Suicide risk in relation to social class: a national register-based study of adult suicides in Korea, 1999-2001.

Science.gov (United States)

Kim, Moon-Doo; Hong, Seong-Chul; Lee, Sang-Yi; Kwak, Young-Sook; Lee, Chang-In; Hwang, Seung-Wook; Shin, Tae-Kyun; Lee, Seung-Min; Shin, Ji-Nam

2006-03-01

Few controlled studies have examined social class as a risk factor for suicide in Korea. The objective of the present study was to investigate the effects of social class on suicide risk in Korea. A case-control design was constructed from cause-of-death statistics for the period 1999 to 2001, in Korea, as published by the Korean National Statistical Office. The cases were defined as people aged between 20 and 64 who died by suicide, while the controls were defined as those who died of natural causes in the same age groups. The proportions and odds ratios for suicide were higher in young people than in elderly people, and higher for divorced subjects than for cohabitants. They were also higher for residents of rural areas, as opposed to residents of Seoul and other metropolitan areas, and for people in social classes III and IV, than they were for those in social class I. To control the variables that influence risk of suicide, such as age, marital status and area of residence, we used multiple logistic regression. Compared with class I, risk of suicide was higher in social classes III and IV, in both sexes. The principal conclusion of this study is that, regardless of sex, lower social class constitutes a high risk for suicide in Korea, even after controlling for variables such as age, marital status and area of residence. We conclude that a well-controlled and balanced social welfare system could reduce suicide risk, especially among people in lower social class.

Suicide risk among homeless population

Directory of Open Access Journals (Sweden)

Fran Calvo-García

2016-06-01

Full Text Available There exists little scientific production on autolytic behaviour in homeless people, despite the fact that it is one of the groups that is more at risk. The aim of this study is to determine the prevalence of previous attempted suicide and suicide risk and its connection with the main risk factors. In order to do so, central tendency and dispersion measures, correlations, contingence tables, and average comparison tables according to type of variable and normality were used. The Plutchik suicide-risk test was used in order to determine the risk of suicide, and specific tests for the main risk factors analysed. The main results show a 24.7% suicide rate and 45.2% (n = 66 displayed suicide risk. The main predictive factor of the risk of suicide was the daily consumption of alcohol (OR = 1.011, p less than .001, followed by being a woman (OR = 1.381, p = .021. It is necessary to design and apply suicide prevention strategies for this population.

Risk of suicide in male prison inmates.

Science.gov (United States)

Saavedra, Javier; López, Marcelino

2015-01-01

Many studies have demonstrated that the risk of suicide in prison is higher than in the general population. This study has two aims. First, to explore the risk of suicide in men sentenced in Andalusian prisons. And second, to study the sociodemographic, criminal and, especially, psychopathological factors associated with this risk. An assessment was made of 472 sentenced inmates in two Andalusian prisons, and included a sociodemographic interview, the IPDE personality disorders questionnaire, the SCID-I diagnostic interview (DSMIV), and the Plutchick suicide risk questionnaire. The interviewers were experienced clinical psychologists with training in prison environments. Adjusted ORs were calculated using a logistic regression. A risk of committing suicide was detected in 33.5% of the sample. The diagnoses (lifetime prevalence) of affective disorder (adjusted OR 3329), substance dependence disorders (adjusted OR 2733), personality disorders (adjusted OR 3115) and anxiety disorder (adjusted OR 1650), as well as a family psychiatric history (adjusted OR 1650), were the predictors that remained as risk factors after the regression analysis. No socio-demographic risk factor was significant in the regression analysis. The psychopathological variables are essential and the most powerful factors to explain suicide risk in prisons. A correct and systematic diagnosis, and an appropriate treatment by mental health professionals during the imprisonment are essential to prevent the risk of suicide. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors.

Science.gov (United States)

Sharmin Salam, Shumona; Alonge, Olakunle; Islam, Md Irteja; Hoque, Dewan Md Emdadul; Wadhwaniya, Shirin; Ul Baset, Md Kamran; Mashreky, Saidur Rahman; El Arifeen, Shams

2017-09-09

The aim of the paper is to quantify the burden and risk factors of fatal and non-fatal suicidal behaviors in rural Bangladesh. A census was carried out in seven sub-districts encompassing 1.16 million people. Face-to-face interviews were conducted at the household level. Descriptive analyses were done to quantify the burden and Poisson regression was run to determine on risk factors. The estimated rates of fatal and non-fatal suicide were 3.29 and 9.86 per 100,000 person years (PY) observed, respectively. The risk of suicide was significantly higher by 6.31 times among 15-17 and 4.04 times among 18-24 olds compared to 25-64 years old. Married adolescents were 22 times more likely to commit suicide compared to never-married people. Compared to Chandpur/Comilla district, the risk of suicide was significantly higher in Narshingdi. Students had significantly lower risk of non-fatal suicidal behavior compared to skilled laborers. The risk of non-fatal suicidal behavior was lower in Sherpur compared to Chandpur/Comilla. Among adolescents, unskilled laborers were 16 times more likely to attempt suicide than students. The common methods for fatal and non-fatal suicidal behaviors were hanging and poisoning. Suicide is a major public health problem in Bangladesh that needs to be addressed with targeted interventions.

Suicide Risk Associated with Experience of Violence and Impulsivity in Alcohol Dependent Patients.

Science.gov (United States)

Khemiri, Lotfi; Jokinen, Jussi; Runeson, Bo; Jayaram-Lindström, Nitya

2016-01-19

Alcohol dependence (AD) and aggression-impulsivity are both associated with increased suicide risk. There is a need to evaluate clinical tools in order to improve suicide risk assessment of AD patients. The present study consisted of 95 individuals with a diagnosis of AD, consecutively admitted for addiction treatment, compared with 95 healthy controls. Suicidal risk was assessed together with exposure of violence and impulsivity. AD patients reported significantly higher rates of exposure to violence in childhood, as measured by the Karolinska Interpersonal Violence Scale (KIVS), compared to HC. Within the AD group, individuals with history of suicidal ideation and suicidal behavior reported higher levels of violence experience compared to AD individuals without such history. AD patients with previous suicidal ideation scored higher on self-reported impulsivity as assessed by the Barratt Impulsivity Scale (BIS). Our main finding was that experience of trauma and expression of violent behavior, coupled with increased impulsivity are associated with an elevated suicide risk in AD patients. Future longitudinal studies assessing these traits are needed to evaluate their potential role in identifying AD patients at risk of future suicide.

Prevention Starts With Awareness: Adoptive Adolescents at High Risk for Suicidal Behavior.

