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1.
Yonsei Med J ; 62(2): 159-163, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33527795

RESUMEN

PURPOSE: Nearly one third of all patients with an eating disorder (ED) present with non-suicidal self-injury (NSSI). Although it is necessary to pay attention clinically to NSSI in ED patients due to an increased suicidal risk, there are limited data on potential predictors of NSSI in ED. We conducted this study to uncover predictors of NSSI in ED. MATERIALS AND METHODS: A total of 1355 ED patients who visited an ED clinic was evaluated through structured interviews by psychiatrists. The demographic and clinical characteristics of ED patients with NSSI (NSSI group) and ED patients without NSSI (non-NSSI group) were analyzed to identify potential predictors of NSSI in ED. RESULTS: Among all ED individuals, 242 (17.9%) reported a history of NSSI. Compared to the non-NSSI group, the NSSI group reported more severe eating symptomatology, more comorbid psychiatric disease, and more suicidal risk. Comorbid alcohol use disorder, depressive disorder, purging behavior, history of suicide attempt, and rumination symptoms were uncovered as predictors of NSSI in ED. CONCLUSION: The findings of the study are meaningful in that they highlight predictors of NSSI in ED in a large clinical sample. Understanding risk factors of NSSI and offering appropriate interventions are important to preventing suicidality in ED.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Conducta Autodestructiva/diagnóstico , Adolescente , Femenino , Humanos , Factores de Riesgo , Conducta Autodestructiva/psicología , Ideación Suicida , Intento de Suicidio/psicología , Adulto Joven
2.
Medicina (Kaunas) ; 57(1)2021 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-33435391

RESUMEN

Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients' psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitation of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.


Asunto(s)
Trastorno Bipolar/psicología , Trastorno Ciclotímico/psicología , Genio Irritable , Calidad de Vida/psicología , Temperamento , Adulto , Afecto , Edad de Inicio , Agresión/psicología , Ansiedad/psicología , Trastorno Bipolar/fisiopatología , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Índice de Severidad de la Enfermedad , Ideación Suicida , Intento de Suicidio/psicología
3.
Epidemiol Psychiatr Sci ; 30: e16, 2021 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-33461639

RESUMEN

AIMS: It remains unclear whether the coronavirus disease 2019 (COVID-19) pandemic is having an impact on suicide rates (SR). Economic insecurity and mental disorders are risk factors for suicide, which may increase during the pandemic. METHODS: Data on suicide events in a major city in Germany, and the corresponding life years (LY) were provided by the local authorities. For the year 2020, periods without restrictions on freedom of movement and social contact were compared with periods of moderate and severe COVID-19 restrictions. To avoid distortions due to seasonal fluctuations and linear time trends, suicide risk during the COVID-19 pandemic was compared with data from 2010 to 2019 using an interrupted time series analysis. RESULTS: A total of 643 suicides were registered and 6 032 690 LY were spent between 2010 and 2020. Of these, 53 suicides and 450 429 LY accounted for the year 2020.In 2020, SR (suicides per 100 000 LY) were lower in periods with severe COVID-19 restrictions (SR = 7.2, χ2 = 4.033, p = 0.045) compared with periods without restrictions (SR = 16.8). A comparison with previous years showed that this difference was caused by unusually high SR before the imposition of restrictions, while SR during the pandemic were within the trend corridor of previous years (expected suicides = 32.3, observed suicides = 35; IRR = 1.084, p = 0.682). CONCLUSIONS: SR during COVID-19 pandemic are in line with the trend in previous years. Careful monitoring of SR in the further course of the COVID-19 crisis is urgently needed. The findings have regional reference and should not be over-generalised.


Asunto(s)
/psicología , Pandemias , Cuarentena/psicología , Aislamiento Social/psicología , Suicidio/psicología , Suicidio/tendencias , /epidemiología , Femenino , Alemania/epidemiología , Humanos , Soledad/psicología , Suicidio/estadística & datos numéricos , Intento de Suicidio/psicología
4.
Nurs Res ; 70(1): E1-E10, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32991529

