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Yip PSF, Caine ED, Yeung CY, Law YW, Ho RTH. Suicide prevention in Hong Kong: pushing boundaries while building bridges. Lancet Reg Health West Pac 2024; 46:101061. [PMID: 38616984 PMCID: PMC11011221 DOI: 10.1016/j.lanwpc.2024.101061] [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: 12/14/2023] [Revised: 02/15/2024] [Accepted: 03/26/2024] [Indexed: 04/16/2024]
Abstract
Hong Kong is a natural laboratory for studying suicides-small geographic footprint, bustling economic activity, rapidly changing socio-demographic transitions, and cultural crossroads. Its qualities also intensify the challenges posed when seeking to prevent them. In this viewpoint, we showed the research and practices of suicide prevention efforts made by the Hong Kong Jockey Club Centre for Suicide Research and Prevention (CSRP), which provide the theoretical underpinning of suicide prevention and empirical evidence. CSRP adopted a multi-level public health approach (universal, selective and indicated), and has collaboratively designed, implemented, and evaluated numerous programs that have demonstrated effectiveness in suicide prevention and mental well-being promotion. The center serves as a hub and a catalyst for creating, identifying, deploying, and evaluating suicide prevention initiatives, which have the potential to reduce regional suicides rates when taken to scale and sustained.
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Affiliation(s)
- Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pofulam, Hong Kong SAR, China
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Eric D. Caine
- Center for the Study and Prevention of Suicide, University of Rochester Medical Center, Rochester, NY, USA
- Canandaigua VA Center of Excellence for Suicide Prevention, Canandaigua, NY, USA
| | - Cheuk Yui Yeung
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pofulam, Hong Kong SAR, China
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Yik Wa Law
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pofulam, Hong Kong SAR, China
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Rainbow Tin Hung Ho
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Fu Z, Hsu YC, Chan CS, Lau CM, Liu J, Yip PSF. Efficacy of ChatGPT in Cantonese Sentiment Analysis: Comparative Study. J Med Internet Res 2024; 26:e51069. [PMID: 38289662 PMCID: PMC10865189 DOI: 10.2196/51069] [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] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Sentiment analysis is a significant yet difficult task in natural language processing. The linguistic peculiarities of Cantonese, including its high similarity with Standard Chinese, its grammatical and lexical uniqueness, and its colloquialism and multilingualism, make it different from other languages and pose additional challenges to sentiment analysis. Recent advances in models such as ChatGPT offer potential viable solutions. OBJECTIVE This study investigated the efficacy of GPT-3.5 and GPT-4 in Cantonese sentiment analysis in the context of web-based counseling and compared their performance with other mainstream methods, including lexicon-based methods and machine learning approaches. METHODS We analyzed transcripts from a web-based, text-based counseling service in Hong Kong, including a total of 131 individual counseling sessions and 6169 messages between counselors and help-seekers. First, a codebook was developed for human annotation. A simple prompt ("Is the sentiment of this Cantonese text positive, neutral, or negative? Respond with the sentiment label only.") was then given to GPT-3.5 and GPT-4 to label each message's sentiment. GPT-3.5 and GPT-4's performance was compared with a lexicon-based method and 3 state-of-the-art models, including linear regression, support vector machines, and long short-term memory neural networks. RESULTS Our findings revealed ChatGPT's remarkable accuracy in sentiment classification, with GPT-3.5 and GPT-4, respectively, achieving 92.1% (5682/6169) and 95.3% (5880/6169) accuracy in identifying positive, neutral, and negative sentiment, thereby outperforming the traditional lexicon-based method, which had an accuracy of 37.2% (2295/6169), and the 3 machine learning models, which had accuracies ranging from 66% (4072/6169) to 70.9% (4374/6169). CONCLUSIONS Among many text analysis techniques, ChatGPT demonstrates superior accuracy and emerges as a promising tool for Cantonese sentiment analysis. This study also highlights ChatGPT's applicability in real-world scenarios, such as monitoring the quality of text-based counseling services and detecting message-level sentiments in vivo. The insights derived from this study pave the way for further exploration into the capabilities of ChatGPT in the context of underresourced languages and specialized domains like psychotherapy and natural language processing.
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Affiliation(s)
- Ziru Fu
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China (Hong Kong)
| | - Yu Cheng Hsu
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China (Hong Kong)
| | - Christian S Chan
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China (Hong Kong)
- Department of Psychology and Linguistics, International Christian University, Tokyo, Japan
| | - Chaak Ming Lau
- Department of Linguistics and Modern Language Studies, The Education University of Hong Kong, Hong Kong SAR, China (Hong Kong)
| | - Joyce Liu
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China (Hong Kong)
| | - Paul Siu Fai Yip
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China (Hong Kong)
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China (Hong Kong)
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So WWY, Fong TCT, Woo BPY, Yip PSF. Psychosocial and financial well-being mediated the effects of COVID-19 distress on suicidality: a serial mediation model among Hong Kong young adults. Soc Psychiatry Psychiatr Epidemiol 2024; 59:165-174. [PMID: 37270725 PMCID: PMC10239540 DOI: 10.1007/s00127-023-02501-4] [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: 12/20/2022] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
PURPOSE The COVID-19 pandemic has brought significant distress on not only the physical health but also mental health of individuals. The present study investigated the direct and indirect effects from COVID-19 distress to suicidality via psychosocial and financial well-being among young people. METHODS This cross-sectional survey recruited 1472 Hong Kong young people via random sampling in 2021. The respondents completed a phone survey on COVID-19 distress, the four-item Patient Health Questionnaire and items on social well-being, financial well-being, and suicidality. Structural equation modeling (SEM) was conducted to examine the direct and indirect effects of COVID-19 distress on suicidality via psychosocial and financial well-being. RESULTS The direct effect of COVID-19 distress on suicidality was not significant (β = 0.022, 95% CI - 0.097-0.156). The total indirect effect from COVID-19 distress to suicidality was significant and positive (αβγ = 0.150, 95% CI = 0.085-0.245) and accounted for 87% of the total effect (B = 0.172, 95% CI = 0.043-0.341). There were significant specific indirect effects via social well-being and psychological distress, and financial well-being and psychological distress. CONCLUSION The present findings support different pathways from COVID-19 distress to suicidality via functioning in different domains among young people in Hong Kong. Measures are needed to ameliorate the impact on their social and financial well-being to reduce their psychological distress and suicidality.
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Affiliation(s)
- Wendy Wing Yan So
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, 2/F, HKJC Building for Interdisciplinary Research, Pokfulam, Hong Kong
| | - Ted Chun Tat Fong
- Centre on Behavioral Health, The University of Hong Kong, Pokfulam, Hong Kong
| | - Bowie Po Yi Woo
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, 2/F, HKJC Building for Interdisciplinary Research, Pokfulam, Hong Kong
| | - Paul Siu Fai Yip
- HKJC Centre for Suicide Research and Prevention, University of Hong Kong, 2/F, HKJC Building for Interdisciplinary Research, Pokfulam, Hong Kong.
- Department of Social Work & Social Administration, University of Hong Kong, Pokfulam, Hong Kong.
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Yeung CY, Men VY, Guo Y, Yip PSF. Spatial-temporal analysis of suicide clusters for suicide prevention in Hong Kong: a territory-wide study using 2014-2018 Hong Kong Coroner's Court reports. Lancet Reg Health West Pac 2023; 39:100820. [PMID: 37927995 PMCID: PMC10625019 DOI: 10.1016/j.lanwpc.2023.100820] [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: 03/20/2023] [Revised: 05/07/2023] [Accepted: 05/25/2023] [Indexed: 11/07/2023]
Abstract
Background This study aimed to (i) identify high-risk suicide-methods clusters, based on location of residence and suicide incidence; and (ii) compare the characteristics of cases and spatial units inside and outside clusters. Methods Suicide data of 4672 cases was obtained from the Coroner's Court reports in Hong Kong (2014-2018). Monthly aggregated suicide numbers based on location of residence, and suicide incidence, were obtained in small tertiary planning units (STPUs). Community-level characteristics and population of STPUs were retrieved from 2016 Census. Retrospective space-time analyses were performed to identify locations with elevated suicide rates over specific time periods, i.e., spatial-temporal clusters. Clusters were evaluated for overall suicide (any method), as well as jumping, hanging, and charcoal burning methods, in location of residence and suicide incidence. Bi-variate analysis was performed to compare the characteristics of cases, and spatial units, inside and outside the clusters. Findings Suicide clusters involving jumping and charcoal burning were identified, but no hanging clusters were found. The within-cluster distribution of types of housing was different from that of outside. For most of the overall suicide and suicide by jumping clusters, spatial units within the clusters were more socially disadvantaged compared to those outside. Interpretation Clusters varied by suicide methods, location of residence and location of incidence. The findings highlighted the need for consistent and concerted support from different stakeholders within suicide clusters, to ensure appropriate design, implementation and sustainability of effective suicide prevention programs. Funding General Research Fund (37000320) and seed fund from the University of Hong Kong (104006710).
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Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
- University of Rochester Medical Center, Rochester, USA
| | - Vera Yu Men
- Sunnybrook Research Institute, The University of Toronto, Toronto, Canada
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
| | - Yingqi Guo
- Department of Social Work, Hong Kong Baptist University, Hong Kong SAR, China
- Department of Geography (Joint), Hong Kong Baptist University, Hong Kong SAR, China
- Smart Society Lab, Hong Kong Baptist University, Hong Kong SAR, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
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So WWY, Woo BPY, Wong C, Yip PSF. Gender differences in the relationships between meaning in life, mental health status and digital media use during Covid-19. BMC Public Health 2023; 23:1770. [PMID: 37697289 PMCID: PMC10496374 DOI: 10.1186/s12889-023-16672-x] [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] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/31/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a significant impact on individuals' social lives, mental health status, and meaning in life (MIL). Globally, the use of different types of digital media has become a proxy for pre-COVID social lives for many people. This study investigated gender differences in the relationship between use of digital media, mental health status and MIL, during COVID-19 in Hong Kong. METHODS This cross-sectional study surveyed 1,488 young people recruited via city-wide random sampling in 2021. Respondents completed a phone survey on digital media use, Patient Health Questionnaire (PHQ-2), Generalized Anxiety Disorder (GAD-2), COVID-19 impact, meaning in life, and demographics. Gender differences in MIL were tested with an independent sample t-test. Gender-specific multiple linear regression models tested associations between MIL and explanatory variables of age, educational level, history of diagnosis, digital media use, and mental health status. RESULTS There was a significant gender difference in MIL (males (M = 12.90, SD = 4.12); females (M = 13.45, SD = 3.96); t (1485) = -2.656, p = .008). For males, all variables significantly associated to MIL (F (9, 759) = 15.731, p < .000, R2 = .157). However, for females, while the overall model for MIL was significant (F (9, 709) = 12.105, p < .001, R2 = .133), the only significant associated variable was mental health status. CONCLUSION Females had significantly better MIL under COVID-19 than males. Digital media use contributed to MIL in males but not females, and there were gender-specific associated factors of MIL.
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Affiliation(s)
- Wendy Wing Yan So
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Bowie Po Yi Woo
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Clifford Wong
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong
| | - Paul Siu Fai Yip
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong.
- Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong.
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Yeung CY, Men VY, So WWY, Fong DYT, Lam MWC, Cheung DYT, Yip PSF. Correction: Risk and protective factors related to changes in mental health among adolescents since COVID-19 in Hong Kong: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2023; 17:84. [PMID: 37391831 DOI: 10.1186/s13034-023-00634-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023] Open
Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Vera Yu Men
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, SAR, China
| | - Wendy W Y So
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | | | - Derek Yee Tak Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, SAR, China.
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, SAR, China.
