Interactive association of maternal education and peer relationship with oppositional defiant disorder: an observational study.

BACKGROUND: The objectives of this research were to gain insights on the interactive effects, by measuring familial and peer-related risk factors in youths with oppositional defiant disorder (ODD). METHODS: Participants were college students recruited nationwide, with age between 18 and 25. Through the consensus of expert meetings, a set of questionnaires were used to evaluate the familial status, participant's peer group conditions, high-risk environment of illicit substance use, and oppositional symptoms. The logistic regression was performed to see the independent and interactive risk factors for ODD. RESULTS: A total of 981 subjects were enrolled. Six variables significantly associated with ODD at the multivariate logistic regression, including male, night division, poor academic performance, high risk environment, peer with illicit substance use and high maternal education level. High maternal education exerted independent protective effect on the development of ODD (adjusted odds ratio, aOR = 0.65, 95% CI = 0.44-0.99). Peer with illicit substance use was more likely to associate with ODD in the low maternal education group. The 2-way interactive effect of maternal education and peer with substance use on the development of ODD was OR = 4.96 (2.96, 8.31). CONCLUSION: The present study highlights the influence of maternal education level to ODD and its interaction with peer of illicit substance use. Our findings imply that the familial attachment and peer interaction are essential stages for the development of human behavior. TRIAL REGISTRATION: The research protocol was reviewed and approved by the ethical review committee of National Taiwan University Hospital (number 201505057RINC ) and registered at clinical trial systems at National Taiwan University. In addition, subjects' information was anonymous and de-identified prior to any analysis.

[Global Health Issues and Trends in Nursing Research].

Research is an indispensable element that shapes every profession and discipline. "Employ evidence-based research into practice" is one of the five core competences highlighted by the American Institute of Medicine (IOM) in 2001 that all healthcare professionals should possess. With the development of evidence-based medicine, "Nursing research competence" has gradually become a core competence that all nurses must have. In light of the major demographic changes and multicultural social revolution underway worldwide, nursing research trends must be adapted to meet new, global challenges rooted in changing environmental, populational, geographical, and ethnic conditions. This paper analyzed the Web of Science database using VOSviewer and inputting the names of schools and departments as key words in consideration of QS rankings among European, American, and Asia regions for the years 2014 - 2018. Analyses of keywords, themes, and countries of international cooperation were conducted on 6333 original nursing articles published in journals indexed on the Science Citation Index (SCI) and/or Social Science Citation Index (SSCI). The results indicate that the cooperation between scholars from Taiwan and scholars from the United States, the United Kingdom, and China is relatively common. With regard to both global and Asia-specific research study trends, the top-five key words used to describe nursing research papers were health, care, depression, prevalence, and quality of life. The differences between Europe and the United States and Taiwan were the "risk, intervention, experience, adolescent" and "risk and impact" depicted by visual analysis. In addition, this research examined the themes of academic nursing conferences announced online for 2020, and found that a majority highlighted "nursing and healthcare" as a major theme. In twenty-two Chinese nursing journals indexed on the Huayi Online Database (2017-2020), geriatric nursing, long-term care and improvement in nursing care quality were the most commonly used research topics. In general, the aims of nursing research are to enhance the professional image and status of global nurses and to achieve the goals of global health. To create a better nursing research environment in Taiwan, nurses should improve their research abilities and cultivate cultural nursing sensitivity with the goals of maximizing the quality and quantity of research and of strengthening international cooperation, with the ultimate aim of enhancing the health and well-being of all. The international visibility of nursing in Taiwan must be increased to improve our international profile.

Risk of suicide within 1 year of cancer diagnosis.

