RESUMO
Suicide is a phenomenon that is not related to a specific class of countries but is a problem worldwide. Many studies have attempted to explain gender differences in suicidal behaviors. Unfortunately, Russia holds the world's top place for the number of suicides committed by its male citizens. Russia is still demonstrating unusually high death rates due to non-natural causes, and these demographic trends are concerning. We analyzed suicidality among men in Russia over the past 20 years using official data published by the Federal State Statistics Service (Rosstat) and secondary sources. We also discussed male suicide as a social problem, analyzed, and evaluated male suicidality in Russia from 2000 to 2020, and reviewed the factors influencing the prevalence of male suicides over female suicides in Russia. Russia is still going through one of the most significant historical changes in the last 100 years. Our analysis showed discrepancies between official numbers and data published by non-government organizations in Russia. Unemployment, low socioeconomic status, underdiagnosed and/or untreated mental illness, and substance abuse are major risk factors for suicide in Russian men. Cultural influences also make suicidal behavior socially scripted in Russia. By providing examples and analyzing data, we aspire to encourage improvements in the practice of mental wellbeing in Russia and other post-Soviet countries. The recommendations within this report are intended as a starting point for dialogue to guide effective suicide prevention in this country.
RESUMO
Objectives We aim to delineate the differences in demographic characteristics and hospitalization outcomes including the severity of illness, hospitalization length of stay (LOS) and cost, utilization of deep brain stimulation (DBS), and disposition in Parkinson's disease (PD) inpatients with psychiatric comorbidities versus without psychiatric comorbidities. Methods We conducted a cross-sectional study using the Nationwide Inpatient Sample (NIS), included 56,844 PD inpatients (age ≥40 years), and subdivided them by inpatients into those without psychiatric comorbidities (N = 38,629) and with psychiatric comorbidities (N = 18,471). We compared the distributions of demographic characteristics and hospitalization outcomes (severity of illness, utilization ofDBS, and disposition) by performing Pearson's chi-square test, and we measured the differences in continuous variables (i.e., age, LOS, and cost) by using the independent samples t-test. Results A significantly higher proportion of PD inpatients with psychiatric comorbidities were female (44.4%) and white (83%) and had a moderate loss of functioning (48.8%) compared to those without psychiatric comorbidities. PD inpatients with psychiatric comorbidities had an increased mean LOS (4.7 days vs. 3.7 days, P <0.001) but a lower mean cost ($37,445 vs. $ 41,957, P <0.001). Also, there was a significantly lower utilization of DBS in PD inpatients with psychiatric comorbidities (19.2% vs. 26.9%, P <0.001) compared to those without psychiatric comorbidities, and an adverse disposition of transfer to a skilled nursing facility/intermediate care facility (47.1% vs. 39.6%, P <0.001) compared to PD inpatients without psychiatric comorbidities. Conclusion Although PD patients with psychiatric comorbidities had a moderate loss of functioning, there was significant underutilization of DBS. Meanwhile, psychiatric comorbidities among PD patients led to increased LOS and transfer to skilled facilities.
RESUMO
Objectives To determine the demographic predictors of suicidal behaviors and measure the association between the spectrum of substance use disorders (SUD) and hospitalization for suicidal behaviors in the adolescent population. Methods We conducted a cross-sectional study using the nationwide inpatient sample and included 466,244 adolescent inpatients with psychiatric illnesses. The study sample was sub-grouped into suicidal (N = 182,454) and non-suicidal (N = 283,790) cohorts. The odds ratio (OR) of association for demographic characteristics and comorbid SUD in the suicidal group was evaluated using a logistic regression model witha P-value < 0.01. Results Our study population included 466,244 adolescent inpatients. Females had higher odds of suicidal behaviors (OR 1.45; 95% CI 1.431-1.470) compared to males. The most prevalent comorbid SUD among suicidal inpatients was cannabis (15.3%) but had a statistically non-significant association with suicidal behaviors (OR 0.98; 95% CI 0.95-0.99). Inpatients with alcohol use disorders had significantly increased odds of association with suicidal behaviors (OR 1.18; CI: 1.142-1.209) compare to other SUD. Among other substances (cannabis and stimulants), there existed a statistically non-significant association with hospitalization for suicidal behaviors. Conclusion Adolescent inpatients with comorbid alcohol use disorders were at 18% higher odds of hospitalization for suicidal behaviors. Our study provides a basis for more research while also suggesting potential avenues for early identification and intervention efforts for comorbid SUD in adolescents requiring psychiatric care to improve their prognosis and quality of life.
