Downloads & Free Reading Options - Results

This is a registration of the data analysis plan prior to commencement of the formal analysis. The attached file contains the analysis plan.

The study will examine the association between prescription of opioids and suicidal behaviour among older adults in Sweden. Using public registers linked via the Swedish personal identification number to collect information on exposure and outcome, we will include all adults aged 75 years or older in Sweden between 2007-2017.

This article is from BMC Public Health , volume 12 . Abstract Background: A link between low parental socioeconomic status and mental health problems in offspring is well established in previous research. The mechanisms that explain this link are largely unknown. The present study investigated whether school performance was a mediating and/or moderating factor in the path between parental socioeconomic status and the risk of hospital admission for non-fatal suicidal behaviour. Methods: A national cohort of 447 929 children born during 1973-1977 was followed prospectively in the National Patient Discharge Register from the end of their ninth and final year of compulsory school until 2001. Multivariate Cox proportional hazards and linear regression analyses were performed to test whether the association between parental socioeconomic status and non-fatal suicidal behaviour was mediated or moderated by school performance. Results: The results of a series of multiple regression analyses, adjusted for demographic variables, revealed that school performance was as an important mediator in the relationship between parental socioeconomic status and risk of non-fatal suicidal behaviour, accounting for 60% of the variance. The hypothesized moderation of parental socioeconomic status-non-fatal suicidal behaviour relationship by school performance was not supported. Conclusions: School performance is an important mediator through which parental socioeconomic status translates into a risk for non-fatal suicidal behaviour. Prevention efforts aimed to reduce socioeconomic inequalities in non-fatal suicidal behaviour among young people will need to consider socioeconomic inequalities in school performance.

26 p. : 28 cm

This article is from BMJ Open , volume 4 . Abstract Introduction: Suicide is an important public health problem and one of the most common causes of death throughout the world. Suicidal behaviour is complex, and its causes are multifactorial. Case–control studies have reported an association between an alteration of the serotonin system and suicidal behaviour. Recently, it has been suggested that the 5-HTRC2 serotonin receptor gene is involved in the pathogenesis of suicidal behaviour. Methods and analysis: To evaluate the role of the 5-HTR2C gene in suicidal behaviour, we will perform a systematic review and a meta-analysis of worldwide reports that have investigated the association between the serotonin system and suicidal behaviour. This analysis will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Studies deemed fit for inclusion in the systematic review will be scored for methodological quality using the Newcastle-Ottawa Assessment Scale (NOS). The inclusion criteria will be to present independent data, to be case–control studies and to be published in journal peer reviews. To generate more accurate analyses, we will grade the reports using the GRADES scale procedures. Ethics and dissemination: This study will describe the association between the HTR2C gene and suicidal behaviour. The results will be reported in a peer-reviewed publication and in scientific presentations in Mexico and throughout the world. Trial registration number: PROSPERO CRD42014009213.

Objective: To identify published evidence covering the disclosure of suicidal ideation and behaviour in young people between the ages of 15 and 25 years old, and to identify the rates of disclosure to family members amongst this age group and the effect of that disclosure on the young person and the confidante. Introduction: Disclosure of suicidal ideation offers a significant opportunity for intervention and pathways to care. Family can be instrumental in young people accessing care but to date there is limited knowledge about the patterns of disclosure of suicidal ideation in young people, particularly to their family. Inclusion criteria: Studies that report on samples aged 15-25 years, or where the mean age range is 25 years or under, who have suicidal ideation or behaviour, and where the study indicates whether they have disclosed this to another party. Methods: Databases searches will be conducted with PsycInfo, Cinahl, Web of Science, Embase, PubMed using the terms ‘Suicid* or attempt survivor’ and ‘conceal* or disclos* or confess* or talk* or share or non-disclosure or discov*’. The search will be conducted in December 2022 and will be limited to English publications. Two reviewers will initially screen titles and abstracts and then full texts, any disagreements will be resolved by all authors. The first author will conduct data extraction based on a tool piloted on a sub-sample of studies

This article is from PLoS ONE , volume 9 . Abstract Introduction: Research on factors associated with suicidal ideation and suicide attempts has been conducted largely in developed countries. Research on West African countries in particular is lacking. Methods: Data were obtained from the Global School-based Health Survey conducted in Benin in 2009. This was a cross-sectional study of three grades, spanning Junior and Senior High, which sampled a total of 2,690 adolescents. Data on the occurrence of demographic, psycho-social and socio-environmental risk factors were tested using multinomial logistic regression for their association with suicidal ideation and suicide attempts. Results: The survey indicated that 23.2% had thought about suicide and 28.3% had made a suicide attempt in the previous year. Anxiety, loneliness, being bullied, alcohol misuse, illicit drug use, and lack of parental support were independently related to the ideation outcomes, suicidal ideation without planning and suicidal ideation with planning. Multinomial regression analysis, using one suicide attempt and multiple suicide attempts as outcomes, revealed that female sex, anxiety, loneliness, being physically attacked, and illicit drug use were associated these outcomes. Discussion: The prevalence of suicide attempts reported in the survey is relatively high. It is possible that there are cultural factors that could explain this finding. Our research indicates that many factors are related to the occurrence of suicidal ideation and suicide attempts among youth in Benin. Illicit drug use and violence in particular are associated with a high rate of suicide attempts in Benin. Measures to address these issues may reduce the risk of self-inflicted violence.