Science.gov (United States)

Morgan, Leslie

2017-09-01

Adolescents are at higher risk for suicide attempts than other age groups. Suicide is now the second leading cause of death in the United States for ages 12 to 18; moreover, the risk of suicide is significantly higher for adoptive teens. In fact, adoptive teenagers have a four times higher rate of suicide attempts than biological children, perhaps due to the underlying nature of adoption, which can involve a pervasive sense of grief and loss for the adoptee. Unresolved anger and sadness from feelings of abandonment-especially when transitioning to adolescence-can cause a seemingly functional child to dissociate through self-harm and eventually demonstrate suicidal behavior. Little evidence-based research exists on the risk factors for adoptive teens who resort to suicidal behavior. Thus, it is vitally important for school nurses to understand the emotional stressors that adolescent adoptees face throughout life to help identify teens at risk for suicide. School districts and registered nurses are well positioned to address this critical health issue through education, assessment, and intervention.

Adolescent insomnia, suicide risk, and the interpersonal theory of suicide.

Science.gov (United States)

Zullo, Lucas; Horton, Sarah; Eaddy, Michael; King, Jessica; Hughes, Jennifer; Diederich, Andrew; Kennard, Betsy; Emslie, Graham; Stewart, Sunita

2017-11-01

Although insomnia has been repeatedly linked with suicide ideation, the reason for the linkage is not clear. The Interpersonal Psychological Theory of Suicide (IPTS) proposes that three core variables (thwarted belongingness, perceived burdensomeness, and acquired capability) are the final common pathway for all risk factors for suicide ideation and behavior. Recent research has suggested that insomnia may be associated with suicide ideation independently of the IPTS. We examined cross-sectional data from 151 psychiatric inpatients (ages 12-17) to determine if the association between insomnia symptoms and a continuous measure of suicide risk (measured as increasingly severe ideation and plan) was explained by the framework of the IPTS. When all IPTS variables and depressive symptoms were included in the model, insomnia symptoms did not contribute unique variance to suicide risk. Perceived burdensomeness and depressive symptoms were found to explain the relationship between insomnia symptoms and suicide risk. Our findings suggest that improved sleep might reduce suicide risk, that management of interpersonal need cognitions might reduce risk in the presence of insomnia symptoms, and reinforce the independent role of depressive symptoms in suicide risk in clinical samples of adolescents. Copyright © 2017 Elsevier B.V. All rights reserved.

Assessment and management of suicide risk in primary care.

Science.gov (United States)

Saini, Pooja; While, David; Chantler, Khatidja; Windfuhr, Kirsten; Kapur, Navneet

2014-01-01

Risk assessment and management of suicidal patients is emphasized as a key component of care in specialist mental health services, but these issues are relatively unexplored in primary care services. To examine risk assessment and management in primary and secondary care in a clinical sample of individuals who were in contact with mental health services and died by suicide. Data collection from clinical proformas, case records, and semistructured face-to-face interviews with general practitioners. Primary and secondary care data were available for 198 of the 336 cases (59%). The overall agreement in the rating of risk between services was poor (overall κ = .127, p = .10). Depression, care setting (after discharge), suicidal ideation at last contact, and a history of self-harm were associated with a rating of higher risk. Suicide prevention policies were available in 25% of primary care practices, and 33% of staff received training in suicide risk assessments. Risk is difficult to predict, but the variation in risk assessment between professional groups may reflect poor communication. Further research is required to understand this. There appears to be a relative lack of suicide risk assessment training in primary care.

Gender role, sexual orientation and suicide risk.

Science.gov (United States)

Fitzpatrick, Kathleen Kara; Euton, Stephanie J; Jones, Jamie N; Schmidt, Norman B

2005-07-01

There has been interest in the relationship between homosexuality, gender role and suicide risk. Though homosexuals are more likely to identify as cross-gender, research has not simultaneously examined sexual orientation and gender role in assessing suicide risk. In the current study, the unique and interactive effects of sexual orientation and gender role were assessed in regard to suicidal ideation, related psychopathology and measures of coping. 77 participants were recruited from an undergraduate psychology subject pool (n=47) or from gay, lesbian and transgender student organizations (n=30) and assessed on measures of gender role, homosexuality, and psychopathology. Consistent with expectations, cross-gender role (i.e., personality traits associated with the opposite sex) is a unique predictor of suicidal symptoms. Moreover, gender role accounted for more of the overall variance in suicidal symptoms, positive problem orientation, peer acceptance and support, than sexual orientation. After accounting for gender role, sexual orientation contributed little to the variance in suicidal symptoms, associated pathology and problem-solving deficits. There was no support for gender role by sexual orientation interaction effects. The cross-sectional nature of the data limits statements regarding causality. Cross-gendered individuals, regardless of sexual orientation, appear to have higher risk for suicidal symptoms. Researchers and clinicians should assess gender role in evaluations of youth samples.

Do major depressive disorder and dysthymic disorder confer differential risk for suicide?

Science.gov (United States)

Witte, Tracy K; Timmons, Katherine A; Fink, Erin; Smith, April R; Joiner, Thomas E

2009-05-01

Although there has been a tremendous amount of research examining the risk conferred for suicide by depression in general, relatively little research examines the risk conferred by specific forms of depressive illness (e.g., dysthymic disorder, single episode versus recurrent major depressive disorder [MDD]). The purpose of the current study was to examine differences in suicidal ideation, clinician-rated suicide risk, suicide attempts, and family history of suicide in a sample of outpatients diagnosed with various forms of depressive illness. To accomplish this aim, we conducted a cluster analysis using the aforementioned suicide-related variables in a sample of 494 outpatients seen between January 2001 and July 2007 at the Florida State University Psychology Clinic. Patients were diagnosed using DSM-IV criteria. Two distinct clusters emerged that were indicative of lower and higher risk for suicide. After controlling for the number of comorbid Axis I and Axis II diagnoses, the only depressive illness that significantly predicted cluster membership was recurrent MDD, which tripled an individual's likelihood of being assigned to the higher risk cluster. The use of a cross-sectional design; the relatively low suicide risk in our sample; the relatively small number of individuals with double depression. Our results demonstrate the importance of both chronicity and severity of depression in terms of predicting increased suicide risk. Among the various forms of depressive illness examined, only recurrent MDD appeared to confer greater risk for suicide.

