, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Ashleigh Taylor
- Early in Life Mental Health Service, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Deandra Desilva
- Early in Life Mental Health Service, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia
| | - Lauren Cameron
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, 3168, Australia
| | - Subhadra Evans
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
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Sekmen M, Grijalva CG, Zhu Y, Williams DJ, Feinstein JA, Stassun JC, Johnson JA, Tanguturi YC, Gay JC, Antoon JW. Characteristics Associated With Serious Self-Harm Events in Children and Adolescents. Pediatrics 2023:191230. [PMID: 37125480 DOI: 10.1542/peds.2022-059817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVES To identify patterns of psychiatric comorbidity among children and adolescents with a serious self-harm event. METHODS We studied children aged 5 to 18 years hospitalized with a neuropsychiatric event at 2 children's hospitals from April 2016 to March 2020. We used Bayesian profile regression to identify distinct clinical profiles of risk for self-harm events from 32 covariates: age, sex, and 30 mental health diagnostic groups. Odds ratios (ORs) and 95% credible intervals (CIs) were calculated compared with a reference profile with the overall baseline risk of the cohort. RESULTS We included 1098 children hospitalized with a neuropsychiatric event (median age 14 years [interquartile range (IQR) 11-16]). Of these, 406 (37%) were diagnosed with a self-harm event. We identified 4 distinct profiles with varying risk for a self-harm diagnosis. The low-risk profile (median 0.035 [IQR 0.029-0.041]; OR 0.08, 95% CI 0.04-0.15) was composed primarily of children aged 5 to 9 years without a previous psychiatric diagnosis. The moderate-risk profile (median 0.30 [IQR 0.27-0.33]; reference profile) included psychiatric diagnoses without depressive disorders. Older female adolescents with a combination of anxiety, depression, substance, and trauma disorders characterized the high-risk profile (median 0.69 [IQR 0.67-0.70]; OR 5.09, 95% CI 3.11-8.38). Younger males with mood and developmental disorders represented the very high-risk profile (median 0.76 [IQR 0.73-0.79]; OR 7.21, 95% CI 3.69-15.20). CONCLUSIONS We describe 4 separate profiles of psychiatric comorbidity that can help identify children at elevated risk for a self-harm event and subsequent opportunities for intervention.
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Affiliation(s)
- Mert Sekmen
- Division of Hospital Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt
- Departments of Pediatrics
| | | | | | - Derek J Williams
- Division of Hospital Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt
- Departments of Pediatrics
| | - James A Feinstein
- Adult and Child Center for Health Outcomes Research and Delivery Science, Children's Hospital Colorado, Aurora, Colorado; and
| | - Justine C Stassun
- Division of Hospital Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt
- Departments of Pediatrics
| | - Jakobi A Johnson
- Division of Hospital Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt
- Departments of Pediatrics
| | - Yasas C Tanguturi
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - James C Gay
- Division of General Pediatrics, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - James W Antoon
- Division of Hospital Medicine, Monroe Carell Jr. Children's Hospital at Vanderbilt
- Departments of Pediatrics
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Kutzner J, Elam KK, Ha T. Genetic influences on the interplay between obsessive-compulsive behavior symptoms and cannabis use during adolescence. J Adolesc 2023; 95:427-436. [PMID: 36443914 PMCID: PMC10588756 DOI: 10.1002/jad.12125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/05/2022] [Accepted: 11/05/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There are overlapping biological origins and behaviors associated with obsessive-compulsive symptoms (OCS) and cannabis use. There is also evidence that OCS and cannabis use are associated over time. Thus, we investigated polygenic predisposition for OCS as predictive of OCS and cannabis use from age 17 to 19. We hypothesized that greater genetic risk for OCS would predict both OCS and cannabis use. METHODS The current study used participants from the Project Alliance 1 study, a US-based sample, for whom genomic, OCS, and cannabis use data were available (n = 547). Polygenic risk scores (PRS) were formed via a meta-genome-wide association study on OCS and examined as a predictor of OCS and cannabis use at age 17 and 19. The sample was diverse (52.4% male; 45% European American, 30% African American, 14% multiracial, 5% Hispanic/Latino, 4% Asian American, and 2% other groups). Sensitivity analysis was performed by gender for European American and African American subsamples. RESULTS Across the whole sample, the greater polygenic risk for OCS was negatively associated with cannabis use at age 17 and positively associated with OCS at 19. Cannabis use at age 17 was positively associated with OCS at age 19. The association between polygenic risk for OCS and cannabis use at age 17 was replicated in European American males, whereas the association between cannabis use at age 17 and OCS at age 19 was replicated in African American males. CONCLUSIONS Cannabis use may exacerbate OCS through adolescence, and genetic predisposition for OCS may be associated with lower cannabis use in efforts to avoid exacerbation of OCS.
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Affiliation(s)
- Jodi Kutzner
- Department of Applied Health Science, Indiana University, Bloomington, Indiana, USA
| | - Kit K. Elam
- Department of Applied Health Science, Indiana University, Bloomington, Indiana, USA
| | - Thao Ha
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
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13
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Long X, Li L, Wang X, Cao Y, Wu B, Roberts N, Gong Q, Kemp GJ, Jia Z. Gray matter alterations in adolescent major depressive disorder and adolescent bipolar disorder. J Affect Disord 2023; 325:550-563. [PMID: 36669567 DOI: 10.1016/j.jad.2023.01.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 12/24/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND Gray matter volume (GMV) alterations in several emotion-related brain areas are implicated in mood disorders, but findings have been inconsistent in adolescents with major depressive disorder (MDD) or bipolar disorder (BD). METHODS We conducted a comprehensive meta-analysis of 35 region-of-interest (ROI) and 18 whole-brain voxel-based morphometry (VBM) MRI studies in adolescent MDD and adolescent BD, and indirectly compared the results in the two groups. The effects of age, sex, and other demographic and clinical scale scores were explored using meta-regression analysis. RESULTS In the ROI meta-analysis, right putamen volume was decreased in adolescents with MDD, while bilateral amygdala volume was decreased in adolescents with BD compared to healthy controls (HC). In the whole-brain VBM meta-analysis, GMV was increased in right middle frontal gyrus and decreased in left caudate in adolescents with MDD compared to HC, while in adolescents with BD, GMV was increased in left superior frontal gyrus and decreased in limbic regions compared with HC. MDD vs BD comparison revealed volume alteration in the prefrontal-limbic system. LIMITATION Different clinical features limit the comparability of the samples, and small sample size and insufficient clinical details precluded subgroup analysis or meta-regression analyses of these variables. CONCLUSIONS Distinct patterns of GMV alterations in adolescent MDD and adolescent BD could help to differentiate these two populations and provide potential diagnostic biomarkers.
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Affiliation(s)
- Xipeng Long
- Department of Nuclear Medicine, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu 610041, Sichuan, PR China; Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, PR China
| | - Lei Li
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, PR China; Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, PR China
| | - Xiuli Wang
- Department of Clinical Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu 610041, Sichuan, PR China
| | - Yuan Cao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu 610041, Sichuan, PR China
| | - Baolin Wu
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, PR China; Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, PR China
| | - Neil Roberts
- The Queens Medical Research Institute (QMRI), School of Clinical Sciences, University of Edinburgh, Edinburgh, UK
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, PR China; Department of Radiology, West China Xiamen Hospital of Sichuan University, 699Jinyuan Xi Road, Jimei District, 361021 Xiamen, Fujian, PR China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Center (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu 610041, Sichuan, PR China; Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, PR China.
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14
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Cramm L, Elgar FJ, Pickett W. Corporal punishment bans and adolescent suicide rates: An international ecological study. Child Abuse Negl 2023; 137:106022. [PMID: 36640589 DOI: 10.1016/j.chiabu.2023.106022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/15/2022] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Exposure to corporal punishment during childhood is associated with suicidal behaviors during adolescence. To date, the protective effects of national policies governing the use of corporal punishment have rarely been studied for adolescent suicide outcomes. OBJECTIVE To investigate contemporaneous and lagged associations between national legislation banning corporal punishment and adolescent suicide rates. PARTICIPANTS AND SETTING We used population-level administrative and mortality data from 97 countries spanning the years 1950 to 2017. METHODS Negative binomial models were used to investigate the relationship between the existence of official corporal punishment bans in countries and national adolescent suicide mortality rates and the potential time lag between the enactment of such bans and reductions in adolescent suicide rates. RESULTS National policies that permitted corporal punishment in all settings (homes, schools, daycares, and alternative care) were associated with a higher relative risk (RR) for suicide in females aged 15-19 (RR = 2.07, p = .03), as were policies allowing corporal punishment in schools specifically (RR = 2.01, p = .02). Partial bans of corporal punishment and bans of school corporal punishment showed lagged effects on suicide rates which peaked after 12 years for females aged 15-19 and after 13 years for males aged 15-19. CONCLUSIONS Study findings add to a body of evidence that suggests that official policies banning corporal punishment may promote adolescent health and well-being. The benefits of such policies in terms of reduced risk for adolescent suicide appear to peak approximately 12 to 13 years after enactment of the legislation.