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Yeung CY, Men VY, So WWY, Fong DYT, Lam MWC, Cheung DYT, Yip PSF. Risk and protective factors related to changes in mental health among adolescents since COVID-19 in Hong Kong: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2023; 17:68. [PMID: 37308933 DOI: 10.1186/s13034-023-00622-x] [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: 12/10/2022] [Accepted: 05/23/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Most research has suggested that children and adolescents had poorer mental health than pre-COVID-19 pandemic status. There have been few investigations into factors associated with pre-peri pandemic differences in young people's mental health status. Our study aimed to investigate the association between sociodemographic factors, attitudes, and daily life experiences and these differences. METHODS We used self-reported cross-sectional data from the Youth Sexuality Survey (YSS) by the Family Planning Association of Hong Kong, collected from secondary school students aged 10-16 between the fourth and fifth waves of the pandemic. The study outcome was pre-peri pandemic differences in mental health (better, unchanged, or poorer). Associations between the study outcome with age, sex, satisfaction with academic performance, school life, relationship with classmates and family life, and average sleeping and exercising time in the past month, were assessed through multinomial logistic regression, controlling for depressive/anxiety symptoms and change in physical health status since the pandemic. RESULTS There were 6,665 respondents. Compared with pre-pandemic, approximately 30% reported poorer mental health, whilst 20% reported better mental health. Females (OR = 1.355, 95% CI = 1.159-1.585) and those dissatisfied with their academic performance (OR = 1.468, 95% CI = 1.233-1.748) were significantly more likely to report poorer mental health with reference to unchanged status, while those satisfied with family life had improved mental health with reference to unchanged (OR = 1.261, 95% CI = 1.006-1.579) and poorer status (OR = 1.369, 95% CI = 1.085-1.728). CONCLUSION Policy and community strategies that promote good family relationships are thus essential for young people's mental health during societal challenges such as the COVID-19 pandemic.
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Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Vera Yu Men
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
| | - Wendy W Y So
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | | | - Derek Yee Tak Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China.
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Yiu Huen JM, Yip PSF, Osman A, Man Leung AN. Item Response Theory and Differential Item Functioning Analyses With the Suicidal Behaviors Questionnaire-Revised in US and Chinese Samples. Crisis 2023; 44:108-114. [PMID: 34915732 DOI: 10.1027/0227-5910/a000837] [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: 11/23/2022]
Abstract
Background: Despite the widespread use of the Suicidal Behaviors Questionnaire-Revised (SBQ-R) and advances in item response theory (IRT) modeling, item-level analysis with the SBQ-R has been minimal. Aims: This study extended IRT modeling strategies to examine the response parameters and potential differential item functioning (DIF) of the individual SBQ-R items in samples of US (N = 320) and Chinese (N = 298) undergraduate students. Method: Responses to the items were calibrated using the unidimensional graded response IRT model. Goodness-of-fit, item parameters, and DIF were evaluated. Results: The unidimensional graded response IRT model provided a good fit to the sample data. Results showed that the SBQ-R items had various item discrimination parameters and item severity parameters. Also, each SBQ-R item functioned similarly between the US and Chinese respondents. In particular, Item 1 (history of attempts) demonstrated high discrimination and severity of suicide-related thoughts and behaviors (STBs). Limitations: The use of cross-sectional data from convenience samples of undergraduate students could be considered a major limitation. Conclusion: The findings from the IRT analysis provided empirical support that each SBQ-R item taps into STBs and that scores for Item 1 can be used for screening purposes.
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Affiliation(s)
- Jenny Mei Yiu Huen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, PR China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, PR China
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PR China
| | - Augustine Osman
- Department of Psychology, The University of Texas at San Antonio, TX, USA
| | - Angel Nga Man Leung
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, PR China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, PR China
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Abstract
INTRODUCTION Suicide by charcoal burning has accounted for more than 100,000 deaths. It has become an increasingly common suicide method in Hong Kong since first reported in 1998, and it has spread into South Korea, Taiwan, Japan and other countries. This systematic scoping review aimed to explore current evidence on trends, risk factors, impact of media and prevention strategies for this suicide method, and to identify research gaps. METHODS A search for articles published from January 1998 to June 2021 was conducted through electronic databases (MEDLINE, EMBASE, SCOPUS and PsycINFO) with the keywords (suicide*) AND (charcoal). Articles describing prevalence, trends, characteristics, risk factors and prevention strategies of charcoal burning suicide deaths were included. Non-peer-reviewed articles, non-English articles, commentaries/editorials/letters, poster abstracts, reviews, meta-analyses and studies that documented only charcoal burning suicide attempters/survivors were excluded. RESULTS Eighty-eight studies were identified, most from East Asia. Charcoal burning suicide rates in Hong Kong, Taiwan and Japan has passed the peak, while continuing to increase in South Korea. Risk factors are changing and not static. Media appears to play an important role in triggering and spreading information. Restricting access to charcoal, and raising public awareness have been effective in the short term in preventing charcoal burning suicide, but there is little information on their long-term effectiveness or sustainability. DISCUSSION More research is required to update the development and dynamic changes of charcoal burning suicide and the contributing factors. The evidence from this review may assist in detecting and intervening early for future novel suicide methods.
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Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Vera Yu Men
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China
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Junus A, Kwan C, Wong C, Chen Z, Yip PSF. Shifts in patterns of help-seeking during the COVID-19 pandemic: The case of Hong Kong's younger generation. Soc Sci Med 2023; 318:115648. [PMID: 36608364 PMCID: PMC9804958 DOI: 10.1016/j.socscimed.2022.115648] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 11/28/2022] [Accepted: 12/30/2022] [Indexed: 01/02/2023]
Abstract
RATIONALE Help-seeking can convert an individual's bonding social capital into social support, which has been shown to buffer the impact of psychological distress. The younger generation (individuals aged 15-35 years) have been the least likely to actively seek help despite facing a rising burden of mental health problems. COVID-19 pandemic restrictions may have altered their help-seeking behaviors, but the extent of such shift remains little understood, particularly in Asian contexts. OBJECTIVE To understand how the younger generation's patterns of help-seeking (activation of different combinations of support sources) have shifted in pandemic times, who have experienced the shift, and what explanatory factors are involved. METHODS Data were obtained from two waves (2019, 2020) of online survey responses by 438 community-dwelling younger generation people in Hong Kong, recruited through the authors' affiliated institutions and territory-wide community outreach organizations. Latent class analysis was conducted on participants' self-reported help-seeking behaviors in each survey wave. Constituents' characteristics in each latent class were examined, and between-wave changes in individuals' class membership were identified. Logistic regressions identified explanatory factors that significantly explained the changes. RESULTS Three consistent patterns of help-seeking were identified in both survey waves. A major shift was observed for individuals with poorer mental health histories who faced moderate distress. They relied on their family, friends, and partner pre-pandemic, but no longer activated these supports during the pandemic. Posting status updates on social media, along with various communication habits and sociodemographic factors that differed by age group, were associated with this shift. CONCLUSIONS Shifts in the younger generation's patterns of help-seeking may be an early warning signal to invest additional resources in facilitating help-seeking among the younger generation. Findings also serve as a reminder that public health restrictions may have inadvertent mental health implications that should be considered in future scenarios.
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Affiliation(s)
- Alvin Junus
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.
| | - Ching Kwan
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong.
| | - Clifford Wong
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong.
| | - Zhansheng Chen
- Department of Psychology, The University of Hong Kong, Hong Kong.
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong; The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong; Institute of Data Science, The University of Hong Kong, Hong Kong; Research Institute of Social Development, Southwestern University of Finance and Economics, China.
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Yeung CY, Men YV, Caine ED, Yip PSF. The differential impacts of social deprivation and social fragmentation on suicides: A lesson from Hong Kong. Soc Sci Med 2022; 315:115524. [PMID: 36413859 DOI: 10.1016/j.socscimed.2022.115524] [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] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/02/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Little research has conducted to examine the association between social deprivation and social fragmentation, overall and method-specific suicide risk, and how these associations may change over time. This study investigated the association between social deprivation and social fragmentation with overall and method-specific suicide in Hong Kong from 1999 to 2018. METHODS Suicide death data of each small tertiary planning unit (STPU) was obtained from the Census and Statistics Department of Hong Kong. Socio-economic characteristics in STPU level were obtained from Census and Bi-census. Exploratory principal component analysis was used to construct the social deprivation (SDI) and social fragmentation indices (SFI) based on the socio-economic characteristics. Bayesian hierarchical modelling was conducted to explore the association between SDI and SFI with overall and method-specific suicide over time, controlling for population density and male-to-female ratio. RESULTS Higher risk of suicide was generally observed around Kowloon Peninsula and some parts in the Northern, Northwestern and Southwestern areas depending on methods. The effect of SDI and SFI on suicide risk varied by years and methods. In 2014-2018, for every 10% increase in SDI, the suicide risk for overall, jumping, hanging, and charcoal burning elevated by 22% (95%Crl = 10%-37%), 26% (95%Crl = 12%-41%), 31% (95%Crl = 14%-51%), and 21% (95%Crl = 4%-42%) respectively. CONCLUSION Spatial variations and effects of SDI and SFI on overall and method-specific suicide risks varied by different periods. SDI was observed to be a stronger factor in the recent years. Situations should be monitored, and interventions should be implemented and adjusted accordingly to the changes.
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Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
| | - Yu Vera Men
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Eric D Caine
- University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642, USA
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, 2/F, the Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China.
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12
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Chen SS, Lam TP, Lam KF, Lo TL, Chao DVK, Mak KY, Lam EWW, Tang WS, Chan HY, Yip PSF. The Use of Close Friends on Instagram, Help-Seeking Willingness, and Suicidality Among Hong Kong Youth: Exploratory Sequential Mixed Methods Study. J Med Internet Res 2022; 24:e37695. [PMID: 36223182 PMCID: PMC9607886 DOI: 10.2196/37695] [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] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/20/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Social networking sites (SNSs) have gained popularity in recent years for help seeking and self-distress expression among adolescents. Although online suicidal expression is believed to have major benefits, various concerns have also been raised, particularly around privacy issues. Understanding youths’ help-seeking behavior on SNSs is critical for effective suicide prevention; however, most research neglects the impacts of the private SNS context. Objective This study aims to examine youths’ private SNS use via the new Instagram feature, Close Friends, and its association with both online and offline help-seeking willingness as well as youths’ suicidality. Methods This study employed an exploratory sequential mixed methods approach with a combination of explorative qualitative interviews and a systematic quantitative survey, targeting youth aged 15-19 years in Hong Kong. The motivations for utilizing Close Friends and concerns regarding online expression were addressed in the focus group and individual interviews (n=40). A cross-sectional survey (n=1676) was conducted subsequently with eligible secondary school students to examine the prevalence of Close Friends usage, their online and offline help-seeking willingness, and suicide-related experiences. Results A total of 3 primary motives for using Close Friends were identified during interviews, including (1) interaction and help seeking, (2) release of negative emotions, and (3) ventilation and self-expression. Most participants also highlighted the privacy concerns associated with public online communication and the importance of contacting close friends for emotional support. Survey results showed that use of Close Friends was quite prevalent among adolescents (1163/1646, 70.66%), with around 46% (754/1646, 45.81%) of respondents being frequent users. Differences by gender and school academic banding were also revealed. Regarding help-seeking intentions, youths were generally positive about seeking help from peers and friends offline (1010/1266, 79.78%) yet negative about seeking assistance from online friends or professionals with whom they had not yet developed a real-world connection (173/1266, 13.67%). Most notably, frequencies of Close Friends usage were differentially associated with online and offline help-seeking willingness and youths’ suicidality. Compared with nonusers, those who had ever used the feature were more likely to seek offline support (adjusted odds ratios [AORs] 1.82-2.36), whereas heavy use of Close Friends was associated with increased odds of online help-seeking willingness (AOR 1.76, 95% CI 1.06-2.93) and a higher risk of suicidality (AOR 1.53, 95% CI 1.01-2.31). Conclusions The popularity of Close Friends reflects the increasing need for private online expression among youth. This study demonstrates the importance of Close Friends for self-expression and private conversation and inadequacy of peer support for suicidal adolescents. Further research is needed to identify the causal relationship between Close Friends usage and help-seeking willingness to guide the advancement of suicide prevention strategies. Researchers and social media platforms may cooperate to co-design a risk monitoring system tailored to the private SNS context, assisting professionals in identifying youth at risk of suicide.