Risk factors that influence suicidal behavior in affective disorders

Directory of Open Access Journals (Sweden)

Stanojević Albina

2016-01-01

Full Text Available It is known in the literature that the incidence and prevalence of suicide and attempted suicide in psychiatric patients is significantly higher than in the general population. The paper examined risk factors for suicidal behavior in the category of admitted patients hospitalized with the diagnosis of sleep disorders and affective (Unipolar resp. Bipolar depression. Study activated by 80 patients, 40 in both diagnostic groups received treatment at the Special Psychiatric Hospital in Gornja Toponica near Nis. The work methodology used are: psychiatric interview, Hamilton Depression Rating Scale (HAMD, and the C-SSRS (Columbia-Suicide Severity Rating Scale- assessment tool that assesses suicidal ideation and behavior. The study results show that there is a relationship between suicidal behavior (suicide attempts and suicidal ideation and the diagnosis of bipolar affective disorder, positive history of previous suicide attempts, so that these factors are stronger, to the degree of suicidality higher. On this sample, clearly suicidal behavior, with the same purpose, intensity of suicidal thoughts and medical impairment after suicide attempts were significantly more frequent in patients with Bipolar Affective Disorder in the depressive phase of the illness. Patients with a previous suicide attempt, and poor personal and social circumstances had a higher rate of attempted suicide.

Relationship of optimism and suicidal ideation in three groups of patients at varying levels of suicide risk.

Science.gov (United States)

Huffman, Jeff C; Boehm, Julia K; Beach, Scott R; Beale, Eleanor E; DuBois, Christina M; Healy, Brian C

2016-06-01

Optimism has been associated with reduced suicidal ideation, but there have been few studies in patients at high suicide risk. We analyzed data from three study populations (total N = 319) with elevated risk of suicide: (1) patients with a recent acute cardiovascular event, (2) patients hospitalized for heart disease who had depression or an anxiety disorder, and (3) patients psychiatrically hospitalized for suicidal ideation or following a suicide attempt. For each study we analyzed the association between optimism (measured by the Life-Orientation Test-Revised) and suicidal ideation, and then completed an exploratory random effects meta-analysis of the findings to synthesize this data. The meta-analysis of the three studies showed that higher levels of self-reported optimism were associated with a lower likelihood of suicidal ideation (odds ratio [OR] = .89, 95% confidence interval [CI] = .85-.95, z = 3.94, p optimism (OR = .84, 95% CI = .76-.92, z = 3.57, p optimism may be associated with a lower risk of suicidal ideation, above and beyond the effects of depressive symptoms, for a wide range of patients with clinical conditions that place them at elevated risk for suicide. Copyright © 2016 Elsevier Ltd. All rights reserved.

Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups.

Science.gov (United States)

Nordentoft, Merete

2007-11-01

with schizophrenia and related disorders. The thesis contains a review of the risk of suicide in homeless. In all the studies included, increased suicide mortality was found, and in the studies that evaluated suicide risk in different age groups, the excess suicide mortality was most dominant in younger age groups. Our own study revealed an increased risk of suicide, and in univariate analysis, significant predictors for suicide were found to be associated with shortest stay in hostel less than 11 days and more than one stay during one year. The thesis also contains a review of the risk of suicide in first-episode patients with schizophrenia, and it was concluded on the basis of the identified studies that long-term risk of suicide was not 10 percent as previously accepted, but lower. Risk factors for suicide among patients with schizophrenia were evaluated in case control studies, in nested case control studies, and in prospective studies. The following risk factors were the most important and frequently observed predictors: male gender, young age, short duration of illness, many admissions during last year, current inpatient, short time since discharge, previous and recent suicide attempt, co-morbid depression, drug abuse, poor compliance with medication, poor adherence to treatment, high IQ, and suicidal ideations. The results of analyses of psychotic symptoms as risk factor for suicide were contradictory, but a recent meta-analysis concluded that both hallucinations and delusions seemed to be protective; however, there was a non-significant tendency that command hallucinations were associated with higher suicide risk. Prevention of suicide in schizophrenia must especially focus on improving assessment of risk of suicide during inpatient treatment and the first week after discharge, and special attention must be paid to patients with one or more of the identified risk factors. There is a need for large randomised clinical trials evaluating the effect on suicide and

Suicide During Perinatal Period: Epidemiology, Risk Factors and Clinical Correlates

Directory of Open Access Journals (Sweden)

Laura Orsolini

2016-08-01

Full Text Available Perinatal period may pose a great challenge for the clinical management and treatment of psychiatric disorders in women. In fact, several mental illnesses can arise during pregnancy and/or following childbirth. Suicide and infanticide have been considered relatively rare events during the perinatal period. However, in some mental disorders (i.e. postpartum depression, bipolar disorder, postpartum psychosis, etc. have been reported a higher risk of suicidal ideation, suicide attempt or suicide. Therefore, a complete screening of mothers’ mental health should also take into account thoughts of suicide and thoughts about harming infants as well. Clinicians should carefully monitor and early identify related clinical manifestations, potential risk factors and alarm symptoms related to suicide. The present paper aims at providing a focused review about epidemiological data, risk and protective factors and an overview about the main clinical correlates associated with the suicidal behaviour during the pregnancy and postpartum period.

Suicidal Ideation in Anxiety-Disordered Youth: Identifying Predictors of Risk

Science.gov (United States)

O'Neil Rodriguez, Kelly A.; Kendall, Philip C.

2014-01-01

Objective Evidence is mixed regarding an independent association between anxiety and suicidality. Beyond associations with demographic factors and depression, do anxiety disorders increase risk for suicidality in youth? Given that not all anxiety-disordered youth experience suicidal ideation, potential predictors of risk also require investigation. Method The present study examined (a) the independent relationship between anxiety and suicidal ideation and (b) emotion dysregulation and distress intolerance as predictors of risk for suicidal ideation in a sample of anxiety-disordered youth aged 7-17 (N = 86, M = 11.5). Youth and their parents reported on suicidality, emotion dysregulation, and distress intolerance. Distress tolerance was also measured by a computerized behavioral task. Results Results support an independent relationship between anxiety symptomatology and youth-reported suicidal ideation, controlling for depressive symptoms. Youth self-report of emotion dysregulation and distress intolerance predicted higher levels of suicidal ideation in univariate analyses. In a multivariate analysis including all significant predictors, only anxiety symptomatology uniquely predicted suicidal ideation. Conclusions Results provide recommendations for the assessment and treatment of suicidality in anxiety-disordered youth. Suggestions for future research investigating the relationship between anxiety and suicidal ideation are offered. PMID:24156368