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Affiliation(s)
- Laura Cramm
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
| | - Frank J Elgar
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
| | - William Pickett
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada; Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
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15
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Sarhangi N, Rostami M, Abbasirad R, Fasihi M, Ahmadboukani S. Cyber victimization and suicidal behavior in high school students: The mediating role of psychological problems and perceived social support. Psychology in the Schools 2023. [DOI: 10.1002/pits.22868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Niloofar Sarhangi
- Department of Counseling, Faculty of Humanities and Social Sciences University of Kurdistan Sanandaj Iran
| | - Mohammad Rostami
- Department of Counseling, Faculty of Humanities and Social Sciences University of Kurdistan Sanandaj Iran
| | - Reza Abbasirad
- Department of Counseling, Faculty of Humanities and Social Sciences University of Kurdistan Sanandaj Iran
| | - Mohadeseh Fasihi
- Department of Counseling, Faculty of Humanities and Social Sciences University of Kurdistan Sanandaj Iran
| | - Soliman Ahmadboukani
- Department of Counseling, Faculty of Education and Psychology University of Mohaghegh Ardabili Ardabil Iran
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Pelcovitz M, Bennett S, Desai P, Schild J, Beaumont R, Walkup J, Shaffer D, Chiu A. High Rates of Anxiety Among Adolescents in a Partial Hospitalization Program. Child Youth Care Forum 2023; 52:105-122. [PMID: 35228789 PMCID: PMC8866547 DOI: 10.1007/s10566-022-09680-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 01/28/2023]
Abstract
Background Anxiety disorders are garnering increasing attention for their contribution to high-risk issues and functional impairment. Adolescents are typically admitted to partial hospitalization programs (PHPs) due to high-risk presentations. However, the frequency of anxiety disorders in PHPs is not well-established, in part because anxiety can be overlooked in acute settings due to limited lengths of stay and focus on stabilization. Objective This study aims to evaluate the frequency and severity of anxiety disorders among a sample of adolescent PHP patients to assess the need for anxiety-specific assessment and interventions in higher acuity settings. Methods Participants were 158 youths ages 13 to 19 years old (M = 15.49 years, SD = 1.50) who were admitted to an adolescent PHP and their caregivers. Clinician-reported diagnostic information was collected from the youth's electronic medical record, and self- and caregiver-rated severity of anxiety was collected using the Screen for Child Anxiety Related Emotions Disorders (SCARED-C/P). Frequency of anxiety and related disorder diagnoses and self- and caregiver-reported severity were assessed using descriptive statistical methods. Results 75% of participants were diagnosed with an anxiety disorder (n = 118). On average, participants with anxiety disorders had elevated SCARED-C scores. Youths with depressive disorders had elevated SCARED-C scores even when they did not carry anxiety disorder diagnoses. Caregiver ratings of the youth's anxiety symptoms on the SCARED-P were elevated when youths had anxiety disorders. Conclusions These findings suggest that anxiety is common in an adolescent PHP setting and support investing in evidence-based assessment and treatment of anxiety in high-acuity settings.
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Affiliation(s)
- Michelle Pelcovitz
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
| | - Shannon Bennett
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
| | - Payal Desai
- grid.21729.3f0000000419368729New York State Psychiatric Institute, Columbia University, New York, United States
| | - Jennifer Schild
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
| | - Renae Beaumont
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
| | - John Walkup
- grid.413808.60000 0004 0388 2248Department of Psychiatry, Lurie Children’s Hospital, Chicago, United States
| | - David Shaffer
- grid.239585.00000 0001 2285 2675Department of Psychiatry, Columbia University Medical Center, New York, United States
| | - Angela Chiu
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, United States
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Smith M, Udo T. The Relationship Between Age at Incarceration and Lifetime Suicide Attempt Among a Nationally Representative Sample of U.S. Adults. Community Ment Health J 2022; 58:1403-15. [PMID: 35247109 DOI: 10.1007/s10597-022-00952-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 02/05/2022] [Indexed: 11/03/2022]
Abstract
To examine the association between age at incarceration and lifetime suicide attempt (SA), and whether it differs by gender. Lifetime prevalence of SA was compared between respondents with no incarceration, juvenile, and adult incarceration who completed the 2012-2013 National Survey of Alcohol and Related Conditions-III (N = 36,107). We compared the odds of SA, adjusting for sociodemographic characteristics, psychiatric disorders, and childhood adverse experiences, and stratified the results by gender. Adjusted odds ratio (AOR) of SA relative to no incarceration history was 1.66 (95% Confidence Interval [CI] 1.32-2.07) for adult incarceration and 2.00 (95% CI 1.49-2.70) for juvenile incarceration. AOR of SA relative to no incarceration history was 2.14 (95% CI 1.56-2.93) for adult and 2.15 (95% CI 1.38-3.35) for juvenile incarceration in women; it was 1.73 (95% CI 1.14-2.60) in juvenile incarceration relative to no incarceration history in men. A history of incarceration may increase SA, particularly among juvenile and women offenders.
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18
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Kreniske P, Morrison C, Spencer BH, Levine A, Liotta L, Fisher PW, Nguyen N, Robbins RN, Dolezal C, Kluisza L, Wiznia A, Abrams EJ, Mellins CA. HIV and suicide risk across adolescence and young adulthood: an examination of socio-demographic, contextual and psychosocial risk factors for attempted suicide in a longitudinal cohort of ageing adolescents affected by HIV living in the New York City Area. J Int AIDS Soc 2022; 25 Suppl 4:e25984. [PMID: 36176026 PMCID: PMC9522633 DOI: 10.1002/jia2.25984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/01/2022] [Indexed: 12/22/2022] Open
Abstract
Introduction As children become adolescents and young adults (AYA), their risk for attempting suicide increases dramatically, with chronic health conditions an important risk factor. This study examined correlates of suicidality across development in AYA living with perinatally acquired HIV (AYALPHIV) and those perinatally HIV‐exposed but uninfected (AYAPHEU). Methods Data come from an ongoing longitudinal New York City‐based study (N = 339) with AYALPHIV and AYAPHEU interviewed every 12–18 months from 2003 to 2019 (mean enrolment age = 12 years; current mean age = 27 years). The Diagnostic Interview Schedule for Children (adolescent or young adult version) assessed psychiatric disorders and first‐reported suicide attempt. Generalized estimating equations were used to examine associations between first‐reported suicide attempt and socio‐demographic, contextual and psychosocial correlates measured concurrently across six timepoints. Results At enrolment, 51% of participants were female, 72% heterosexual, 60% Black and 50% Latinx. Attempted suicide was significantly higher among AYALPHIV (27%, CI 21–33%) compared to AYAPHEU (16%, CI 10–22%), with an OR of 1.74 (CI 1.04–2.92) in a model adjusting for age. For AYALPHIV, anxiety (OR 2.66, CI 1.46–4.85), mood (OR 3.62, CI 1.49–8.81) and behaviour disorders (OR 5.05, CI 2.15–11.87) and past‐year arrest (OR 3.05, CI 1.26–7.4), negative life events (OR 1.27, CI 1.11–1.46), city stress (OR 2.28, CI 1.46–3.57), pregnancy (OR 2.28, CI 1.08–4.81) and HIV stigma (OR 2.46, CI 1.27–4.75) were associated with increased odds of attempted suicide, while identifying as heterosexual (OR 0.27, CI 0.14–0.52), higher personal (OR 0.45, CI 0.26–0.80) and family self‐concept (OR 0.36, CI 0.22–0.57) were protective. Interactions by HIV status and age were found: substance use was more strongly associated with attempted suicide among AYAPHEU than AYALPHIV, while negative life events and higher religiosity were more strongly associated with increased odds of attempted suicide among AYA ≥ 19 versus ≤ 18 years. Conclusions AYALPHIV compared to AYAPHEU faced unique risks for attempted suicide as they age into adulthood, with the highest risk among AYALPHIV experiencing HIV stigma or pregnancy and the highest risk among AYAPHEU with substance use. Assessing for suicide risk and correlates with attention to ageing can inform preventive interventions tailored to meet AYALPHIV and AYAPHEU needs.
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Affiliation(s)
- Philip Kreniske
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Corey Morrison
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Bailey Holmes Spencer
- Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Alina Levine
- Mental Health Data Science, Research Foundation for Mental Hygiene, New York City, New York, USA
| | - Lucy Liotta
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Prudence W Fisher
- Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Nadia Nguyen
- The Aaron Diamond AIDS Research Center, New York City, New York, USA
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
| | - Andrew Wiznia
- Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Elaine J Abrams
- ICAP at Columbia University, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York City, New York, USA
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York City, New York, USA
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Ruan-Iu L, Rivers AS, Barzilay R, Moore TM, Tien A, Diamond G. Identifying Youth at Risk for Suicidal Thoughts and Behaviors Using the "p" factor in Primary Care: An Exploratory Study. Arch Suicide Res 2022:1-16. [PMID: 35924886 DOI: 10.1080/13811118.2022.2106925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Suicide is a major, preventable public health problem. The general factor of psychopathology ("p" factor) might help improve detection and prediction of individuals at risk for suicide. This cross-sectional proof-of-concept study tests whether the p-factor score is associated with suicidal thoughts and behaviors (STB) better than a depression scale alone. Youth (N = 841; mean age 18.02, SD = 3.36) in primary care were universally screened using the Behavioral Health Screen (BHS). Factor analysis and ROC results showed the BHS assesses the p-factor, and the p-factor score demonstrates higher classification accuracy of several types of STB than a depression scale. The p-factor could help clinicians in the identification of youths with STB.