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Affiliation(s)
- Sikky Shiqi Chen
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Kwok Fai Lam
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Tak Lam Lo
- Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - David Vai Kiong Chao
- Department of Family Medicine and Primary Health Care, Hospital Authority Kowloon East Cluster, Hong Kong, China
| | - Ki Yan Mak
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Edmund Wing Wo Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Wai Sin Tang
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Hoi Yan Chan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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13
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Chen SS, Lam TP, Lam KF, Lo TL, Chao DVK, Mak KY, Lam EWW, Tang WS, Chan HY, Yip PSF. Youths' attitudes toward open discussion of suicide, preferred contexts, and the impact of Internet use: An exploratory sequential mixed-methods study in Hong Kong. Int J Soc Psychiatry 2022; 69:575-586. [PMID: 36120996 DOI: 10.1177/00207640221123394] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although the necessity and benefits of having the open and public discussion about suicide have been recognized, youths' opinions regarding such discussion remain unknown. AIMS To explore youths' attitudes toward open suicide discussion, particularly concerning their preference of discussion contexts and impacts of Internet use. METHOD This exploratory sequential mixed-methods study targeted Hong Kong youths aged 15 to 19. A total of six focus groups and 12 individual interviews were held (N = 40). Topics included adolescents' views of open suicide discussion, concerns, perceived benefits, and preferred contexts. The questionnaire survey (N = 1,676) was conducted subsequently to investigate the prevalence of youths' perspectives on public discussion of suicide and relationships with discussion contexts, use of social media platforms, and motivations of online expression. RESULTS Qualitative findings revealed three types of attitudes toward open suicide discussion: reluctance, support, and indifference. Major barriers included cultural norms, topic sensitivity, privacy concerns, contagion effect, fear of embarrassment, and unpleasant experiences in school programs. Results of quantitative analyses showed that reluctance was the dominant attitude among adolescents, and taboo was the top concern. Variations in youths' attitudes were related to gender, school academic banding, and suicide-related experiences. Notably, adolescents who had been exposed to suicide messages in contexts of peer networks and online platforms were more likely to endorse open suicide discussion. In addition, an increased likelihood of engaging in public suicide discussion was associated with the use of Instagram, WhatsApp, and Snapchat, and the motive of 'expressing emotions and opinions' online. CONCLUSIONS Our results indicated a prevalent rejection among adolescents toward open suicide discussion, suggesting the issue of stigma, the need for tailored programs, the value of appropriate contexts, and the impact of Internet use. These findings may facilitate the development of school-based suicide prevention initiatives and the efficacy of online services for suicide-related communication.
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Affiliation(s)
- Sikky Shiqi Chen
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Kwok Fai Lam
- Department of Statistics and Actuarial Science, the University of Hong Kong, Hong Kong, China.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Tak Lam Lo
- Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - David Vai Kiong Chao
- Department of Family Medicine and Primary Health Care, Hospital Authority Kowloon East Cluster, Hong Kong, China
| | - Ki Yan Mak
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Edmund Wing Wo Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Wai Sin Tang
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Hoi Yan Chan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, the University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, the University of Hong Kong, Hong Kong, China.,Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
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14
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Abstract
BACKGROUND Cancer patients had elevated risk of suicidality. However, few researches studied the risk/protective factors of suicidal/self-harm behaviors considering the competing risk of death. The objective of this study is to systematically investigate the risk of suicidal/self-harm behaviors among Hong Kong cancer patients as well as the contributing factors. METHODS Patients aged 10 or above who received their first cancer-related hospital admission (2002-2009) were identified and their inpatient medical records were retrieved. They were followed for 365 days for suicidal/self-harm behaviors or death. Cancer-related information and prior 2-year physical and psychiatric comorbidities were also identified. Competing risk models were performed to explore the cumulative incidence of suicidal/self-harm behavior within 1 year as well as its contributing factors. The analyses were also stratified by age and gender. RESULTS In total, 152 061 cancer patients were included in the analyses. The cumulative incidence of suicidal/self-harm behaviors within 1 year was 717.48/100 000 person-years. Overall, cancer severity, a history of suicidal/self-harm behaviors, diabetes and hypertension were related to the risk of suicidal/self-harm behaviors. There was a U-shaped association between age and suicidal/self-harm behaviors with a turning point at 58. Previous psychiatric comorbidities were not related to the risk of suicidal/self-harm behaviors. The stratified analyses confirmed that the impact of contributing factors varied by age and gender. CONCLUSIONS Cancer patients were at risk of suicidal/self-harm behaviors, and the impacts of related factors varied by patients' characteristics. Effective suicide prevention for cancer patients should consider the influence of disease progress and the differences in age and gender.
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Affiliation(s)
- Vera Yu Men
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Clifton Robert Emery
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Tai-Chung Lam
- Department of Clinical Oncology, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
- Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong SAR
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15
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Abstract
Prognostic prediction is the task of estimating a patient's risk of disease development based on various predictors. Such prediction is important for healthcare practitioners and patients because it reduces preventable harm and costs. As such, a prognostic prediction model is preferred if: 1) it exhibits encouraging performance and 2) it can generate intelligible rules, which enable experts to understand the logic of the model's decision process. However, current studies usually concentrated on only one of the two features. Toward filling this gap, in the present study, we develop a novel knowledge-aware Bayesian model taking into consideration accuracy and transparency simultaneously. Real-world case studies based on four years' territory-wide electronic health records are conducted to test the model. The results show that the proposed model surpasses state-of-the-art prognostic prediction models in accuracy and c-statistic. In addition, the proposed model can generate explainable rules.
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16
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Chen SS, Lam TP, Lam KF, Lo TL, Chao DVK, Mak KY, Lam EWW, Tang WS, Chan HY, Yip PSF. Motivations for Online Expression, Willingness of Online Help-Seeking, and the Risk of Suicide Among Hong Kong Youths: A Mixed-Methods Study. Cyberpsychol Behav Soc Netw 2022; 25:384-391. [PMID: 35594242 DOI: 10.1089/cyber.2022.0007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Despite widespread interest in social media use, little is known about the heterogeneity of underlying motivations for online engagement among at-risk adolescents. This study adopted a mixed-methods approach to evaluate the motives of online expression among Hong Kong youths aged 15-19, as well as their relationships to online help-seeking willingness and suicide risks. In total, 6 focus groups and 12 individual interviews were conducted (N = 40) to elicit information regarding online expression purposes and to construct questionnaire items. The cross-sectional survey (N = 1,676) was undertaken subsequently to determine the prevalence of motives, and their correlations with online help-seeking willingness and suicide risks. Qualitative interviews revealed two key themes: major motivations for online expression, and features of online expression and help-seeking among suicidal youths. Quantitative analyses demonstrated the prevalence of each online expression purpose, with most reporting on "emotional expression" and "life sharing and documentation," but variations identified by gender, school academic banding, and suicide-related experience. Notably, an ordinal logistic regression model revealed that motives of "emotional expression" and "image building" were associated with increased suicide risks, while the purpose of "life sharing" was associated with decreased suicide risks. Those who expressed online for "self-expression" and "friend making" showed a stronger willingness for online help-seeking. These findings provide a more holistic overview of the purposes of online expression, which suggested the likelihood of mental health issues and the need for support. Such insight may facilitate the development of more effective suicide prevention strategies and online intervention services.
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Affiliation(s)
- Sikky Shiqi Chen
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Tai Pong Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Kwok Fai Lam
- Department of Statistics and Actuarial Science and The University of Hong Kong, Hong Kong, China.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
| | - Tak Lam Lo
- Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - David Vai Kiong Chao
- Department of Family Medicine and Primary Health Care, Hospital Authority Kowloon East Cluster, Hong Kong, China
| | - Ki Yan Mak
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Edmund Wing Wo Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Wai Sin Tang
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Hoi Yan Chan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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17
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Yeung CY, Morgan PR, Lai CCS, Wong PWC, Yip PSF. Short- and long-term effects of a community-based suicide prevention program: A Hong Kong experience. Suicide Life Threat Behav 2022; 52:515-524. [PMID: 35142390 DOI: 10.1111/sltb.12842] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/11/2021] [Accepted: 08/31/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND A multidisciplinary, multilayer, community-based suicide prevention program (2008-2012) was implemented in the Eastern District, Hong Kong. This article documents the program and reports on short- and longer-term program evaluation. METHODS Characteristics and rates of self-harm/suicidal behaviors and suicide deaths by age group and gender in the Eastern District before, during, and after the intervention were calculated and compared with the rest of Hong Kong, using Kruskal-Wallis and chi-squared tests, and Jonckheere-Terpstra and Cochran-Mantel-Haenszel tests for trend analyses. RESULTS The program impacts varied by age and gender subgroups. Suicide rates in the Eastern District were lower compared to the rest of Hong Kong during the intervention period. They slowly rebounded after the intervention ceased; nevertheless, they remained lower than the rest of Hong Kong until 2016. The rates of self-harm continuously dropped and remained lower than the rest of Hong Kong. During the intervention period in the Eastern District, the age of people who died by suicide increased; more deaths occurred from jumping and fewer by charcoal burning. CONCLUSIONS The program coincided with the lowered self-harm and suicide rates after the implementation. Some of the strategies need to be rebooted or routinely and continuously implemented to ensure the sustainability.
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Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Peter R Morgan
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Carmen Chui Shan Lai
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Paul Wai Ching Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China.,The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong, China
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18
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Huen JMY, Yip PSF, Osman A, Leung ANM. The Suicidal Behaviors Questionnaire-Revised (SBQ-R) and its Chinese version (C-SBQ-R): Further validity testing using the culture, comprehension, and translation bias procedure. Psychol Assess 2022; 34:704-710. [PMID: 35467908 DOI: 10.1037/pas0001134] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Suicidal Behaviors Questionnaire-Revised (SBQ-R), a 4-item instrument for assessing and screening suicide-related thoughts and behaviors, has been translated into several different languages. In this study, we examined the psychometric properties of the SBQ-R and a new Chinese version of the instrument (C-SBQ-R) for college student samples. We used the culture, comprehension, and translation bias (CCT) procedure to examine the responses of independent Chinese college student samples who completed the C-SBQ-R (N₁ = 298) and the SBQ-R (N₂ = 292) and a U.S. college student sample (N₃ = 320) who completed the SBQ-R. We found that the samples' C-SBQ-R and SBQ-R scale scores showed acceptable internal consistency reliability estimates, factor structures, and concurrent validity estimates. Measurement invariance was established across groups differing in (a) language but not culture, (b) culture but not language, and (c) both language and culture. Receiver operating characteristic curve analysis results showed that the cutoff score of 7 was similar for both the C-SBQ-R and the SBQ-R in screening for suicide-related thoughts and behaviors. Our findings provided empirical support that the psychometric properties of the C-SBQ-R and the SBQ-R are similar; both could be used to assess the suicide-related thoughts and behaviors constructs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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19
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Abstract
OBJECTIVE In the last half of the 20th century, many countries have already abolished antisuicide laws; however, more than 20 countries still adopt them. This paper is the first to systematically explore the association between criminalisation of suicide and national suicide rates in 171 countries/regions to examine the deterring effects of the antisuicide laws. DESIGN A cross-sectional ecological study. SETTING 171 countries in the world. PARTICIPANTS In 2012, 25 countries were identified to carry antisuicide laws. A linear regression analysis was adopted to explore the association between national suicide rates (log transformed) and criminalisation of suicide in the world in 2012, having controlled for the Human Development Index (HDI), majority religious affiliations and the national unemployment rate. MAIN OUTCOME MEASURE Sex-specific age standardised suicide mortality rates. RESULTS Criminalisation of suicide was associated with slightly increased national suicide rates (β estimate=0.29, 95% CI -0.04 to 0.61). Stronger association was found in women (β estimate=0.40, 95% CI 0.06 to 0.74), connecting criminalisation of suicide and higher suicide rates. The harmful effect of antisuicide laws on women was particularly prominent in non-Muslim countries and countries with lower HDI. CONCLUSIONS Laws penalising suicide were associated with higher national suicide rates and even more so in the female population in the low HDI, non-Muslim countries. The non-supportive patriarchal culture with laws penalising suicide may render women vulnerable to suicidality. Instead of criminalising suicide, alternative approaches such as providing good mental healthcare and adjusting the socioeconomic, legal and cultural factors that contribute to suicide should be considered.