RESUMEN

BACKGROUND: Studies focusing on adolescent suicide in Arab countries are particularly scarce, with the few available undertaken from within an epidemiological paradigm. OBJECTIVE: This study aimed to understand Jordanian adolescents' perceptions, beliefs, and attitudes toward suicide. METHODS: A qualitative design using 12 dual-moderator focus group discussions was conducted in public schools. Participants were selected from the three main regions of the country (rural southern, urban central, and suburban northern). Participants included Jordanian adolescent boys and girls, aged 14-17 years, who reported experiencing mild to moderate depressive symptoms. A relational content analysis approach was used for coding data, and a content analysis was used to identify salient thematic categories. Data were analyzed using NVivo software. RESULTS: Four themes emerged, including perceived risk factors, perceived protective factors, active and passive suicidal ideations, and e-games and Internet influences. Main risk factors were depression; anxiety; stigma, shame, and isolation; family issues; life pressures; and guilt. Conversely, religiosity, perceived positive family functioning, and availability of long-term goals seemed to confer resilience to adolescents' suicidal ideation and behavior. Passive suicidality (having death wishes without any plans to complete suicide) was noticed most among participants who feared jeopardizing the family's reputation if they committed suicide. Several boys with active suicidal ideations used the Blue Whale Challenge e-game to learn how to complete suicide and relinquish their problems. DISCUSSION: Suicide is a multifactorial problem requiring multimodal strategies. Evidence from this research suggests that those most passionate about the outcome of interest are encouraged to redouble efforts to reduce modifiable risk factors, enrich protective factors, target the underlying psychiatric illness that informs suicidal ideations and behavior, and research the effect of social media and Internet activity more deeply. Parents are advised to monitor the online activities of their children and familiarize themselves with the digital applications they use.


Asunto(s)
Conducta del Adolescente/psicología , Actitud Frente a la Muerte , Geografía/estadística & datos numéricos , Trastornos Mentales/epidemiología , Ideación Suicida , Intento de Suicidio/psicología , Suicidio/psicología , Adolescente , Femenino , Humanos , Jordania/epidemiología , Masculino , Factores de Riesgo , Población Rural/estadística & datos numéricos , Población Suburbana/estadística & datos numéricos , Población Urbana/estadística & datos numéricos
5.
J Psychiatr Res ; 134: 32-38, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33360222

RESUMEN

Evidence suggests that the negative consequences of COVID-19 may extend far beyond its considerable death toll, having a significant impact on psychological well-being. Despite work highlighting the link between previous epidemics and elevated suicide rates, there is limited research on the relationship between the COVID-19 pandemic and suicidal thoughts and behaviors. Utilizing an online survey, the current study aimed to better understand the presence, and extent, of the association between COVID-19-related experiences and past-month suicidal thoughts and behaviors among adults in the United States recruited via Amazon Mechanical Turk (n = 907). Results support an association between several COVID-19-related experiences (i.e., general distress, fear of physical harm, effects of social distancing policies) and past-month suicidal ideation and suicide attempts. Further, a significant proportion of those with recent suicidal ideation explicitly link their suicidal thoughts to COVID-19. Exploratory analyses highlight a potential additional link between COVID-19 and suicidal behavior, suggesting that a portion of individuals may be intentionally exposing themselves to the virus with intent to kill themselves. These findings underscore the need for suicide risk screening and access to mental health services during the current pandemic. Particular attention should be paid to employing public health campaigns to disseminate information on such services to reduce the enormity of distress and emotional impairment associated with COVID-19 in the United States.


Asunto(s)
/psicología , Cuarentena/psicología , Ideación Suicida , Intento de Suicidio/psicología , Intento de Suicidio/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Riesgo , Estados Unidos , Adulto Joven
6.
Artículo en Inglés | MEDLINE | ID: mdl-33095519

RESUMEN

Objective: To expand knowledge during the coronavirus disease 2019 (COVID-19) pandemic with regard to suicide prevention among the elderly population by providing recommendations for interview strategies using 3 suicide theories. Methods: Two hypothetical geriatric suicide cases (1 low lethality and 1 high lethality) are presented and categorized according to 3 suicide theories: interpersonal theory of suicide, three-step theory of suicide, and hopelessness theory of depression. Results: In crisis intervention, the clinician's interview must match the intrinsic belief of the suicide attempter to enable engagement and rapport. Use of different aspects of the 3 suicide theories can be useful but are dependent on the emergent nature of the attempt. Conclusion: The need for identification and treatment of those with mental health issues, especially among the elderly population, and collaborative multidiscipline management teams is increasing during the current global pandemic. Specific interview strategies are needed when engaging with elderly suicidal patients. Suicide prevention in elderly patients is worthy of strong public attention.


