Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 44.161
Filter
1.
Article in English | MEDLINE | ID: mdl-35524717

ABSTRACT

OBJECTIVES: This study aimed at investigating gender differences in the relationship between sociodemographic factors and suicide mortality, as well as in the method used for suicide and the presence of comorbidities in an older population in Italy. METHODS/DESIGN: We conducted a historical cohort study based on individual record linkage across the 15th Italian Population Census, the Italian Population Register, and the National Register of Causes of Death. Suicides among people aged 75 years or older from 2012 to 2017 were analyzed. Crude mortality rates were computed, and cause-specific mortality rate ratios were estimated using negative binomial regression models. Chi-square tests were used to evaluate significant gender differences in suicide methods and comorbidities associated with suicide. RESULTS: The study included 9,686,698 individuals (41% men, 59% women). Compared to living alone, living with children or partners reduced suicide mortality, especially among men. Having high or medium educational levels was associated with lower mortality than low educational levels among men. Foreign citizens had lower mortality among men, but not among women. Living in urban areas was associated with lower suicide rates in men and higher rates in women. Methods of suicide significantly differed by gender: leading methods were hanging, strangulation, and suffocation in men, and falling from height in women. Mental comorbidity was significantly more frequent among women, especially at ages 75-84 years. CONCLUSIONS: We believe that our findings might help to promote public health strategies taking gender differences in old age into account to improve social support and quality of life of older men and women.


Subject(s)
Suicide , Aged , Cohort Studies , Comorbidity , Female , Humans , Italy/epidemiology , Male , Quality of Life , Risk Factors , Sex Factors
3.
J Psychiatr Pract ; 28(3): 184-192, 2022 May 01.
Article in English | MEDLINE | ID: mdl-35511094

ABSTRACT

INTRODUCTION: The loss of a patient to suicide has an enormous impact on clinicians, but few studies have examined its effects. METHOD: In this retrospective study, we compared clinicians who have and have not experienced a patient suicide using a survey of 2157 outpatient clinicians from 169 New York clinics to determine differences in their suicide prevention knowledge, practices, training, and self-efficacy. RESULTS: Approximately 25% of the clinician respondents lost patients to suicide; psychiatrists, nurses/nurse practitioners, and those with more years of experience were disproportionately affected. After controlling for these demographic/professional differences, clinicians who had experienced patient suicide reported feeling that they had insufficient training, despite actually having more suicide prevention training, greater knowledge of suicide prevention practices, and feeling more comfortable working with suicidal patients than clinicians who had not lost a patient to suicide. There were no differences in self-efficacy or utilization of evidence-based clinical practices. CONCLUSIONS: Controlling for demographic/professional differences, clinicians who experienced a patient suicide had more training, knowledge, and felt more comfortable working with suicidal patients. It is critical that sufficient training be available to clinicians, not only to reduce patient deaths, but also to help clinicians increase their comfort, knowledge, skill, and ability to support those bereaved by suicide loss.


Subject(s)
Mental Health , Suicide , Humans , Professional Practice , Retrospective Studies , Suicidal Ideation , Suicide/prevention & control , Suicide/psychology
4.
BMJ Open ; 12(5): e058196, 2022 May 09.
Article in English | MEDLINE | ID: mdl-35534056

ABSTRACT

OBJECTIVE: In 2016, Arizona enacted SB 1487 to nullify Tucson's ordinance permitting the municipality to destroy confiscated and forfeited firearms and instead require the firearms to be resold to the public through an auctioneer. Our objective was to examine whether firearm suicide rates increased in Pima County (greater Tucson area) relative to other Arizona counties following the enactment of Arizona's 2016 pre-emption law. DESIGN: An observational study of a natural policy experiment. We used a difference-in-differences approach to estimate the effects of Arizona enacting SB 1487 on firearm suicide rates in Pima County. Our statistical analyses adjusted for county-level differences in population demographics (age, gender and race) and unemployment rates, as well as a proxy for firearm availability and mental health professional shortage area status. SETTING: 9 Arizona counties from 2014 to 2019. PARTICIPANTS: A policy group was constructed using Pima County (Tucson area) observations. A comparison group was created using data from eight other Arizona counties. 54 county-year observations were analysed. INTERVENTION: SB 1487, which pre-empted Tucson law and allowed firearms that were seized/surrendered to law enforcement to be recirculated instead of destroyed. OUTCOMES AND MEASURES: Annual rates of firearm and non-firearm suicides per 100 000 persons extracted from the Centers for Disease Control and Prevention WONDER system. RESULTS: Over the study period, comparison group counties had an average of 14.87 firearm suicides per 100 000 persons per year, compared with 11.56 firearm suicides per 100 000 persons per year in Pima County. A 1.13 increase in Pima County's firearm suicides per 100 000 persons coincided with the enactment of Arizona's 2016 pre-emption law, relative to comparison group counties over the same period. CONCLUSIONS: SB 1487 was associated with higher firearm suicide rates in Pima County relative to other areas not targeted by the law, assuming fewer firearms were destroyed and more firearms re-entered the greater Tucson area through 2019.