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Affiliation(s)
- Kevin Chien-Chang Wu
- Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ziyi Cai
- Department of Social Work and Social Administration, Faculty of Social Sciences, University of Hong Kong, Hong Kong, Hong Kong
| | - Qingsong Chang
- School of Sociology and Anthropology, Xiamen University, Xiamen, China
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, Faculty of Social Sciences, University of Hong Kong, Hong Kong, Hong Kong
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, Hong Kong
| | - Ying-Yeh Chen
- General Psychiatry, Taipei City Psychiatric Centre, Taipei City Hospital, Taipei City, Taiwan
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
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20
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Yip PSF, Yeung CY, Chen YC, Lai CCS, Wong CLH. An evaluation of the long-term sustainability of suicide prevention programs in an offshore Island. Suicide Life Threat Behav 2022; 52:4-13. [PMID: 33998032 DOI: 10.1111/sltb.12764] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/06/2020] [Accepted: 01/18/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In 2002, a suicide prevention program for visitors was implemented in Cheung Chau, an offshore island with 21,000 residents and many visitors. This research revisited the intervention and evaluated its long-term effectiveness. Insights are provided into implementing a sustainable intervention. METHODS Suicide death records (2007-2017) of Cheung Chau residents and visitors were retrieved. Information related to suicide method and sociodemographic characteristics of people who died by suicide were explored. Bivariate analyses were conducted to examine differences between visitors and residents; visitors and residents who died in Cheung Chau; and residents who died in or outside Cheung Chau. RESULTS After post-implementation period, suicide rate for visitors and residents increased. Visitors were generally younger than the residents with a different distribution of type of housing. Most of the visitors killed themselves by charcoal burning, and nearly half of the residents used hanging. CONCLUSION Long-term evaluation and monitoring of suicide prevention programs and sustained efforts are crucial to ensure program success. The prevention program in Cheung Chau was initially effective, but its long-term effects wore off. Both the mental health needs of visitors and residents should be addressed. Refinement of the current program and sustainable efforts are required for ensuring long-term success.
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Affiliation(s)
- Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, Pokfulam, Hong Kong SAR
| | - Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Yu-Chih Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Carmen Chui Shan Lai
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, Pokfulam, Hong Kong SAR
| | - Clifford Long Hin Wong
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, Pokfulam, Hong Kong SAR
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21
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Junus A, Yip PSF. Suicide risk profile and the social convoy: Population-level patterns of the young generation's help-seeking behavior and implications for suicide prevention. J Affect Disord 2022; 297:559-569. [PMID: 34715165 DOI: 10.1016/j.jad.2021.10.106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/17/2021] [Revised: 09/09/2021] [Accepted: 10/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Social support network offers a large potential in augmenting suicide prevention efforts tailored for the young generation (YG), but has so far been largely overlooked in population health studies. Key issues that remain scarcely understood include the composition of the YG's activated support network when they faced psychological distress, along with the prevalence and suicide risk profile associated with these patterns. METHODS Using data from three consecutive population-representative surveys (2018-2020) on help-seeking behaviors of the YG living in Hong Kong, we first conducted latent class analysis to derive the YG's help-seeking patterns. Next, we conducted multinomial logistic regression to identify unique factors associated with each pattern and multiple logistic regressions for suicide risk indicators to examine risk levels associated with each pattern. RESULTS Analyses revealed 4 underlying patterns of help-seeking behaviors among the study population. Each pattern was consistently associated with a distinct suicide risk profile based on constituents' level of distress and history of suicide risk behaviors. Severity of suicide risk increased as individuals increased the activation radius of their social convoy, and this increase was more pronounced when individuals extended the radius beyond their inner circle. Individuals whose activated inner circle consisted of family members in addition to just friends & partner had lower suicide risks. CONCLUSIONS Social support networks hold much potential in augmenting suicide prevention efforts tailored for the general young population. Such efforts may be directed at empowering the inner circle of their convoy, given its predominance for the YG to seek help from.
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Affiliation(s)
- Alvin Junus
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong; The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong.
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22
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Lim JTY, Cheng Q, Ng YP, Pheh KS, Panirselvam RR, Tay KW, Lim JBY, Chan WL, Amer Nordin AS, Zakaria H, Bartlett S, Skehan J, Chen YY, Yip PSF, Shah SA, Chan LF. Effectiveness of a Malaysian Media Intervention Workshop: Safe Reporting on Suicide. Front Psychol 2021; 12:666027. [PMID: 34975604 PMCID: PMC8715920 DOI: 10.3389/fpsyg.2021.666027] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Suicide remains an important cause of premature deaths and draws much media attention. However, unsafe reporting and portrayal of suicides by the media have been associated with increased risk of suicidal behavior. Current evidence suggests that media capacity-building could potentially prevent suicide. However, there are still knowledge gaps in terms of a lack of data on effective strategies for improving awareness and safe reporting of suicide-related media content. This study aims to investigate the effectiveness of a workshop conducted with members of the media community on the safe reporting of suicide-related content.Methods: An interventional single-arm pre and post pilot study was conducted on a sample of the Malaysian media community recruited through purposive and snowball sampling. The media safe reporting workshop was conducted by a suicide prevention expert with a media industry background. Thirty participants completed a self-reported evaluation questionnaire on their awareness and knowledge of reporting on suicide-related media content; before and after the interventional workshop.Results: There was a significant difference between the total scores before and after the intervention, with a large effect size. Post-intervention scores were significantly improved in 8 items, namely those related to the reporting of: (i) the content of any suicide note; (ii) headlines with methods of suicide; (iii) headlines with the location of suicide; (iv) cases of suspected suicide despite the unconfirmed cause of death; (v) suicide news to cater to readers’ interests; (vi) cause of suicide; (vii) details of the location of suicide; and (viii) the negative impact to media community when reporting suicide stories. In particular, there was an improvement in the majority of items for people from the media community with no lived experience of suicidal behavior.Conclusion: The media safe reporting workshop is a potentially effective intervention for improving awareness and knowledge measures relating to safe reporting on suicide among the media community, with a more pronounced effect in those without lived experience of suicidal behavior. Limitations in the sample size, generalizability, short-term evaluation, and lack of a control group warrant future larger, longer-term controlled, and more representative studies.
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Affiliation(s)
- Jane Tze Yn Lim
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Qijin Cheng
- Department of Social Work, The Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Yin Ping Ng
- Psychiatry Specialty, Pantai Hospital Penang, Bayan Lepas, Malaysia
| | - Kai Shuen Pheh
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, University Tunku Abdul Rahman, Kampar, Malaysia
| | | | - Kok Wai Tay
- Department of Psychology and Counselling, Faculty of Arts and Social Sciences, University Tunku Abdul Rahman, Kampar, Malaysia
| | - Joanne Bee Yin Lim
- School of Media, Languages & Cultures, Faculty of Arts & Social Sciences, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Wen Li Chan
- Nottingham University Business School, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Amer Siddiq Amer Nordin
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Hazli Zakaria
- Malaysian Psychiatric Association, Kuala Lumpur, Malaysia
| | | | | | - Ying-Yeh Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan
- Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei City, Taiwan
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shamsul Azhar Shah
- Department of Community Health, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
- *Correspondence: Lai Fong Chan,
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23
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Yip PSF, Chan WL, Chan CS, He L, Xu Y, Chan E, Chau YC, Cheng Q, Cheng SH, Cheung F, Chow J, Chow S, Fung J, Hsu SM, Law YW, Lo B, Miu SM, Ng WM, Ngai K, Tsang C, Xiong C, Xu Z. The Opportunities and Challenges of the First Three Years of Open Up, an Online Text-Based Counselling Service for Youth and Young Adults. Int J Environ Res Public Health 2021; 18:13194. [PMID: 34948802 PMCID: PMC8701729 DOI: 10.3390/ijerph182413194] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 10/18/2021] [Revised: 12/06/2021] [Accepted: 12/11/2021] [Indexed: 11/22/2022]
Abstract
We present the opportunities and challenges of Open Up, a free, 24/7 online text-based counselling service to support youth in Hong Kong. The number of youths served more than doubled within the first three years since its inception in 2018 in response to increasing youth suicidality and mental health needs. Good practice models are being developed in order to sustain and further scale up the service. We discuss the structure of the operation, usage pattern and its effectiveness, the use of AI to improve users experience, and the role of volunteer in the operation. We also present the challenges in further enhancing the operation, calling for more research, especially on the identification of the optimal number of users that can be concurrently served by a counsellor, the effective approach to respond to a small percentage of repeated users who has taken up a disproportional volume of service, and the way to optimize the use of big data analytics and AI technology to enhance the service. These advancements will benefit not only Open Up but also similar services across the globe.
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Affiliation(s)
- Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China;
| | - Wai-Leung Chan
- Youth and Community Services, Caritas Hong Kong, Hong Kong, China; (W.-L.C.); (S.C.); (W.M.N.)
| | - Christian S. Chan
- Department of Psychology, The University of Hong Kong, Hong Kong, China;
| | - Lihong He
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Yucan Xu
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Evangeline Chan
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Yui Chi Chau
- Head Office, Hong Kong Children and Youth Services, Hong Kong, China;
| | - Qijin Cheng
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China;
| | | | - Florence Cheung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - James Chow
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Shirley Chow
- Youth and Community Services, Caritas Hong Kong, Hong Kong, China; (W.-L.C.); (S.C.); (W.M.N.)
| | - Jerry Fung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Siu-Man Hsu
- Headquarter, The Hong Kong Federation of Youth Groups, Hong Kong, China;
| | - Yik Wa Law
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China;
| | - Billie Lo
- IT Unit, The Hong Kong Federation of Youth Groups, Hong Kong, China;
| | - Sze-Man Miu
- Jockey Club Online Youth Emotional Support, The Boys’ and Girls’ Clubs Association of Hong Kong, Hong Kong, China;
| | - Wai Man Ng
- Youth and Community Services, Caritas Hong Kong, Hong Kong, China; (W.-L.C.); (S.C.); (W.M.N.)
| | - Ken Ngai
- Independent Researcher, Hong Kong, China;
| | - Christy Tsang
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Cynthia Xiong
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
| | - Zhongzhi Xu
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China; (L.H.); (Y.X.); (E.C.); (F.C.); (J.C.); (J.F.); (C.T.); (C.X.); (Z.X.)