Asunto(s)
Infecciones por Coronavirus/psicología , Pandemias , Neumonía Viral/psicología , Psiquiatría/métodos , Suicidio/prevención & control , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/complicaciones , Depresión/etiología , Depresión/psicología , Femenino , Humanos , Masculino , Neumonía Viral/complicaciones , Ideación Suicida , Suicidio/psicología , Intento de Suicidio/psicología
7.
Epidemiol Psychiatr Sci ; 29: e175, 2020 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-33070799

RESUMEN

AIMS: Previous studies regarding associations between depressive symptoms and suicidality (suicidal ideation, plans and attempts) have usually employed a variable-centred approach, without considering the individual variance in time-varying changes of depressive symptoms. Through 10-year follow-up of a large cohort of Chinese adolescents exposed to the 2008 Wenchuan earthquake, this study examined whether individual variance in depressive symptoms during the early phases post-earthquake could generate different suicidality outcomes in young adulthood. METHODS: A total of 1357 Chinese adolescents exposed to the Wenchuan earthquake were surveyed on depressive symptoms and other variables at 6, 18 and 30 months post-earthquake. In total, 799 participants responded to the 10-year follow-up and completed an online survey covering suicidality and other variables. The analytic sample was 744 participants who had valid data on depressive symptoms and suicidality. Data were analysed using logistic regressions. RESULTS: Prevalence estimates of past-year suicidal ideation, suicide plans and suicide attempts measured at 10 years post-earthquake were found to be 10.8%, 7.3% and 3.0%, respectively. Five trajectories of depressive symptoms were classified: resistance (54.4%), chronicity (13.3%), recovery (10.4%), delayed dysfunction (12.0%) and relapsing/remitting (10.0%). After controlling for covariates, whole-sample regressions revealed only the relapsing/remitting depressive trajectory remained significantly predictive of suicidality. Moreover, males not females in the chronic group were more likely to have suicide plans. CONCLUSIONS: The findings highlight the importance of detecting disaster survivors with different trajectories of mental status and providing with them individualised and effective mental health services, to decrease their risk of suicidality in the future.


Asunto(s)
Grupo de Ascendencia Continental Asiática/psicología , Terremotos , Trastornos por Estrés Postraumático/psicología , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Adaptación Psicológica , Adolescente , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Estudios de Cohortes , Depresión/diagnóstico , Depresión/etnología , Depresión/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Prevalencia , Factores de Riesgo , Distribución por Sexo , Trastornos por Estrés Postraumático/etnología , Suicidio/psicología , Intento de Suicidio/psicología , Encuestas y Cuestionarios , Sobrevivientes
8.
BMJ ; 370: m2984, 2020 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-32878868

RESUMEN

OBJECTIVE: To analyse the relation between exposure to workplace sexual harassment and suicide, as well as suicide attempts. DESIGN: Prospective cohort study. SETTING: Sweden. PARTICIPANTS: 86 451 men and women of working age in paid work across different occupations responded to a self-report questionnaire including exposure to work related sexual harassment between 1995 and 2013. The analytical sample included 85 205 people with valid data on sexual harassment, follow-up time, and age. MAIN OUTCOME MEASURES: Suicide and suicide attempts ascertained from administrative registers (mean follow-up time 13 years). RESULTS: Among the people included in the respective analyses of suicide and suicide attempts, 125 (0.1%) died from suicide and 816 (1%) had a suicide attempt during follow-up (rate 0.1 and 0.8 cases per 1000 person years). Overall, 11 of 4095 participants exposed to workplace sexual harassment and 114 of 81 110 unexposed participants committed suicide, and 61/4043 exposed and 755/80 513 unexposed participants had a record of suicide attempt. In Cox regression analyses adjusted for a range of sociodemographic characteristics, workplace sexual harassment was associated with an excess risk of both suicide (hazard ratio 2.82, 95% confidence interval 1.49 to 5.34) and suicide attempts (1.59, 1.21 to 2.08), and risk estimates remained significantly increased after adjustment for baseline health and certain work characteristics. No obvious differences between men and women were found. CONCLUSIONS: The results support the hypothesis that workplace sexual harassment is prospectively associated with suicidal behaviour. This suggests that suicide prevention considering the social work environment may be useful. More research is, however, needed to determine causality, risk factors for workplace sexual harassment, and explanations for an association between work related sexual harassment and suicidal behaviour.


Asunto(s)
Acoso Sexual/psicología , Intento de Suicidio/prevención & control , Intento de Suicidio/psicología , Lugar de Trabajo/psicología , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Autoinforme , Acoso Sexual/estadística & datos numéricos , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Encuestas y Cuestionarios , Suecia/epidemiología
9.
PLoS One ; 15(9): e0238884, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32913352