Subject(s)
Firearms , Suicide , Arizona/epidemiology , Homicide , Humans , Policy , Potassium Iodide , Suicide/prevention & control , United States
5.
Tijdschr Psychiatr ; 64(4): 214-219, 2022.
Article in Dutch | MEDLINE | ID: mdl-35506974

ABSTRACT

BACKGROUND: A psychological autopsy study (Mérelle e.a. 2020) demonstrates a subgroup of female adolescents with chronic suicidal behavior and severe internalizing problems. AIM: To describe characteristics of the suicidal process and the challenges experienced in providing mental health care for this subgroup. METHOD: A case description and review of literature. RESULTS: The persistent suicidal threat and the following despair of the patient and its parents are forcing care providers into an impasse: the primary focus of treatment is to guarantee the patient's safety, whereby the treatment of underlying problems is underexposed. Based on expert knowledge we make recommendations including autonomy-promoting treatment policy, treating suicidality as a transdiagnostic phenomenon, creating a multidisciplinary network of care providers and making chronic suicidality tolerable for care providers. CONCLUSION: We propose preliminary practical recommendations in our quest for optimal mental health care for chronic suicidal adolescents.


Subject(s)
Suicidal Ideation , Suicide , Adolescent , Female , Humans , Parents , Patient Care Planning , Suicide/prevention & control
6.
Epidemiol Psychiatr Sci ; 31: e32, 2022 May 06.
Article in English | MEDLINE | ID: mdl-35514090

ABSTRACT

AIMS: People diagnosed with a severe mental illness (SMI) are at elevated risk of dying prematurely compared to the general population. We aimed to understand the additional risk among people with SMI after discharge from inpatient psychiatric care, when many patients experience an acute phase of their illness. METHODS: In the Clinical Practice Research Datalink (CPRD) GOLD and Aurum datasets, adults aged 18 years and older who were discharged from psychiatric inpatient care in England between 2001 and 2018 with primary diagnoses of SMI (schizophrenia, bipolar disorder, other psychoses) were matched by age and gender with up to five individuals with SMI and without recent hospital stays. Using survival analysis approaches, cumulative incidence and adjusted hazard ratios were estimated for all-cause mortality, external and natural causes of death, and suicide. All analyses were stratified by younger, middle and older ages and also by gender. RESULTS: In the year after their discharge, the risk of dying by all causes examined was higher than among individuals with SMI who had not received inpatient psychiatric care recently. Suicide risk was 11.6 times (95% CI 6.4-20.9) higher in the first 3 months and remained greater at 2-5 years after discharge (HR 2.3, 1.7-3.2). This risk elevation remained after adjustment for self-harm in the 6 months prior to the discharge date. The relative risk of dying by natural causes was raised in the first 3 months (HR 1.6, 1.3-1.9), with no evidence of elevation during the second year following discharge. CONCLUSIONS: There is an additional risk of death by suicide and natural causes for people with SMI who have been recently discharged from inpatient care over and above the general risk among people with the same diagnosis who have not recently been treated as an inpatient. This mortality gap shows the importance of continued focus, following discharge, on individuals who require inpatient care.


Subject(s)
Mental Disorders , Suicide , Adult , Cohort Studies , Humans , Inpatients , Mental Disorders/epidemiology , Mental Disorders/psychology , Mental Disorders/therapy , Patient Discharge , Suicide/psychology
11.
BMC Public Health ; 22(1): 882, 2022 05 04.
Article in English | MEDLINE | ID: mdl-35509027