The association of the risk of suicide with cancer at different time points after a new cancer diagnosis is unclear. This study explored the suicide hazard at different time points after a first cancer diagnosis during the 1-year period before suicide. This case-crossover study included 2,907 suicide cases from 2002 to 2012 in Taiwan and compared the odds of suicide risk at different time points during one year after any cancer diagnosis with self-matched periods. The 13th month preceding the suicide date was used as the control period, and the hazard period was the duration from the 1st to 12th month in the conditional logistic regression for case-crossover comparisons. Among major groups of cancers, group of lip, oral cavity and pharynx cancers tended to have higher risk of suicide than other groups of cancers. The first month of cancer diagnosis was associated with the highest risk of suicide compared with the 13th month before suicide. The odds ratio (OR) of suicide were significantly in the first six months after cancer diagnosis but declined afterwards. For example, the adjusted OR was 3.47 [95% confidence interval (CI) = 2.60-4.62] in the first month and 1.53 (95% CI = 1.11-2.12) in the sixth month following cancer diagnosis. These findings provide clinicians with a vital reference period during which sufficient support and necessary referral to mental health support should be provided to reduce the risk of suicide among patients with newly diagnosed cancer morbidity.

Is Heart Failure Associated With Risk of Suicide?

BACKGROUND: The high prevalence of heart failure (HF) in developed countries imposes a substantial burden on health care resources. Depression is widely recognized as a risk factor associated with HF. This study examined the relationship between suicide and HF after controlling for depression and other comorbidities. METHODS AND RESULTS: The population comprised 52,749 adult patients who died from suicide from 2000 to 2012 and 210,996 living control subjects matched by age, sex, and residence area. Data were obtained from the Health and Welfare Data Science Center, Taiwan. Multivariable models were constructed to evaluate the relationship between HF and suicide. In the case and control groups 1624 (3.08%) and 4053 (1.92%) patients had HF, respectively, indicating that HF was associated with an increased risk of suicide (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.59-1.79). The risk of suicide was highest during the initial 6 months after HF (adjusted OR 7.04, 95% CI 5.37-9.22) and subsequently declined gradually. Among psychiatric disorders, mood disorders (adjusted OR 7.42, 95% CI 7.06-7.79) yielded the highest odds of suicide. CONCLUSIONS: The risk of suicide is higher for patients with HF than for healthy individuals without HF. This risk is particularly high during the first 6 months after HF diagnosis. This study provides strong evidence that depression is a negative prognostic factor for patients with HF and increases the risk of suicide. The results suggest that early screening and treatment for depression and suicide risk should be conducted for patients with HF.

Suicide and chronic kidney disease: a case-control study.

BACKGROUND: The association of chronic kidney disease (CKD) and dialysis with suicide is not well established. The objectives of this study were to assess the association of suicide with CKD and dialysis and investigate whether differences exist between dialysis modalities or the durations of dialysis. METHODS: Data were obtained from the Taiwan National Health Insurance Research Database. A total of 51 642 patients who died from suicide between 2000 and 2012 and 206 568 living control patients matched by age, gender and residency area were examined. Known risk factors included sociodemographic characteristics, physical comorbidities and psychiatric disorders, which were controlled for as covariates in the analysis. The crude odds ratios (ORs) and adjusted ORs (aORs) for various risk factors were obtained using conditional logistic regression. RESULTS: After potential confounders were controlled for, CKD was significantly associated with an increased risk of suicide [aOR = 1.25, 95% confidence interval (CI) = 1.17-1.34]. End-stage renal disease patients on haemodialysis (HD) had an increased risk of suicide compared with controls (aOR = 3.35, 95% CI = 3.02-3.72). Moreover, patients who initially underwent dialysis within 0-3 months had a significantly increased risk of suicide (aOR = 20.26, 95% CI = 15.99-25.67). CONCLUSIONS: CKD and HD are positively associated with suicide. Suicide is preventable; therefore, assessing mental and physical disorders is essential and recommended to all physicians, particularly those treating patients in the early phase of HD.

Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

BACKGROUND: In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. METHODS: We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). FINDINGS: Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. INTERPRETATION: Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. FUNDING: Bill & Melinda Gates Foundation.

A mechanistic study on urine retention in d-amphetamine addicts.