RESUMEN

In Australia, physiotherapists are registered healthcare practitioners who possess the knowledge and skills to care for clients with poor physical health as a result of musculoskeletal, neurological, and respiratory conditions. Although physiotherapists are not considered a primary profession in the Australian mental health workforce, the association between suicide and poor physical health suggests that they may encounter clients with suicidal thoughts and behaviours. We used a qualitative approach inspired by phenomenology to explore the experiences of nine physiotherapists who encountered clients with suicidal thoughts and behaviours. We used a combination of focus groups and in-depth interviews to collect this data. The data were analysed inductively using framework analysis. The main themes identified in the data were: i) the importance of trust, ii) the mechanism of conversation, and iii) the 'middle space'. The middle space refers to the experience of working with clients at risk of low or medium risk of suicide. A trusting practitioner-client relationship was reported to be essential in facilitating the disclosure of suicidal thoughts and behaviours. Physiotherapists also reported that less structured subjective assessments encourage clients to talk more openly, which in turn facilitates the disclosure of suicidal thoughts and behaviours. Once the disclosure of suicidal thoughts and behaviours occurred, physiotherapists reported a lack of confidence regarding role clarity and issues associated with this. Difficulties were most evident during encounters with clients with low to medium suicide risk due to a lack of confidence in the accuracy of assessment of these clients. The findings suggest that physiotherapists are well placed to detect and/or receive disclosure of suicidal thoughts and behaviours, as well as the need for physiotherapists to be trained in how to support clients who disclose suicidal thoughts and behaviours.


Asunto(s)
Fisioterapeutas/psicología , Intento de Suicidio/psicología , Confianza/psicología , Adulto , Australia , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Relaciones Profesional-Paciente , Investigación Cualitativa , Factores de Riesgo , Ideación Suicida , Revelación de la Verdad
10.
Am J Emerg Med ; 38(9): 1743-1747, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32738470

RESUMEN

BACKGROUND: The emergency department (ED) is one of the first gateways when suicide attempt patients seek health care services. The purpose of this study was to analyze the hypothesis that people who received emergency psychiatric services in previous suicide attempts will have a lower mortality rate in current ED visits owing to subsequent suicide attempts. METHOD: This retrospective study included patients who visited six EDs, and participated in the injury surveillance and in-depth suicide surveillance for 10 years, from January 2008 to December 2017. The study subjects were adult patients 18 years or older who visited EDs due to suicide attempts. The main explanatory variable is whether psychiatric treatment was provided in previous suicide attempts. The main outcome variable was suicide related mortality. RESULTS: The study included 2144 suicide attempt patients with a previous history of suicide attempts. Among these, 1335 patients (62.2%) had received psychiatric treatment in previous suicide attempts. Mortality was significantly different between the psychiatric consultation group (n = 33, 2.5%) and non-consultation group (n = 47, 5.8%) (P < 0.01). In multivariate logistic regression analysis, previous psychiatric consultation showed a significant association with low mortality (adjusted OR 0.41; 95% CI [0.23-0.72]) and selecting non-fatal suicide methods (adjusted OR 0.47; 95% CI [0.36-0.61]). CONCLUSION: Patients who received psychiatric consultation in previous suicide attempts had a lower suicide-related mortality in current ED visits as compared to patients who did not, and this may have been related to choosing non-fatal suicide methods.


Asunto(s)
Servicios de Urgencia Psiquiátrica , Intento de Suicidio/prevención & control , Intento de Suicidio/psicología , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Estudios Retrospectivos
11.
PLoS One ; 15(8): e0236398, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32785295

RESUMEN

INTRODUCTION: Suicide is a disastrous act which has a significant effect on the global burden of disease, contributing yearly to 1.4% of the total burden with the foremost role played by a people aged between 15 and 35 years. Medical students are one of the high-risk groups for suicide. This increased risk may begin during medical school and leads to premature death. But, there is a paucity of epidemiologically reliable data on the issue. Therefore, the current study was aimed to assess the prevalence and associated factors of suicidal ideations and attempt among undergraduate medical students of Haramaya University. METHOD: An institutional based cross-sectional study was conducted from May 13 to June 12, 2019 at College of Health and Medical Science, Haramaya University. Stratified sampling technique was used and a total of 757 participants were selected by using simple random sampling technique. Data were collected using a self-administered questionnaire. Suicidal ideation and attempt were assessed by using suicidal module of world mental health survey initiative version of the World Health Organization, composite international diagnostic interview. Data were analyzed using Statistical Package for Social Science Version 20. Descriptive results were presented by tables and graphs. Bivariate and multivariate logistic regression analyses were done to identify factors associated with suicidal ideation and attempt. P-values less than 0.05 were considered statistically significant and the strength of association was presented by an adjusted odds ratio with 95% confidence interval. RESULT: The study showed that the prevalence of suicidal ideation and attempt were 23.7% (95%CI, 20.5-26.8) and 3.9% (95%CI, 2.6-5.5), respectively. Cumulative grade point average (AOR = 0.30, 95% CI: 0.18-0.49), current alcohol use (AOR = 2.26, 95%CI: 1.45-3.55), depression (AOR = 3.58, 95%CI: 2.23-5.76), anxiety (AOR = 3, 95%CI: 1.88-4.77), and poor social support (AOR = 2.57, 95%CI: 1.41-4.68) were the factors statistically associated with the suicidal ideation. Depression (AOR = 5.4, 95%CI: 1.45-20.14) and anxiety (AOR = 3.19, 95%CI: 1.01-10.18) were associated with the suicidal attempts. CONCLUSION: This study showed that the high prevalence of suicidal ideation and attempt as compared to the prevalence of suicidal behavior among other university students who were studying in other fields. Cumulative Grade Point Average, current alcohol use, depression, anxiety and poor social support were the factors statistically associated with the suicidal ideation. Depression and anxiety were the ones associated with the suicidal attempt. Early screening, detection and management of suicidal behavior and associated mental health problems were recommended for undergraduate medical students.