Risk Factors for Suicide Attempt in Drug Abusers

Directory of Open Access Journals (Sweden)

farideh faraji

2015-06-01

Full Text Available Objective: The present study was conducted to identify risk and prediction factors of suicide attempts among drug abusers. Method: This causal-comparative study was conducted on 91 drug abusers that included 42 male and female suicide attempters and 49 male and female counterparts. Millon multi-axial personality inventory-II (MCMI-II, Dass-42 (depression, anxiety, stress, and coping styles inventory were used for data collection purposes. Results: The highest rate of suicide attempt was found in young male drug abusers with these characteristics: single, junior school graduate, unemployed, suicide history, sex and physical abuse history during childhood, legal problems, suicide and self-injury witness, and violence and suicide in family members. Compared to non-attempters, suicide attempters obtained higher scores in depressive, obsessive, masochistic, and borderline personality disorders clinical somatoform symptoms, alcohol abuse in addition to drug use, major depressive disorder, and stress. Suicide attempters also used lower levels of task-focused and avoidance-focused strategies and higher levels of emotion-focused strategies to cope with stressors. Conclusion: The findings of this study can contribute to suicide identification and prevention among drug abusers.

Increased Suicide Risk in Patients with Hidradenitis Suppurativa

DEFF Research Database (Denmark)

Thorlacius, Linnea; Cohen, Arnon D; Gislason, Gunnar H

2018-01-01

Patients with skin disorders are considered at a higher risk of depression and anxiety than the background population. Patients with hidradenitis suppurativa (HS) may be particularly affected. We explored the association between HS and depression, anxiety, and completed suicides in the Danish...... nonsignificant association with depression (odds ratio [95% confidence interval] = 1.13; 0.87-1.47]; P = 0.36 and hospitalization due to depression (1.32 [0.94-1.85]; P = 0.1083). To the best of our knowledge, no previous studies have reported on the increased risk of completed suicide among HS patients...... national registries, expanding to include data on suicidal behavior, using both a cross-sectional and a cohort study design. Both designs included 7,732 patients with HS and a background population of 4,354,137. The cohort study revealed that HS patients had an increased risk of completed suicide after...

Associations between emotional intelligence, depression and suicide risk in nursing students.

Science.gov (United States)

Aradilla-Herrero, Amor; Tomás-Sábado, Joaquín; Gómez-Benito, Juana

2014-04-01

The most important factor which predisposes young people to suicide is depression, although protective factors such as self-esteem, emotional adaptation and social support may reduce the probability of suicidal ideation and suicide attempts. Several studies have indicated an elevated risk of suicide for health-related professions. Little is known, however, about the relationship between perceived emotional intelligence and suicide risk among nursing students. The main goals were to determine the prevalence of suicide risk in a sample of nursing students, to examine the relationship between suicide risk and perceived emotional intelligence, depression, trait anxiety and self-esteem, and to identify any gender differences in relation to these variables. Cross-sectional study of nursing students (n=93) who completed self-report measures of perceived emotional intelligence (Trait Meta-Mood Scale, which evaluates three dimensions: emotional attention, clarity and repair), suicide risk (Plutchik Suicide Risk Scale), self-esteem (Rosenberg Self-esteem Scale), depression (Zung Self-Rating Depression Scale) and anxiety (Trait scale of the State-Trait Anxiety Inventory). Linear regression analysis confirmed that depression and emotional attention are significant predictors of suicidal ideation. Moreover, suicide risk showed a significant negative association with self-esteem and with emotional clarity and repair. Gender differences were only observed in relation to depression, on which women scored significantly higher. Overall, 14% of the students were considered to present a substantial suicide risk. The findings suggest that interventions to prevent suicidal ideation among nursing students should include strategies to detect mood disorders (especially depression) and to improve emotional coping skills. In line with previous research the results indicate that high scores on emotional attention are linked to heightened emotional susceptibility and an increased risk of

A within-person approach to risk for suicidal ideation and suicidal behavior: Examining the roles of depression, stress, and abuse exposure.

Science.gov (United States)

Miller, Adam Bryant; Eisenlohr-Moul, Tory; Giletta, Matteo; Hastings, Paul D; Rudolph, Karen D; Nock, Matthew K; Prinstein, Mitchell J

2017-07-01

This study tests a novel, within-person model that reexamines depression and stress as risk factors for suicidal ideation and behavior among adolescent girls with and without sexual/physical abuse histories. This longitudinal study includes data from 220 adolescent girls between 12 and 16 years of age (M = 14.69 years, SD = 1.37; 61% White). At baseline, adolescents reported the presence or absence of prior abuse as part of a clinical interview. At baseline and every 3 months for 18 months, adolescents completed measures of suicidal ideation and behavior, depressive symptoms, and stress. Multilevel models examined within-person mean, deviations from within-person mean, depression, and stress and their interactions with abuse as predictors of suicidal ideation and behavior. In addition to within-person mean depression, higher-than-usual depression (odds ratio [OR] = 1.99) and higher-than-usual stress (OR = 1.53) predicted greater risk of suicidal ideation at each follow-up assessment. Periods of higher-than-usual stress (1 SD increase) and periods of higher-than-usual depression (1 SD increase) were associated with an 82% and 57% increase in the odds of suicidal behavior, respectively, but only among those with abuse histories. Depression, stress, and abuse are well-known risk factors for suicidal ideation and behavior; however, it has been unclear for whom, and when, these factors have their greatest impact. These results show that depression and stress are potent risk factors among those with a history of abuse and that within-person elevations in these risk factors signal increased short-term risk of suicidal ideation and behavior. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Suicidal communication signifies suicidal intent in Chinese completed suicides.

Science.gov (United States)

Zhou, Xue Mei; Jia, Shu Hua

2012-11-01

Recognizing suicidal communication from the distressful catharsis in a high-risk group with suicidal tendencies is essential for suicide prevention. This study analyzes whether suicidal communication can indicate the severity of suicidal intent. Various types of suicidal communication are defined, and their clinical significance is further explored. A comprehensive analysis of the psychological autopsy data of 200 victims of completed suicide, including their general socio-demographic status, suicidal communication methods, previous suicide attempts, mental disorders, and psychosocial situation. Our results showed that 39.5% of all the subjects were suicidal communicators, 23.0% had previously attempted suicide, and 14.0% left suicide notes; 32.4% of 142 subjects free of physical disease suffered from mental disorders. Suicidal communication included verbal communication, behavioral communication, and suicidal notes. Younger people with a higher level of education were more inclined to communicate their suicidal intent by leaving a suicide note. Suicide notes, but not previous suicide attempts or psychosocial situation, were significantly correlated with suicidal intent. Suicidal communicators showed higher depression scores than non-communicators. Those who suffered from mood disorders with higher levels of both depression and suicidal intent were more likely to expose their intent through behavioral communication. The present study provides strong evidence that suicidal communication can indicate the severity of suicidal intent. Current findings help interpret high-risk, self-destructive behavior and consequently provide the theoretical basis for a feasible suicide prevention program.