Chronic amphetamine intake leads to neurogenic bladder and chronic urinary retention. The mechanism underlying persistent urinary retention is unclear. The pelvic-urethral reflex (PUR) is essential for the urethra to develop sufficient resistance to maintain urine continence, an important function of the urinary system. Recent studies on PUR activities have indicated that repetitive/tetanic stimulation of the pelvic afferent fibers induces spinal reflex potentiation (SRP) in PUR activities, which further increases urinary retention. In this study, results showed that test stimulation (TS, 1/30 Hz) evoked a baseline reflex activity, while repetitive stimulation (RS, 1 Hz) induced reflex potentiation in the external urethral sphincter. Intrathecal d-amphetamine (AMPH, 30 µM) did not but higher AMPH concentration (100 µM) induced SRP in TS-induced reflex activity. H89 (10 µM, a protein kinase A inhibitor), but not chelerythrine chloride (CTC, 10 µM, a protein kinase C inhibitor), prevented the 100 µM AMPH-elicited SRP. At 30 µM, forskolin, an activator of adenylyl cyclase, elicited SRP. The co-administration of 10 µM forskolin and 30 µM AMPH induced SRP in TS-induced reflex activity. These results implied that the repetitive/tetanic stimulation of the pelvic afferent fibers could induce SRP in PUR activities, so that the urethra can produce sufficient resistance and played a significant role in urinary retention. Findings in this study demonstrated that amphetamine could induce bladder dysfunction by triggering protein kinase A activation, and provide a practical basis for the development of treatment for amphetamine-associated urinary retention.

A Chinese herbal medicine, jia-wei-xiao-yao-san, prevents dimethylnitrosamine-induced hepatic fibrosis in rats.

Jia-wei-xiao-yao-san (JWXYS) is a traditional Chinese herbal medicine that is widely used to treat neuropsychological disorders. Only a few of the hepatoprotective effects of JWXYS have been studied. The aim of this study was to investigate the hepatoprotective effects of JWXYS on dimethylnitrosamine- (DMN-) induced chronic hepatitis and hepatic fibrosis in rats and to clarify the mechanism through which JWXYS exerts these effects. After the rats were treated with DMN for 3 weeks, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) levels were significantly elevated, whereas the albumin level decreased. Although DMN was continually administered, after the 3 doses of JWXYS were orally administered, the SGOT and SGPT levels significantly decreased and the albumin level was significantly elevated. In addition, JWXYS treatment prevented liver fibrosis induced by DMN. JWXYS exhibited superoxide-dismutase-like activity and dose-dependently inhibited DMN-induced lipid peroxidation and xanthine oxidase activity in the liver of rats. Our findings suggest that JWXYS exerts antifibrotic effects against DMN-induced chronic hepatic injury. The possible mechanism is at least partially attributable to the ability of JWXYS to inhibit reactive-oxygen-species-induced membrane lipid peroxidation.

Metabolic syndrome and the risk of suicide: a community-based integrated screening samples cohort study.

OBJECTIVE: Metabolic syndrome (MetS) is reportedly associated with mental disorders that are known to increase the risk of suicide. However, it is not known whether this association is independent of other risk indicators of suicide. This study therefore investigated whether metabolic abnormalities increase the risk of suicide during a 10-year follow-up period. METHODS: This prospective study enrolled participants from a community-based integrated screening samples cohort in Taiwan. Of the 76,297 people recruited for this study, 12,094 had MetS at baseline. The independent variables were MetS and its components such as high blood pressure and high blood lipid levels. The outcome was death from suicide (n = 146). RESULTS: MetS was associated with an increased risk of suicide risk by 16% per MetS component (95% confidence interval [CI] = 1%-33%), adjusting for demographics, life-style factors, and clinical correlates. Of the five MetS components, elevated blood pressure was independently associated with suicide-related mortality (adjusted hazard ratio [aHR] = 1.49, 95% CI = 1.03-2.15). CONCLUSIONS: This analysis of community-based longitudinal data showed that MetS and its components, particularly elevated blood pressure, correlated positively with suicide risk after controlling other factors. Therefore, public mental health interventions targeting suicide reduction may need to specifically focus on individuals with hypertension and other components of the MetS.