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Moller CI, Davey CG, Badcock PB, Wrobel AL, Cao A, Murrihy S, Sharmin S, Cotton SM. Correlates of suicidality in young people with depressive disorders: A systematic review. Aust N Z J Psychiatry 2022; 56:910-948. [PMID: 35362327 DOI: 10.1177/00048674221086498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Depression is one of the most prevalent and disabling mental health conditions among young people worldwide. The health and economic burdens associated with depressive illness are substantial. Suicide and depression are closely intertwined, yet a diagnosis of depression itself lacks predictive specificity for suicidal behaviour. To better inform suicide prevention and early intervention strategies for young people, improved identification of modifiable intervention targets is needed. The objective of this review was to identify clinical, psychosocial and biological correlates of suicidality in young people diagnosed with a broad range of unipolar and bipolar depressive disorders. METHOD Systematic searches were conducted across MEDLINE, Embase and PsycINFO to identify studies of young people aged 15-25 years diagnosed with unipolar or bipolar depressive disorders. An assessment of suicidality was required for inclusion. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 and Synthesis Without Meta-analysis guidelines. RESULTS We integrated findings from 71 studies including approximately 24,670 young people with clinically diagnosed depression. We identified 26 clinical, psychosocial and biological correlates of suicidality. Depression characteristics (type and severity), psychiatric comorbidity (particularly anxiety and substance use disorders) and neurological characteristics emerged as having the most evidence for being associated with suicidal outcomes. Our ability to pool data and conduct meaningful quantitative synthesis was hampered by substantial heterogeneity across studies and incomplete reporting; thus, meta-analysis was not possible. CONCLUSION Findings of this review reinforce the notion that suicidality is a complex phenomenon arising from the interplay of multiple contributing factors. Our findings question the utility of considering a diagnosis of depression as a specific risk factor for suicidality in young people. Suicidality itself is transdiagnostic; adoption of a transdiagnostic approach to investigating its aetiology and treatment is perhaps warranted. Future research investigating specific symptoms, or symptom networks, might help to further our understanding of suicidality among young people experiencing mental illness.
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Affiliation(s)
- Carl I Moller
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G Davey
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Paul B Badcock
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Anna L Wrobel
- Orygen, The University of Melbourne, Parkville, VIC, Australia
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Alice Cao
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Sean Murrihy
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
| | - Sonia Sharmin
- Department of Occupational Therapy, Social Work and Social Policy, La Trobe University, Bundoora, VIC, Australia
- Research and Evaluation, Take Two, Berry Street, Eaglemont, VIC, Australia
- Department of Public Health, Torrens University Australia, Melbourne, VIC, Australia
| | - Sue M Cotton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, The University of Melbourne, Parkville, VIC, Australia
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McManimen SL, Ross K, Wong MM. The Moderating Role of Stress Response on the Relationship Between Subjective Sleep Quality and Suicide Ideation in Adolescence. Arch Suicide Res 2022; 26:1423-1435. [PMID: 33999779 DOI: 10.1080/13811118.2021.1922106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Problems sleeping and stress are known to contribute to the development of suicide ideation. However, it is unclear how these risk factors interact longitudinally. The purpose of this study was to determine the impact of problems sleeping on the development of suicide ideation in adolescence one year later and how the relationship changes with the addition of stress as a moderator. METHOD Data were collected from 153 adolescents (M age = 12.8, SD = 1.6) over three years as part of a larger study. Participants completed the MINI-Kid and Youth Self-Report, which were used to assess for suicidality. The Stress scale of the YSR was used to measure stress. Participants also completed the Adolescent Sleep Wake Scale, which was used to assess their perceptions of their sleep quality. RESULTS Logistic moderation analyses demonstrated a significant interaction between ASWS and YSR Stress in the prediction of suicide ideation one year later, Wald χ2(1)=4.57, OR = 0.68, p < 0.05. Results demonstrated higher odds of endorsing SI as stress increased when sleep quality was poor (OR = 21.51) compared to when sleep quality was high (OR = 4.03), suggesting that adequate sleep may act as a protective factor against suicide ideation. CONCLUSIONS The results are indicative of long-term consequences of sleep on adolescent mental health, particularly when faced with high levels of stress. These results may have significant clinical implications for suicide prevention efforts as this relationship may help identify at-risk adolescents prior to the initial experience of suicide ideation.
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Jopling E, LeMoult J, Kerns CM, Nugent S, Eslami A. Potential lethality of suicide attempts in youth. Eur Child Adolesc Psychiatry 2022; 31:919-927. [PMID: 33523314 DOI: 10.1007/s00787-021-01724-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Rates of suicide in youth have increased over the last 50 years, yet our ability to predict suicidal behaviours has not significantly improved during this time. Examining predictors of suicide attempt lethality can enhance our understanding of suicidality in youth, yet research has focused on actual medical lethality (the actual danger to life resulting from a suicide attempt) rather than potential lethality (the potential for death that is associated with a suicide attempt). Thus, the aim of the present study was twofold: first, we quantified the percentage of youth for whom the severity of suicide attempt was misclassified by considering only actual lethality; second, we tested whether key variables that predict the actual lethality of suicide attempts also predict the potential lethality of suicide attempts in youth. We examined these questions in a sample of children and adolescents admitted to a psychiatric inpatient unit following a suicide attempt. Over 70% of youth who made serious suicide attempts would have been misclassified by assessments relying on only actual lethality. Although several variables relevant to the construct of actual lethality significantly predicted potential lethality (e.g., male sex, substance use disorder), others did not. In addition, we found that the subset of youth who would have been misclassified as low risk based on actual lethality had a disproportionately high need for healthcare resources due to future hospital admissions. The present study provides evidence to suggest that considering potential lethality may lead to improved detection and prediction of suicide risk in youth, and in doing so supports recent calls to broaden considerations of the lethality associated with suicide attempts.
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Affiliation(s)
- E Jopling
- Department of Psychology, University of British Columbia, Vancouver, Canada.
| | - J LeMoult
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - C M Kerns
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - S Nugent
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - A Eslami
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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Liu H, Huang Y, Tjung J, Sun F, Liu S. Recent exposure to others’ confided suicidal thoughts and risk of self-harm and suicidality among adolescents. Curr Psychol. [DOI: 10.1007/s12144-022-03123-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kline EA, Ortin-Peralta A, Polanco-Roman L, Miranda R. Association Between Exposure to Suicidal Behaviors and Suicide Attempts Among Adolescents: The Moderating Role of Prior Psychiatric Disorders. Child Psychiatry Hum Dev 2022; 53:365-374. [PMID: 33569742 DOI: 10.1007/s10578-021-01129-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Abstract
Theories suggest that adolescents exposed to suicide attempts and/or deaths are at higher risk of attempting suicide, themselves. However, research findings have been mixed, with most studies not accounting for psychiatric vulnerability. We examined past psychiatric diagnosis as a moderator of the association between lifetime exposure to suicide attempts and/or deaths and adolescents' suicide attempts. Adolescents (N = 518; 60% female; 45% White), ages 12-21, reported on prior suicide ideation and attempts, and mood, anxiety, and substance use disorders at baseline. Suicide attempts since baseline and exposure to suicidal behaviors were assessed 4-6 years later. Lifetime exposure to family suicide attempts and/or suicide deaths, but not to suicidal behaviors of peers/friends or others, was associated with a suicide attempt at follow-up among those with prior psychiatric disorders. Psychologically vulnerable adolescents may require additional support after exposure to suicidal behaviors of a family member to reduce their risk of attempting suicide.
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Affiliation(s)
- Emily A Kline
- Hunter College, City University of New York, New York, USA.,Montclair State University, Montclair, USA
| | - Ana Ortin-Peralta
- Hunter College, City University of New York, New York, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, New York, USA
| | - Lillian Polanco-Roman
- Columbia University Medical Center, New York State Psychiatric Institute, New York, USA.,The New School for Social Research, New York, USA
| | - Regina Miranda
- Hunter College, City University of New York, New York, USA. .,The Graduate Center, City University of New York, New York, USA. .,Department of Psychology, Hunter College, City University of New York, 695 Park Ave., Room 611HN, New York, NY, 10065, USA.
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25
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Morgan-López AA, McDaniel HL, Bradshaw CP, Saavedra LM, Lochman JE, Kaihoi CA, Powell NP, Qu L, Yaros AC. Design and methodology for an integrative data analysis of coping power: Direct and indirect effects on adolescent suicidality. Contemp Clin Trials 2022; 115:106705. [PMID: 35176503 PMCID: PMC9018598 DOI: 10.1016/j.cct.2022.106705] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 02/08/2022] [Accepted: 02/08/2022] [Indexed: 01/02/2023]
Abstract
As suicide rates have risen in the last decade, there has been greater emphasis on targeting early risk conditions for suicidality among youth and adolescents as a form of suicide "inoculation". Two particular needs that have been raised in this nascent literature are a) the dearth of examination of early intervention effects on distal suicide risk that target externalizing behaviors and b) the need to harmonize multiple existing intervention datasets for greater precision in modeling intervention effects on low base rate outcomes such as suicidal behaviors. This project, entitled "Integrative Data Analysis of Coping Power (CP): Effects on Adolescent Suicidality", funded by the National Institute of Mental Health (NIMH), will harmonize and analyze data from 11 randomized controlled trials of CP (total individual-level N = 3183, total school-level N = 189). CP is an empirically-supported, child- and family-focused preventive intervention that focuses on reducing externalizing more broadly among youth who exhibit early aggression, which makes it ideally suited to targeting externalizing pathways to suicidality. The project utilizes three measurement and data analysis frameworks that have emerged across multiple independent disciplines: integrative data analysis (IDA), random treatment effects multilevel modeling (RTE-MLM), and propensity score weighting (PSW). If successful, the project will a) provide initial evidence that CP would have gender-specific indirect effects on suicidality through reductions in externalizing for boys and reductions in internalizing for girls and b) identify optimal conditions under which CP is delivered (e.g., groups, individuals, online) across participants on reductions in suicidality and other key intermediate endpoints.