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Abstract
INTRODUCTION There has been little research into at-home suicide cases globally, and particularly in Asian regions. This study aimed to investigate the differences in characteristics between suicide cases in Hong Kong that occurred at home and elsewhere; identify at-home suicide hotspots in the community and compare the differences in area-level characteristics between suicide hotspots and other areas. METHODS Suicide cases (2013-2017) were identified from Hong Kong Coroner's Court reports. Area-level socioeconomic data were retrieved from the 2016 Hong Kong census. Wilcoxon signed-rank tests, χ2 tests and multiple logistic regression models were applied to compare differences in characteristics between people committing suicide at home and elsewhere. Global hotspot tests (Moran's I and Getis-Ord General G) and local analysis (Getis-Ord Gi*) identified at-home suicide community hotspots. The Wilcoxon signed-rank test was used to compare differences in area-level characteristics between at-home suicide hotspots and non-hotspots. RESULTS About 60% of suicide cases in Hong Kong occurred at home. Being female, widowed and/or living alone were significant predictors of at-home suicide cases. A U-shaped association between age and at-home suicide was identified, with 32 years of age being the critical turning point. An at-home suicide hotspot was identified in the north-western region of Hong Kong, which had lower median household income, higher income inequality and higher percentages of households with single elderly people, and new arrivals, compared with other areas. CONCLUSION Suicide prevention should start at home by restricting access to suicide methods. Community-based suicide prevention interventions with improvement of social services should target vulnerable members in identified suicide hotspots.
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Affiliation(s)
- Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Yu Men
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Yu-Chih Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR .,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong SAR
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Men YV, Yeung CY, Lam TC, Fai Yip PS, Emery CR. Using suicide notes to understand suicide among cancer patients: A mixed-method study. Psychooncology 2021; 31:614-621. [PMID: 34704322 DOI: 10.1002/pon.5845] [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] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cancer patients are at risk of suicide. However, no studies have used suicide notes to investigate their expressed reasons for suicide. The objectives of this study were to compare the characteristics between note leavers and non-leavers among cancer suicide cases and to understand the patterns in expressed reasons for suicide using suicide notes. METHOD Suicide cases (2012-2017) were identified from the Hong Kong Coroner's Court reports, which provide detailed information as well as the content of suicide notes. Bivariate tests and multiple logistic regression were performed to compare the characteristics of note leavers and non-leavers among suicide cases with cancer. Thematic analysis was performed on suicide notes to extract themes of expressed reasons for suicides by cancer status and age group. RESULTS Among cancer suicide cases and compared to non-leavers, note leavers were younger, more likely to be male, use non-violent suicide methods, have better housing conditions, and live alone. Suffering from physical disease was a major theme identified among cancer note leavers across all age groups. Young and middle-aged non-cancer note leavers had various themes identified. Physical illness was the major theme for elderly non-cancer note leavers. CONCLUSIONS Cancer note leavers had unique characteristics and suffering from physical illness was the major expressed reason identified in the suicide notes. Healthcare professionals should pay attention to the mental as well as the physical needs of patients. Improving quality of life and regaining control of life are vital for suicide prevention among cancer patients.
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Affiliation(s)
- Yu Vera Men
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Cheuk Yui Yeung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Tai-Chung Lam
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Clifton R Emery
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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26
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Yip PSF, Zheng Y, Wong C. Demographic and epidemiological decomposition analysis of global changes in suicide rates and numbers over the period 1990-2019. Inj Prev 2021; 28:117-124. [PMID: 34400542 DOI: 10.1136/injuryprev-2021-044263] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 07/09/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Suicide presents an ongoing public health challenge internationally. Nearly 800 000 people around the world lose their life to suicide every year, and many more attempt suicide. METHODS A decomposition analysis was performed using global suicide mortality and population data from the Global Burden of Disease Study 2019. RESULTS Despite a significant decrease in age-specific suicide rate between 1990 and 2019 (-4.01; from 13.8% to 9.8% per 100 000), the overall numbers of suicide deaths increased by 19 897 (from 738 799 to 758 696) in the same time period. The reductions in age-specific suicide rates (-6.09; 152%) contributed to the overall reductions in suicide rates; however, this was offset by overtime changes in population age structure (2.08; -52%). The increase in suicide numbers was partly attributable to population growth (300 942; 1512.5%) and population age structure (189 512; 952.4%), which was attenuated by the significant reduction in overall suicide rates (-470 556; 2364.9%). The combined effect of these factors varied across the World Bank income level regions. For example, in the upper-middle-income level region, the effect of the reduction in age-specific suicide rates (-289 731; -1456.1%) exceeded the effect of population age structure (124 577; 626.1%) and population growth (83 855; 421.4%), resulting in its substantial decline in total suicide deaths (-81 298; -408.6%). However, in lower-middle income region, there was a notable increase in suicide death (72 550; 364.6%), which was related to the net gain of the reduction in age-specific suicide rates (-115 577; -580.9%) and negated by the increase in the number of suicide deaths due to population growth (152 093; 764.4%) and population age structure (36 034; 181.1%). CONCLUSION More support and resources should be deployed for suicide prevention to the low-income and middle-income regions in order to achieve the reduction goal. Moreover, suicide prevention among older adults is increasingly critical given the world's rapidly ageing populations in all income level regions.
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Affiliation(s)
- Paul Siu Fai Yip
- HKJC Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Yan Zheng
- The School of Nursing, The Hong Kong Polytechnic University, Kowloon, People's Republic of China
| | - Clifford Wong
- Social Work and Social Administration, The University of Hong Kong, Hong Kong, People's Republic of China
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Yang CT, Yip PSF. Changes in the epidemiological profile of suicide in Hong Kong: a 40-year retrospective decomposition analysis. China Popul Dev Stud 2021; 5:153-173. [PMID: 34249402 PMCID: PMC8259555 DOI: 10.1007/s42379-021-00087-5] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022]
Abstract
The suicide rate in Hong Kong has increased significantly over the past four decades. Population subgroups such as the elderly or economically-distressed are reported to be more vulnerable than others to suicidal behaviors, while changing suicide methods (such as charcoal burning which emerged in 1998), has also contributed significantly to increasing suicide rates. However, the extent of the contribution of different factors to changes in suicide rate remains unclear. This paper reported on a decomposition analysis of the epidemiological profile of suicide in Hong Kong between 1976 and 2015, specifically considering factors underlying the increasing suicide rate over this period. Completed death registry information was available from the Census and Statistics Department of the Hong Kong SAR for this investigation. We compared absolute and relative contributions of gender, age and suicide method to rate changes over time. Changes in suicide rate were generally underpinned by more than one factor. Population aging in a rapidly-aging city contributed significantly to suicide rate increases, whilst jumping from a height had the greatest influence on rate changes throughout the study period. Suicides by male aged 25-34 years and 45-54 years were more likely to be triggered by economic factors, compared with the other gender-age subgroups. The decomposition approach provided a comprehensive understanding about how socioeconomic factors and suicide methods interacted to influence over-time suicide patterns. This research supports development of more focused suicide prevention measures to reduce suicide rate. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s42379-021-00087-5.
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Affiliation(s)
- Chi-Ting Yang
- Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong, China
| | - Paul Siu Fai Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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28
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Xiao Y, Hinrichs R, Johnson N, McKinley A, Carlson J, Agley J, Yip PSF. Suicide Prevention Among College Students Before and During the COVID-19 Pandemic: Protocol for a Systematic Review and Meta-analysis. JMIR Res Protoc 2021; 10:e26948. [PMID: 33878016 PMCID: PMC8130819 DOI: 10.2196/26948] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/29/2021] [Accepted: 04/16/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Suicide is the second leading cause of death for college-aged individuals worldwide and in the United States. Recent studies have identified preliminary evidence of widening disparities in suicidal behaviors across sex, sexual orientation, race/ethnicity, age, and socioeconomic status among college students. Few systematic reviews and meta-analyses offer a comprehensive understanding of on-campus and off-campus suicide interventions, nor is collated information available for different types of screening, assessment, treatment, and postvention plans. Further challenges have been identified since the COVID-19 pandemic, calling for cost-effective and innovative interventions to address increased rates of suicidal behaviors among college students facing unprecedented stressors. OBJECTIVE This research protocol describes the first systematic review and meta-analysis to identify the most effective and cost-effective intervention components for universal and targeted (indicated and selected) suicide prevention among college students in a global context. Special attention will be placed on disparities in suicide prevention across sociodemographic subgroups, inclusive interventions beyond campus, global context, and intervention responses to the COVID-19 pandemic. METHODS A sensitive search strategy will be executed across MEDLINE (Ovid), EMBASE, PsycINFO (EBSCO), ERIC (EBSCO), Cochrane Library, Dissertations and Theses Global (ProQuest), Scopus, Global Index Medicus, SciELO, African Journals Online, Global Health (CABI), and Google Scholar. Data extraction and evaluation will be conducted by three independent researchers. Risk of bias will be assessed. A multilevel meta-regression model and subgroup analysis will be used to analyze the data and estimate effect sizes. RESULTS The initial search was completed in December 2020 and updated with additional other-language studies in March 2020. We expect the results to be submitted for publication in mid-2021. CONCLUSIONS Despite increasing rates of suicidal behaviors among college students, few preventative efforts have targeted this population, and fewer focus on factors that might place specific demographic groups at heightened risk. The impact of COVID-19 on suicidal behaviors among college students highlights and exacerbates the urgent need for rapid and effective interventions that might differ from traditional approaches. This equity-focused study will address these gaps and provide a valuable analysis of the effectiveness of suicide prevention programs and interventions. Findings will inform clinicians, researchers, policy makers, families, and organizations about evidence-based interventions for reducing the gaps in the suicide crisis among college students from different sociodemographic groups. TRIAL REGISTRATION PROSPERO CRD42020225429; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=225429. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/26948.
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Affiliation(s)
- Yunyu Xiao
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
- School of Social Work, Indiana University-Bloomington, Bloomington, IN, United States
| | - Rachel Hinrichs
- IUPUI University Library, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Nina Johnson
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Amanda McKinley
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Joan Carlson
- School of Social Work, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Jon Agley
- School of Public Health, Indiana University Bloomington, Bloomington, IN, United States
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China (Hong Kong)
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Guo Y, Chan KST, Chan CH, Chang Q, Lee RS, Yip PSF. Combined effects of individual and neighbourhood socioeconomic status on older adults' mortality: a retrospective follow-up study in Hong Kong. BMJ Open 2021; 11:e043192. [PMID: 33906837 PMCID: PMC8088262 DOI: 10.1136/bmjopen-2020-043192] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study examined the interaction effects of individual and neighbourhood socioeconomic status (SES) in older adults in Hong Kong, considering all-cause and cause-specific mortality from respiratory disease, cancer, cardiovascular diseases, ischaemic heart disease, stroke, nonmedical disease and suicide. DESIGN A retrospective follow-up study. SETTING Hong Kong Special Administrative Region, a rapidly ageing society with 16.1% residents aged 65 years or older in 2020. PARTICIPANTS 43 910 people aged 65 years or older were enrolled at baseline. They had participated in health check-ups during 2000-2003 in one of the Elderly Health Centres. Observation periods started on the date of the participant's first health check-up, and ended at death, or 31 December 2011, whichever occurred first. OUTCOME MEASURES All-cause and cause-specific mortality over the study timeframe. ANALYSIS Cox's proportional hazards regression models were applied to estimate the adjusted HRs of mortality, by including covariates at neighbourhood (deprivation) and individual levels (poverty, education and type of housing). RESULTS The 'double tragedy theory' (ie, lower SES persons living in lower SES neighbourhoods have worst health outcomes) was more related to cancer, while the 'psychosocial comparison theory' (ie, lower SES persons living in higher SES neighbourhoods have poorer health outcomes) was more related to cardiovascular, ischaemic heart disease, and stroke. CONCLUSION There were important interaction effects between neighbourhood and individual factors on mortality. Policies based on the interaction between individual and neighbourhood SES should be considered. For instance, for cancer, targeted services (ie, free consultation, relevant treatment information, health check-up, etc) could be allocated in socioeconomically deprived areas to support individuals with low SES. On the other hand, more free public services to reduce psychological stresses (ie, psychological support services, recreational services, health knowledge information, etc) could be provided for those individuals with low SES living in higher SES areas to reduce stroke, cardiovascular and ischaemic heart diseases.