This article is from PLoS ONE , volume 9 . Abstract Background: Common mental disorders (CMD) have become one of the leading causes for disability pension (DP). Studies on predictors of adverse health outcome following DP are sparse. This study aimed to examine the association of different socio-demographic factors and health care consumption with subsequent suicidal behaviour among individuals on DP due to CMD. Method: This is a population-based prospective cohort study based on register data. All individuals aged 18–64 years, living in Sweden on 31-Dec-2004 who in 2005 were on DP due to CMD (N = 46 745) were followed regarding suicide attempt and suicide (2006–10). Univariate and multivariate hazard ratios (HR) and 95% confidence intervals (CI) for suicidal behaviour were estimated by Cox regression. Results: During the five-year follow-up, 1 046 (2.2%) and 210 (0.4%) individuals attempted and committed suicide, respectively. Multivariate analyses showed that young age (18–24 years) and low education predicted suicide attempt, while living alone was associated with both higher suicide attempt and suicide (range of HRs 1.23 to 1.68). Combined prescription of antidepressants with anxiolytics during 2005 and inpatient care due to mental diagnoses or suicide attempt (2001–05) were strongly associated with suicide attempt and suicide (range of HRs 1.3 to 4.9), while inpatient care due to somatic diagnoses and specialized outpatient care due to mental diagnoses during 2001–05 only predicted suicide attempt (HR 1.45; 95% CI: 1.3–1.7; HR 1.30; 95% CI: 1.1–1.7). Conclusions: Along with socio-demographic factors, it is very important to consider type of previous healthcare use and medication history when designing further research or intervention aiming at individuals on DP due to CMD. Further research is warranted to investigate both characteristics of disability pension due to CMD, like duration, diagnoses and grade as well as mechanisms to subsequent suicidal behavior, taking potential gender differences into consideration.

This article is from PLoS ONE , volume 9 . Abstract Background: Common mental disorders (CMD) have become one of the leading causes for disability pension (DP). Studies on predictors of adverse health outcome following DP are sparse. This study aimed to examine the association of different socio-demographic factors and health care consumption with subsequent suicidal behaviour among individuals on DP due to CMD. Method: This is a population-based prospective cohort study based on register data. All individuals aged 18–64 years, living in Sweden on 31-Dec-2004 who in 2005 were on DP due to CMD (N = 46 745) were followed regarding suicide attempt and suicide (2006–10). Univariate and multivariate hazard ratios (HR) and 95% confidence intervals (CI) for suicidal behaviour were estimated by Cox regression. Results: During the five-year follow-up, 1 046 (2.2%) and 210 (0.4%) individuals attempted and committed suicide, respectively. Multivariate analyses showed that young age (18–24 years) and low education predicted suicide attempt, while living alone was associated with both higher suicide attempt and suicide (range of HRs 1.23 to 1.68). Combined prescription of antidepressants with anxiolytics during 2005 and inpatient care due to mental diagnoses or suicide attempt (2001–05) were strongly associated with suicide attempt and suicide (range of HRs 1.3 to 4.9), while inpatient care due to somatic diagnoses and specialized outpatient care due to mental diagnoses during 2001–05 only predicted suicide attempt (HR 1.45; 95% CI: 1.3–1.7; HR 1.30; 95% CI: 1.1–1.7). Conclusions: Along with socio-demographic factors, it is very important to consider type of previous healthcare use and medication history when designing further research or intervention aiming at individuals on DP due to CMD. Further research is warranted to investigate both characteristics of disability pension due to CMD, like duration, diagnoses and grade as well as mechanisms to subsequent suicidal behavior, taking potential gender differences into consideration.

This mini systematic review analyses the evidence surrounding the experiences of professionals to assemble such information based on health care staff’s perception of self-harming patients for the increased awareness of a more successful implementation of better-quality care.

This article is from BMC Psychiatry , volume 13 . Abstract Background: To investigate attitudes of professionals working in mental health care outpatient clinics in Child and Adolescent Psychiatry (CAP) (for children and adolescents aged 0–18 years) and District Psychiatric Centres (DPC) (for adults aged 18–67 years). Methods: Professionals in four outpatient units in Oslo were enrolled (n = 229: 77%). The Understanding of Suicidal Patient scale (USP) (11 = positive to 55 = negative) and Attitudes Towards Suicide questionnaire (ATTS) (1 = totally disagree to 5 = totally agree) were used to assess professionals’ attitudes. Questions explored competence, religion, experiences of and views on suicidal behaviour and its treatment. Results: All the professionals indicated positive attitudes (USP 18.7) and endorsed the view that suicide was preventable (ATTS 4.3). Professionals who had received supervision or were specialists had attitudes that were more positive. Professionals in CAP were less satisfied with available treatment. Psychiatric disorders were considered the most common cause of suicidal behaviour, and psychotherapy the most appropriate form of treatment. The professionals confirmed that patients with other disorders of comparable severity are followed up more systematically. Conclusions: The professionals showed positive attitudes with minor differences between CAP and DPC.

