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1.
Int J Soc Psychiatry ; : 207640211070399, 2022 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-35057650

RESUMEN

BACKGROUND: Suicidality among youth is one of the most challenging public health issues. A thorough understanding of the risk factors that contribute to youth suicidality is necessary. The main aim of the study is to estimate the proportion of suicidality and understand factors associated with suicidality amongst clients attending youth mental health promotion clinics in Karnataka, India. METHODS: A retrospective cross-sectional case record analysis was performed utilising data from real-time digitised management information system specifically developed for the programme. All case records of clients aged 15 to 35 years who received mental health promotion (MHP) services between January 2017 and December 2020 across 30 districts of Karnataka were included in this analysis. Multivariate logistic regression analysis was performed with suicidality among clients as outcome. Socio-demographic characteristics, issues reported, feelings/emotions that indicate underlying mental health issue/crisis, being aware of suicidality among friends and family and personal habits (smoking/chewing tobacco and drinking alcohol) were considered potential exposure variables. FINDINGS: Overall proportion of suicidality among youth presenting to youth mental health promotion clinics in Karnataka was 3.5% (357/10,340). Among factors associated with suicidality, the strongest association was found among those clients who reported attempted suicide among friends (AOR 8.94; 95% CI 5.95-13.45), family members (AOR 5.50; 95% CI 3.66-8.29), being anxious (AOR 4.90; 95% CI 3.43-6.99), inability to trust anyone (AOR 4.07; 95% CI 2.75-6.03), had issues of Gender, Sex and Sexuality (AOR 3.16; 95% CI 1.93-5.17) and relationship issues (AOR 2.77; 95% CI 2.05-3.73). CONCLUSION: The results alert all institutions, organisations and departments that cater to services and development of youth, to be sensitive towards risk factors of suicidality. The study advocates youth mental health promotion clinics to be equipped with measures/interventions to identify and manage such risk factors. This study has implications for Youth mental health promotion in India and other similar South-East Asian countries.

2.
Artículo en Alemán | MEDLINE | ID: mdl-34962579

RESUMEN

The cause of death statistics is an elementary basis for determining important indicators such as death rates, years of life lost, and avoidable deaths as well as their changes over time. The results are used in epidemiological and medical research and provide important recommendations for prevention programs and for health policy in general.This article first gives an overview of the history, legal basis, and methodology of the cause of death statistics in Germany. This is followed by the presentation of the data on suicides in Germany with a focus on the year 2019. These data are mapped based on the characteristics of age, gender, region, and method of suicide. Comparisons with older data available since 1980 are made. The outlook gives an overview of the further development of the cause of death statistics, the reasons for current weaknesses in the data collection process, and possible solutions.


Asunto(s)
Suicidio , Causas de Muerte , Recolección de Datos , Alemania/epidemiología , Política de Salud , Humanos , Suicidio/prevención & control
3.
J Affect Disord ; 298(Pt A): 408-420, 2022 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-34728296

RESUMEN

BACKGROUND: Suicidal thoughts and behaviors (STBs) among adolescents have hardly decreased despite preventative efforts. School-based prevention programs could have a great reach, yet suicide prevention is not an easy topic to address. To increase acceptability of school-based suicide prevention, it is important to evaluate whether programs that target known risk factors of STBs, such as depression, could be equally effective. METHODS: We conducted a systematic literature search in major electronic databases. Outcomes were suicidal ideation and behaviors. Multivariate random effects meta-regression-analyses were conducted. RESULTS: Eleven primary studies met the inclusion criteria, totalling 23,230 participants. The post-test effect size was small for both suicidal ideation (g = 0.15) and suicidal behaviors (g = 0.30). Meta-regression indicated that targeting known risk factors of STBs was not a significant modifier of effect size for ideation, indicating equal effectiveness. However, it was significant modifier of effect for behaviors, but only one intervention targeted know risk factors. Effects at follow-up (3-12 months) were also significant but small for both outcomes. LIMITATIONS: Substantial heterogeneity between studies was noted. Only few and small sample size studies could be included that targeted known risk factors of STBs. Therefore, these results should be interpreted with caution. CONCLUSIONS: School-based prevention of STBs shows some promise within three months post-test assessments, and potentially also have effects that are sustained over time. More studies are needed to make conclusions regarding school-based interventions that target risk factors of STBs.