Biomarkers of suicide risk in psychosis

OpenAIRE

Carlborg, Andreas

2009-01-01

Suicide and attempted suicide are major health problems. Approximately 1400 people die from suicide every year in Sweden and ten times more attempt suicide. Patients with schizophrenia spectrum psychosis have an increased risk of suicide and suicide rates have been suggested to be as high as 10%. Important risk factors include a prior suicide attempt and depressive disorder. Low concentrations of monoamine metabolites in cerebrospinal fluid (CSF) have been related to suicida...

Combining the Suicide Intent Scale and the Karolinska Interpersonal Violence Scale in suicide risk assessments.

Science.gov (United States)

Stefansson, J; Nordström, P; Runeson, B; Åsberg, M; Jokinen, J

2015-09-23

High suicide intent, childhood trauma, and violent behavior are risk factors for suicide in suicide attempters. The aim of this study was to investigate whether the combined assessment of suicide intent and interpersonal violence would provide a better prediction of suicide risk than an assessment of only suicide intent or interpersonal violence. This is a cohort study involving 81 suicide attempters included in the study between 1993 and 1998. Patients were assessed with both the Suicide Intent Scale (SIS) and the Karolinska Interpersonal Violence Scale (KIVS). Through the unique personal identification number in Sweden, patients were linked to the Cause of Death Register maintained by the Swedish National Board of Health and Welfare. Suicides were ascertained from the death certificates. Seven of 14 patients who had died before April 2013 had committed suicide. The positive predictive value for the Suicide Intent Scale alone was 16.7 %, with a specificity of 52 % and an area under the curve of 0.74. A combined assessment with the KIVS gave higher specificity (63 %) and a positive predictive value of 18.8 % with an AUC of 0.83. Combined use of SIS and KIVS expressed interpersonal violence as an adult subscale gave a sensitivity of 83.3 %, a specificity of 80.3 %, and a positive predictive value of 26 % with an AUC of 0.85. The correlation between KIVS and SIS scores was not significant. Using both the the SIS and the KIVS combined may be better for predicting completed suicide than using them separately. The nonsignificant correlation between the scales indicates that they measure different components of suicide risk.

Creating a Chinese suicide dictionary for identifying suicide risk on social media.

Science.gov (United States)

Lv, Meizhen; Li, Ang; Liu, Tianli; Zhu, Tingshao

2015-01-01

Introduction. Suicide has become a serious worldwide epidemic. Early detection of individual suicide risk in population is important for reducing suicide rates. Traditional methods are ineffective in identifying suicide risk in time, suggesting a need for novel techniques. This paper proposes to detect suicide risk on social media using a Chinese suicide dictionary. Methods. To build the Chinese suicide dictionary, eight researchers were recruited to select initial words from 4,653 posts published on Sina Weibo (the largest social media service provider in China) and two Chinese sentiment dictionaries (HowNet and NTUSD). Then, another three researchers were recruited to filter out irrelevant words. Finally, remaining words were further expanded using a corpus-based method. After building the Chinese suicide dictionary, we tested its performance in identifying suicide risk on Weibo. First, we made a comparison of the performance in both detecting suicidal expression in Weibo posts and evaluating individual levels of suicide risk between the dictionary-based identifications and the expert ratings. Second, to differentiate between individuals with high and non-high scores on self-rating measure of suicide risk (Suicidal Possibility Scale, SPS), we built Support Vector Machines (SVM) models on the Chinese suicide dictionary and the Simplified Chinese Linguistic Inquiry and Word Count (SCLIWC) program, respectively. After that, we made a comparison of the classification performance between two types of SVM models. Results and Discussion. Dictionary-based identifications were significantly correlated with expert ratings in terms of both detecting suicidal expression (r = 0.507) and evaluating individual suicide risk (r = 0.455). For the differentiation between individuals with high and non-high scores on SPS, the Chinese suicide dictionary (t1: F 1 = 0.48; t2: F 1 = 0.56) produced a more accurate identification than SCLIWC (t1: F 1 = 0.41; t2: F 1 = 0.48) on different

Creating a Chinese suicide dictionary for identifying suicide risk on social media

Directory of Open Access Journals (Sweden)

Meizhen Lv

2015-12-01

Full Text Available Introduction. Suicide has become a serious worldwide epidemic. Early detection of individual suicide risk in population is important for reducing suicide rates. Traditional methods are ineffective in identifying suicide risk in time, suggesting a need for novel techniques. This paper proposes to detect suicide risk on social media using a Chinese suicide dictionary.Methods. To build the Chinese suicide dictionary, eight researchers were recruited to select initial words from 4,653 posts published on Sina Weibo (the largest social media service provider in China and two Chinese sentiment dictionaries (HowNet and NTUSD. Then, another three researchers were recruited to filter out irrelevant words. Finally, remaining words were further expanded using a corpus-based method. After building the Chinese suicide dictionary, we tested its performance in identifying suicide risk on Weibo. First, we made a comparison of the performance in both detecting suicidal expression in Weibo posts and evaluating individual levels of suicide risk between the dictionary-based identifications and the expert ratings. Second, to differentiate between individuals with high and non-high scores on self-rating measure of suicide risk (Suicidal Possibility Scale, SPS, we built Support Vector Machines (SVM models on the Chinese suicide dictionary and the Simplified Chinese Linguistic Inquiry and Word Count (SCLIWC program, respectively. After that, we made a comparison of the classification performance between two types of SVM models.Results and Discussion. Dictionary-based identifications were significantly correlated with expert ratings in terms of both detecting suicidal expression (r = 0.507 and evaluating individual suicide risk (r = 0.455. For the differentiation between individuals with high and non-high scores on SPS, the Chinese suicide dictionary (t1: F1 = 0.48; t2: F1 = 0.56 produced a more accurate identification than SCLIWC (t1: F1 = 0.41; t2: F1 = 0.48 on

Risk profiles of personality traits for suicidality among mood disorder patients and community controls.