This project is a systematic review of previous studies which aims to investigate the role of personality traits in risk of suicidal behaviour in patients with schizophrenia and related disorders

Examining the motivational phase of the IMV model in a sample of young adults in Turkey

This article is from BMJ Open , volume 3 . Abstract Objectives: Increasing rates of disability pension (DP), particularly owing to mental diagnoses, have been observed among young adults in Organisation for Economic Co-operation and Development (OECD) countries. There is a lack of knowledge about the health prognosis in this group. The aim of this study was to investigate whether DP in young adulthood owing to specific mental diagnoses or somatic diagnoses predicts suicidal behaviour and all-cause mortality. Design: A nationwide prospective cohort study. Setting: A register study of all young adults who in 2005 were 19–23 years old and lived in Sweden. Registers held by the National Board of Health and Welfare, Statistics Sweden and the National Social Insurance Agency were used. Participants: 525 276 young adults. Those who in 2005 had DP with mental diagnoses (n=8070) or somatic diagnoses (n=3975) were compared to all the other young adults in the same age group (n=513 231). Outcome measures: HRs for suicide attempt, suicide and all-cause mortality in 2006–2010 were calculated by Cox proportionate hazard regression models, adjusted for sex, country of birth, parental education and parental and previous own suicidal behaviour. Results: The adjusted HR for suicide attempt was 3.32 (95% CI 2.98 to 3.69) among those on DP with mental diagnoses and 1.78 (95% CI 1.41 to 2.26) among those on DP with somatic diagnoses. For the specific mental diagnoses, the unadjusted HRs ranged between 2.42 (mental retardation) and 22.94 (personality disorders), while the adjusted HRs ranged between 2.03 (mental retardation) and 6.00 (bipolar disorder). There was an increased risk of mortality for young adults on DP in general, but only those with mental DP diagnoses had a significantly elevated HR of completed suicide with an adjusted HR of 3.92 (95% CI 2.83 to 5.43). Conclusions: Young adults on DP are at increased risk of suicidal behaviour and preterm death, which emphasises the need for improved treatment and follow-up.

A qualitative investigation focusing on young's people suicidal ideation, suicidal behaviour, and self-harm in Rwanda. Attitudes and experiences are sought from young people (16-22) with and without personal experience of self-harm and suicide, as well as parents with and without personal experience of having a youth who has self-harmed and/or engaged in suicidal behaviour, as well as health-care professionals with experience of working with families affected by this.

Sleep disturbances are a common difficulty for individuals with a history of substance misuse with 36 to 91% reporting sleep difficulties. This lack of sufficient sleep is concerning as insufficient sleep is associated with a range of emotional regulation difficulties and mental health difficulties including depression, anxiety, and even suicidal behaviour. Suicidal behaviour is often an indicator of intense distress and can include thoughts of self-harm or suicide or any behaviours that an individual does on purpose to hurt themselves, (e.g., cutting or burning your skin) regardless of the reasons or intention, including past suicide attempts. The nature and interrelatedness of the relationship between sleep difficulties, emotions, and suicidal thoughts and behaviours has not yet been explored in individuals with substance misuse. However, it is important to clarify these factors in individuals with substance misuse as are at higher risk of experiencing sleep disturbance, emotional difficulties, and suicidal thoughts and behaviours than others. This research aims to explore the perceptions and views of service users and staff in an inpatient addiction service on sleep, how it might be related to suicidal behaviour, and how emotions may be relevant to this relationship. This will be explored through interviews with service users and staff in Saint John of God Hospital. This project will expand our knowledge by clarifying the relationships between sleep, emotional regulation, and suicidal behaviour in individuals with substance misuse and will add valuable evidence to the limited international literature in the field. The findings of this study may be used to improve support available for future patients attending St John of God Hospital such as through the development of a psychoeducational programme.

This scoping review will aim to provide a summary of research findings from recent literature (from 2000 to 2022) on the relationship between substance use disorder (SUD) and lifetime suicidal behaviour, identify gaps in knowledge, and propose specific avenues for future research. The research question guiding this scoping review is: What is known about suicidal behaviour in clinical samples in treatment for SUD?

This scoping review will aim to provide a summary of research findings from recent literature (from 2000 to 2022) on the relationship between substance use disorder (SUD) and lifetime suicidal behaviour, identify gaps in knowledge, and propose specific avenues for future research. The research question guiding this scoping review is: What is known about suicidal behaviour in clinical samples in treatment for SUD?