Asunto(s)
Ideación Suicida , Suicidio , Adolescente , Humanos , Servicios Preventivos de Salud , Instituciones Académicas , Intento de Suicidio
6.
Rev. cient. cienc. salud ; 3(2): [126-135], 20211200.
Artículo en Español | BDNPAR | ID: biblio-1352361

RESUMEN

El trastorno de Personalidad Límite (TPL) es un padecimiento caracterizado por un patrón de inestabilidad emocional, dificultades con la autoimagen y con las relaciones interpersonales. Las personas que la padecen suelen actuar con una impulsividad intensa, lo cual hace que vaya de la mano con los intentos de suicidios recurrentes y la conducta autolesiva. El presente artículo es un estudio de revisión bibliográfica respecto a la eficacia de la terapia dialéctica comportamental (TDC) para el tratamiento del TPL, fueron analizados y comparados unos 20 artículos científicos, algunos de ellos basados en ensayos controlados de manera aleatoria, otros son estudios controlados de caso único, publicados en importantes revistas electrónicas de impacto, la búsqueda se realizó utilizando las palabras clave. Como conclusión se obtuvo que el tratamiento psicológico con enfoque dialéctico comportamental ayuda a una reducción significativa de la frecuencia y el riesgo de las conductas suicidas e intencionalidad suicida, también a una mejor adherencia al tratamiento, disminuyendo los días de internación y de la conducta autolesiva. Además de demostrar su eficacia en el alivio de sentimientos desesperanzadores con falta de razones para vivir y depresión. Aunque todavía es necesaria la realización de más investigación controlada en el ámbito.


Borderline Personality Disorder (BPD) is a condition characterized by a pattern of emotional instability, difficulties with self-image and with interpersonal relationships. People who suffer from it tend to act with intense impulsivity, which goes hand in hand with recurrent suicide attempts and self-injurious behavior. This article is abibliographic review study regarding the efficacy of dialectical behavioral therapy (DBT) for the treatment of LPD, about 20 scientific articles were analyzed and compared, some of them based on randomized controlled trials, others are Single case-controlled studies published in important impact electronic journals, the search was carried out using the keywords. As a conclusion, it was obtained that psychological treatment with a behavioral dialectical approach helps to significantly reduce the frequency and risk of suicidal behaviors and suicidal intentionality, as well as a better adherence to treatment, reducing the days of hospitalization and self-injurious behavior. In addition to proving its effectiveness in relieving hopeless feelings with no reason to live and depression. Although it is still necessary to carry out more controlled research in the field.


Asunto(s)
Trastorno de Personalidad Limítrofe , Terapia Conductual Dialéctica , Intento de Suicidio , Resultado del Tratamiento
7.
Psychol Res Behav Manag ; 14: 2035-2043, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34934369

RESUMEN

Purpose: This study identified the relationships between perceived household economic status and household economic downturn due to COVID-19 and adolescent depressive symptoms and suicidal ideation. Methods: Participants for this study were extracted from the 13th Korea Youth Risk Behavior Web-Based Survey, conducted from August to November 2020. The participants comprised 54,948 middle and high school students selected by stratified random cluster sampling. Results: The prevalence rates of depressive symptoms and suicidal ideation were 25.2% and 10.9%, respectively. Multivariate logistic regression analysis showed that lower perceived household economic status significantly predicted higher prevalence of depressive symptoms and suicidal ideation. Participants who perceived that their household economic status had declined because of COVID-19 were more likely to have experienced depression and suicidal ideation. These results were similar regardless of the participants' perceptions of household economic status. Conclusion: This study found that in the ongoing pandemic, there is a need for an active mental health promotion program for adolescents from low-income households, especially those who experienced a recent decline in the household economy.