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Affiliation(s)
- Antonio A Morgan-López
- RTI International, Community Health Research Division, Research Triangle Park, NC, United States of America.
| | - Heather L McDaniel
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States of America
| | - Catherine P Bradshaw
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States of America
| | - Lissette M Saavedra
- RTI International, Community Health Research Division, Research Triangle Park, NC, United States of America
| | - John E Lochman
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, United States of America
| | - Chelsea A Kaihoi
- School of Education and Human Development, University of Virginia, Charlottesville, VA, United States of America
| | - Nicole P Powell
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, United States of America
| | - Lixin Qu
- Center for Youth Development and Intervention, University of Alabama, Tuscaloosa, AL, United States of America
| | - Anna C Yaros
- RTI International, Community Health Research Division, Research Triangle Park, NC, United States of America
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Cwik M, Doty SB, Hinton A, Goklish N, Ivanich J, Hill K, Lee A, Tingey L, Craig M. Community Perspectives on Social Influences on Suicide Within a Native American Reservation. Qual Health Res 2022; 32:16-30. [PMID: 34825619 PMCID: PMC10040248 DOI: 10.1177/10497323211045646] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Relative to the general population, Native Americans (NA) bear a disproportionate burden of suicide-related mortality rates. NA males and females aged 15 to 24 years experience suicide rates nearly 3 times than the U.S. all races rates in this age group. Although efforts have been made to understand and reduce suicide in tribal communities, a large portion has focused on individual characteristics with less attention given to social factors that may also inform suicide. This article aims to build on a local conceptual model of NA youth suicide by examining additional potential social factors through qualitative interviews. Findings from the thematic analysis resulted in the identification of seven perceived social influences: contagion, violence and abuse, discrimination and bullying, negative expectations, spirituality, social support, and cultural strengths. Public health approaches to reduce suicide should consider local social factors that resonate with tribal communities to build resilience.
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Affiliation(s)
- Mary Cwik
- Johns Hopkins University, Baltimore, MD, USA
| | | | | | | | | | - Kyle Hill
- Johns Hopkins University, Baltimore, MD, USA
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Kreniske P, Mellins CA, Dolezal C, Morrison C, Shea E, Fisher PW, Kluisza L, Robbins RN, Nguyen N, Leu CS, Wiznia A, Abrams EJ. Predictors of Attempted Suicide Among Youth Living With Perinatal HIV Infection and Perinatal HIV-Exposed Uninfected Counterparts. J Acquir Immune Defic Syndr 2021; 88:348-355. [PMID: 34406984 PMCID: PMC8693508 DOI: 10.1097/qai.0000000000002784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Suicide is a leading cause of death among adolescents and young adults (AYA). AYA living with perinatally acquired HIV infection (AYALPHIV) are at higher risk of attempted suicide when compared with AYA who were perinatally HIV-exposed but uninfected (AYAPHEU). To inform interventions, we identified risk and protective factors of attempted suicide among AYALPHIV and AYAPHEU. SETTING Data were obtained from a longitudinal New York City-based study of AYALPHIV and AYAPHEU (n = 339; enrollment age 9-16 years) interviewed approximately every 12-18 months. METHOD Our main outcome was suicide attempt at any follow-up. The DISC was used to assess psychiatric disorder diagnoses and attempted suicide and the Child Depression Inventory to assess depressive symptoms. Psychosocial and sociodemographic risk factors were also measured. Analyses used backward stepwise logistic regression modeling. RESULTS At enrollment, 51% was female individuals, 49% Black, 40% Latinx, and 11% both Black and Latinx. Attempted suicide prevalence was significantly higher among AYALPHIV compared with AYAPHEU (27% vs 16%, P = 0.019), with AYALPHIV having 2.21 times the odds of making an attempt [95% confidence interval: (1.18 to 4.12), P = 0.013]. Higher Child Depression Inventory scores were associated with an increased risk of attempted suicide in both groups and the total sample. The presence of DISC-defined behavior disorder increased the risk of attempted suicide in the total sample and the AYALPHIV subgroup. Religiosity was protective of attempted suicide in AYALPHIV. CONCLUSIONS AYALPHIV had increased suicide attempts compared with AYAPHEU. Religiosity was protective in AYALPHIV. Highlighting a need for prevention of early mental health challenges was associated with risk.
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Affiliation(s)
- Philip Kreniske
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Claude Ann Mellins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Corey Morrison
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Eileen Shea
- Department of Psychiatry, Mental Health Data Science, Columbia University Medical Center, New York, NY
| | - Prudence W Fisher
- Child and Adolescent Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Luke Kluisza
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Nadia Nguyen
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
| | - Cheng-Shiun Leu
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Andrew Wiznia
- Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY; and
| | - Elaine J Abrams
- ICAP at Columbia University, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
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Carlson C, Namy S, Nakuti J, Mufson L, Ikenberg C, Musoni O, Hopson L, Anton-Erxleben K, Naker D, Wainberg ML. Student, teacher, and caregiver perceptions on implementing mental health interventions in Ugandan schools. Implementation Research and Practice 2021; 2. [DOI: 10.1177/26334895211051290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background The vast majority of children and adolescents in low and middle-income countries (LMICs) lack access to interventions for mental health problems. Schools provide a critical platform for evidence-based intervention delivery for young people. However, a significant need exists to understand the implementation context and strategies for delivering school mental health interventions in LMICs. Methods We conducted a focused ethnography to explore students’, teachers’, and caregivers’ perspectives on implementing evidence-based mental health interventions (EBIs) within a widespread violence prevention program in Uganda. Data collection occurred in Kampala, Uganda, using two schools that have previously implemented an evidence-based violence prevention program widely used in Ugandan schools schools, the Good School Toolkit (GST). Trained, local researchers facilitated four focus group discussions (FGDs) with caregivers ( n = 22), four FGDs with teachers ( n = 25), and in-depth interviews with primary school students ( n = 12). Verbatim transcripts were analyzed using a framework analysis approach. Results Participants revealed a school culture that promotes schools’ responsibility to students beyond academics, including positive teacher–student relationships. Participants recommended an implementation process that trains teachers and students in screening and referral, peer group delivery, and is accompanied by a school-wide approach to stigma reduction and mental health literacy. Participants fundamentally agreed that teachers could be trained as intervention facilitators. Conclusions This study highlights the potential advantage of leveraging an existing intervention that already addresses implementation factors, such as school culture, as a fertile platform for implementing interventions for child and adolescent mental health in LMICs. Plain language abstract Despite the growth of implementation research for child and adolescent mental health, the study of implementation science for child and adolescent mental health in low and middle-income countries (LMICs) remains scarce. Schools provide a critical platform for evidence-based intervention delivery for young people. However, a significant need exists to understand the implementation context and strategies for delivering school mental health interventions in LMICs. This study provides rich qualitative data describing the context and influences for the successful implementation of mental health interventions in LMIC schools. We conducted interviews and focus groups with teachers, students, and caregivers to determine their perspectives on implementing evidence-based mental health interventions (EBIs) within a widespread violence prevention program in Uganda. Participants revealed a school culture promoted by the existing program that promotes schools’ responsibility to students beyond academics, including positive teacher–student relationships. Findings suggest the existing program provides fertile ground for the successful implementation of evidence-based mental health interventions in schools.
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Affiliation(s)
| | | | | | - Laura Mufson
- Columbia University College of Physicians and Surgeons, USA
- New York State Psychiatric Institute, USA
| | | | - Olive Musoni
- School of Social Work, University of Alabama, USA
| | - Laura Hopson
- School of Social Work, University of Alabama, USA
| | | | | | - Milton L. Wainberg
- Columbia University College of Physicians and Surgeons, USA
- New York State Psychiatric Institute, USA
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Papsdorf R, von Klitzing K, Radeloff D. [Suicides Among Adolescents in a Major German City]. Z Kinder Jugendpsychiatr Psychother 2021; 50:93-104. [PMID: 34749520 DOI: 10.1024/1422-4917/a000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Suicides Among Adolescents in a Major German City Abstract. Objective: Adolescent suicide is a major contributor to the overall mortality in this age group. This study examined sex and age differences in suicide methods. Method: The investigation is based on death certificates from the years 1996 to 2019 of the city of Leipzig and includes all suicides in the age group under 25 years. The impact of sex and age on the method and location of suicide was examined using chi square statistics. Moreover, we verified the association between suicides and death by drug overdose through statistical regression. Results: 140 suicides were included in the study. The suicide methods differed between the age groups (χ² = 17,878; p = .022). Individuals under 21 years of age committed suicide almost exclusively by strangulation, jumping from heights, railway suicide, or deliberate intoxication. With the onset of early adulthood, the spectrum of methods expanded. Suicide methods were also different between the sexes (χ² = 35,166; p < .001): Male adolescents preferred highly lethal methods such as strangulation, whereas in female adolescents intoxication was the leading method of suicide, with a predominance of antidepressants. The annual rates of suicide and death by drug overdose were found to correlate (Pearson correlation = 0,571, p = .004). Minors (χ² = 3.125, p = .077) tended to avoid their own residential environment as a place of suicides compared to adults. Conclusion: When assessing the individual suicide risk and weighing safeguarding measures in clinical practice, the differences shown in the choice of methods should be taken into account.