The primary objective of the scoping review will be to identify and synthesise studies regarding male victims of intimate partner violence (IPV) and their experiences of suicidal behaviours. The review questions are: 1. How are the associations between male victims of intimate partner violence and suicidal behaviour reported in the literature? 2. What are the knowledge gaps that exist?

This article is from Behavioral and Brain Functions : BBF , volume 7 . Abstract Background: Suicidal behaviour is known to aggregate in families. Patients with psychiatric disorders are at higher risk for suicide attempts (SA), however protective and risk genetic variants for suicide appear to be independent of underlying psychiatric disorders. Here we investigate genetic variants in genes important for neurobiological pathways linked to suicidal behaviour and/or associated endophenotypes, for association with SA among patients with co-existing psychiatric illness. Selected gene-gene and gene-environment interactions were also tested. Methods: DNA was obtained from bloods of 159 patients (76 suicide attempters and 83 non-attempters), who were profiled for DSM-IV Axis I psychiatric diagnosis. Twenty-eight single nucleotide polymorphisms (SNPs) from 18 candidate genes (COMT, 5-HT2A, 5-HT1A, 5-HTR1B, TPH1, MAO-A, TPH2, DBH, CNR1, BDNF, ABCG1, GABRA5, GABRG2, GABRB2, SLC1A2, SLC1A3, NTRK2, CRHR1) were genotyped. Genotyping was performed by KBioscience. Tests of association between genetic variants and SA were conducted using Chi squared and Armitage Trend tests. Binary logistical regression analyses were performed to evaluate the contribution of individual genetic variants to the prediction of SA, and to examine SNPs for potential gene-gene and gene-environment interactions. Results: Our analysis identified 4 SNPs (rs4755404, rs2269272, rs6296 and rs1659400), which showed evidence of association with SA compared to a non-attempter control group. We provide evidence of a 3-locus gene-gene interaction, and a putative gene-environment interaction, whereby genetic variation at the NTRK2 locus may moderate the risk associated with history of childhood abuse. Conclusion: Preliminary findings suggest that allelic variability in SLC1A2/3, 5-HTR1B and NTRK2 may be relevant to the underlying diathesis for suicidal acts.

This article is from Behavioral and Brain Functions : BBF , volume 7 . Abstract Background: Suicidal behaviour is known to aggregate in families. Patients with psychiatric disorders are at higher risk for suicide attempts (SA), however protective and risk genetic variants for suicide appear to be independent of underlying psychiatric disorders. Here we investigate genetic variants in genes important for neurobiological pathways linked to suicidal behaviour and/or associated endophenotypes, for association with SA among patients with co-existing psychiatric illness. Selected gene-gene and gene-environment interactions were also tested. Methods: DNA was obtained from bloods of 159 patients (76 suicide attempters and 83 non-attempters), who were profiled for DSM-IV Axis I psychiatric diagnosis. Twenty-eight single nucleotide polymorphisms (SNPs) from 18 candidate genes (COMT, 5-HT2A, 5-HT1A, 5-HTR1B, TPH1, MAO-A, TPH2, DBH, CNR1, BDNF, ABCG1, GABRA5, GABRG2, GABRB2, SLC1A2, SLC1A3, NTRK2, CRHR1) were genotyped. Genotyping was performed by KBioscience. Tests of association between genetic variants and SA were conducted using Chi squared and Armitage Trend tests. Binary logistical regression analyses were performed to evaluate the contribution of individual genetic variants to the prediction of SA, and to examine SNPs for potential gene-gene and gene-environment interactions. Results: Our analysis identified 4 SNPs (rs4755404, rs2269272, rs6296 and rs1659400), which showed evidence of association with SA compared to a non-attempter control group. We provide evidence of a 3-locus gene-gene interaction, and a putative gene-environment interaction, whereby genetic variation at the NTRK2 locus may moderate the risk associated with history of childhood abuse. Conclusion: Preliminary findings suggest that allelic variability in SLC1A2/3, 5-HTR1B and NTRK2 may be relevant to the underlying diathesis for suicidal acts.

Background: In light of increasing stress resulting from deployment abroad, one of the psychologic consequences to be expected is an increase in suicidal behaviour among soldiers. Material and Methods: 200 soldiers receiving psychiatric inpatient care in a Bundeswehr hospital, of whom n=100 exhibiting and n=100 not exhibiting (control group) suicidal tendency, were compared in terms of sociodemographic and clinical characteristics. Results: Significant predictors of suicidal ideation were alcohol abuse within the immediate family and pathologically high scores in the Minnesota Multiphasic Personality Inventory (MMPI). Significant predictors of suicidal acts were pathologic scores in MMPI, an unfinished vocational training, suicide attempts within the family as well as the situation of basic military training. Conclusion: The data gathered in this pilot study indicates an influence of individual and military risk factors in the development of suicidality in Bundeswehr soldiers.