8.
Trials ; 22(1): 786, 2021 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-34749782

RESUMEN

BACKGROUND: Electroconvulsive therapy (ECT) is well-established and effective for treatment-resistant depression (TRD), but in Canada and the USA, less than 1% of patients with TRD receive ECT mainly due to its cognitive adverse effects (i.e. amnesia). Thus, new treatment alternatives for TRD are urgently needed. One such treatment is magnetic seizure therapy (MST). ECT involves applying a train of high-frequency electrical stimuli to induce a seizure, whereas MST involves applying a train of high-frequency magnetic stimuli to induce a seizure. METHODS: In this manuscript, we introduce our international, two-site, double-blinded, randomized, non-inferiority clinical trial to develop MST as an effective and safe treatment for TRD. This trial will compare the efficacy of MST to right unilateral ultra-brief pulse width electroconvulsive therapy (RUL-UB-ECT) with a combined primary endpoint of remission of depression and superior cognitive adverse effects in 260 patients with TRD. Amelioration of suicidal ideation will be assessed as a secondary endpoint. Inpatients or outpatients, over 18 years of age with a MINI International Neuropsychiatric Interview (MINI) diagnosis of non-psychotic major depressive disorder (MDD) can be enrolled in the study provided that they meet illness severity and full eligibility criteria. Participants are randomized to receive MST or RUL-UB ECT, 2-3 days per week over seven weeks, or a maximum of 21 treatments. The study will involve before-, during-, and after-treatment assessments of depression severity, suicidal ideation, subjective side-effects, and cognitive performance consistent with an intent-to-treat study design approach. DISCUSSION: Positive results from this trial could have an immediate and tremendous impact for patients with TRD. If MST demonstrates comparable antidepressant treatment efficacy to ECT, but with greater cognitive safety, it could rapidly be adopted into clinical practice. Indeed, given that the administration of MST is nearly identical to ECT, the majority of ECT facilities in North America could readily adopt MST. Furthermore, the potential for cognitive safety could lead to improved treatment acceptability. Healthcare providers, patients and care partners, and policymakers would therefore demand this form of convulsive therapy. TRIAL STATUS: Enrollment for this study began on June 26, 2018, and is estimated to complete recruitment by July 2024. At the time of submission, we have enrolled and randomized 117 participants. TRIAL REGISTRATION: ClinicalTrials.gov NCT03191058 , Registered on June 19, 2017. Primary sponsor: Daniel Blumberger (DMB), Principal Investigator Daniel.Blumberger@camh.ca , 416-535-8501 x 33662 Contact for public queries: DMB, Daniel.Blumberger@camh.ca Contact for scientific queries: ZJD, Zdaskalakis@health.ucsd.edu.


Asunto(s)
Trastorno Depresivo Mayor , Trastorno Depresivo Resistente al Tratamiento , Terapia Electroconvulsiva , Adolescente , Adulto , Depresión , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/terapia , Trastorno Depresivo Resistente al Tratamiento/diagnóstico , Trastorno Depresivo Resistente al Tratamiento/terapia , Terapia Electroconvulsiva/efectos adversos , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Convulsiones/diagnóstico , Convulsiones/terapia , Resultado del Tratamiento
9.
Can J Psychiatry ; : 7067437211055417, 2021 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-34796744