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Affiliation(s)
- Rainer Papsdorf
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universitätsklinikum Leipzig, Leipzig
| | - Kai von Klitzing
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universitätsklinikum Leipzig, Leipzig
| | - Daniel Radeloff
- Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters, Universitätsklinikum Leipzig, Leipzig
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Looijmans M, van Bergen D, Gilissen R, Popma A, Balt E, Creemers D, van Domburgh L, Mulder W, Rasing S, Mérelle S. Additional Value of Peer Informants in Psychological Autopsy Studies of Youth Suicides. Qual Health Res 2021; 31:2056-2068. [PMID: 34166153 PMCID: PMC8552373 DOI: 10.1177/10497323211022316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In this study, we examined the feasibility and added value of including peer informants in a psychological autopsy study of youth suicides. Peer semi-structured interview data from 16 cases were analyzed qualitatively and compared to parent data. Results show that peers added information to parents' narratives in general and particularly on social relationships, bullying, school experiences, social media, and family relations. Peers also provided additional information on the presence of certain issues (such as social media contagion) as well as on the emotional impact from certain adverse events that seemed to have functioned as precipitating factors. We conclude that including peers in psychological autopsy studies of youth suicides is feasible and of added value but that more research is desirable. The results initially can be used in the design of psychological autopsies so that the maximum amount of information about each suicide will be learned.
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Affiliation(s)
- Milou Looijmans
- 113 Suicide Prevention, Amsterdam, The Netherlands
- Amsterdam UMC, Amsterdam, The Netherlands
| | - Diana van Bergen
- 113 Suicide Prevention, Amsterdam, The Netherlands
- University of Groningen, Groningen, The Netherlands
| | | | - Arne Popma
- Amsterdam UMC, Amsterdam, The Netherlands
| | - Elias Balt
- 113 Suicide Prevention, Amsterdam, The Netherlands
- Amsterdam UMC, Amsterdam, The Netherlands
| | - Daan Creemers
- GGZ Oost Brabant, Boekel, The Netherlands
- Radboud University, Nijmegen, The Netherlands
| | - Lieke van Domburgh
- Amsterdam UMC, Amsterdam, The Netherlands
- Pluryn, Nijmegen, The Netherlands
| | - Wico Mulder
- Dutch Center for Youth Health, Utrecht, The Netherlands
| | - Sanne Rasing
- GGZ Oost Brabant, Boekel, The Netherlands
- Radboud University, Nijmegen, The Netherlands
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Parmar A, Esser K, Barreira L, Miller D, Morinis L, Chong YY, Smith W, Major N, Church P, Cohen E, Orkin J. Acceptance and Commitment Therapy for Children with Special Health Care Needs and Their Parents: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2021; 18:ijerph18158205. [PMID: 34360497 PMCID: PMC8345967 DOI: 10.3390/ijerph18158205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/28/2021] [Accepted: 07/31/2021] [Indexed: 11/23/2022]
Abstract
Context: Acceptance and Commitment Therapy (ACT) is an emerging treatment for improving psychological well-being. Objective: To summarize research evaluating the effects of ACT on psychological well-being in children with special health care needs (SHCN) and their parents. Data Sources: An electronic literature search was conducted in PubMed, Web of Science, Ovid/EMBASE and PsycINFO (January 2000–April 2021). Study Selection: Included were studies that assessed ACT in children with SHCN (ages 0–17y) and/or parents of children with SHCN and had a comparator group. Data Extraction: Descriptive data were synthesized and presented in a tabular format, and data on relevant outcomes (e.g., depressive symptoms, stress, avoidance and fusion) were used in the meta-analyses to explore the effectiveness of ACT (administered independently with no other psychological therapy) compared to no treatment. Results: Ten studies were identified (child (7) and parent (3)). In children with SHCN, ACT was more effective than no treatment at helping depressive symptoms (standardized mean difference [SMD] = −4.27, 95% CI: −5.20, −3.34; p < 0.001) and avoidance and fusion (SMD = −1.64, 95% CI: −3.24, −0.03; p = 0.05), but not stress. In parents of children with SHCN, ACT may help psychological inflexibility (SMD = −0.77, 95% CI: −1.07, −0.47; p < 0.01). Limitations: There was considerable statistical heterogeneity in three of the six meta-analyses. Conclusions: There is some evidence that ACT may help with depressive symptoms in children with SHCN and psychological inflexibility in their parents. Research on the efficacy of ACT for a variety of children with SHCN and their parents is especially limited, and future research is needed.
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Affiliation(s)
- Arpita Parmar
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Kayla Esser
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Lesley Barreira
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON LS8 4L8, Canada; (D.M.); (W.S.)
| | - Douglas Miller
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON LS8 4L8, Canada; (D.M.); (W.S.)
| | - Leora Morinis
- Institute of Health, Policy, Management & Evaluation, Univeristy of California San Francisco, San Francisco, CA 94143, USA;
| | - Yuen-Yu Chong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Wanda Smith
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON LS8 4L8, Canada; (D.M.); (W.S.)
| | - Nathalie Major
- Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada;
| | - Paige Church
- Divison of Neonatology, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada;
| | - Eyal Cohen
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Institute of Health, Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M6, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1P7, Canada
| | - Julia Orkin
- Department of Paediatrics, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; (A.P.); (K.E.); (L.B.); (E.C.)
- Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1P7, Canada
- Correspondence: ; Tel.: +416-813-7654
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Conner KR, Chapman BP, Beautrais AL, Brent DA, Bridge JA, Conwell Y, Falter T, Holbrook A, Schneider B. Introducing the Psychological Autopsy Methodology Checklist. Suicide Life Threat Behav 2021; 51:673-683. [PMID: 33559215 PMCID: PMC8378509 DOI: 10.1111/sltb.12738] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Case-control psychological autopsy studies are the research standard for the postmortem, quantitative study of ongoing or recent risk factors for suicide. We aimed to develop a reliable checklist of methodological quality of these studies. METHOD We adapted items from a validated checklist to address general methodological elements and created novel items to address the unique aspects of psychological autopsy research to generate a 16-item checklist assessing reporting, external validity, internal validity, and power. We used percent agreement and kappa to evaluate inter-rater reliability of the items and overall checklist based on independent ratings of 26 case-control psychological autopsy studies conducted internationally. We also summed the items to generate overall quality ratings, assessing internal consistency with coefficient alpha (α). RESULTS Inter-rater reliability for the overall checklist was high (percent agreement, 86.5%) and that based conservatively on kappa was substantial (κ .71) whereas internal consistency was low (α = 0.56). The inter-rater reliability of the individual items showed acceptable to high agreement. CONCLUSION A novel checklist provides a reliable means to assess the methodological quality of specific elements of quantitative case-control psychological autopsy studies, providing detailed guidance in planning such studies. Lower internal consistency may limit its utility as a summary measure of study quality.
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Affiliation(s)
- Kenneth R. Conner
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, USA,Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Benjamin P. Chapman
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA,Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | - David A. Brent
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jeffrey A. Bridge
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Yeates Conwell
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Tyler Falter
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Amanda Holbrook
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Barbara Schneider
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Centre of Psychiatry, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
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Yang Y, Li C, Zhao L, Li J, Han F, Xiao F. Factors Associated with Depression and Sub-Dimension Symptoms in Adolescent Narcolepsy. Nat Sci Sleep 2021; 13:1075-1082. [PMID: 34262378 PMCID: PMC8273757 DOI: 10.2147/nss.s312000] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/10/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE We evaluate the association between depression symptoms, clinical features (disease onset-age, disease duration, sleep-related hallucination), sleepiness, and polysomnography parameters in adolescent narcolepsy type 1 patients. METHODS Eighty-three adolescent narcolepsy type 1 patients were involved in this cross-sectional study. Patients completed questionnaires evaluating depression symptoms (Center for Epidemiologic Studies Depression Scale) and sleepiness (Epworth Sleepiness Scale). Parameters from polysomnography and multiple sleep latency test were also collected. RESULTS Patients with depression symptoms (62.7%) have later disease onset-age. Depression symptoms were associated with sleep-related hallucination (OR = 2.75). Six independent variables were associated with sub-dimensional depression symptoms, including sleep latency, sleep efficiency, sleep-related hallucination, Epworth sleepiness scale, disease duration, and disease onset-age. CONCLUSION Sleep-related hallucination is associated with total depression symptoms in adolescent narcolepsy. Subjective sleepiness is associated with depressed affect, somatic symptoms, and interpersonal problems. Lower sleep efficiency is associated with a lack of positive affect.