Evaluation of Guided Respiration Mindfulness Therapy (GRMT) for Reducing Stress in Nurses.

Guided respiration mindfulness therapy (GRMT) is a clinical model of breathwork that has shown promise as a treatment for depression, anxiety, and stress. This study examined the effectiveness of GRMT as a holistically oriented intervention for reducing psychological distress in nurses. Sixty-two nurses were assigned to either five sessions of GRMT or 5 sessions of a mindfulness-based intervention (MBI) comparison condition which were conducted over 5 weeks. A no-treatment control was also included. Session-by-session change in depression, anxiety, and stress, along with change in mindfulness and self-compassion were assessed. Multilevel analysis showed GRMT resulted in statistically significant reductions in overall psychological distress, anxiety, and stress levels, as well as significant increases in mindfulness and self-compassion with large to very large effect sizes. On all measures, GRMT performed better than the comparison MBI intervention which showed no significant effect on stress levels. Results suggest that GRMT can provide nurses with an effective group intervention for reducing stress, and increasing mindfulness and self-compassion which are foundational elements of self-care for the holistic nurse.

Primary and booster vaccination in reducing severe clinical outcomes associated with Omicron Naïve infection.

BACKGROUND: Little is known about long-term effectiveness of COVID-19 vaccine in reducing severity and deaths associated with Omicron VOC not perturbed by prior infection and independent of oral anti-viral therapy and non-pharmaceutical (NPI). METHODS: A retrospective observational cohort study was applied to Taiwan community during the unprecedent large-scale outbreaks of Omicron BA.2 between April and August, 2022. Primary vaccination since March, 2021 and booster vaccination since January, 2022 were offered on population level. Oral Anti-viral therapy was also offered as of mid-May 2022. The population-based effectiveness of vaccination in reducing the risk of moderate and severe cases of and death from Omicron BA.2 with the consideration of NPI and oral anti-viral therapy were assessed by using Bayesian hierarchical models. RESULTS: The risks of three clinical outcomes associated with Omicron VOC infection were lowest for booster vaccination, followed by primary vaccination, and highest for incomplete vaccination with the consistent trends of being at increased risk for three outcomes from the young people aged 12 years or below until the elderly people aged 75 years or older with 7 age groups. Before the period using oral anti-viral therapy, complete primary vaccination with the duration more than 9 months before outbreaks conferred the statistically significant 47 % (23-64 %) reduction of death, 48 % (30-61 %) of severe disease, and 46 % (95 % CI: 37-54 %) of moderate disease after adjusting for 10-20 % independent effect of NPI. The benefits of booster vaccination within three months were further enhanced to 76 % (95 % CI: 67-86 %), 74 % (95 % CI: 67-80 %), and 61 % (95 % CI: 56-65 %) for three corresponding outcomes. The additional effectiveness of oral anti-viral therapy in reducing moderate disease was 13 % for the booster group and 5.8 % for primary vaccination. CONCLUSIONS: We corroborated population effectiveness of primary vaccination and its booster vaccination, independent of oral anti-viral therapy and NPI, in reducing severe clinical outcomes associated with Omicron BA.2 naïve infection population.

Critical care nurses' knowledge, attitudes and practices of oral care for patients with oral endotracheal intubation: a questionnaire survey.