RESUMEN

OBJECTIVE: The life course of children and adolescents with mental disorders is an important area of investigation, yet it remains understudied. This study provides a first-ever comprehensive examination of the relationship between child and adolescent mental disorders and subsequent suicidal and adverse social outcomes in early adulthood using population-based data. METHODS: De-identified administrative databases were used to create a birth cohort of 60,838 residents of Manitoba born between April 1980 to March 1985 who were followed until March 2015. Unadjusted and adjusted hazard ratios (aHRs) and odds ratios (aORs) were calculated to determine associations between physician-diagnosed mental disorders in childhood or adolescence and a range of adverse early adulthood (ages 18 to 35) outcomes. RESULTS: Diagnoses of mood/anxiety disorders, attention-deficit hyperactivity disorder, substance use disorder, conduct disorder, psychotic disorder, personality disorders in childhood or adolescence were associated with having the same diagnoses in adulthood. These mental disorder diagnoses in childhood/adolescence were strongly associated with an increased risk of suicidal behaviors and adverse adult social outcomes in adulthood. Similarly, suicide attempts in adolescence conferred an increased risk in adulthood of suicide death (aHR: 3.6; 95% confidence interval [CI]: 1.9-6.9), suicide attempts (aHR: 6.2; CI: 5.0-7.6), social housing use (aHR: 1.7; CI 1.4-2.1), income assistance (aHR: 1.8; CI 1.6-2.1), criminal accusation (aHR: 2.2; CI 2.0-2.5), criminal victimization (aHR:2.5; CI 2.2-2.7), and not completing high school (aOR: 3.1; CI: 2.5-3.9). CONCLUSION: Mental disorders diagnosed in childhood and adolescence are important risk factors not only for mental disorders in adulthood but also for a range of early adult adversity. These findings provide an evidence-based prognosis of children's long-term well-being and a rationale for ensuring timely access to mental health services. Better population-level mental health promotion and early intervention for children and adolescents with mental disorders are promising for improving future adult outcomes.

11.
BMC Public Health ; 21(1): 2118, 2021 11 18.
Artículo en Inglés | MEDLINE | ID: mdl-34794401

RESUMEN

BACKGROUND: Social circumstances in which people live and work impact the population's mental health. We aimed to synthesise evidence identifying effective interventions and policies that influence the social determinants of mental health at national or scaled population level. We searched five databases (Cochrane Library, Global Health, MEDLINE, EMBASE and PsycINFO) between Jan 1st 2000 and July 23rd 2019 to identify systematic reviews of population-level interventions or policies addressing a recognised social determinant of mental health and collected mental health outcomes. There were no restrictions on country, sub-population or age. A narrative overview of results is provided. Quality assessment was conducted using Assessment of Multiple Systematic Reviews (AMSTAR 2). This study was registered on PROSPERO (CRD42019140198). RESULTS: We identified 20 reviews for inclusion. Most reviews were of low or critically low quality. Primary studies were mostly observational and from higher income settings. Higher quality evidence indicates more generous welfare benefits may reduce socioeconomic inequalities in mental health outcomes. Lower quality evidence suggests unemployment insurance, warm housing interventions, neighbourhood renewal, paid parental leave, gender equality policies, community-based parenting programmes, and less restrictive migration policies are associated with improved mental health outcomes. Low quality evidence suggests restriction of access to lethal means and multi-component suicide prevention programmes are associated with reduced suicide risk. CONCLUSION: This umbrella review has identified a small and overall low-quality evidence base for population level interventions addressing the social determinants of mental health. There are significant gaps in the evidence base for key policy areas, which limit ability of national policymakers to understand how to effectively improve population mental health.

12.
Int J Ment Health Syst ; 15(1): 79, 2021 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-34674726

RESUMEN

OBJECTIVE: The evidence base for suicide prevention programs in Australian schools is limited. The aim of this study was to examine the impact of a universal, mental health promotion and suicide prevention program-Youth Aware of Mental Health (YAM)-on suicidal ideation, mental health, and help-seeking in Australian secondary school students from baseline to post-intervention and 6-month follow up. METHODS: Using a single-arm design, the YAM program was delivered to Year 9 students (13-16 years) in secondary schools located within four regions across New South Wales, Australia. A structured self-report questionnaire using validated scales was administered at each time point. Linear mixed-effects modelling was used to examine differences in suicidal ideation scores across time, while accounting for random effects of individual schools. RESULTS: Suicidal ideation reduced significantly from baseline to post, and from baseline to follow-up (p < 0.001). Depression severity declined (p < 0.001) and help-seeking intentions increased (p < 0.001) at post-intervention and 6- months following the intervention period. No suicide deaths were reported for any study participants. CONCLUSION: The current findings provide preliminary evidence that the YAM program is a promising preventive intervention for Australian schools, particularly for reducing suicidal ideation, depression and increasing help-seeking intentions in young people. The implementation of YAM in a large number of schools across New South Wales demonstrates the feasibility, and acceptability by schools, of implementing this program at scale. TRIAL REGISTRATION: ANZCTR, ACTRN12619000338167. Registered 5 March 2019-Retrospectively registered, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376989&isReview=true .