Background: In light of increasing stress resulting from deployment abroad, one of the psychologic consequences to be expected is an increase in suicidal behaviour among soldiers. Material and Methods: 200 soldiers receiving psychiatric inpatient care in a Bundeswehr hospital, of whom n=100 exhibiting and n=100 not exhibiting (control group) suicidal tendency, were compared in terms of sociodemographic and clinical characteristics. Results: Significant predictors of suicidal ideation were alcohol abuse within the immediate family and pathologically high scores in the Minnesota Multiphasic Personality Inventory (MMPI). Significant predictors of suicidal acts were pathologic scores in MMPI, an unfinished vocational training, suicide attempts within the family as well as the situation of basic military training. Conclusion: The data gathered in this pilot study indicates an influence of individual and military risk factors in the development of suicidality in Bundeswehr soldiers.

Background: In light of increasing stress resulting from deployment abroad, one of the psychologic consequences to be expected is an increase in suicidal behaviour among soldiers. Material and Methods: 200 soldiers receiving psychiatric inpatient care in a Bundeswehr hospital, of whom n=100 exhibiting and n=100 not exhibiting (control group) suicidal tendency, were compared in terms of sociodemographic and clinical characteristics. Results: Significant predictors of suicidal ideation were alcohol abuse within the immediate family and pathologically high scores in the Minnesota Multiphasic Personality Inventory (MMPI). Significant predictors of suicidal acts were pathologic scores in MMPI, an unfinished vocational training, suicide attempts within the family as well as the situation of basic military training. Conclusion: The data gathered in this pilot study indicates an influence of individual and military risk factors in the development of suicidality in Bundeswehr soldiers.

A scoping review to map what is currently known from the literature about suicidal behaviour in Huntington's disease.

A scoping review to map what is currently known from the literature about suicidal behaviour in Huntington's disease.

Background: Suicide is a significant public health issue globally. Patterns and disparities of suicide may have changed with the onset of the COVID-19 pandemic. Through epidemiological compar-ative studies we can identify them how suicide incidence is influenced by risk factors such as per-sonal pressures and social support. This study analyses Spanish suicide data during the period from 2017 to 2022, and compares them with previously analysed data from Japan, with the aim to ex-plore the variability of suicide distribution in both countries. Methods: We used a retrospective observational design with national-level suicide data from Spain to estimate trends in suicide mortality over this period to compare with previously analysed data from Japan. Results: In Spain, no significant changes in suicide rates were found before and after the pandemic period, but notable monthly variations occurred at the pandemic's onset in the youngest, highlighting the increase in poisoning in women until 2020. In Japan, a notable variation was found following the pandemic: older age groups and younger women were at higher suicide risk, while in men, the suicide risk transitioned from younger to older ages between 2020 and 2021, probably attributed to exacerbated socio-economic factors. A similar trend was observed in both countries on sex with different in-fluence on women. Conclusions: This study offers a detailed insight into the patterns and circum-stances of suicide in these countries, offering a basis for future interventions and preventive measures. These comparisons emphasize the critical nature of suicide and underline the necessity for enhanced prevention efforts.

Pre-registration of data relates to the quantitative study included in the above titled doctoral research which used secondary data from the 'Student Psychological Intervention Trial' (SPIT), conducted as part of the WHO World Mental Health International Student College Initiative. For context, existing literature has highlighted the significant mental health disparities that exist for LGBTQ+ young adults globally, and the impact of minority stress on mental health outcomes including suicidal behaviours. However, the current study is concerned with addressing gaps in knowledge, including the complex intersection between LGBTQ+ identities, interpersonal trauma including minority stress, and pathways to suicidal behaviour. This study will therefore assess and compare the mental health (emotional wellbeing, depression, anxiety), suicidal behaviour, trauma exposure, and help-seeking behaviours of LGB students with heterosexual students. Further, it will seek to understand the association and relevant factors, based on extant literature, between LGBTQ+ status (minority status) and an increased risk of mental health difficulties, trauma exposure and suicide risk. As such, the current study seeks to provide new knowledge and evidence that can inform national policies on better meeting mental health needs, and therefore adding to suicide prevention efforts here in Northern Ireland.

Scoping Review of current literature that shows best practice responses that can be employed by schools to address incidents of self-harm, suicidal ideation, and/or intentions and suicide attempts amongst primary and secondary school aged children.

Scoping Review of current literature that shows best practice responses that can be employed by schools to address incidents of self-harm, suicidal ideation, and/or intentions and suicide attempts amongst primary and secondary school aged children.