AIM: This study investigated intensive care unit nurses' knowledge, attitudes and practices of oral care for intubated patients together with the associated factors of the same. BACKGROUND: Effective oral care improves patient comfort and prevents oral infection. Although oral care is a common requirement of nursing practice, providing intubated patients with oral care is a challenging task. DESIGN: A descriptive, cross-sectional design. METHODS: This study applied purposive sampling method at 12 adult intensive care units in one medical centre in northern Taiwan. Two hundred and five nurses were recruited. Data were collected by structured questionnaires which consisted of four sections: knowledge, attitudes and practices of oral care for intubated patients and demographic information for the nurses. RESULTS: The average percentages indicating the intensive care unit nurses' oral care knowledge, attitudes and practices were 58·8, 79·4 and 49·8%, respectively. Higher scores on oral care knowledge were associated with nurses performing oral care more frequently. Nurses learning about oral care from reading related studies and materials of their own accord may increase the frequency with which they provide oral care to intubated patients. The nurses' age and the type of intensive care unit they work in were significant factors related to the frequency of performing practices related to oral care. CONCLUSION: Findings show that nurses who have more resources for learning about oral care have greater knowledge about it and provide oral care to intubated patients more frequently. RELEVANCE TO CLINICAL PRACTICE: Encouraging nurses to learn more about oral care using diverse educational resources will enhance their knowledge and improve their practice. Nursing administrators are encouraged to establish policies and procedures for oral care of intubated patients based on the type of patients cared for, in addition to holding in-service training, with a view to enhancing the quality of oral care for critically ill patients.

Screening illicit substance use in college students: The Chinese version of the Drug Abuse Screening Test.

BACKGROUND: This study investigated the applicability of the Chinese versions of Drug Abuse Screening Test (DAST) to detect illicit substance use in college students. METHODS: The data arising from a campus prevention program, Screening for Illicit Substance Use in College (SISUC), were utilized to explore the psychometrics of 26 items (DAST-26) and 10 items (DAST-10) versions of DAST in college students (CS group). A group of youth with illicit substance use were enrolled as the Illicit Substance Use group (IS group). A set of self-report questionnaires, including the Chinese version of DAST, were administered. RESULTS: A total of 1214 participants were recruited as the CS group and 208 as the IS group. The Cronbach's alpha of DAST-26 was 0.74 in CS and 0.90 in IS; while 0.59 in CS and 0.78 in IS for the DAST-10. At a cut-off of 4 for DAST-26, the sensitivity was 87 % and specificity 97 %. As to DAST-10, a cut-off of 2 produced the sensitivity of 86 % and specificity of 96 %. The area under the curve was 0.943 for DAST-26 and 0.940 for DAST-10. The confirmatory factor analyses found a single-factor solution for the DAST-26 and DAST-10. CONCLUSIONS: With comparison to the DAST-26, the shorter version, DAST-10, may offer promise for detecting illicit substance use in college students.

Development of a Chinese version of the Suicide Intent Scale.

This study established the psychometric properties of the Chinese version of the Suicide Intent Scale (SIS) in a clinic- and community-based sample of 36 patients and 592 respondents, respectively. Results showed that the Chinese SIS demonstrated good inter-rater and test-retest reliability. Factor analysis generated three factors (Precautions, Planning, and Seriousness) explaining 92.9% of the total variance with high internal consistency. It was moderately correlated with depressive symptoms. Results suggest that the Chinese SIS is a reliable and valid instrument for use in assessing the extent of suicidal intention among subjects with deliberate self-harm in ethnic Chinese populations.

[Oral care practice and procedures in intubated patients: an observational study].

BACKGROUND: Effective oral care improves patient comfort and prevents oral infection. While common in general nursing practice, administering oral care to intubated patients is particularly challenging. PURPOSE: This study investigated practices and factors associated with oral care of intubated patients in intensive care units (ICUs). METHODS: This study used a cross-sectional design and recruited nurses using purposive sampling. Data were collected with a structured observational checklist between January and April 2008 at a medical center in northern Taiwan. Observational data reflected oral care procedures performed by thirty-one ICU nurses on intubated patients in six ICUs. RESULTS: Cotton and foam swabs were found to be the main oral care cleaning instruments used with intubated patients, with dilute mouthwash the primary cleaning solution. Nearly three-quarters (72.4%) of participants were found to employ proper oral care procedures. Participants selected different cleaning equipment, cleaning solutions, cleaning solution usage methods and oral endotracheal tube securement methods based on differing conditions. ICU nurse age was positively associated oral care completeness. The level of oral care completeness achieved by participants in medical ICUs was significantly higher those assigned to surgical ICUs. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Study findings showed that ICU nurses did not follow procedures and steps recommended by current evidence-based practice (e.g., brushing the teeth and gums; positioning patients in a side or semi- / high-fowlers position when providing oral care to intubated patients). ICUs must establish policies and procedures for oral care of intubated patients that reflect patient characteristics. Furthermore, ICUs should provide oral care related on-the-job training and education in order to improve the quality of oral care administered to critical care patients.