13.
Lupus Sci Med ; 8(1)2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34697129

RESUMEN

OBJECTIVES: To evaluate the risk of psychiatric disorders and all-cause mortality associated with belimumab therapy in patients with SLE. METHODS: A literature search of four electronic bibliographic databases, including PubMed, EMBASE, Scopus and Cochrane databases, was conducted for randomised controlled trials (RCTs) reporting adverse reactions between belimumab and placebo. OR and 95% CI were calculated using the Mantel-Haenszel method with fixed-effects or random-effects model, depending on the heterogeneity test. RESULTS: In total, 11 eligible RCTs including 8824 patients with SLE were randomised into belimumab (5160 patients with 5552 patient-years) and placebo (3664 patients with 3985 patient-years) groups, respectively. Overall, no increased risk was identified with belimumab therapy at all dosages compared with placebo in patients with SLE regarding all psychiatric disorders (OR 0.89, 95% CI 0.64 to 1.23, I2=58%) and all-cause mortality (OR 1.10, 95% CI 0.64 to 1.89, I2=0%). The subgroup analysis of psychiatric disorders also revealed no statistically elevated risks in serious psychiatric disorders (OR 1.15, 95% CI 0.77 to 1.70, I2=47%), non-serious psychiatric disorders (OR 0.83, 95% CI 0.60 to 1.16, I2=52%), suicidal ideation or behaviour (OR 0.87, 95% CI 0.57 to 1.33, I2=0%), and depression (OR 1.29, 95% CI 0.90 to 1.85, I2=15%). Secondary analysis restricting belimumab at approved dose of 10 mg/kg only yielded similar results. CONCLUSION: Belimumab therapy overall does not increase psychiatric events and all-cause mortality risks, whereas the results from Belimumab Assessment of Safety in SLE Study are suggestive of increased risk of psychiatric adverse events with belimumab exposure. Consequently, post-marketing data are needed to ascertain its psychiatric safety, especially serious mental disorders.


Asunto(s)
Lupus Eritematoso Sistémico , Trastornos Mentales , Anticuerpos Monoclonales Humanizados/efectos adversos , Humanos , Lupus Eritematoso Sistémico/tratamiento farmacológico , Trastornos Mentales/tratamiento farmacológico , Resultado del Tratamiento
15.
Psychiatr Q ; 2021 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-34599735

RESUMEN

The immediate period following psychiatric hospitalization is marked by increased risk for suicide behavior and rehospitalization. Because adolescents commonly return to school settings following hospital discharge, school-related stressors and supports are important considerations for psychiatric treatment and discharge planning. The current study aimed to inform recommendations provided by hospitals to schools to improve school reintegration practices by employing a concurrent, mixed-methods design. Specifically, we: (1) surveyed school professionals (n = 133) in schools varying in resource availability and populations in one southeastern state of the United States about supports and services provided to returning students; and (2) conducted in-depth interviews with a subset of these professionals (n = 19) regarding their perceptions of the hospital to school transition for youth recovering from suicide-related crises. Findings from survey responses indicated that, compared to schools located in urban and suburban areas, schools in rural areas were less likely to have school reintegration protocols for returning students. More generally, however, available interventions and modifications were relatively consistent across rural and urban/suburban schools, schools serving high and low poverty communities, and schools with predominantly white and predominantly ethnic and racial minoritized student bodies. Key themes across interviews signify the importance of communication between stakeholders, the type of information used to develop re-entry plans, available school-based services for returning youth, and the need to mitigate stigma associated with mental health crises. Findings inform recommendations that can be provided by hospitals to schools to support adolescent recovery as they return to school following psychiatric hospitalization.