This article is from BMJ Open , volume 4 . Abstract Objectives: To examine predictive power of psychache and life satisfaction on risks for suicidal ideation and suicide attempt among young people. Design: A cross-sectional study. Setting: Data were collected from an online survey in Wuhan, China. Participants: 5988 university students from six universities were selected by a stratified cluster sampling method. Primary and secondary outcome measures: Suicidal ideation and suicide attempt at some point of the students’ lifetime were the outcomes of interest. Results: Students with suicidal ideation or attempted suicide reported a lower level of life satisfaction and high degree of psychache than counterparts without suicidal ideation or attempt. Regression analyses indicated that life satisfaction and psychache were significantly associated with the risk of suicidal ideation and the risk of suicidal attempt. Though psychache showed a relatively stronger predictive power than life satisfaction, the effect of the two factors remained significant when they were individually adjusted for personal demographic characteristics. However, when the two factors were included in the model simultaneously to adjust for each other, psychache could fully explain the association between life satisfaction and suicidal attempt. Life satisfaction remained to contribute unique variance in the statistical prediction of suicidal ideation. Conclusions: Psychache and life satisfaction both have a significant predictive power on risk for suicidal behaviour, and life satisfaction could relieve the predictive power of psychache when suicidal behaviour is just starting. Shneidman's theory that psychache is the pre-eminent psychological cause of suicide is perhaps applicable only to a more serious form of suicidal behaviour.

This article is from BMC Psychiatry , volume 13 . Abstract Background: An important reason for the high risk of suicide in the elderly is the determination with which they act out their suicidal thoughts. Early identification of suicidal behaviours in the elderly is therefore important for suicide prevention efforts in this population. Method: Data are from the Ibadan Study of Ageing (ISA), a household multi-stage probability sample of 2149 Yoruba Nigerians aged 65 years or older conducted between 2003 and 2004. We used the third version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI) to explore suicidal experiences and behaviours. In this report, only those experiences or behaviours reported to have occurred after the age of 65 years are the focus of analysis. Derived weights were applied to the data in accordance with the study design and associations were explored using logistic regression. The results are presented as odds ratios (ORs) with 95% confidence intervals. Result: In all, 4.0% (95% C.I= 3.1-4.2) of the subjects had suicidal ideation occurring after the age of 65 years, while 0.7% (95% C.I=0.4-1.3) and 0.2% (95% C.I= 0.1-0.4) reported suicidal plans and attempts, respectively. There was a significantly elevated likelihood of suicidal ideation among persons who had experienced spousal separation through death or divorce (O.R=4.9., 95% C.I= 1.5-15) or who were residing in rural settings (O.R=2.5, 95% C.I=1.3-4.8). Conclusion: Suicidal ideation is common among the elderly. About 20% and 6% of those with ideation proceed to plans and attempts, respectively. Circumstances of social isolation and exclusion are important correlates of suicidal behaviour in the elderly.

This article is from BMC Public Health , volume 11 . Abstract Background: While suicide is the second leading cause of death among young people in most industrial countries, non-fatal suicidal behaviour is also a very important public health concern among adolescents. The aim of this study was to investigate gender differences in prevalence and emotional and behavioural correlates of suicidal behaviour in a representative school-based sample of adolescents. Methods: A cross-sectional design was used to assess suicidal behaviour and various areas of emotional and behavioural problems by using a self-report booklet including the Youth Self-Report. One hundred sixteen schools in a region of Southern Germany agreed to participate. A representative sample of 5,512 ninth-grade students was studied. Mean age was 14.8 years (SD 0.73); 49.8% were female. Results: Serious suicidal thoughts were reported by 19.8% of the female students and 10.8% of the females had ever attempted suicide. In the male group, 9.3% had a history of suicidal thoughts and 4.9% had previously attempted suicide. Internalizing emotional and behavioural problems were shown to be higher in the female group (difference of the group means 4.41) while externalizing emotional and behavioural problems slightly predominated in male students (difference of the group means -0.65). However, the total rate of emotional and behavioural problems was significantly higher in the adolescent female group (difference of the group means 4.98). Using logistic regression models with suicidal thoughts or attempted suicide as dependent variables, the pseudo-R2 of gender alone was only 2.7% or 2.3%, while it was 30% or 23.2% for emotional and behavioural problems measured by the YSR syndrome scales. By adding gender to the emotional and behavioural problems only an additional 0.3% of information could be explained. Conclusions: The findings suggest that gender differences in non-fatal suicidal behaviour among adolescents can to a large extent be explained by the gender differences in emotional and behavioural problems during this age.

This article is from BMC Public Health , volume 14 . Abstract Background: Suicide is a major cause of premature mortality worldwide, but data on its epidemiology in Africa, the world’s second most populous continent, are limited. Methods: We systematically reviewed published literature on suicidal behaviour in African countries. We searched PubMed, Web of Knowledge, PsycINFO, African Index Medicus, Eastern Mediterranean Index Medicus and African Journals OnLine and carried out citation searches of key articles. We crudely estimated the incidence of suicide and suicide attempts in Africa based on country-specific data and compared these with published estimates. We also describe common features of suicide and suicide attempts across the studies, including information related to age, sex, methods used and risk factors. Results: Regional or national suicide incidence data were available for less than one third (16/53) of African countries containing approximately 60% of Africa’s population; suicide attempt data were available for