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Affiliation(s)
- Yang Yang
- Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China
| | - Chenyang Li
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Long Zhao
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Jing Li
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Fang Han
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
| | - Fulong Xiao
- Department of General Internal Medicine, Peking University People’s Hospital, Beijing, 100044, People’s Republic of China
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Kim JS, Choi SH, Lee SE, Lee CW, Kim WH, Bae JN, Lee JS, Maeng S, Son J, Kim H. Significant Domains of Life Satisfaction That Affect Suicidal Behavior in Adolescents. Soa Chongsonyon Chongsin Uihak 2021; 32:104-111. [PMID: 34285635 PMCID: PMC8262976 DOI: 10.5765/jkacap.210004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/09/2021] [Accepted: 03/23/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives Adolescent suicide is a serious national issue in Korea. Recently, life satisfaction has been recognized as a major factor related to this issue. The main purpose of this study was to identify the domains of life satisfaction that affect suicidal behavior in adolescence. Methods Data were collected from eight middle schools in Incheon, Korea. A total of 1297 students answered questions regarding their demographic characteristics, happiness, self-related life satisfaction domains (appearance, leisure time, physical health, and mental health), depressive symptoms, and suicidal behavior. Results In the Spearman correlation analysis, female sex, perceived socioeconomic status (SES), happiness, and all four self-related satisfaction scores showed significant correlations with depression and suicidality. Multivariate regression analysis suggested that suicidality was significantly affected by perceived SES, satisfaction with appearance, mental health satisfaction, and depression. Finally, depression was identified as a partial mediator of the association between mental health satisfaction and suicidality, and a complete mediator of the association between female sex and suicidality. Conclusion Perceived SES, satisfaction with appearance, and mental health satisfaction significantly affected students’ suicidality, with or without the effect of depression. Health authorities, educators, and family members must be aware of this to identify adolescents at suicide risk earlier.
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Affiliation(s)
- Ji Soo Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Seo-Hyun Choi
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Sang-Eun Lee
- Incheon Jung-gu Community Mental Health Center, Incheon, Korea.,Department of Nursing, Inha University College of Medicine, Incheon, Korea
| | - Chai Won Lee
- Incheon Jung-gu Community Mental Health Center, Incheon, Korea.,Department of Nursing, Inha University College of Medicine, Incheon, Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Jae Nam Bae
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Jeong Seop Lee
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Seri Maeng
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Jisung Son
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Hyeyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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Sekowski M, Gambin M, Sharp C. The Relations Between Identity Disturbances, Borderline Features, Internalizing Disorders, and Suicidality in Inpatient Adolescents. J Pers Disord 2021; 35:29-47. [PMID: 33779274 DOI: 10.1521/pedi_2021_35_501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Previous studies have demonstrated positive associations between identity disturbances and suicidality in adolescents; however, mechanisms underlying these relationships are not well understood. The authors propose that borderline features and various internalizing disorders may mediate these relations. The aim of this study was to test a multiple mediation model of the associations between these constructs using structural equation modeling. Ninety-six inpatient adolescents aged 12-17 years completed the Assessment of Identity Development in Adolescents, the Childhood Interview for DSM-IV Borderline Personality Disorder, the Youth Self-Report, and the Columbia-Suicide Severity Rating Scale. Findings partly confirmed the theoretical model. Borderline features mediated the positive effect of identity disturbances on suicidal ideation severity. Mediations of withdrawn/depression and anxiety/depression on the effect of identity disruption on suicidal ideation intensity were demonstrated. Identity disruptions and borderline and depressive symptoms could be possible targets for interventions for youth experiencing suicidal ideation.
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Affiliation(s)
- Marcin Sekowski
- Department of Psychology, The Maria Grzegorzewska University, Warsaw
| | | | - Carla Sharp
- Department of Psychology, University of Houston, Houston, Texas
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Wright-Hughes A, Walwyn R, Wright JM, Farrin A, Fonagy P, Ougrin D, Stahl D, Cottrell D. Reducing Self-harm in Adolescents. An individual participant data meta-analysis (RISA-IPD): systematic review protocol. BMJ Open 2021; 11:e049255. [PMID: 33941640 PMCID: PMC8098984 DOI: 10.1136/bmjopen-2021-049255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Up to 10% of adolescents report self-harm in the previous year. Non-fatal repetition is common (18% in 1 year), death from any cause shows a fourfold and suicide a 10-fold excess. Despite the scale of the problem, there is insufficient evidence for effective interventions for self-harm. Those who self-harm do so for a variety of different reasons. Different treatments may be more effective for subgroups of adolescents; however, little is known about which subgroups are appropriate for further study. This protocol outlines a systematic review and individual participant data meta-analysis (IPD-MA) to identify subgroups of adolescents for which therapeutic interventions for self-harm show some evidence of benefit. METHODS AND ANALYSIS A systematic literature search was conducted in August 2019 (including Cochrane Library, Embase, trial registers and other databases). An update search is planned. Study selection will identify randomised controlled trials examining interventions to reduce self-harm in adolescents who have self-harmed and presented to services. Identified research teams will be invited to contribute data and form a collaborative group. Two-stage IPD-MA will be used to evaluate effectiveness of different therapeutic interventions compared with any active or non-active control on repetition of self-harm, general psychopathology, depression, suicidal ideation, quality of life and death. Subgroup analyses will identify adolescent subgroups in whom different therapeutic interventions may be more effective. Meta-regression will explore moderating study and intervention effects. Sensitivity analyses will incorporate aggregate data from studies lacking IPD and test the robustness of results to methods for handling missing data, within-study clustering, non-adherence and study quality. ETHICS AND DISSEMINATION Ethical approval is provided by the University of Leeds, Faculty of Medicine and Health Ethics Committee (18-098). Outcomes will inform research recommendations and will be disseminated internationally through the collaborative group, a service user advisory group, open-access peer-reviewed publication and conference presentations. PROSPERO REGISTRATION NUMBER CRD42019152119.
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Affiliation(s)
- Alexandra Wright-Hughes
- Complex Interventions Division, Clinical Trial Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Rebecca Walwyn
- Complex Interventions Division, Clinical Trial Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Judy M Wright
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Amanda Farrin
- Complex Interventions Division, Clinical Trial Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Dennis Ougrin
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Stahl
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David Cottrell
- Division of Psychological and Social Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Moitra M, Santomauro D, Degenhardt L, Collins PY, Whiteford H, Vos T, Ferrari A. Estimating the risk of suicide associated with mental disorders: A systematic review and meta-regression analysis. J Psychiatr Res 2021; 137:242-249. [PMID: 33714076 PMCID: PMC8095367 DOI: 10.1016/j.jpsychires.2021.02.053] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mental disorders (MDs) are known risk factors for suicide. This systematic review updates the evidence base for this association and improves upon analytic approaches by incorporating study-level and methodological variables to account for measurement error in pooled suicide risk estimates. METHODS A systematic review was conducted to review studies on MDs as risk factors for suicide. Relevant studies were searched using PubMed, Embase, PsychINFO, and existing reviews from 2010 to 19. Studies were eligible if they were longitudinal/case-control studies, representative of the general population, used diagnostic instruments, and quantified suicide risk. The outcome assessed was relative risks (RRs) for suicide due to MDs. A multi-level meta-regression approach was used to obtain pooled RRs adjusted for covariates and between-study effects. FINDINGS We identified 20 eligible studies yielding 69 RRs. Disorder type, age, sex, use of psychological autopsy, study design, and adjustment for confounders were tested as predictors of pooled suicide risk. Overall, all disorders were significant predictors of suicide with predicted adjusted RRs ranging from 4·11 [2·09, 8·09] for dysthymia to 7·64 [4·3, 13·58] for major depressive disorder. INTERPRETATION Our results indicate that MDs are important risk factors for suicide. This systematic review provides pooled RRs that have been adjusted for methodological sources of bias. Findings from our paper may inform suicide prevention strategies as part of national health agendas.
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Affiliation(s)
- Modhurima Moitra
- Institute for Health Metrics and Evaluation, University of Washington, United States; Department of Global Health, University of Washington, United States.
| | - Damian Santomauro
- Institute for Health Metrics and Evaluation, University of Washington, United States; The University of Queensland, School of Public Health, Queensland, Australia; Queensland Centre for Mental Health Research, Queensland, Australia
| | - Louisa Degenhardt
- Institute for Health Metrics and Evaluation, University of Washington, United States; National Drug and Alcohol Research Center, University of New South Wales, Australia
| | - Pamela Y Collins
- Department of Global Health, University of Washington, United States; Department of Psychiatry and Behavioral Sciences, University of Washington, United States
| | - Harvey Whiteford
- Institute for Health Metrics and Evaluation, University of Washington, United States; The University of Queensland, School of Public Health, Queensland, Australia; Queensland Centre for Mental Health Research, Queensland, Australia
| | - Theo Vos
- Institute for Health Metrics and Evaluation, University of Washington, United States
| | - Alize Ferrari
- Institute for Health Metrics and Evaluation, University of Washington, United States; The University of Queensland, School of Public Health, Queensland, Australia; Queensland Centre for Mental Health Research, Queensland, Australia
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Ruch DA, Steelesmith DL, Warner LA, Bridge JA, Campo JV, Fontanella CA. Health Services Use by Children in the Welfare System Who Died by Suicide. Pediatrics 2021; 147:peds.2020-011585. [PMID: 33685986 PMCID: PMC8015154 DOI: 10.1542/peds.2020-011585] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To examine characteristics and health service use patterns of suicide decedents with a history of child welfare system involvement to inform prevention strategies and reduce suicide in this vulnerable population. METHODS A retrospective matched case-control design (120 suicide decedents and 1200 matched controls) was implemented. Suicide decedents included youth aged 5 to 21 who died by suicide and had an open case in Ohio's Statewide Automated Child Welfare Information System between 2010 and 2017. Controls were matched to suicide decedents on sex, race, and ethnicity. Comparisons were analyzed by using conditional logistic regressions to control for matching between the suicide and control groups. RESULTS Youth in the child welfare system who died by suicide were significantly more likely to experience out-of-home placements and be diagnosed with mental and physical health conditions compared with controls. Suicide decedents were twice as likely to access mental health services in the 1 and 6 months before death, regardless of the health care setting. A significantly higher percentage of suicide decedents used physical health services 6 months before their death or index date. Emergency department visits for both physical and mental health conditions were significantly more likely to occur among suicide decedents. CONCLUSIONS Suicide decedents involved in the child welfare system were more likely to use both mental and physical health care services in the months before their death or index date. Findings suggest that youth involved in the child welfare system may benefit from suicide prevention strategies in health care settings.