Science.gov (United States)

Su, M-H; Chen, H-C; Lu, M-L; Feng, J; Chen, I-M; Wu, C-S; Chang, S-W; Kuo, P-H

2018-01-01

To examine the associations between personality traits and suicidal ideation (SI) and attempt (SA) in mood disorder patients and community controls. We recruited 365 bipolar, 296 major depressive disorder patients, and 315 community controls to assess their lifetime suicidality. Participants filled out self-reported personality questionnaires to collect data of personality traits, including novelty seeking (NS), harm avoidance (HA), extraversion (E), and neuroticism (N). We used logistic regression models adjusted for diagnoses to analyze combinational effects of personality traits on the risk of suicide. Additionally, radar charts display personality profiles for suicidal behaviours by groups. All personality traits were associated with the risk of suicidality with various effect size, except for E that showed protective effect. High N or HA had prominent and independent risk effects on SI and SA. Combinations of high N and low E, or high HA and NS were the risk personality profiles for suicidality. Higher N scores further distinguished SA from SI in mood disorder patients. Introvert personality traits showed independent risk effects on suicidality regardless of diagnosis status. Among high-risk individuals with suicidal thoughts, higher neuroticism tendency is further associated with increased risk of suicide attempt. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Holocaust exposure and subsequent suicide risk: a population-based study.

Science.gov (United States)

Bursztein Lipsicas, Cendrine; Levav, Itzhak; Levine, Stephen Z

2017-03-01

To examine the association between the extent of genocide exposure and subsequent suicide risk among Holocaust survivors. Persons born in Holocaust-exposed European countries during the years 1922-1945 that immigrated to Israel by 1965 were identified in the Population Registry (N = 209,429), and followed up for suicide (1950-2014). They were divided into three groups based on likely exposure to Nazi persecution: those who immigrated before (indirect; n = 20,229; 10%), during (partial direct; n = 17,189; 8%), and after (full direct; n = 172,061; 82%) World War II. Groups were contrasted for suicide risk, accounting for the extent of genocide in their respective countries of origin, high (>70%) or lower levels (Holocaust survivors (full direct exposure) as a resilient group. A tentative mechanism for higher vulnerability to suicide risk of the partial direct exposure group from countries with higher genocide exposure includes protracted guilt feelings, having directly witnessed atrocities and escaped death.

Ruminative subtypes and impulsivity in risk for suicidal behavior.

Science.gov (United States)

Valderrama, Jorge; Miranda, Regina; Jeglic, Elizabeth

2016-02-28

Rumination has been previously linked to negative psychological outcomes, including depression and suicidal behavior. However, there has been conflicting research on whether or not two different subtypes of rumination - brooding and reflection - are more or less maladaptive. The present research sought to (1) examine whether individuals high in brooding but lower in reflection would show higher trait and behavioral impulsivity, relative to individuals low in brooding and low in reflection; and (2) examine impulsivity as a mediator of the relation between ruminative subtypes and suicidal ideation. In Study 1, participants (N=78) were recruited based on high, average, and low scores on a measure of brooding and reflective rumination. Individuals who scored high in brooding and average in reflection scored significantly higher in negative urgency, that is, in the tendency to act rashly in an attempt to reduce negative affect, than did those who scored low in brooding and low in reflection. Study 2 (N=1638) examined the relationship between ruminative subtypes, impulsivity, and suicide risk. We found an indirect relationship between brooding and suicide risk through lack of premeditation and lack of perseverance, independently of reflection. These findings are discussed in relation to cognitive risk for suicide. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Suicide risk in relation to level of urbanicity - a population-based linkage study

DEFF Research Database (Denmark)

Qin, Ping

2005-01-01

from various Danish longitudinal registers. Data were analysed with conditional logistic regression. RESULTS: This study confirms that people living in more urbanized areas are at a higher risk of suicide than their counterparts in less urbanized areas. However, this excess risk is largely eliminated...... when adjusted for personal marital, income, and ethnic differences; it is even reversed when further adjusted for psychiatric status. Moreover, the impact of urbanicity on suicide risk differs significantly by sex and across age. Urban living reduces suicide risk significantly among men, especially......BACKGROUND: The extent to which the high suicide rate in urban areas is influenced by exposures to risk factors for suicide other than urbanicity remains unknown. This population-based study aims to investigate suicide risk in relation to the level of urbanicity in the context of other factors...

Identifying Adolescents at Highly Elevated Risk for Suicidal Behavior in the Emergency Department

Science.gov (United States)

Berona, Johnny; Czyz, Ewa; Horwitz, Adam G.; Gipson, Polly Y.

2015-01-01

Abstract Objective: The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. Method: Participants were 81 adolescents, ages 14–19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. Results: Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). Conclusions: In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior. PMID:25746114

Suicide Mortality Risk in Kermanshah Province, Iran: A County-level Spatial Analysis

Directory of Open Access Journals (Sweden)

Mehran Rostami

2016-09-01

Full Text Available Background: Kermanshah province has one of the highest suicide rates in Iran. The aim of this study is to explore spatial variations in the relative risk of suicide across the counties of Kermanshah province. Methods: This is an applied ecological study in which county-level counts of suicide deaths recorded by the forensic medicine organization of Kermanshah province during the period March 21, 2006 to March 20, 2013 have been used. Following a Bayesian approach, Besag, York and Mollie's (BYM model was fitted to the number of suicide deaths of males, females and all persons to make inference about the relative risk of suicide across the counties of the province. Results: Over the study period and based on 95% credible intervals, Kangavar, Harsin and Sonqor counties had significantly lower relative risks of suicide for both males and females, Slas-Babajani, Paveh, Javanrud and Ravansar counties had significantly lower relative risks of suicide only for males and Kermanshah county had a significantly higher relative risk of suicide only for males. The relative risk of suicide for the other counties were not significantly different from the province’s overall risk neither for males nor females. Conclusion: The counties of Kermanshah province can be classified into four categories by the level of relative risk of suicide: low relative risk for both males and females, low relative risk only for males, high relative risk only for males and average relative risk. Findings from this study could be used to specify priority counties for suicide prevention initiatives.

Suicide Risks among Adolescents and Young Adults in Rural China

Directory of Open Access Journals (Sweden)

Sibo Zhao

2014-12-01

Full Text Available Background: In China, suicide is one of the major causes of death among adolescents and young adults aged 15 to 34 years. Aim: The current study examines how risk factors vary by age groups in rural China, referring to those aged 15 to 24 years and those aged 25 to 34 years. Method: A case-control psychological autopsy (PA study is conducted in sixteen counties from three Chinese provinces, including 392 suicide cases and 416 community living controls in the sample. Results: In China, young adults aged 25 to 34 years have a higher risk for suicide than adolescents aged 15 to 24 years, and it holds true even controlling for relevant social factors. In addition, age-related factors such as education, marital status, whether having children, status in the family, physical health, and personal income all have varying degrees of impact on suicide risks for rural youth. Conclusions: This study shows that there are some age-related risk factors for suicide at certain life stages and emphasizes that young adults in rural China aged 25 to 34 years have an increased risk of suicide as a result of experiencing more psychological strains with age.