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Affiliation(s)
- Yingqi Guo
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Kristy Shuk Ting Chan
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Chee Hon Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Qingsong Chang
- School of Sociology and Anthropology, Xiamen University, Fujian, China
| | - Ruby Sy Lee
- Elderly Health Service, Department of Health, The Government of the Hong Kong SAR, Hong Kong, China
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong, China
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
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Huen JMY, Zhang J, Osman A, Lew B, Yip PSF. Using Contemporary Psychometric Methods to Construct and Validate Scores on a Short-Form Version of the Psychological Strain Scales. J Affect Disord 2021; 281:1-8. [PMID: 33278765 DOI: 10.1016/j.jad.2020.11.069] [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: 05/24/2020] [Revised: 09/28/2020] [Accepted: 11/08/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The 40-item Psychological Strain Scales (PSS) was developed to measure four dimensions of psychological strains based on the Strain Theory of Suicide. Although the PSS has been increasingly used in recent years, the dimensionality and scoring of the PSS remained to be thoroughly examined using the Item Response Theory (IRT) approach. METHODS Data came from a large sample of 11,412 Chinese undergraduate students. A bifactor-IRT model, specifying one general strain factor and four specific strains factors, was examined for fit to the sample data. A detailed item analysis, with analysis of the differential item functioning (DIF) of the items across gender, was undertaken to evaluate the dimensionality of the PSS. The associations among the PSS scale scores with scores on the concurrent measures, assessing psychache and suicidal behaviors, were examined. RESULTS IRT-derived specific bifactor indices showed that the PSS was unidimensional, and thus the PSS total scores should be reported. Unidimensional subset of 5 items identified (Item 9, Item 12, Item 14, Item 16, and Item 20), using bifactor-IRT modeling and incremental validation, were selected to construct a potential short form of the PSS (PSS-SF). The PSS-SF scale scores demonstrated strong psychometric properties and associations with scores on the concurrent measures assessing relevant constructs. LIMITATIONS This study used cross-sectional data from a non-clinical sample of Chinese undergraduate students. CONCLUSIONS The PSS-SF should be considered as a unidimensional instrument with potential in enhancing our understanding and measurement of psychological strains with reduced response burden.
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Affiliation(s)
- Jenny Mei Yiu Huen
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
| | - Jie Zhang
- Central University of Finance and Economics, Beijing, China; State University of New York Buffalo State Department of Sociology, New York, USA
| | - Augustine Osman
- Department of Psychology, University of Texas at San Antonio, TX USA
| | - Bob Lew
- Department of Social Psychology, Faculty of Human Ecology, Putra University of Malaysia, Malaysia
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China; The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
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Cheung T, Lam SC, Lee PH, Xiang YT, Yip PSF. Global Imperative of Suicidal Ideation in 10 Countries Amid the COVID-19 Pandemic. Front Psychiatry 2021; 11:588781. [PMID: 33519545 PMCID: PMC7838349 DOI: 10.3389/fpsyt.2020.588781] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 07/29/2020] [Accepted: 12/10/2020] [Indexed: 11/13/2022] Open
Abstract
Background: The novel coronavirus (COVID-19) has had a detrimental impact on individuals' psychological well-being; however, a multi-country comparison on the prevalence of suicidal ideation due to the virus is still lacking. Objectives: To examine the prevalence and correlates of suicidal ideation among the general population across 10 countries during the COVID-19 pandemic. Materials and methods: This was a cross-sectional study which used convenience sampling and collected data by conducting an online survey. Participants were sourced from 10 Eastern and Western countries. The Patient Health Questionnaire (PHQ-9) was used to measure the outcome variable of suicidal ideation. Ordinal regression analysis was used to identify significant predictors associated with suicidal ideation. Results: A total of 25,053 participants (22.7% male) were recruited. Results from the analysis showed that the UK and Brazil had the lowest odds of suicidal ideation compared to Macau (p < 0.05). Furthermore, younger age, male, married, and differences in health beliefs were significantly associated with suicidal ideation (p < 0.05). Conclusions: The findings highlight the need for joint international collaboration to formulate effective suicide prevention strategies in a timely manner and the need to implement online mental health promotion platforms. In doing so, the potential global rising death rates by suicide during the pandemic can be reduced.
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Affiliation(s)
- Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- Squina International Centre for Infection Control, The Hong Kong Polytechnic University, Hong Kong, China
| | - Paul Hong Lee
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yu Tao Xiang
- Faculty of Health Sciences, University of Macau, Macau, China
| | - Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong, China
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Xu Z, Zhang Q, Yip PSF. Predicting post-discharge self-harm incidents using disease comorbidity networks: A retrospective machine learning study. J Affect Disord 2020; 277:402-409. [PMID: 32866798 DOI: 10.1016/j.jad.2020.08.044] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Self-harm is preventable if the risk can be identified early. The co-occurrence of multiple diseases is related to self-harm risk. This study develops a comorbidity network-based deep learning framework to improve the prediction of individual self-harm. METHODS Between 01/01/2007-12/31/2010, we obtained 2,323 patients with self-harm records and 46,460 randomly sampled controls from 1,764,094 inpatients across 44 public hospitals in Hong Kong. 80% of the samples were randomly selected for model training, and the remaining 20% were set aside for model testing. We propose a novel patient embedding method, namely Dx2Vec (Diagnoses to Vector), based on the comorbidity network constructed by all historical diagnoses. Dx2Vec represents the comorbidity patterns among diseases and temporal patterns of historical admissions for each patient. RESULTS Experiments demonstrate that the Dx2Vec-based model outperforms the baseline deep learning model in identifying patients who would self-harm within 12 months (C-statistic: 0.89). The precision is 0.54 for positive cases and 0.98 for negative cases, whilst the recall is 0.72 for positive cases and 0.96 for negative cases. The model extracted the most predictive diagnoses, and pairwise comorbid diagnoses to help medical professionals identify patients with risk. LIMITATIONS The inpatient data does not contain lab test information. CONCLUSIONS Incorporation of a disease comorbidity network can significantly improve self-harm prediction performance, indicating that it is critical to consider comorbidity patterns in self-harm screening and prevention programs. The findings have the potential to be translated into effective self-harm screening systems.
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Affiliation(s)
- Zhongzhi Xu
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, China.
| | - Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
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Chen YY, Yang CT, Cha ES, Sha F, Yip PSF. Quantifying the contributions of age, sex, methods, and urbanicity to the changing suicide rate trends in South Korea, 2001-2016. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1121-1132. [PMID: 32189039 DOI: 10.1007/s00127-020-01855-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 11/02/2019] [Accepted: 02/28/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Suicide rates in South Korea have been one of the highest in the world. The aim of this study is to quantify the contributions of age, sex, method, and place of residence to the trends of the suicide rates between 2001 and 2016 in South Korea. METHODS Using the suicide data obtained from the South Korean National Death Registration data set for the years 2001-2016, a Joinpoint regression analysis was conducted to determine if there was a significant change in the trend of suicide rates. Next, a decomposition analysis method was used to quantify the contributions of age, sex, method, and places of residence to the changes in the suicide rates. RESULTS Suicide rates increased between 2001 and 2010, and decreased between 2010 and 2016. Among all the age groups, the 65-79 age group contributed most to the rise (18% in men and 7% in women) and fall (- 15% in men and - 14% in women) of suicide rates. Men contributed much more than women to the increasing trend of suicide rate (63.0% vs. 37.0%). Hanging was the key method of suicide, dominating the ups and downs of the suicide rates. The rates of suicide by pesticide poisoning have been decreasing since 2005 and suicide by charcoal burning continued to increase against a decreasing trend of suicide rate during the period of 2010-2016. The gap of the metropolitan-city-rural suicide rates was narrowing during the period under study, although the rural areas remained to have the highest suicide rates. CONCLUSION The ups and downs of suicide rates in South Korea were not uniform across different sociodemographic groups. Age, sex, method, and place of residence contributed differently to the changes in suicide rates. Suicide prevention measures can be more focused on certain age-sex-method-region subgroups.
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Affiliation(s)
- Ying-Yeh Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan.,Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Chi-Ting Yang
- Department of Statistics and Actuarial Science, The University of Hong Kong, Pokfulam, Hong Kong
| | - Eun-Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Feng Sha
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Pokfulam, Hong Kong
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong. .,The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong.
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Abstract
OBJECTIVES To promote gender diversity and equity in higher education, Athena Scientific Women's Academic Network (SWAN) supports and recognises higher education institutions (HEI) in advancing the careers of women through charter commitment, awards, training and advocacy since 2005. Most evaluation studies, however, are based on qualitative assessments. This study sought to (1) examine the relationship between Athena SWAN accreditation/awards in the UK and gender diversity of leaders and senior academics using quantitative data from 2012/2013 to 2016/2017, and (2) explore the associations between Athena SWAN awards and university performance as measured by overall scores in global ranking systems. DESIGN Retrospective cohort study based on the UK HEIs. SETTING Higher education sector in the UK provided by the Higher Education Statistics Agency. PARTICIPANTS 148 HEIs who provided employment data on female-to-male ratios (55% complete data) for each academic year between 2012/2013 and 2016/2017. PRIMARY AND SECONDARY OUTCOME MEASURES Gender diversity, defined as female representation rates of positions in managerial leadership (eg, heads of institutions, department heads) and professors. The Quacquarelli Symonds (QS) World University Rankings scores, an indicator of research, teaching, employability and internationalisation, were collected to measure university performance. RESULTS Gender diversity of managerial leaders and non-managerial professors at all levels of Athena SWAN status has improved over the 5 years. Linear mixed effects models identified that Athena SWAN awardees had lower female representation than non-awardees in managerial leadership positions (p<0.05), while the gap was narrowed among Silver awardees over time. Athena SWAN Charter members had increasingly higher female representation than those not in the Charter (p<0.05). Silver-award institutions ranked higher in QS rankings than Bronze-award institutions (β=11.80, p<0.05). CONCLUSIONS There are overall rising trends in gender diversity from 2012/2013 to 2016/2017. Athena SWAN members showed greater and faster growth in female representations. Silver awardees had greater university performance than Bronze awardees.
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Affiliation(s)
- Yunyu Xiao
- Silver School of Social Work, New York University, New York, New York, USA
| | - Edward Pinkney
- Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong
| | - Terry Kit Fong Au
- Department of Psychology, University of Hong Kong, Pokfulam, Hong Kong
- President's Office, University of Hong Kong, Pokfulam, Hong Kong
| | - Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, University of Hong Kong, Pokfulam, Hong Kong
- Department of Social Work and Social Administration, University of Hong Kong, Pokfulam, Hong Kong
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Xu Z, Zhang Q, Li W, Li M, Yip PSF. Individualized prediction of depressive disorder in the elderly: A multitask deep learning approach. Int J Med Inform 2019; 132:103973. [PMID: 31569007 DOI: 10.1016/j.ijmedinf.2019.103973] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/27/2019] [Accepted: 09/17/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Depressive disorder is one of the major public health problems among the elderly. An effective depression risk prediction model can provide insights on the disease progression and potentially inform timely targeted interventions. Therefore, research on predicting the onset of depressive disorder for elderly adults considering the sequential progression patterns is critically needed. OBJECTIVE This research aims to develop a state-of-the-art deep learning model for the individualized prediction of depressive disorder with a 22-year longitudinal survey data among elderly people in the United States. METHODS We obtain the 22-year longitudinal survey data from the University of Michigan Health and Retirement Study, which consists of information on 20,000 elderly people in the United States from 1992 to 2014. To capture temporal and high-order interactions among risk factors, the proposed deep learning model utilizes a recurrent neural network framework with a multitask structure. The C-statistic and the mean absolute error are used to evaluate the prediction accuracy of the proposed model and a set of baseline models. RESULTS The experiments with the 22-year longitudinal survey data indicate that (a) machine learning models can provide an accurate prediction of the onset of depressive disorder for elderly individuals; (b) the temporal patterns of risk factors are associated with the onset of depressive disorder; and (c) the proposed multitask deep learning model exhibits superior performance as compared with baseline models. CONCLUSION The results demonstrate the capability of deep learning-based prediction models in capturing temporal and high-order interactions among risk factors, which are usually ignored by traditional regression models. This research sheds light on the use of machine learning models to predict the onset of depressive disorder among elderly people. Practically, the proposed methods can be implemented as a decision support system to help clinicians make decisions and inform actionable intervention strategies for elderly people.