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Affiliation(s)
- Donna A. Ruch
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio
| | - Danielle L. Steelesmith
- Department of Psychiatry and Behavioral Health, The Ohio State University Medical Center, The Ohio State University, Columbus, Ohio
| | - Lynn A. Warner
- School of Social Welfare, State University of New York at Albany, Albany, New York
| | - Jeffrey A. Bridge
- Center for Suicide Prevention and Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio;,Department of Pediatrics, The Ohio State University, Columbus, Ohio; and
| | - John V. Campo
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Cynthia A. Fontanella
- Department of Psychiatry and Behavioral Health, The Ohio State University Medical Center, The Ohio State University, Columbus, Ohio
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Abstract
Among US geographic regions classified as rural, death rates are significantly higher for children and teens as compared with their urban peers; the disparity is even greater for Alaskan Native/American Indian and non-Hispanic black youth. Violence-related injuries and death contribute significantly to this finding. This article describes the epidemiology of violence-related injuries, with a limited discussion on child abuse and neglect and an in-depth analysis of self-inflicted injuries including unintentional firearm injuries and adolescent suicide. Potential interventions are also addressed, including strategies for injury prevention, such as firearm safe storage practices.
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Affiliation(s)
- James M Dodington
- Yale School of Medicine, 100 York Street, Suite 1F, New Haven, CT 06511, USA.
| | - Kathleen M O'Neill
- Investigative Medicine Program, Yale School of Medicine, 100 York Street, Suite 1F, New Haven, CT 06511, USA
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Masciale M, Dongarwar D, Salihu HM. Predictors of Prolonged Length of Stay in Suicidal Children Transferred to Psychiatric Facilities. Hosp Pediatr 2021; 11:366-373. [PMID: 33782014 DOI: 10.1542/hpeds.2020-001230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To determine if sociodemographic factors or underlying mental health conditions serve as predictors for prolonged length of stay (pLOS) in children hospitalized for suicidal ideation (SI) or suicide attempt (SA) requiring transfer to psychiatric facilities. We hypothesized an association between certain patient and hospital characteristics and pLOS. METHODS For this retrospective cross-sectional study, we used the National Inpatient Sample. We included children <18 years old hospitalized with a primary or secondary International Classification of Diseases, 10th Edition, Clinical Modification diagnosis of SI or SA who were dispositioned to psychiatric facilities from 2016 to 2017. Exposures were patient sociodemographics, underlying mental health diagnoses, and hospital characteristics. Our outcome was pLOS. Adjusted prevalence ratios with 95% confidence intervals (CIs) were generated with log binomial regression. RESULTS Of 12 715 hospitalizations meeting inclusion criteria, 5475 had pLOS. After adjusting for sociodemographics and hospital characteristics, predictive factors for pLOS were public insurance use (prevalence ratio: 1.40; CI: 1.12-1.78), urban nonteaching hospital location (prevalence ratio: 4.61; CI: 2.33-9.12), urban teaching hospital location (prevalence ratio: 3.26; CI: 1.84-5.76), and underlying diagnosis of mood disorder (prevalence ratio: 1.98; CI: 1.63-3.42). Hispanic patients had decreased probability of pLOS (prevalence ratio: 0.69; CI: 0.52-0.93). Otherwise, age, zip income, sex, and hospital region were not predictive of pLOS. CONCLUSIONS Among children hospitalized for SI or SA requiring transfer to psychiatric facilities, public insurance, urban hospital location, and diagnoses of mood disorder, depression, and bipolar disorder were predictive of pLOS. Further research is needed on how to decrease disparities in length of stay among this vulnerable population.
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Affiliation(s)
- Marina Masciale
- Baylor College of Medicine and Texas Children's Hospital, Houston, Texas; and
| | - Deepa Dongarwar
- Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, Houston, Texas
| | - Hamisu M Salihu
- Center of Excellence in Health Equity, Training, and Research, Baylor College of Medicine, Houston, Texas
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Rostad WL, Basile KC, Clayton HB. Association Among Television and Computer/Video Game Use, Victimization, and Suicide Risk Among U.S. High School Students. J Interpers Violence 2021; 36:2282-2305. [PMID: 29502506 PMCID: PMC6119526 DOI: 10.1177/0886260518760020] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
With the increasing popularity of mobile Internet devices, the exposure of adolescents to media has significantly increased. There is limited information about associations between the types and frequency of media use and experiences of violence victimization and suicide risk. The current study sought to examine the association of bullying and teen dating violence (TDV) victimization, suicide risk with different types of media use (i.e., television and computer/video game use), and number of total media use hours per school day. Data from the nationally representative 2015 Youth Risk Behavior Survey (n = 15,624) were used to examine the association between media use and violence victimization and suicide risk. Logistic regression models generated prevalence ratios adjusted for demographic characteristics and substance use behaviors to identify significant associations between media use and victimization and suicide risk, stratified by gender. Media use was associated with TDV victimization for male students only, while media use was related to experiences of bullying and suicide risk for both male and female students. In addition, limited (2 or fewer hours) and excessive (5 or more hours) media use emerged as significant correlates of suicide risk and bullying victimization, with limited media use associated with decreased risk and excessive media use with increased risk. Comprehensive, cross-cutting efforts to prevent different forms of victimization should take into account media use and its potential association with adolescent victimization and suicide risk. The current study results suggest limiting adolescent media use, as part of comprehensive prevention programming, might relate to reductions in risk for victimization and suicide.
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Kwan Y, Choi S, Min S, Ahn JS, Kim H, Kim MH, Lee J. Does personality problems increase youth suicide risk?: A characteristic analysis study of youth who visit the emergency department following suicide attempt. J Affect Disord 2021; 282:539-544. [PMID: 33433383 DOI: 10.1016/j.jad.2020.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 12/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Youth suicide attempts are a major risk factor for future complete suicides. However, the characteristics of suicide attempters based on the emergency department (ED) have rarely been explored, making it challenging to comprehend the characteristics of youth suicide attempters comprehensively. This study aims to investigate the characteristics of youth suicide attempters who visited the ED. METHODS We examined the youth (age: 12-25 years) and adult (age: 26-65 years) groups of suicide attempters who visited the ED in Wonju-si, Gangwon-do, Korea. Interviews were conducted with attempters and guardians to identify sociodemographic, clinical, and suicide-related variables. Besides, we performed bivariate logistic regression analysis with statistically adjusted gender, educational age, Socioeconomic Status(SES) level, and medical illness. RESULTS Youth were diagnosed more frequently with Personality disorder compared to adults. Besides, youth tended to report interpersonal or abuse as motivations for suicide, whereas adults tended to report medical illness or economic problems. Furthermore, youth attempted suicide more impulsively and repeatedly; however, medical lethality of each attempt tended to be lower than adults. LIMITATION We experienced difficulty in collecting complete information because of poor consciousness or cooperation of patients who visited the ED immediately after suicide attempt. Also, the study cohort was only recruited from one hospital in a region. CONCLUSION Youth suicide attempters are suggested to have relatively serious and persistent problems involving personality or traits than adults. Thus, this study highlights the significance of preventive strategies based on early psychopathological evaluation and treatment.
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Affiliation(s)
- Yunna Kwan
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea; Department of Psychology, Duksung Women's University, 33, Samyang-ro 144-gil, Dobong-gu, 01369 Seoul, Korea
| | - SungWon Choi
- Department of Psychology, Duksung Women's University, 33, Samyang-ro 144-gil, Dobong-gu, 01369 Seoul, Korea
| | - Seongho Min
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
| | - Joung-Sook Ahn
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
| | - Huiju Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea.
| | - Jinhee Lee
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Korea.
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Trimble DG, Chandran A. Associations Between Sad Feelings and Suicide Behaviors in the 2019 Youth Risk Behavior Survey: A Call for Action. Front Pediatr 2021; 9:694819. [PMID: 34595142 PMCID: PMC8477038 DOI: 10.3389/fped.2021.694819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/23/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose: Suicide is the second leading cause of death among high school aged students in the United States. Significant risk factors for suicidal behaviors among youth include diagnoses of depression or other mental illnesses. The association between self-reported sad feelings and suicidal behaviors has been understudied in the literature among United States high school students. Methods: The 2019 National Youth Risk Behavior Survey (YRBS) school-based questionnaire, coordinated by the CDC, captured a nationally-representative sample (N = 13,677) of students' responses to health-related behaviors. National sex-stratified prevalences of sad feelings and suicidal behaviors were calculated. Adjusted weighted logistic regression was used to examine the association between self-reported sad feelings and suicidal behaviors. Results: Out of 13,677 high-school students, 35.8% of students self-reported sad feelings. Suicidal behaviors in the overall sample included 18.2% had seriously considered suicide, 15.2% made a plan on how they would attempt suicide, and 7.3% attempted suicide within the past 12 months. There was an 8-11-fold increased odds of all suicidal behaviors among those who reported sad feelings among both females and males. Conclusions: This study reveals a remarkably high prevalence of sad feelings among US youth, and underscores a significant association between self-reported sad feelings and suicidal behaviors among this population. The YRBS survey, routinely administered across US high school students, should be better leveraged to target interventions toward these high-risk youth in order to decrease the significant burden of suicidal behaviors among adolescents.