Response to unfairness across the suicide risk spectrum.

Science.gov (United States)

Carbajal, Jessica M; Gamboa, Jorge L; Moore, Jordan; Smith, Favrin; Ann Eads, Lou; Clothier, Jeffrey L; Cáceda, Ricardo

2017-12-01

Suicidal behavior is frequently triggered by social crises, such as familial, romantic, social or work-related conflict. A variety of cognitive and social functioning impairments has been associated with suicidal thoughts and acts. One of the precipitating and perpetuating factors of social conflict is the desire for retribution after a perceived offense, even at one's own detriment. We utilized the Ultimatum Game-a behavioral economic task which examines the behavioral response to perceived unfairness-in order to characterize the response to unfairness across the acute suicide risk spectrum. We examined five groups of adult individuals of both genders (n = 204): High- and Low-Lethality recent Suicide Attempters, Suicidal Ideators, Non-Suicidal Depressed Patients; and Healthy Controls. We also measured demographic and clinical variables. Even though all depressed groups showed similar rejection rates in the Ultimatum Game, there was a higher likelihood of rejecting offers in the low stakes condition in all acutely suicidal groups compared with healthy controls. Stake size, offer, education, and gender of the proposer were significantly associated with rejection rates. Acutely suicidal patients may be more vulnerable to adverse interpersonal interactions. Further characterization of social behavior may provide targets for secondary and tertiary prevention for high-risk individuals. Published by Elsevier B.V.

Youth Suicide Risk and Sexual Orientation.

Science.gov (United States)

Rutter, Philip A.; Soucar, Emil

2002-01-01

Study examines the relationship between sexual orientation and youth suicide risk. The suicide risk demonstrated by sexual minorities in this study was no greater than that of their heterosexual peers. Youth who reported more external support demonstrated lower overall suicide risk and, specifically, lower levels of hostility, hopelessness, and…

Epilepsy and risk of suicide: a population-based case-control study

DEFF Research Database (Denmark)

Christensen, Jakob; Vestergaard, Mogens; Mortensen, Preben Bo

2007-01-01

by sex, birth year, and calendar date, were assigned to each suicide case. FINDINGS: We identified 21 169 cases of suicide and 423 128 controls. 492 (2.32%) individuals who committed suicide had epilepsy compared with 3140 (0.74%) controls, corresponding to a three times higher risk (rate ratio [RR] 3...

Lifetime prevalence of and risk factors for suicidal ideation and suicide attempts in a Korean community sample.

Science.gov (United States)

Bagalkot, Tarique Rajasaheb; Park, Jong-Il; Kim, Hyeong-Tai; Kim, Hyun-Min; Kim, Myung Sig; Yoon, Myeong-Sook; Ko, Sung-Hee; Cho, Hye-Chung; Chung, Young-Chul

2014-01-01

Our study evaluated the lifetime prevalence of and risk factors for suicidal ideation and suicide attempts in Jeollabuk-do Province, Korea. Participants were selected from the population of individuals aged 13-100 years living Jeollabuk-do Province, Korea. A total of 2,964 subjects provided information about lifetime suicidal behavior and sociodemographic and psychological characteristics, completing the Zung Depression Scale, the Scale for Suicidal Ideation, the Multidimensional Anger Inventory, and the Rosenberg Self-Esteem Scale. The lifetime prevalence of suicidal ideation and suicide attempts, 24.8% and 6.2%, respectively, were higher than in previous studies. Multivariate regression revealed that family harmony had the highest odds ratio of all variables, including psychological factors. Along with depression and self-esteem, anger--which is the basic symptom of the Korean culture-related anger syndrome, Hwa-byung--was significantly associated with lifetime suicidal behavior. Lifetime suicidal behavior was highly prevalent in Jeollabuk-do Province. The most significant risk factors were found to be social support, family disharmony, anger, depression, and low self-esteem in Koreans.

Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew.

Science.gov (United States)

Bostwick, J Michael; Pabbati, Chaitanya; Geske, Jennifer R; McKean, Alastair J

2016-11-01

While suicide attempt history is considered to robustly predict completed suicide, previous studies have limited generalizability because of using convenience samples of specific methods/treatment settings, disregarding previous attempts, or overlooking first-attempt deaths. Eliminating these biases should more accurately estimate suicide prevalence in attempters. This observational retrospective-prospective cohort study using the Rochester Epidemiology Project identified 1,490 (males, N=555; females, N=935) Olmsted County residents making index suicide attempts (first lifetime attempts reaching medical attention) between January 1, 1986, and December 31, 2007. The National Death Index identified suicides between enrollment and December 31, 2010 (follow-up 3-25 years). Medical records were queried for sex, age, method, and follow-up care for index attempt survivors. Coroner records yielded data on index attempt deaths. During the study period, 81/1,490 enrollees (5.4%) died by suicide. Of the 81, 48 (59.3%) perished on index attempt; 27 of the surviving 33 index attempt survivors (81.8%) killed themselves within a year. Males were disproportionately represented: 62/81 (11.2% of men, 76.5% of suicides) compared with 19/81 (2.0% of women, 23.5% of suicides). Of dead index attempters, 72.9% used guns, yielding an odds ratio for gunshot death, compared with all other methods, of 140 (95% CI=60-325). When adjusted for covariates, survivors given follow-up psychiatric appointments had significantly lower likelihood of subsequent suicide (odds ratio=0.212, 95% CI=0.089-0.507). At 5.4%, completed suicide prevalence in this community cohort of suicide attempters was almost 59% higher than previously reported. An innovative aspect of this study explains the discrepancy: by including index attempt deaths-approximately 60% of total suicides-suicide prevalence more than doubled. We contend that counting both index and subsequent attempt deaths more accurately reflects

Proximal risk factors and suicide methods among suicide completers from national suicide mortality data 2004-2006 in Korea.