Asunto(s)
Estudiantes de Medicina/psicología , Ideación Suicida , Intento de Suicidio/psicología , Suicidio/psicología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Ansiedad/epidemiología , Ansiedad/psicología , Estudios Transversales , Depresión/epidemiología , Depresión/psicología , Etiopía/epidemiología , Femenino , Humanos , Masculino , Factores de Riesgo , Facultades de Medicina , Suicidio/prevención & control , Universidades , Adulto Joven
12.
PLoS One ; 15(8): e0236880, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32764776

RESUMEN

Sexual minority (SM) youth are at high risk for intimate partner violence (IPV) and suicidal ideation/attempts compared to their heterosexual peers. We examined whether SM identity enhanced the relationship between experiences of IPV and suicidal ideation/attempts. Weighted logistic regression models were run using the 2017 Youth Risk Behavior Survey. All main effects were significant; each SM identity and both physical and sexual IPV were significantly associated with suicidal ideation and suicide attempts. The interaction between bisexual identity and physical IPV was significant for suicidal ideation; as physical IPV experiences increased, the difference between bisexual identity and heterosexual youth was non-significant. Findings suggest exploring trauma and suicidal ideation by aggregate groups and increasing support for SM youth in schools and communities.


Asunto(s)
Violencia de Pareja/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Adolescente , Niño , Femenino , Humanos , Violencia de Pareja/psicología , Modelos Logísticos , Masculino , Factores de Riesgo , Intento de Suicidio/psicología
13.
Artículo en Inglés | MEDLINE | ID: mdl-32752251

RESUMEN

The objective of this study was to examine the clinical characteristics of adolescents hospitalized after a suicide attempt or instrumental suicide-related behavior. Participants included thirty-six adolescents from the pediatric unit of a Polish hospital who made a nonfatal suicide attempt (SAA) or engaged in instrumental suicide-related behavior (IBA), as well as a general population sample (GPS). Psychosocial features were measured using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), the Social and Occupational Functioning Assessment Scale (SOFAS), the Suicide Behaviors Questionnaire-Revised (SBQ-R), the Psychache Scale (TPS), the State-Trait Anxiety Inventory (STAI), the Center of Epidemiological Studies Depression Scale for Children (CES-DC), and the Prodromal Questionnaire (PQ-16). The SAA group scored significantly higher than the IBA group and the GPS in modules related to irritability and anhedonia, voice hallucinations and delusions, suicidal acts, thoughts and ideation, and medical lethality. Additionally, the SAA scored higher on the SBQ-R and PQ-16 compared to the IBA group and the GPS. Although anxiety, mental pain, and depressive symptoms could not independently distinguish between the SAA and IBA groups, psychotic symptoms were more frequently present within the SAA group. The above symptoms may be important to consider when screening for suicide risk in the general population.


Asunto(s)
Trastornos Psicóticos , Ideación Suicida , Intento de Suicidio , Adolescente , Adolescente Hospitalizado/psicología , Ansiedad , Niño , Niño Hospitalizado/psicología , Femenino , Humanos , Intento de Suicidio/psicología
14.
Actas esp. psiquiatr ; 48(4): 163-168, jul.-ago. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-193804