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Affiliation(s)
- Zhongzhi Xu
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, China.
| | - Wentian Li
- Wuhan Hospital for Psychotherapy, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mingyang Li
- Department of Industrial and Management Systems Engineering, The University of South Florida, Tampa, USA
| | - Paul Siu Fai Yip
- Centre for Suicide Research and Prevention and the Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
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Fong TCT, Ho RTH, Yip PSF. Effects of urbanization on metabolic syndrome via dietary intake and physical activity in Chinese adults: Multilevel mediation analysis with latent centering. Soc Sci Med 2019; 234:112372. [PMID: 31254966 DOI: 10.1016/j.socscimed.2019.112372] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 04/09/2019] [Accepted: 06/14/2019] [Indexed: 12/28/2022]
Abstract
RATIONALE China has undergone rapid urbanization in the past decades. Metabolic syndrome refers to a cluster of cardiometabolic risk factors such as abdominal obesity, raised blood pressure, and elevated glucose. Existing studies have not explicitly examined the urbanization effect on metabolic syndrome. OBJECTIVE The present study aims to examine the temporal effects of urbanization on metabolic syndrome in the Chinese context and evaluate dietary intake and physical activity as potential mediating factors. METHOD The study sample comprised 6,217 Chinese adults aged between 30 and 65 recruited in 218 communities from 2000 to 2009 waves of the China Health and Nutrition Survey. Growth in urbanization of the communities was derived using latent growth modeling on continuous urbanization index from 2000 to 2009. The participants reported their physical activity and dietary intake. Body mass index and biomarkers were measured at 2009 for diagnosis of metabolic syndrome. Multilevel mediation analysis with novel latent centering approach was conducted across gender to evaluate direct and indirect effects of urbanization on metabolic syndrome via changes in dietary intake and physical activity. RESULTS The sample displayed linear increasing trends in urbanization, intakes of red meat, dairy products and fast food and declining cereal intake and physical activity with significant inter-individual variations. Controlling for individual-level and community-level covariates, urbanization showed a positive but non-significant direct effect on metabolic syndrome across gender. There were significant and positive indirect effects from urbanization to metabolic syndrome via changes in physical activity in males and via changes in fast food intake in females. CONCLUSIONS The present results highlight the health impact of urbanization as a dynamic process at the community level on metabolic syndrome via different indirect pathways of lifestyle factors across gender. Methodological and practical implications are discussed in relation to these modifiable lifestyle factors in the urbanizing Chinese society.
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Affiliation(s)
- Ted Chun Tat Fong
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong; Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong.
| | - Rainbow Tin Hung Ho
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong; Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong.
| | - Paul Siu Fai Yip
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong; Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong.
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Zheng Y, Chang Q, Yip PSF. Understanding the Increase in Life Expectancy in Hong Kong: Contributions of Changes in Age- and Cause-Specific Mortality. Int J Environ Res Public Health 2019; 16:ijerph16111959. [PMID: 31159482 PMCID: PMC6603858 DOI: 10.3390/ijerph16111959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 04/08/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 11/17/2022]
Abstract
To assess the mechanism responsible for the improvement in life expectancy in Hong Kong over the past several decades, Arriaga’s decomposition method was applied to quantify the influence of the age structure and the leading causes of death on the increase in life expectancy in Hong Kong from 1986 to 2015. Our results showed that, during the observed period, the major contribution to the improvement in life expectancy in Hong Kong was attributable to the older population for both males and females. Contributions of malignant neoplasms in the period of 1986–1995, 1996–2005 and 2006–2015 were 0.613, 0.279 and 0.887 years in males and 0.391, 0.312 and 0.226 years in females, respectively. For circulatory diseases, the corresponding figures were 1.452, 0.202 and 0.832 years in males and 0.675, 0.192 and 1.069 years in females, with the largest contribution also shifting to older ages. However, these positive contributions were partly offset by the negative contribution of pneumonia, especially among those at advanced ages. Furthermore, although the impact was limited, attention should also be paid to the prevalence of some chronic diseases among the younger age groups in recent years.
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Affiliation(s)
- Yan Zheng
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
| | - Qingsong Chang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
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Law YW, Yeung TL, Ip FWL, Yip PSF. Evidence-Based Suicide Prevention: Collective Impact of Engagement with Community Stakeholders. J Evid Based Soc Work (2019) 2019; 16:211-227. [PMID: 30784376 DOI: 10.1080/23761407.2019.1578318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Purpose: In response to the rising suicide trend in Hong Kong, the Centre for Suicide Research and Prevention ("CSRP") was established in 2002, with the aim to capitalize on the collective impact of research-support practices to prevent suicides.Method: The CSRP has since become an international knowledge hub that applies a public health approach and innovative strategies to address suicide-related problems at multiple levels.Results: The CSRP actively engages in research, teaching, and knowledge exchange with community stakeholders. These effort are associated with Hong Kong's more than 30% reduction in suicide rates between 2003 and 2016.Discussion: The rationale for and examples of the CSRP's practices in face of the suicide prevention challenges lay ahead were also discussed.Conclusion: The outcomes of these practices, which hold great potential for suicide prevention worldwide, have contributed to important academic debates in the field of suicidology.
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Affiliation(s)
- Yik Wa Law
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PRC
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, PRC
| | - Tsz Long Yeung
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PRC
| | - Flora Wai Lam Ip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PRC
| | - Paul Siu Fai Yip
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, PRC
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, PRC
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Wu X, Law CK, Yip PSF. A Projection of Future Hospitalisation Needs in a Rapidly Ageing Society: A Hong Kong Experience. Int J Environ Res Public Health 2019; 16:ijerph16030473. [PMID: 30736289 PMCID: PMC6388233 DOI: 10.3390/ijerph16030473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 01/16/2019] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 12/02/2022]
Abstract
To assess the impact of ageing on hospitalisation in a rapidly ageing society. A study using retrospective and prospective data was conducted using hospitalisation data with age-specific admission rates in the period from 2001–2010 and demographic data from the period of 2001–2066 by the United Nations. The Hong Kong Special Administrative Region (SAR) with a 7 million population experiences extreme low fertility (1.1 children per woman) and long life expectancy (84 years old). Days of hospitalisation: For the period 2010–2066, the length of stay (LOS) in the age group 85+ is projected to increase by 555.3% while the LOS for the whole population is expected to increase by only 134.4% and by ageing only. In 2010, the proportion in the LOS contributed to by the oldest age group (85+) was 15%. In 2066, this proportion is projected to nearly triple (42%). Around 70% of the projected days of hospitalisation would be taken by people aged 75 years and above. It is projected that this phenomenon would be converted to a more balanced structure when the demographic transition changes into a more stable distribution. Apparently, the impact of ageing on the public hospital system has not been well understood and prepared. The determined result provides insight into monitoring the capacity of the hospital system to cope with a rapidly changing demographic society. It provides empirical evidence of the impact of ageing on the public hospitalisation system. It gives a long term projection up to the year 2066 while the situation would be different from the transient period of 2016–2030. The analysis adopts a fixed rate approach, which assumes the LOS to be only driven by demographic factors, while any improvements in health technologies and health awareness are not accounted for. Only inpatient data from the Hospital Authority were used, nonetheless, they are the best available for the study. Due to the limitation of data, proximity to death is not controlled in conducting this analysis.
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Affiliation(s)
- Xueyuan Wu
- Department of Economics, The University of Melbourne, Parkville, VIC 3010, Australia.
| | - Chi-Kin Law
- Centre for Applied Health Economics, Menzies Health Institute Queensland, School of Medicine, Griffith University, Nathan, QLD 4111, Australia.
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
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Chan CH, Wong HK, Yip PSF. Associations of relative income deprivation with perceived happiness and self-rated health among the Hong Kong Chinese population. Int J Public Health 2017; 62:697-707. [PMID: 28293717 DOI: 10.1007/s00038-017-0953-x] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 12/12/2016] [Accepted: 01/24/2017] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To investigate the association of relative income deprivation (RID) with perceived happiness and self-rated health in Hong Kong. METHODS We measured RID on Yitzhaki indices constructed using multiple reference groups and used multilevel ordinal logistic regression models to assess its linkages with the two outcomes, using data from 6272 respondents from a large-scale representative household survey. RESULTS Among the overall population, increased RID was found to be consistently associated with reduced perceived happiness, even after adjusting for respondents' level of absolute income and other socio-demographic covariates; however, there were no consistent associations between RID and self-rated health. In subgroup analysis, we observed significant linkages between RID and self-rated health only among men, the middle and older age ranges, and among those with less education and those not engaged in economic activities. CONCLUSIONS Our findings suggest that RID is adversely associated with perceived happiness. However, its negative linkage with self-rated health is less clear. The weak tie between RID and self-rated health may relate to the Hong Kong context, where the public health system is relatively equitable and has multiple pro-poor health policies.
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Affiliation(s)
- Chee Hon Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong.,Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, Hong Kong
| | - Ho Kit Wong
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, Hong Kong
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong. .,Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, Hong Kong.
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Zhang Y, Yip PSF, Chang SS, Wong PWC, Law FYW. Association Between Changes in Risk Factor Status and Suicidal Ideation Incidence and Recovery. Crisis 2016; 36:390-8. [PMID: 26648226 DOI: 10.1027/0227-5910/a000343] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Little is known about risk factors associated with the incidence of and recovery from suicidal ideation. AIMS To examine the association between potential risk factors and their change in status over the follow-up period and the incidence of and recovery from suicidal ideation. METHOD A 12-month follow-up survey was conducted among 997 adults aged between 20 and 59 years living in Hong Kong. RESULTS The incidence rates of suicidal ideation increased in individuals who were divorced, separated, or widowed, in low economic status, had a history of psychiatric treatment, and experienced bereavement at baseline. Experiencing three or more life events and persistent unemployment over the follow-up period was associated with increased incidence of suicidal ideation. Increased levels of depression, anxiety, hopelessness, and irrational beliefs were associated with suicidal ideation incidence in men but not in women (p = .009-.067 for interactions). Among individuals who had suicidal ideation at baseline, those who had increased severity of depression, anxiety, and hopelessness over the follow-up period were less likely to recover from suicidal ideation. CONCLUSION Life events and persistent unemployment were associated with increased risk of suicidal ideation. Gender differences were detected in the association between changes in the status of psychological factors and the occurrence of suicidal ideation.