17.
Psychol Med ; : 1-7, 2021 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-34664545

RESUMEN

BACKGROUND: To characterize the association between the protracted biopsychosocial coronavirus disease 2019 (COVID-19) pandemic exposures and incident suicide attempt rates. METHODS: Data were from a nationally representative cohort based on electronic health records from January 2013 to February 2021 (N = 852 233), with an interrupted time series study design. For the primary analysis, the effect of COVID-19 pandemic on incident suicide attempts warranting in-patient hospital treatment was quantified by fitting a Poisson regression and modeling the relative risk (RR) and the corresponding 95% confidence intervals (CIs). Scenarios were forecast to predict attempted suicide rates at 10 months after social mitigation strategies. Fourteen sensitivity analyses were performed to test the robustness of the results. RESULTS: Despite the increasing trend in the unexposed interval, the interval exposed to the COVID-19 pandemic was statistically significant (p < 0.001) associated with a reduced RR of incident attempted suicide (RR = 0.63, 95% CI 0.52-0.78). Consistent with the primary analysis, sensitivity analysis of sociodemographic groups and methodological factors were statistically significant (p < 0.05). No effect modification was identified for COVID-19 lockdown intervals or COVID-19 illness status. All three forecast scenarios at 10 months projected a suicide attempt rate increase from 12.49 (7.42-21.01) to 21.38 (12.71-35.99). CONCLUSIONS: The interval exposed to the protracted mass social trauma of the COVID-19 pandemic was associated with a lower suicide attempt rate compared to the unexposed interval. However, this trend is likely to reverse 10 months after lifting social mitigation policies, underscoring the need for enhanced implementation of public health policy for suicide prevention.

18.
Front Sociol ; 6: 727069, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34660775

RESUMEN

While research has explored the intersection between masculinities and men's experiences of suicidality, comparatively little attention has been paid to the stories surrounding suicidal men's decision to seek help. The ways in which men experiencing suicidal thoughts and behaviors embody masculinities alongside their enlistment of mental health services remains largely unknown. The present study explored 262 Australian men's stories surrounding the impetus for help-seeking for suicidal thoughts and behaviors. The sample comprised men ranging in age from 17 to 74 years (M = 40.99; SD = 15.92 years), with most participants residing in a metropolitan area (55.3%), employed full time (43.1%), non-indigenous (95.4%) and heterosexual (73.7%). Participants elaborated on their reasons for help-seeking via an open-text qualitative survey, delivered as part of a larger study exploring help-seeking experiences of Australian men. Thematic analysis of responses generated four themes highlighting the diversity of experience across men, with some highlighting impacts of emasculating early trauma(s) on their suicidality, while others reflected an impulsiveness tied to situational stressors that fractured their masculine identity (e.g., relationship breakdown; job loss). Many men had epiphanies as they reached the limits of their self-reliance and came to terms with their need for help. As their suicidality was witnessed by-and began to impact-those around them, the sight of their previously masked pain by others often facilitated their help-seeking journey. The present findings underscore the complex and multifactorial role of masculinities in men's suicidality and their paths to help-seeking. Important inroads for future public mental health promotion efforts are discussed, in terms of leveraging self-reliant and caring masculinities in helping men to develop healthy coping in the context of suicidality.

20.
Artículo en Inglés | MEDLINE | ID: mdl-34639459

RESUMEN

The notion of candidacy emerged three decades ago through Davison and colleagues' exploration of people's understanding of the causes of coronary heart disease. Candidacy was a mechanism to estimate one's own or others risk of disease informed by their lay epidemiology. It could predict who would develop illness or explain why someone succumbed to it. Candidacy's predictive ability, however, was fallible, and it was from this perspective that the public's reticence to adhere to prevention messages could be explained, as ultimately anybody could be 'at-risk'. This work continues to resonate in health research, with over 700 citations of Davison's Candidacy paper. Less explored however, is the candidacy framework in its entirety in other illness spheres, where prevention efforts could potentially impact health outcomes. This paper revisits the candidacy framework to reconsider it use within prevention. In doing so, candidacy within coronary heart disease, suicide prevention, diabetes, and cancer will be examined, and key components of candidacy and how people negotiate their candidacy within differing disease contexts will be uncovered. The applicability of candidacy to address modifiable breast cancer risk factors or cancer prevention more broadly will be considered, as will the implications for public health policy.


Asunto(s)
Neoplasias , Suicidio , Humanos , Neoplasias/epidemiología , Neoplasias/prevención & control
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