RESUMEN

INTRODUCCIÓN: La evaluación del riesgo suicida sigue siendo un hándicap para políticas públicas sanitarias. La conducta más predictiva del suicidio consumado es la tentativa suicida previa. Sin embargo, los estudios centrados en factores de riesgo, hasta la fecha, no han disminuido las tasas de muertes por suicidio. OBJETIVO: El objetivo de este estudio sería adaptar el Herth Hope Index (HHI) y la Beck Hopelessness Scale como instrumentos de evaluación de la esperanza y desesperanza en población clínica española que ha realizado una tentativa de suicidio y valorar su validez estructural y validez divergente. METODOLOGÍA: La muestra estuvo constituida por N=682 personas (62,4% mujeres), con edades comprendidas entre 18 y 77 años (M = 39; DT=19,1) con tentativas suicidas previas a los que se les aplicó la Herth Hope Index (HHI), la Beck Hopelessness Scale y la Escala de Resiliencia CD-RISC-10. RESULTADOS: Los resultados muestran que la HHI presenta una estructura bididimensional que explica el 71,2% de la varianza, una alta consistencia interna (alpha = 0,97), y adecua-da validez divergente con desesperanza de -0,77. Y además existen importantes diferencias en esperanza según el nivel de resiliencia de los participantes. CONCLUSIONES: El riesgo de suicidio debe evaluarse mediante enfoques preventivos y clínicos. La esperanza modula la resiliencia ante tentativas de suicidio y se ofrece una nueva escala breve adaptada a población clínica española y fácil de aplicar en urgencias hospitalarias que predice el nivel de vulnerabilidad futura al reintento de suicidio futuro más grave


INTRODUCTION: Suicide risk assessment remains a handicap for public health policies. Suicide is a major global public health problem. The most predictive behavior of completed suicide is prior suicide attempt. However, studies focused on risk factors have to date proved unsuccessful in reducing death by suicide rates. AIM: To adapt the Herth Hope Index and the Beck Hope-lessness Scale as assessment tools for assessing hope and hopelessness to a Spanish clinical population having carried out a suicide attempt, and assess its structural validity and divergent validity. METHODS: The sample comprised 682 people (62.4% female) aged between 18 and 77 years (M = 39; SD =19.1) with previous suicide attempts who were administered the Herth Hope Index (HHI), the Beck Hopelessness Scale, and the CD-RISC-10 Resilience Scale. RESULTS: The findings showed that the HHI had a two-dimensional structure that explains 71.2% of the variance, a high internal consistency (alpha = .97), and adequate divergent validity with hopelessness of -.77. And there are also important differences in hope according to the resilience level of the participants. CONCLUSION: The suicide risk should be assessed by preventive and clinical approaches. Hope modulates resilience to suicide attempts and a new short scale adapted to the Spanish clinical population is offered. This short tool is easy to use in emergency department settings and predicts the level of potential vulnerability to more serious future re-peated attempts


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Intento de Suicidio/psicología , Encuestas y Cuestionarios , Resiliencia Psicológica , Esperanza , Factores Socioeconómicos , España
15.
Epidemiol Psychiatr Sci ; 29: e140, 2020 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-32635966

RESUMEN

AIMS: Mental ill-health is a known risk factor for suicide mortality. However, the relationship between physical ill-health and suicide is less clear. This study examined the relationship between different aspects of physical ill-health and the risk of suicide death. METHODS: Data for 1 196 364 adults (aged 18 years and over) were identified from the 2011 Northern Ireland Census and linked to death registrations until the end of 2015. Multivariate logistic regression was used to construct models to test associations with likelihood ratio tests for interactions. RESULTS: Over one in eight individuals (13.7%) reported multimorbidity (⩾2 physical health conditions) and one in four (25.4%) identified having limitation of daily activities. During follow-up, 51 672 individuals died; 877 due to suicide. The gradient in suicide risk by number of physical conditions disappeared following adjustment for activity limitation. Individuals with a lot of activity limitation were over three times more likely to die by suicide (OR = 3.13, 95% CI 2.50-3.93) compared to those with no limitations though this was reduced to OR = 1.72 (95% CI 1.35-2.20) with adjustment for poor mental health. The relationship between activity limitation and suicide was most pronounced at younger ages (18-34 years). CONCLUSIONS: This study suggests that it is the effect that physical illness has on a person's life, in terms of disruption to daily activity, rather than the number of conditions that predicts suicide risk, especially at younger ages. Improved awareness and better management of mental wellbeing of individuals with physical health conditions may help to reduce suicides, especially in younger people.