ABSTRACT

BACKGROUND: This study examines the 20-year trend of suicide in 46 Muslim-majority countries throughout the world and compares their suicide rates and trends with the global average. Ecological-level associations between the proportion of the Muslim population, the age-standardized suicide rates, male-to-female suicide rate ratio, and the Human Development Index (HDI) in 2019 were examined. METHODS: Age-standardized suicide rates were extracted from the WHO Global Health Estimates database for the period between 2000 and 2019. The rates in each country were compared with the age-standardized global average during the past 20 years. The countries were further grouped according to their regions/sub-regions to calculate the regional and sub-regional weighted age-standardized suicide rates involving Muslim-majority countries. Correlation analyses were conducted between the proportion of Muslims, age-standardized suicide rate, male: female suicide rate ratio, and the HDI in all countries. Joinpoint regression was used to analyze the age-standardized suicide rates in 2000-2019. RESULTS: The 46 countries retained for analysis included an estimated 1.39 billion Muslims from a total worldwide Muslim population of 1.57 billion. Of these countries, eleven (23.9%) had an age-standardized suicide rate above the global average in 2019. In terms of regional/sub-regional suicide rates, Muslim-majority countries in the Sub-Saharan region recorded the highest weighted average age-standardized suicide rate of 10.02/100,000 population, and Southeastern Asia recorded the lowest rate (2.58/100,000 population). There were significant correlations between the Muslim population proportion and male-to-female rate ratios (r=-0.324, p=0.028), HDI index and age-standardized suicide rates (r=-0.506, p<0.001), and HDI index and male-to-female rate ratios (r=0.503, p<0.001) in 2019. Joinpoint analysis revealed that seven Muslim-majority countries (15.2%) recorded an increase in the average annual percentage change regarding age-standardized suicide rates during 2000-2019. CONCLUSIONS: Most Muslim-majority countries had lower age-standardized suicide rates than the global average, which might reflect religious belief and practice or due to Muslim laws in their judicial and social structure which may lead to underreporting. This finding needs further in-depth country and region-specific study with regard to its implication for public policy.


Subject(s)
Islam , Suicide , Adult , Africa, Northern , Female , Global Health , Humans , Male , Young Adult
12.
J Psychiatry Neurosci ; 47(3): E162-E175, 2022.
Article in English | MEDLINE | ID: mdl-35508327

ABSTRACT

BACKGROUND: Transient receptor potential ankyrin 1 (TRPA1), a cation channel, is expressed predominantly in primary sensory neurons, but its central distribution and role in mood control are not well understood. We investigated whether TRPA1 is expressed in the urocortin 1 (UCN1)-immunoreactive centrally projecting Edinger-Westphal nucleus (EWcp), and we hypothesized that chronic variable mild stress (CVMS) would reduce its expression in mice. We anticipated that TRPA1 mRNA would be present in the human EWcp, and that it would be downregulated in people who died by suicide. METHODS: We exposed Trpa1 knockout and wild-type mice to CVMS or no-stress control conditions. We then performed behavioural tests for depression and anxiety, and we evaluated physical and endocrinological parameters of stress. We assessed EWcp Trpa1 and Ucn1 mRNA expression, as well as UCN1 peptide content, using RNA-scope in situ hybridization and immunofluorescence. We tested human EWcp samples for TRPA1 using reverse transcription polymerase chain reaction. RESULTS: Trpa1 mRNA was colocalized with EWcp/UCN1 neurons. Non-stressed Trpa1 knockout mice expressed higher levels of Ucn1 mRNA, had less body weight gain and showed greater immobility in the forced swim test than wild-type mice. CVMS downregulated EWcp/Trpa1 expression and increased immobility in the forced swim test only in wild-type mice. We confirmed that TRPA1 mRNA expression was downregulated in the human EWcp in people who died by suicide. LIMITATIONS: Developmental compensations and the global lack of TRPA1 may have influenced our findings. Because experimental data came from male brains only, we have no evidence for whether findings would be similar in female brains. Because a TRPA1-specific antibody is lacking, we have provided mRNA data only. Limited access to high-quality human tissues restricted sample size. CONCLUSION: TRPA1 in EWcp/UCN1 neurons might contribute to the regulation of depression-like behaviour and stress adaptation response in mice. In humans, TRPA1 might contribute to mood control via EWcp/UCN1 neurons.