This article is from Indian Journal of Psychiatry , volume 55 . Abstract Background, Setting and Design:: The chronicity, distress, high rates of comorbidity and varying degree of non response to treatment in Obsessive Compulsive Disorder (OCD) may contribute to suicidal behavior. There is relatively little information on suicidal behavior in OCD subjects. Our study design is Single point non-invasive, cross sectional, clinical study of new and follow up cases. Materials and Methods:: Assessment of Suicidal Behavior in patients of OCD attending the adult Psychiatry O.P.D. of Chatrapati Shahuji Maharaj Medical University (CSMMU) U.P. Lucknow using (DSM-IV) criteria for diagnosis of Obsessive Compulsive Disorder, Structured Clinical Interview for DSM-IV Axis-I disorders, Yale Brown Obsessive Compulsive Rating Scale, Scale for Suicidal Ideation (SSI), Beck's Hopelessness Scale (BHS). Statistical Analysis:: Mean standard deviation and t test for independent samples, Pearson's correlation coefficient. Results:: Statistically significant differences were seen in the SSI score between the “Clinical” and “Sub-Clinical” cases with Clinical group having higher scores. Value of correlation coefficient between YBOCS score and SSI and BHS score is positive and statistically significant (P

This article is from Indian Journal of Psychiatry , volume 55 . Abstract Background, Setting and Design:: The chronicity, distress, high rates of comorbidity and varying degree of non response to treatment in Obsessive Compulsive Disorder (OCD) may contribute to suicidal behavior. There is relatively little information on suicidal behavior in OCD subjects. Our study design is Single point non-invasive, cross sectional, clinical study of new and follow up cases. Materials and Methods:: Assessment of Suicidal Behavior in patients of OCD attending the adult Psychiatry O.P.D. of Chatrapati Shahuji Maharaj Medical University (CSMMU) U.P. Lucknow using (DSM-IV) criteria for diagnosis of Obsessive Compulsive Disorder, Structured Clinical Interview for DSM-IV Axis-I disorders, Yale Brown Obsessive Compulsive Rating Scale, Scale for Suicidal Ideation (SSI), Beck's Hopelessness Scale (BHS). Statistical Analysis:: Mean standard deviation and t test for independent samples, Pearson's correlation coefficient. Results:: Statistically significant differences were seen in the SSI score between the “Clinical” and “Sub-Clinical” cases with Clinical group having higher scores. Value of correlation coefficient between YBOCS score and SSI and BHS score is positive and statistically significant (P

This article is from BMJ : British Medical Journal , volume 348 . Abstract Objective To investigate the association between drug treatment for attention-deficit/hyperactivity disorder (ADHD) and risk of concomitant suicidal behaviour among patients with ADHD.Design Register based longitudinal study using within patient design.Setting Linkage of multiple national registers in Sweden.Participants 37 936 patients with ADHD born between 1960 and 1996 and followed from 2006 to 2009 for treatment status by ADHD drug treatment and suicide related events (suicide attempt and completed suicide).Main outcome measure Incidence rate of suicide related events during ADHD drug treatment periods compared with that during non-treatment periods.Results Among 37 936 patients with ADHD, 7019 suicide related events occurred during 150 721 person years of follow-up. At the population level, drug treatment of ADHD was associated with an increased rate of suicide related events (hazard ratio 1.31, 95% confidence interval 1.19 to 1.44). However, the within patient comparison showed a reverse association between ADHD drug treatment and rate of suicide related events (0.89, 0.79 to 1.00). Among stimulant users, a reduced within patient rate of suicide related events was seen during treatment periods (0.81, 0.70 to 0.94). Among non-stimulant/mixed users, no significantly increased within patient rate of suicide related events during non-stimulant treatment periods was seen (0.96, 0.72 to 1.30).Conclusions This study found no evidence for a positive association between the use of drug treatments for ADHD and the risk of concomitant suicidal behaviour among patients with ADHD. If anything, the results pointed to a potential protective effect of drugs for ADHD on suicidal behaviour, particularly for stimulant drugs. The study highlights the importance of using within patient designs to control for confounding in future pharmacoepidemiological studies.