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Affiliation(s)
- Yi Zhang
- 1 Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, PRC.,2 Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, PRC
| | - Paul Siu Fai Yip
- 1 Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, PRC.,2 Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, PRC
| | - Shu-Sen Chang
- 2 Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, PRC.,3 Institute of Health Policy and Management, and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Paul Wai Ching Wong
- 1 Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, PRC
| | - Frances Yik Wa Law
- 1 Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, PRC.,2 Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, PRC
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Chang SS, Bjørngaard JH, Tsai MK, Bjerkeset O, Wen CP, Yip PSF, Tsao CK, Gunnell D. Heart rate and suicide: findings from two cohorts of 533 000 Taiwanese and 75 000 Norwegian adults. Acta Psychiatr Scand 2016; 133:277-88. [PMID: 26493376 DOI: 10.1111/acps.12513] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 09/17/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the association of resting heart rate with suicide in two large cohorts. METHOD The MJ cohort (Taiwan) included 532 932 adults from a health check-up programme (1994-2008). The HUNT cohort (Norway) included 74 977 adults in the Nord-Trøndelag County study (1984-1986), followed up to 2004. In both cohorts heart rate was measured at baseline, and suicide was ascertained through linkage to cause-of-death registers. Risk of suicide was estimated using Cox proportional hazards models. RESULTS There were 569 and 188 suicides (average follow-up period of 8.1 and 16.9 years) in the MJ and HUNT cohorts respectively. Sex- and age-adjusted hazard ratio for every 10 beat increase in heart rate per minute was 1.08 (95% Confidence Interval 1.00-1.16) and 1.24 (1.12-1.38) in the MJ and HUNT cohorts, respectively. In the MJ cohort this association was confined to individuals with a history of heart diseases vs. those without such a history (P for interaction = 0.008). In the HUNT cohort the association did not differ by history of heart diseases and was robust to adjustment for health-related life style, medication use, and symptoms of anxiety and depression. CONCLUSION Elevated resting heart rate may be a marker of increased suicide risk.
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Affiliation(s)
- S-S Chang
- Institute of Health Behaviors and Community Sciences, and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - J H Bjørngaard
- Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Forensic Department and Research Centre, Bröset St. Olav's University Hospital Trondheim, Trondheim, Norway
| | - M K Tsai
- China Medical University Hospital, Taichung, Taiwan.,Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan
| | - O Bjerkeset
- Faculty of Health Sciences, Nord-Trøndelag University College (HiNT), Levanger, Norway.,Institute of Neuromedicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - C P Wen
- China Medical University Hospital, Taichung, Taiwan.,Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan
| | - P S F Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong SAR, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - C K Tsao
- MJ Health Management Institution, Taipei, Taiwan
| | - D Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Abstract
OBJECTIVES Studies have highlighted the association between the degree of urbanicity and spatial disparities in suicide, but few have evaluated its changes across time. We explored the geospatial trends of suicide in South Korea from 1992 to 2012, and their relationship to the nation's evolving urbanicity. SETTING South Korea. PRIMARY OUTCOME MEASURES Age-sex-specific suicide rate. RESULTS Suicide rates increased in all regions of South Korea during the study period. Controlling the effects of age and sex, there was an overall inverse relationship between the degree of urbanicity and regional suicide rates. These associations were, however, attenuated across the periods, as there were smaller increases in suicide rates in mid-sized urban regions as compared to larger cities and to rural areas. Increases over time in the suicide rates among youth and working-age adults were greater in large urban centres and in rural regions. For elders, the increase was far greater in rural regions. CONCLUSIONS The association of urbanicity and the geospatial pattern of suicide in South Korea was a dynamic process and varied by age groups across the course of two decades. Internal migration and related social processes most likely contributed to these changes.
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Affiliation(s)
- Chee Hon Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
| | - Eric D Caine
- Injury Control Research Center for Suicide Prevention and Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA
- VA Center of Excellence for Suicide Prevention, Canandaigua, New York, USA
| | - Sungeun You
- Department of Psychology, Chungbuk National University, Republic of Korea
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong
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Chan CH, Caine ED, Chang SS, Lee WJ, Cha ES, Yip PSF. The impact of improving suicide death classification in South Korea: a comparison with Japan and Hong Kong. PLoS One 2015; 10:e0125730. [PMID: 25992879 PMCID: PMC4439106 DOI: 10.1371/journal.pone.0125730] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 03/23/2015] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION The suicide rate of South Korea has increased dramatically during the past decades, as opposed to steadily decreasing trends in Japan and Hong Kong. Although the recent increase of suicide in South Korea may be related to changing socioeconomic conditions and other contextual factors, it may also reflect, in part, a reduction of misidentified suicide cases due to improving classification of manner of death. METHOD We compared the annual proportional change of suicide, undetermined death, and accidental death from South Korea with those of Japan and Hong Kong from 1992 to 2011; a greater proportional change of the manner-of-death categories during the period is indicative of a relatively less stable registration and hence a greater potential for misclassification bias on reported suicide trends. Subgroup analyses stratifying the deaths by methods were also conducted. To estimate the impact, the age-standardized rates of these three death categories in each site were calculated. RESULTS We found that, during the 20-year observation period, the proportional change of suicide, undetermined death, and accidental death in South Korea was significantly greater than Japan and Hong Kong. Similar observations were made in subgroup analyses. While death rates of the three manners in Japan and Hong Kong generally moved in a parallel fashion, the increase of suicide in South Korea occurred concomitantly with a significant reduction of its accidental death rate. 43% of the increase in suicides could be attributed to the decrease in accidental deaths, while 57% of the increase could be due to fundamental causes. CONCLUSION Our data suggest that, during the mid-1990s and after, the increasing burden of suicide in South Korea initially was masked, in part, by misclassification. Thus, the later apparently rapid increase of suicides reflected steadily improving classification of manner of death, as well as a more fundamental increase in the suicide rate.
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Affiliation(s)
- Chee Hon Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong Special Administrative Region, China
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Eric D. Caine
- The Injury Control Research Center for Suicide Prevention, Department of Psychiatry, University of Rochester Medical Center, Rochester, United States of America
| | - Shu Sen Chang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong Special Administrative Region, China
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Institute of Health Policy and Management, and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Korea University, Seoul, South Korea
| | - Eun Shil Cha
- Department of Preventive Medicine, Korea University College of Medicine, Korea University, Seoul, South Korea
| | - Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong Special Administrative Region, China
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong Special Administrative Region, China
- * E-mail:
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Guan L, Hao B, Liu T, Cheng Q, Yip PSF, Zhu T. [A pilot study of differences in behavioral and linguistic characteristics between Sina suicide microblog users and Sina microblog users without suicide idea]. Zhonghua Liu Xing Bing Xue Za Zhi 2015; 36:421-425. [PMID: 26080626] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate how suicide microblog users in China "act" and "speak" differently from other microblog users without suicide idea. METHODS The suicide group consisted of 31 Chinese microblog users identified as suicide via online information provided by a Sina microblog user, and the control group consisted of 30 active microblog users without suicide idea screened by using suicide-related psychological scales. The differences in 10 microblog use behavioral characteristics and 88 linguistic characteristics between the suicide group and the control group were compared with normality test and rank sum test respectively. RESULTS In the behavioral characteristics, the suicide group used hyperlinks and "@" less frequently than the control group [0.04 (0.04) vs. 0.06 (0.04), P=0.029; 0.60 (0.27) vs. 0.69 (0.18), P=0.028], and was more self-focused [0.47 (0.25) vs. 0.30 (0.10), P=0.010]. In the linguistic characteristics, the suicide group showed less frequency in using measure word, work related word and apostrophe than the control group (P<0.05), and showed more frequency in using pronoun, personal pronoun, third person singular, non-specific pronoun, word expressing social experience, word expressing anxiety, word expressing exclusion, sexual word, religious word, second person singular, human being related word, negative emotion related word, anger related word, sadness or death related word (P<0.05). CONCLUSION Suicides seemed to interact less with others, showed more self-concern and more negative expressions, use more cognitively exclusive, death-related, religion-related words, and use less work-related words. The results of this study might be helpful for the research on suicide among netizen.
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Affiliation(s)
- Li Guan
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; University of Chinese Academy of Sciences
| | - Bibo Hao
- University of Chinese Academy of Sciences
| | - Tianli Liu
- Institute of Population Research, Peking University
| | - Qijin Cheng
- Hong Kong Jockey Club Center for Suicide Research and Prevention, the University of Hong Kong
| | - Paul Siu Fai Yip
- Hong Kong Jockey Club Center for Suicide Research and Prevention, the University of Hong Kong
| | - Tingshao Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China;
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Zhang H, Law FYW, Hu D, Fan S, Yip PSF. Profiles of higher earning wives in Hong Kong and the implications for marital satisfaction. J Sex Marital Ther 2014; 41:457-466. [PMID: 24836412 DOI: 10.1080/0092623x.2014.920446] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Higher earning wives are emerging as a global phenomenon; however, the profiles of higher earning wives and the implications for marital satisfaction remain unknown in Hong Kong. On the basis of a representative household survey of 689 Hong Kong Chinese couples in 2012, this study aimed to explore the profiles of higher earning wives in Hong Kong and examine the effect of wives' income advantage on the couples' marital satisfaction. Results indicated that higher earning wives were clustered into 2 groups. One group of higher earning wives was older, was better educated, held managerial and professional jobs, and lived in high-income families compared with lower earning wives. The other group of higher earning wives was not well educated, held nonprofessional jobs, and lived in low-income families. Higher earning wives reported similar marital satisfaction with lower earning wives as well as their husbands. However, higher earning wives with nonprofessional jobs and from low-income families reported lower life and marital satisfaction than did those with better socioeconomic status. The implications of these findings are discussed.
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Affiliation(s)
- Huiping Zhang
- a Department of Social Work , Renmin University of China , Beijing , China
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Yip PSF, So BK, Kawachi I, Zhang Y. A Markov chain model for studying suicide dynamics: an illustration of the Rose theorem. BMC Public Health 2014; 14:625. [PMID: 24948330 PMCID: PMC4082176 DOI: 10.1186/1471-2458-14-625] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Accepted: 06/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND High-risk strategies would only have a modest effect on suicide prevention within a population. It is best to incorporate both high-risk and population-based strategies to prevent suicide. This study aims to compare the effectiveness of suicide prevention between high-risk and population-based strategies. METHODS A Markov chain illness and death model is proposed to determine suicide dynamic in a population and examine its effectiveness for reducing the number of suicides by modifying certain parameters of the model. Assuming a population with replacement, the suicide risk of the population was estimated by determining the final state of the Markov model. RESULTS The model shows that targeting the whole population for suicide prevention is more effective than reducing risk in the high-risk tail of the distribution of psychological distress (i.e. the mentally ill). CONCLUSIONS The results of this model reinforce the essence of the Rose theorem that lowering the suicidal risk in the population at large may be more effective than reducing the high risk in a small population.
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Affiliation(s)
- Paul Siu Fai Yip
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong.
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Zhang Y, Yip PSF, Fu KW. Validation of the Chinese version of the Reynolds' Suicidal Ideation Questionnaire: psychometric properties and its short version. Health Qual Life Outcomes 2014; 12:33. [PMID: 24612650 PMCID: PMC3996563 DOI: 10.1186/1477-7525-12-33] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 03/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aims to validate the Chinese version of the Reynolds' Suicidal Ideation Questionnaire (SIQ) in a Chinese society and explore a convenient short version. METHODS A sample of 711 cases was derived from two territory-wide surveys of Hong Kong adolescents aged between 15 and 19 years old. RESULTS The SIQ and the Suicidal Ideation Questionnaire-Junior (SIQ-JR) demonstrated good reliability and concurrent validity among Hong Kong adolescents. However, the factor structure for both SIQ and SIQ-JR appeared to be unclear. A four-item short form of the SIQ-JR, namely, SIQ-JR-4, was proposed. CONCLUSION The SIQ-JR-4 is an ideal substitute of the SIQ/SIQ-JR for future quick assessment of suicidal ideation in Chinese young adolescents.
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Affiliation(s)
- Yi Zhang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong Special Administration Region, People's Republic of China.
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