Asunto(s)
Enfermedad Crónica/psicología , Calidad de Vida , Intento de Suicidio/estadística & datos numéricos , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , Censos , Enfermedad Crónica/epidemiología , Femenino , Estudios de Seguimiento , Estado de Salud , Humanos , Irlanda/epidemiología , Masculino , Salud Mental , Persona de Mediana Edad , Mortalidad , Multimorbilidad , Factores de Riesgo , Suicidio/psicología , Intento de Suicidio/psicología , Adulto Joven
16.
PLoS One ; 15(7): e0235379, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32628722

RESUMEN

AIM: To estimate the pooled prevalence and incidence of suicidal ideation, attempts, and deaths in people with sleep apnea. METHOD: We will identify epidemiological studies reporting the prevalence or incidence rate of suicide in people with sleep apnea. We will search the following databases: PubMed (MEDLINE), Scopus, Cochrane Library, OVID (HEALTH STAR), OVID (MEDLINE) and Joana Briggs Institute EBF Database. No age, geographical location, study-design or language limits will be applied. This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. Two reviewers (YY and YP) will independently screen citations, abstracts and will identify full-text articles for inclusion, extract data, and appraise the quality and bias of included studies. Discrepancies will be resolved by consulting with a third researcher (MC). Study quality will be assessed by the Newcastle-Ottawa Scale. The primary outcomes will be the overall prevalence or incidence of suicidal ideation, attempts and completion and the risk of suicide in people with sleep apnea. For pooling of the studies, we will use a random-effects model with a logit transformation. The DerSimonian and Laird (DL) random-effects method will be used to estimate the pooled inter-study variance. We will assess the between-study heterogeneity using I2 statistics, and Cochrane's Q statistic (significance level < 0.05). If the I2 is high (>75%), we will perform subgroup meta-analyses and conduct a meta-regression analysis to explore sources of study heterogeneity using study level median age, study-level proportions of race, gender, depression and quality scores. We will report effect estimates as suicide risk per 1000 individuals. Egger's test and funnel plots will be used to assess publication bias, and adjusted estimates using trim and fill methods will be reported if publication bias is suspected. ETHICS AND DISSEMINATION: No ethics clearance is required as no primary data will be collected. The results of this systematic review and meta-analysis will be presented at scientific conferences and published in a peer-review journal. The results may shed more light on the burden of suicide risk among individuals with sleep apnea and may guide future population-specific interventions. TRIAL REGISTRATION: PROSPERO registration number: CRD42020165404.


Asunto(s)
Proyectos de Investigación , Síndromes de la Apnea del Sueño/complicaciones , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Suicidio Completo/estadística & datos numéricos , Humanos , Incidencia , Metaanálisis como Asunto , Prevalencia , Investigación Cualitativa , Síndromes de la Apnea del Sueño/psicología , Intento de Suicidio/psicología , Revisiones Sistemáticas como Asunto
17.
Artículo en Inglés | MEDLINE | ID: mdl-32605104

RESUMEN

: People with a lived experience of suicide are commonly included within suicide prevention research. This includes participation in conferences, policy development, research and other activities. Yet little is known about the impact on the person in the long term of regularly sharing one's experience to different audiences and, in some cases, to a schedule not of your choosing. This qualitative study asked twenty people to share their reflections of being lived experience representatives within suicide prevention. Participants varied in the length of time they had been sharing their stories, and how they shared with different audiences. These narratives were thematically analysed within a reflective framework, including field notes. Four broad themes were noted that highlighted participants' recommendations as to how the lived experience speaker training could grow alongside suicide prevention activities to facilitate safe activities that include a shared understanding of the expected outcome from participation. The environment for people with lived experience of suicide to tell their stories already exists, meaning that the suicide prevention sector needs to move quickly to ensure people understand the variety of spaces where lived experience needs to be incorporated, evaluated and better supported. When lived experience is a valued inclusion in the creation of effective and appropriate suicide prevention research and interventions, those who share their experience must be valued and supported in a way that reflects this. This study recommends strategies to practically and emotionally support speakers, including ways to ensure debriefing and support, which can enhance the longevity of the speakers in the suicide prevention space by valuing the practical and emotional labour required to be suicide prevention representatives, with an outcome recommendation for best practice guidelines for those who engage people with lived experience in suicide prevention activities.


Asunto(s)
Intento de Suicidio/psicología , Suicidio/prevención & control , Australia , Femenino , Humanos , Masculino , Investigación Cualitativa
18.
Arch Womens Ment Health ; 23(5): 673-679, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32623514

RESUMEN

Suicidal ideation and suicidal behavior are common after experiencing a sexual assault. Therefore, it is imperative to assess for and manage suicidal ideation using evidence-based techniques after a sexual assault medical forensic examination (SAMFE). We assessed factors associated with higher suicidal ideation identified in a post-SAMFE mental health screening conducted over the phone and strategies to manage suicide risk. We also discuss three case examples and unique considerations when assessing post-SAMFE suicide risk. It was found that among individuals who completed a post-SAMFE screen, individuals who have been previously hospitalized for a mental health problem, who had higher acute stress symptoms, and who were homeless reported more suicidal ideation than those without those histories or symptom presentations. No matter the risk factors for suicidal ideation post-SAMFE, it is essential to screen all individuals post-SAMFE due to their high risk for suicidal ideation and death by suicide.