Subject(s)
Edinger-Westphal Nucleus , Suicide , Animals , Edinger-Westphal Nucleus/metabolism , Female , Humans , Ion Channels/metabolism , Male , Mice , Mice, Knockout , Neurons/metabolism , RNA, Messenger/metabolism , TRPA1 Cation Channel/genetics , TRPA1 Cation Channel/metabolism , Urocortins/metabolism
13.
Pediatr Int ; 64(1): e15130, 2022 Jan.
Article in English | MEDLINE | ID: mdl-35510727

ABSTRACT

BACKGROUND: We aimed to examine suicide probability, factors affecting suicide, and personality traits of children and adolescents diagnosed with epilepsy, and to compare their results with those of children without epilepsy. METHODS: Fifty-six children diagnosed with epilepsy and 56 control children, aged 11-16 years, were evaluated by using the Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria, the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version, the Child Depression Inventory, the Suicide Probability Scale (SPS), and the Personality Inventory for DSM-5 - Brief Form - Children (PID-5-BF) scales. Factors predicting suicide risk in children with epilepsy were analyzed. RESULTS: The mean age, SPS total score, and hopelessness subscale score, PID-5-BF total score as well as disinhibition and psychoticism subscale scores of the epilepsy group were significantly higher than those of the control group (P < 0.05). There was no significant difference between the groups in terms of the Child Depression Inventory, and other subscales of the Suicide Probability Scales and PID-5-BF scales. The SPS total score was higher in patients with comorbid psychiatric diseases, those using psychiatric drugs, and girls (P < 0.05). An ANCOVA analysis indicated that the most important factor that predicted the probability of suicide and its subscale scores was the level of depression, and the presence of epilepsy was not predictive. CONCLUSIONS: We found a high probability of suicide and personality pathology in children with epilepsy but the main predictor of suicide probability was the level of depression, not the presence of epilepsy.


Subject(s)
Epilepsy , Suicide , Adolescent , Child , Diagnostic and Statistical Manual of Mental Disorders , Epilepsy/diagnosis , Epilepsy/epidemiology , Female , Humans , Personality Disorders/diagnosis , Personality Disorders/psychology , Probability
14.
MedEdPORTAL ; 18: 11241, 2022.
Article in English | MEDLINE | ID: mdl-35518385

ABSTRACT

Introduction: An estimated 11% of medical students experience suicidal ideation during medical school. Many medical schools teach students how to intervene on behalf of patients experiencing suicidal ideation, but no curriculum in MedEdPORTAL teaches students how to intervene on behalf of peers. Methods: The authors designed, implemented, and evaluated a 2-hour workshop to equip medical students with skills and resources to intervene on behalf of a peer in crisis. This workshop comprised a peer-led didactic session and small-group sessions with role-plays and a guided debrief. The resource included a slide deck for the didactic session, a facilitator guide for the small-group session, a student handout with role-plays and self-evaluation questions, and the pre-/postsurvey. Results: This workshop was conducted with cohorts of first- and second-year medical students (n = 273) in October and November 2019. Pre-/postsurveys showed the greatest improvements in suicide prevention knowledge (self-rated) and the confidence in and likelihood of asking peers about suicide. Discussion: Student feedback indicated that the most valuable parts of the workshop were the peer-led nature of the didactic session, the perspective of a peer's lived experience, and the role-plays. Opportunities for improvement included the scheduling of the session, the potentially triggering nature of the role-play exercises, and the importance of enabling students to opt out discreetly. A version of this workshop is now a permanent part of the first-year curriculum at our institution.


Subject(s)
Students, Medical , Suicide , Counseling , Curriculum , Humans , Peer Group , Suicide/prevention & control
15.
Trends Psychiatry Psychother ; 44: e20210202, 2022 May 03.
Article in English | MEDLINE | ID: mdl-35502993

ABSTRACT

INTRODUCTION: Suicide is the cause of death of almost 800 thousand people worldwide every year. In Brazil, Rio Grande do Sul is one of the states with the highest suicide rates. This study aimed to assess whether there is a significant monthly time pattern of suicide in Rio Grande do Sul, by gender and age ranges, and whether suicide characteristics in the state are coherent with findings from previous studies. METHODS: All data were collected from official secondary sources maintained by the national Brazilian and Rio Grande do Sul governments, covering a period from 2015 to 2019. Data included suicide deaths and population, divided by gender and age range. Sum totals, frequencies, odds ratios, and time series analyses were performed. RESULTS: From 2015 to 2019, 6,287 people committed suicide in Rio Grande do Sul. Most of them were men and the most prevalent age band was from 50 to 59 years old. Men had higher suicide rates then women in all age ranges (p < 0.001) and in all months of the year, with an approximately 4-fold higher risk of committing suicide when compared to women. Men had a trending peak of suicide in January and December (p < 0.001), whereas women's suicide rates peaked in March and December (p = 0.001). CONCLUSION: There are monthly time trends and seasonal patterns of suicide rates in Rio Grande do Sul, varying by gender and age range. Gender differences occurred mainly in the first three months of the year, and the age pattern was more evident among individuals aged 60 years or older.