This article is from BMJ : British Medical Journal , volume 348 . Abstract Objective To investigate the association between drug treatment for attention-deficit/hyperactivity disorder (ADHD) and risk of concomitant suicidal behaviour among patients with ADHD.Design Register based longitudinal study using within patient design.Setting Linkage of multiple national registers in Sweden.Participants 37 936 patients with ADHD born between 1960 and 1996 and followed from 2006 to 2009 for treatment status by ADHD drug treatment and suicide related events (suicide attempt and completed suicide).Main outcome measure Incidence rate of suicide related events during ADHD drug treatment periods compared with that during non-treatment periods.Results Among 37 936 patients with ADHD, 7019 suicide related events occurred during 150 721 person years of follow-up. At the population level, drug treatment of ADHD was associated with an increased rate of suicide related events (hazard ratio 1.31, 95% confidence interval 1.19 to 1.44). However, the within patient comparison showed a reverse association between ADHD drug treatment and rate of suicide related events (0.89, 0.79 to 1.00). Among stimulant users, a reduced within patient rate of suicide related events was seen during treatment periods (0.81, 0.70 to 0.94). Among non-stimulant/mixed users, no significantly increased within patient rate of suicide related events during non-stimulant treatment periods was seen (0.96, 0.72 to 1.30).Conclusions This study found no evidence for a positive association between the use of drug treatments for ADHD and the risk of concomitant suicidal behaviour among patients with ADHD. If anything, the results pointed to a potential protective effect of drugs for ADHD on suicidal behaviour, particularly for stimulant drugs. The study highlights the importance of using within patient designs to control for confounding in future pharmacoepidemiological studies.

This article is from International Journal for Equity in Health , volume 13 . Abstract Introduction: Although suicide rates have increased in some European countries in relation to the current economic crisis and austerity policies, that trend has not been observed in Spain. This study examines the impact of the economic crisis on suicide attempts, the previously neglected endpoint of the suicidal process, and its relation to unemployment, age and sex. Methods: The study was carried out in Andalusia, the most populated region of Spain, and which has a high level of unemployment. Information on suicide attempts attended by emergency services was extracted from the Health Emergencies Public Enterprise Information System (SIEPES). Suicide attempts occurring between 2003 and 2012 were included, in order to cover five years prior to the crisis (2003–2007) and five years after its onset (2008–2012). Information was retrieved from 24,380 cases (11,494 men and 12,886 women) on sex, age, address, and type of attention provided. Age-adjusted suicide attempt rates were calculated. Excess numbers of attempts from 2008 to 2012 were estimated for each sex using historical trends of the five previous years, through time regression models using negative binomial regression analysis. To assess the association between unemployment and suicide attempts rates, linear regression models with fixed effects were performed. Results: A sharp increase in suicide attempt rates in Andalusia was detected after the onset of the crisis, both in men and in women. Adults aged 35 to 54 years were the most affected in both sexes. Suicide attempt rates were associated with unemployment rates in men, accounting for almost half of the cases during the five initial years of the crisis. Women were also affected during the recession period but this association could not be specifically attributed to unemployment. Conclusions: This study enhances our understanding of the potential effects of the economic crisis on the rapidly increasing suicide attempt rates in women and men, and the association of unemployment with growing suicidal behaviour in men. Research on the suicide effects of the economic crisis may need to take into account earlier stages of the suicidal process, and that this effect may differ by age and sex.

This article is from BMC Health Services Research , volume 14 . Abstract Background: Competence and attitudes to suicidal behaviour among physicians are important to provide high-quality care for a large patient group. The aim was to study different physicians’ attitudes towards suicidal behaviour and their perceived competence to care for suicidal patients. Methods: A random selection (n = 750) of all registered General Practitioners, Psychiatrists and Internists in Norway received a questionnaire. The response rate was 40%. The Understanding of Suicidal Patients Scale (USP; scores 

This article is from Child and Adolescent Psychiatry and Mental Health , volume 7 . Abstract Background: Deliberate Self-Harm (DSH) is a common problem among children and adolescents in clinical and community populations, and there is a considerable amount of literature investigating factors associated with DSH risk and the effects of DSH on the child. However, there is a dearth of research examining the impact of DSH on parents, and there are few support programmes targeted at this population. This cross-sectional study examines the profile of a sample of parents of young people with DSH who participated in a support programme (Supporting Parents and Carers of young people with self-harm: the SPACE programme), with the goal of investigating pre-test parental well-being, family communication, parental satisfaction, perceived parental social support, and child strengths and difficulties. Methods: Participants were 130 parents who attended the SPACE programme between 2009 and 2012, and who completed six questionnaires at baseline: the General Health Questionnaire-12, Strengths and Difficulties Questionnaire, Kansas Parenting Satisfaction Scale, General Functioning Scale of the McMaster Family Assessment Device, Multidimensional Scale of Perceived Social Support, and a demographic questionnaire. Results: The majority of parents met criteria for minor psychological distress (86%) and rated the quantity and severity of their children’s difficulties as being in the abnormally high range (74%) at baseline. A majority of participants (61%) rated their perceived social support as being poor. Lower parental well-being was significantly correlated with poorer family communication, poorer parenting satisfaction, and a greater number of difficulties for the child. Perceived social support was not significantly correlated with parental well-being. Parents whose children were not attending school at baseline had significantly lower well-being scores than those whose children were. Parents whose children had received a formal diagnosis of a mental health disorder also had significantly lower well-being scores than those whose children had not. Conclusions: Parents of young people with DSH behaviours face considerable emotional and practical challenges; they have low levels of well-being, parenting satisfaction, social support, and experience poor family communication. Given the importance of parental support for young people with DSH behaviours, consideration should be given to the need for individual or group support for such parents.