Asunto(s)
Delitos Sexuales/psicología , Ideación Suicida , Intento de Suicidio/psicología , Adolescente , Adulto , Depresión/psicología , Femenino , Humanos , Salud Mental , Persona de Mediana Edad , Factores de Riesgo , Trastornos por Estrés Postraumático/psicología , Suicidio/psicología , Estados Unidos , Adulto Joven
19.
JAMA Netw Open ; 3(6): e206639, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32484554

RESUMEN

Importance: Children placed in out-of-home care (OHC) have higher rates of suicidal behaviors, including suicide attempts, compared with those who grow up in their family of origin. Several studies have shown that this elevated risk persists into young adulthood. Yet, our knowledge about any longer-term associations of OHC with suicide attempts is limited. Objective: To examine how childhood experiences of placement in OHC are associated with trajectories of hospitalization because of suicide attempts (HSA) from early into late adulthood. Design, Setting, and Participants: This prospective birth cohort study that was conducted in Stockholm, Sweden, and analyzed in March 2020 included 14 559 individuals born in 1953 who were living in the greater metropolitan of Stockholm in November 1963 and followed through registers up until December 2016. Exposures: Childhood experiences of OHC based on information from the Social Register (age 0-19 years). Main Outcomes and Measures: Hospitalization because of suicide attempts based on in-patient care data from the National Patient Register. Group-based trajectory modeling was used to cluster individuals according to their probabilities of HSA across adulthood (age 20-63 years). Results: In this cohort of 14 559 individuals (7146 women [49.1%]), 1320 individuals (9.1%) had childhood experiences of OHC, whereas 525 individuals ( 3.6%) had HSA. A Cox regression analysis showed a substantially higher risk of HSA among those with childhood experiences of OHC (hazard ratio, 3.58; 95% CI, 2.93-4.36) and after adjusting for a range of adverse childhood living conditions (hazard ratio, 2.51; 95% CI, 2.00-3.15). Those with at least 1 HSA were grouped into 4 trajectories: (1) peak in middle adulthood (66 [12.6%]), (2) stable low across adulthood (167 [31.8%]), (3) peak in early adulthood (210 [40.0%]), and (4) peak in emerging adulthood (82 [15.6%]). A multinomial regression analysis suggested that those with experiences of OHC had higher risks of following any of these trajectories (trajectory 1: relative risk ratio [RRR], 2.91; 95% CI, 1.61-5.26; trajectory 2: RRR, 3.18; 95% CI, 2.21-4.59; trajectory 3: RRR, 4.32; 95% CI, 3.18-5.86; trajectory 4: RRR, 3.26; 95% CI, 1.94-5.46). The estimates were reduced after adjusting for adverse childhood living conditions. Conclusions and Relevance: The findings suggest that the elevated risk of suicide attempts among former child welfare clients does not cease after young adulthood, indicating the necessity for clinical attention to childhood experiences of OHC as a risk marker for suicidal behavior across the life span.


Asunto(s)
Bienestar del Niño/psicología , Cuidados en el Hogar de Adopción/estadística & datos numéricos , Hospitalización/tendencias , Intento de Suicidio/psicología , Adolescente , Adulto , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Suecia/epidemiología , Adulto Joven
20.
Braz J Psychiatry ; 42(4): 367-371, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32491023

RESUMEN

OBJECTIVE: Suicide risk (including attempted and completed suicide) should be measured over short periods of time after contacting health services. The objective of this study was to identify the patterns of attempted and completed suicides within 24-months of a psychiatric emergency department visit, as well as to investigate predictive risk factors, including sociodemographic and clinical variables, previous suicidal behavior, and service utilization. METHOD: A convenience sample (n=147), recruited at a general hospital's psychiatric emergency room, included patients with suicidal ideation, suicidal plans or previous suicide attempts. These patients were followed for 24 months, focusing on two main outcomes: attempted and completed suicides. RESULTS: After six months there were no completed suicides and 36 suicide attempts, while after 24 months there were seven completed suicides and 69 suicide attempts. A final logistic regression model for suicide attempts at 24 months identified somatic pathology and the number of previous psychiatric hospitalizations as predictive factors, with a good area under the receiver operating characteristic curve. CONCLUSIONS: The findings showed distinct patterns of attempted and completed suicides over time, indicating the importance of a systematic multidisciplinary suicide risk evaluation in psychiatric emergency rooms.


Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Trastornos Mentales/psicología , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Suicidio/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Humanos , Modelos Logísticos , Masculino , Trastornos Mentales/terapia , Persona de Mediana Edad , Factores de Riesgo , Suicidio/psicología , Intento de Suicidio/psicología
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