Subject(s)
Suicide , Brazil/epidemiology , Female , Humans , Infant, Newborn , Male , Middle Aged , Research Design , Time Factors
16.
N C Med J ; 83(3): 182-188, 2022.
Article in English | MEDLINE | ID: mdl-35504715

ABSTRACT

Transgender youth face health disparities in suicidality, which have been exacerbated by the COVID-19 pandemic. Health care providers should advocate for upstream interventions to reduce suicide disparities, including Medicaid expansion, family acceptance therapy, improved access to name and gender marker changes, continuation of telehealth, and creation of trauma-informed schools.


Subject(s)
COVID-19 , Suicide , Transgender Persons , Adolescent , COVID-19/epidemiology , Humans , Pandemics , Suicidal Ideation , Suicide/prevention & control , United States
17.
Epidemiology ; 33(3): 386-394, 2022 May 01.
Article in English | MEDLINE | ID: mdl-35383646

ABSTRACT

BACKGROUND: Recent increases in national rates of suicide and fatal overdose have been linked to a deterioration of economic and social stability. The American auto industry experienced comparable pressures beginning in the 1980s with the emergence of a competitive global market. METHODS: Using the United Autoworkers-General Motors (GM) cohort as a case study, we examine the impact of employment loss on these self-injury mortality events. For 29,538 autoworkers employed on or after 1 January 1970, we apply incremental propensity score interventions, a novel causal inference approach, to examine how proportional shifts in the odds of leaving active GM employment affect the cumulative incidence of self-injury mortality. RESULTS: Cumulative incidence of self-injury mortality was 0.87% (255 cases) at the observed odds of leaving active GM employment (δ = 1) over a 45-year period. A 10% decrease in the odds of leaving active GM employment (δ = 0.9) results in an estimated 8% drop in self-injury mortality (234 cases) while a 10% increase (δ = 1.1) results in a 19% increase in self-injury mortality (303 cases). CONCLUSIONS: These results are consistent with the hypothesis that leaving active employment at GM increases the risk of death due to suicide or drug overdose.


Subject(s)
Self-Injurious Behavior , Suicide , Cohort Studies , Humans , Incidence , Industry , United States/epidemiology
18.
J Clin Psychiatry ; 83(3)2022 Apr 06.
Article in English | MEDLINE | ID: mdl-35390233

ABSTRACT

Background: Depression, anxiety, well-being, and suicidality are highly associated during adolescence and greatly predict mental health outcomes during adulthood. This study explored relationships between these variables among students from Mexico City.Methods: This representative cross-sectional study was carried out in education centers in Mexico City during the 2019-2020 academic year. Using a smartphone app, we implemented validated questionnaires for depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), well-being (World Health Organization 5 Well-Being Index), and risk of suicide (Columbia-Suicide Severity Rating Scale). Partial least squares structural equation modeling was performed for the entire sample and after stratifying by gender.Results: Out of 3,042 students, 1,686 were females; mean age of the sample was 17.3 years. Compared to males, females had higher levels of anxiety, depressive symptoms, and suicidal ideation and lower levels of self-perceived well-being. Structural equation models indicated that depression was the main predictor of the rest of the outcomes in the overall sample. The role of anxiety was heterogeneous across genders and not clearly correlated to suicidal behavior or well-being.Conclusions: Large-scale mental health screening using an online tool proved feasible, with high response rates. Depression was the most important factor influencing anxiety, suicidal behavior, and well-being in Mexican high school students. The roles of depression and anxiety were heterogeneous across genders.Trial Registration: ClinicalTrials.gov Identifier: NCT04067076.


Subject(s)
Suicidal Ideation , Suicide , Adolescent , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , Anxiety Disorders , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Depression/psychology , Female , Humans , Male , Mental Health , Mexico , Smartphone , Students/psychology , Suicide/psychology , Young Adult
19.
Tidsskr Nor Laegeforen ; 142(6)2022 04 05.
Article in English, Norwegian | MEDLINE | ID: mdl-35383440

ABSTRACT

A young woman with a history of several serious intoxications was admitted to the Emergency Department with another suspected life-threatening intoxication. A rare phenomenon would prove to be life-saving.


Subject(s)
Suicidal Ideation , Suicide , Adolescent , Female , Humans , Suicide, Attempted , Tablets
20.
JAMA Netw Open ; 5(4): e226025, 2022 Apr 01.
Article in English | MEDLINE | ID: mdl-35380648
SELECTION OF CITATIONS
SEARCH DETAIL
...