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Affiliation(s)
- Deana G Trimble
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Institute for Global Tobacco Control, Baltimore, MD, United States
| | - Aruna Chandran
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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44
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Kodali M, Pasupula S, Benerji T, Parvathaneni K. Depression and behavior problems among children residing at welfare hostels and orphanages. Arch Ment Health 2021. [DOI: 10.4103/amh.amh_52_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Koposov R, Stickley A, Ruchkin V. Non-Suicidal Self-Injury Among Incarcerated Adolescents: Prevalence, Personality, and Psychiatric Comorbidity. Front Psychiatry 2021; 12:652004. [PMID: 34093271 PMCID: PMC8170036 DOI: 10.3389/fpsyt.2021.652004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/12/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Incarcerated adolescents represent a risk group for non-suicidal self-injury (NSSI), but research on this population has been limited and no studies have been conducted in Russia. To address this deficit, this study examined NSSI and the factors associated with it among youth in a juvenile correctional facility in Russia. Methods: NSSI and psychopathology were assessed using a psychiatric interview and self-report questionnaire in 368 incarcerated male adolescents aged 14-19 years (mean age 16.4 years, S.D. 0.9) from Northern Russia. Results: 18.2% (N = 67) of the study participants had a history of NSSI and also had higher rates of anxiety, post-traumatic stress disorder (PTSD), depression, community violence exposure and scored higher on most of the Youth Self-Report problem scales. In addition, 31.3% of the NSSI group reported previous suicidal ideation and had thought about a specific suicide method compared to 12.0% in the No-NSSI group. Adolescents with NSSI also differed significantly from the No-NSSI group on self-directedness (lower) and self-transcendence (higher) personality traits. Conclusion: NSSI is common in incarcerated adolescents in Russia and is associated with extensive psychiatric comorbidity, suicidal ideation and specific personality traits.
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Affiliation(s)
- Roman Koposov
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Epidemiology and Modern Technologies of Vaccination, Institute of Professional Education, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, Kodaira, Japan.,Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Child Study Center, Yale School of Medicine, New Haven, CT, United States.,Säter Forensic Psychiatric Clinic, Säter, Sweden
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Baroud E, Al Rojolah L, Ghandour LA, Akoury Dirani L, Barakat M, Elbejjani M, Shamseddeen W, Brent D, Maalouf FT. Risk and protective factors for depressive symptoms and suicidality among children and adolescents in Lebanon: Results from a national survey. Journal of Affective Disorders Reports 2020; 2:100036. [DOI: 10.1016/j.jadr.2020.100036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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47
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Ruch D, Sheftall AH, Heck K, McBee-Strayer SM, Tissue J, Reynolds B, Ackerman J, Brent DA, Campo JV, Bridge JA. Neurocognitive vulnerability to youth suicidal behavior. J Psychiatr Res 2020; 131:119-26. [PMID: 32961501 DOI: 10.1016/j.jpsychires.2020.08.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/09/2020] [Accepted: 08/25/2020] [Indexed: 11/20/2022]
Abstract
Neurocognitive deficits have been associated with suicidal behavior in adults with major depressive disorder (MDD), but it is unclear if similar impairments are linked to youth suicidal behavior. This study compared neurocognitive functioning in suicidal and non-suicidal youth with a lifetime history of MDD and explored whether neurocognitive functioning predicted future suicide attempts. Neurocognition was examined using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and Iowa Gambling Task (IGT) in 309 youths ages 12-15 (117 suicide attempters; 132 suicidal ideators; 60 never-suicidal). Prospective analyses included 284 youths (41 youth with a future attempt; 243 without a future attempt). Multivariate analysis of variance (MANOVA) yielded a significant group-by-sex interaction effect [Wilks' Λ = 0.901, F (16, 560) = 1.87, p = .021] for the primary neurocognitive outcomes, guiding the decision to stratify the sample by sex. Female suicide attempters and ideators were slower to respond correctly to both positive and negative emotion words than never-suicidal controls on tests of affective bias. Male suicide attempters and ideators made significantly more total and between errors than never-suicidal subjects. Exploratory analyses found that total commission errors on the Affective Go/No-Go (AGN) test significantly predicted future suicide attempts in females, and that higher strategy scores on Spatial Working Memory (SWM) tests predicted future male attempts. Study findings identified sex-specific neurocognitive deficits that differentiate suicidal and non-suicidal youth with histories of MDD. Extended longitudinal studies are needed to elucidate the temporal association between neurocognitive impairments and suicidal behavior and frame targets for early preventive interventions.
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Byrne SP, Farrell LJ, Rapee RM. Using cognitive enhancers to improve the treatment of anxiety disorders in young people: Examining the potential for D‐cycloserine to augment exposure for child anxiety. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/j.1742-9552.2011.00005.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Simon P. Byrne
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, and
| | - Lara J. Farrell
- Behavioural Basis of Health, Griffith Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Ronald M. Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, and
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Abstract
BACKGROUND Accurately identifying patients at an elevated risk of suicide in minimal time is an important mental health issue. Therefore, we developed the Ultra Brief Checklist for Suicidality (UBCS) and reported its psychometric properties. METHODS We studied 544 participants who had completed the UBCS, other self-report measures, and structured clinical interviews by trained interviewers. We explored the psychometric properties of the UBCS's paper-based and online versions by identifying optimal cutoff points, sensitivity, specificity, etc. of all participants. RESULTS The mean score of the UBCS (paper-pencil version) in the no-suicide-risk group was 0.23 (SD = 0.73), while in the Risk-Positive (RP) and the High-Risk (HR) groups it was 3.54 (SD = 3.22) and 6.31 (SD = 3.97), respectively. Optimal cutoff points for the RP and HR groups were 1 (AUC = 0.914) and 3 (AUC = 0.928), respectively. LIMITATIONS The current findings apply only to adults, not to children or adolescents. The original MINI was used as the assessment instrument's reference standard rather than MINI 7.0.2 of DSM-5. Predictive validity was not addressed as this was not a longitudinal cohort study. CONCLUSIONS The UBCS was rigorously tested and validated. More than half the participants completed the UBCS within a minute. It possesses adequate psychometric properties and can be easily administered with minimal clinician time and effort, via paper or Internet. We believe it can contribute to suicide risk identification and timely interventions.
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Affiliation(s)
- Seowon Yoon
- Department of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, Korea
| | - Kiho Park
- Department of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, Korea; KU Mind Health Institute, Korea University, Seoul, Korea
| | - Kee-Hong Choi
- Department of Psychology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, Korea; KU Mind Health Institute, Korea University, Seoul, Korea.
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Mansour M, Krishnaprasadh D, Lichtenberger J, Teitelbaum J. Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre. BMJ Open Qual 2020; 9:bmjoq-2019-000751. [PMID: 33028654 PMCID: PMC7542616 DOI: 10.1136/bmjoq-2019-000751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/27/2020] [Accepted: 09/18/2020] [Indexed: 11/21/2022] Open
Abstract
Background Depression, which is a serious medical illness, is prevalent worldwide and it negatively impacts the adolescent lifestyle. Adolescent depression is associated with adverse emotional and functional outcomes and suboptimal physical health. Over the last decade, it has been found that approximately 9% of teenagers meet the criteria for depression at any given time, and one in five teenagers have a history of depression during adolescence. Ninety per cent of paediatricians believe that recognition of child and adolescent depression is their responsibility; however, it has been reported that 46% lacked confidence that they could recognise depression. Methods In this study, adolescents between 12 and 17 years of age were screened during their well-child visits using the Patient Health Questionnaire Modified for Adolescents. A score of 10 or higher warrants a referral to a social worker and psychiatrist. The goals of this quality improvement project were to implement a standardised questionnaire and to improve the screening, diagnosis and treatment of depression in children from 12 to 17 years of age. Results It was found that the adolescent depression screening rate significantly improved within 6 months of implementing this quality improvement project. The screening rate improved to 50% by mid-cycle (Plan-Do-Study-Act (PDSA) cycle 3) and up to 70% at the end of the 6-month period (PDSA cycle 5). Improvement was noted among all providers, across all age groups, and in both male and female patients by the end of the study period. Conclusion Standardised screening tests with a scoring system help providers to identify and monitor depression symptoms using a common language, especially in the outpatient clinical setting where the patient may be seen by different providers.
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Affiliation(s)
- Mohamed Mansour
- Department of Pediatrics, Monmouth Medical Center, Long Branch, New Jersey, USA
| | - Dharshana Krishnaprasadh
- Department of Pediatrics, Monmouth Medical Center, Long Branch, New Jersey, USA.,Beaumont Health, Royal Oak, Michigan, USA
| | | | - Jonathan Teitelbaum
- Department of Pediatrics, Monmouth Medical Center, Long Branch, New Jersey, USA
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