Diseases, Injuries, and Risk Factors in Child and Adolescent Health, 1990 to 2017: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study.

Importance: Understanding causes and correlates of health loss among children and adolescents can identify areas of success, stagnation, and emerging threats and thereby facilitate effective improvement strategies. Objective: To estimate mortality and morbidity in children and adolescents from 1990 to 2017 by age and sex in 195 countries and territories. Design, Setting, and Participants: This study examined levels, trends, and spatiotemporal patterns of cause-specific mortality and nonfatal health outcomes using standardized approaches to data processing and statistical analysis. It also describes epidemiologic transitions by evaluating historical associations between disease indicators and the Socio-Demographic Index (SDI), a composite indicator of income, educational attainment, and fertility. Data collected from 1990 to 2017 on children and adolescents from birth through 19 years of age in 195 countries and territories were assessed. Data analysis occurred from January 2018 to August 2018. Exposures: Being under the age of 20 years between 1990 and 2017. Main Outcomes and Measures: Death and disability. All-cause and cause-specific deaths, disability-adjusted life years, years of life lost, and years of life lived with disability. Results: Child and adolescent deaths decreased 51.7% from 13.77 million (95% uncertainty interval [UI], 13.60-13.93 million) in 1990 to 6.64 million (95% UI, 6.44-6.87 million) in 2017, but in 2017, aggregate disability increased 4.7% to a total of 145 million (95% UI, 107-190 million) years lived with disability globally. Progress was uneven, and inequity increased, with low-SDI and low-middle-SDI locations experiencing 82.2% (95% UI, 81.6%-82.9%) of deaths, up from 70.9% (95% UI, 70.4%-71.4%) in 1990. The leading disaggregated causes of disability-adjusted life years in 2017 in the low-SDI quintile were neonatal disorders, lower respiratory infections, diarrhea, malaria, and congenital birth defects, whereas neonatal disorders, congenital birth defects, headache, dermatitis, and anxiety were highest-ranked in the high-SDI quintile. Conclusions and Relevance: Mortality reductions over this 27-year period mean that children are more likely than ever to reach their 20th birthdays. The concomitant expansion of nonfatal health loss and epidemiological transition in children and adolescents, especially in low-SDI and middle-SDI countries, has the potential to increase already overburdened health systems, will affect the human capital potential of societies, and may influence the trajectory of socioeconomic development. Continued monitoring of child and adolescent health loss is crucial to sustain the progress of the past 27 years.

The influence of media reporting of a celebrity suicide on suicidal behavior in patients with a history of depressive disorder.

BACKGROUND: Few studies have directly assessed the impact of a specific media report in vulnerable people. This study investigates possible influences of media reporting of a celebrity suicide on subsequent suicidal behaviors and associated risk factors among depressive patients. METHODS: Depressive patients (N=461) were assessed through a structured interview soon after extensive media reporting of a celebrity suicide. RESULTS: Among 438 depressive patients exposed to the media report, 38.8% reported an influence on subsequent suicidal behaviors, including 24 (5.5%) with a suicide attempt. The risk of such influence was highest among patients in a severe depressive state just prior to the media report (adjusted OR 7.81, 95% CI 3.28-18.59). Such influence on a subsequent suicide attempt was highest in patients with a most recent suicide attempt within one month prior to the media reports (adjusted hazard ratio 11.91, 95% CI 3.76-37.72). LIMITATIONS: Our finding of the significant media influence may reflect adverse thoughts among more suicidal and depressed individuals. The possible influence of other factors on the findings cannot be ruled out. CONCLUSIONS: This study has provided more convincing evidence suggesting negative influences of media reporting of a celebrity suicide on subsequent suicidal behaviors among depressive patients. Particular attention in terms of potential negative media influences should be paid to patients who are younger and currently depressed and have made a recent suicide attempt.

Comorbid diseases as risk factors for incident posttraumatic stress disorder (PTSD) in a large community cohort (KCIS no.PSY4).

Nature disasters and terrorist attacks have occurred globally in recent years. Posttraumatic stress disorder (PTSD) has gained increasing attention, but its incidence and comorbidities in the general population are different from those inside the disaster areas. The present study estimated incident PTSD and comorbid diseases for over a decade in a cohort from a community-based integrated screening program. Factors associated with the incidence of PTSD were analyzed using Cox regression models. PTSD incidence was estimated as 81 per 105 person-years. Incidence was higher in females than in males and one-year increments in age lowered the risk for PTSD by 3%. Adjusting for other factors, cardiovascular heart disease (adjusted hazard ratio (aHR) = 1.45, 95% confidence interval (CI): 1.03-2.04), bipolar disorder (aHR = 1.86, 95% CI: 1.07-3.24) and major depressive disorder (aHR = 7.03, 95% CI: 5.02-9.85) all significantly increased 45%, 86% and 603%, respectively, the risk of developing PTSD. The low rate of people with incident PTSD receiving treatment in this community health screening population implies there is room for improvement in terms of early detection and intervention. Clinical preventive efforts may be made for patients seeking general medical help, especially those with cardiovascular disorders or mood disorders.

Factors influencing attempted and completed suicide in postnatal women: A population-based study in Taiwan.

The aims of study were to investigate risk factors associated with attempted and completed suicide. This nested case-control study was conducted using the medical and death data of nearly all pregnant women for the period 2002-2012 in Taiwan. A total of 139 cases of attempted suicide and 95 cases of completed suicide were identified; for each case, 10 controls were randomly selected and matched to the cases according to age and year of delivery. A conditional logistic regression model was used. The mean attempted and completed suicide rates were 9.91 and 6.86 per 100,000 women with live births, respectively. Never having married and postpartum depression also increased the risk of attempted suicide (OR = 2.06; 95% CI = 1.09-3.88 and OR = 2.51; 95% CI = 1.10-5.75, respectively) and completed suicide (OR = 20.27; 95% CI = 8.99-45.73 and OR = 21.72; 95% CI = 8.08-58.37, respectively). Other factors for attempted suicide included being widowed or divorced, and having a caesarean delivery or suicide history. Other factors for completed suicide included lower education level, low infant birth weight, and diagnosis of anxiety or mood disorder. These results suggest that people should appropriately assess potential risk factors and provide assistance for postnatal women to reduce the occurrence of suicide events.

GADL1 variant and medication adherence in predicting response to lithium maintenance treatment in bipolar I disorder.

BACKGROUND: Genetic variants and medication adherence have been identified to be the main factors contributing to lithium treatment response in bipolar disorders. AIMS: To simultaneously examine effects of variant glutamate decarboxylase-like protein 1 (GADL1) and medication adherence on response to lithium maintenance treatment in Han Chinese patients with bipolar I (BPI) disorder. METHOD: Frequencies of manic and depressive episodes between carriers and non-carriers of the effective GADL1 rs17026688 T allele during the cumulative periods of off-lithium, poor adherence to lithium treatment and good adherence to lithium treatment were compared in Han Chinese patients with BPI disorder (n=215). RESULTS: GADL1 rs17026688 T carriers had significantly lower frequencies of recurrent affective episodes than non-T carriers during the cumulative period of good adherence, but not during those of poor adherence. CONCLUSIONS: GADL1 rs17026688 and medication adherence jointly predict response to lithium maintenance treatment in Han Chinese BPI patients. DECLARATION OF INTEREST: None. COPYRIGHT AND USAGE: © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.