Science.gov (United States)

Im, Jeong-Soo; Choi, Soon Ho; Hong, Duho; Seo, Hwa Jeong; Park, Subin; Hong, Jin Pyo

2011-01-01

This study was conducted to examine differences in proximal risk factors and suicide methods by sex and age in the national suicide mortality data in Korea. Data were collected from the National Police Agency and the National Statistical Office of Korea on suicide completers from 2004 to 2006. The 31,711 suicide case records were used to analyze suicide rates, methods, and proximal risk factors by sex and age. Suicide rate increased with age, especially in men. The most common proximal risk factor for suicide was medical illness in both sexes. The most common proximal risk factor for subjects younger than 30 years was found to be a conflict in relationships with family members, partner, or friends. Medical illness was found to increase in prevalence as a risk factor with age. Hanging/Suffocation was the most common suicide method used by both sexes. The use of drug/pesticide poisoning to suicide increased with age. A fall from height or hanging/suffocation was more popular in the younger age groups. Because proximal risk factors and suicide methods varied with sex and age, different suicide prevention measures are required after consideration of both of these parameters. Copyright © 2011 Elsevier Inc. All rights reserved.

Multiple risk behaviors and suicidal ideation and behavior among Israeli and Palestinian adolescents.

Science.gov (United States)

Harel-Fisch, Yossi; Abdeen, Ziad; Walsh, Sophie D; Radwan, Qasrowi; Fogel-Grinvald, Haya

2012-07-01

Based conceptually on Problem Behavior Theory, Normalization Theory and theories of adolescent ethnic identity formation this study explores relationships between individual and cumulative multiple risk behaviors and suicidal ideation and behavior among mid-adolescents in three different populations in the Middle East. Data from the 2004 Health Behavior in School-Aged Children in the Middle-East (HBSC-ME) study included 8345 10th-grade pupils in three populations: Jewish Israelis (1770), Arab Israelis (2185), and Palestinians in Gaza and the West Bank (4390). We considered risk behaviors and factors including tobacco use, bullying, medically-attended injuries, excessive time with friends, parental disconnectedness, negative school experience, truancy and poor academic performance. Substantial population differences for suicidal tendency and risk behaviors were observed, with notably high levels of suicidal ideation and behavior among Arab-Israeli youth and higher levels of risk behaviors among the Jewish and Arab-Israeli youth. For all populations suicidal tendency was at least 4 times higher among adolescents reporting 4+ risk behaviors, suggesting that similar psychosocial determinants affect patterns of risk behaviors and suicidal tendency. Results highlight the importance of understanding cultural contexts of risk behaviors and suicidal ideation and behavior. Copyright © 2012 Elsevier Ltd. All rights reserved.

[Suicide risk in somatoform disorders].

Science.gov (United States)

Giupponi, Giancarlo; Maniscalco, Ignazio; Mathà, Sandra; Ficco, Carlotta; Pernther, Georg; Sanna, Livia; Pompili, Maurizio; Kapfhammer, Hans-Peter; Conca, Andreas

2018-03-01

The somatoform disorders include a group of complex disorders consist of somatic symptoms for which there are no identifiable organic cause or pathogenetic mechanisms. Given the importance of these disorders and the need to clarify the diagnosis of somatoform disorder affecting the suicide risk, we took into consideration the scientific literature to investigate the correlation between the two conditions. We performed a bibliographic search through Medline, Embase, PsycINFO, Scopus, SciELO, ORCID, Google Scholar, DOAJ using the following terms: somatoform, somatization disorder, pain disorder AND psychological factor, suicide, parasuicide, suicidality. In all studies reported in our review, the suicidal behavior risk is high. But in the majority, the data are relatively unreliable because it takes into account the category nosographic "Neurotic, stress-related and somatoform disorders", too wide to be able to identify the clinical characteristics of patients at risk of only somatoform disorder. Several studies conclude that psychiatric comorbidity increases the suicide risk: patients with two or more psychiatric disorders are more likely to commit a suicide attempt; in particular if there is a axis I diagnosis, the risk reduplicate. The somatization disorder seems to have a significant psychiatric comorbidity in particular with anxious and affective disorders spectrum.

Effects of suicide bereavement on mental health and suicide risk

DEFF Research Database (Denmark)

Pitman, Alexandra; Osborn, David; King, Michael

2014-01-01

to psychiatric care for parents bereaved by the suicide of an offspring, increased risk of suicide in mothers bereaved by an adult child's suicide, and increased risk of depression in offspring bereaved by the suicide of a parent. Some evidence was shown for increased rejection and shame in people bereaved......Between 48 million and 500 million people are thought to experience suicide bereavement every year. Over the past decade, increased policy attention has been directed towards suicide bereavement, but with little evidence to describe the effect of exposure or to provide appropriate responses. We...... used a systematic approach to carry out a narrative review of studies of the effect of suicide bereavement on mortality, mental health, and social functioning, and compared them with effects from other bereavements. We found 57 studies that satisfied strict inclusion criteria. Results from...

Morbidity of curative cancer surgery and suicide risk.

Science.gov (United States)

Jayakrishnan, Thejus T; Sekigami, Yurie; Rajeev, Rahul; Gamblin, T Clark; Turaga, Kiran K

2017-11-01

Curative cancer operations lead to debility and loss of autonomy in a population vulnerable to suicide death. The extent to which operative intervention impacts suicide risk is not well studied. To examine the effects of morbidity of curative cancer surgeries and prognosis of disease on the risk of suicide in patients with solid tumors. Retrospective cohort study using Surveillance, Epidemiology, and End Results data from 2004 to 2011; multilevel systematic review. General US population. Participants were 482 781 patients diagnosed with malignant neoplasm between 2004 and 2011 who underwent curative cancer surgeries. Death by suicide or self-inflicted injury. Among 482 781 patients that underwent curative cancer surgery, 231 committed suicide (16.58/100 000 person-years [95% confidence interval, CI, 14.54-18.82]). Factors significantly associated with suicide risk included male sex (incidence rate [IR], 27.62; 95% CI, 23.82-31.86) and age >65 years (IR, 22.54; 95% CI, 18.84-26.76). When stratified by 30-day overall postoperative morbidity, a significantly higher incidence of suicide was found for high-morbidity surgeries (IR, 33.30; 95% CI, 26.50-41.33) vs moderate morbidity (IR, 24.27; 95% CI, 18.92-30.69) and low morbidity (IR, 9.81; 95% CI, 7.90-12.04). Unit increase in morbidity was significantly associated with death by suicide (odds ratio, 1.01; 95% CI, 1.00-1.03; P = .02) and decreased suicide-specific survival (hazards ratio, 1.02; 95% CI, 1.00-1.03, P = .01) in prognosis-adjusted models. In this sample of cancer patients in the Surveillance, Epidemiology, and End Results database, patients that undergo high-morbidity surgeries appear most vulnerable to death by suicide. The identification of this high-risk cohort should motivate health care providers and particularly surgeons to adopt screening measures during the postoperative follow-up period for these patients. Copyright © 2016 John Wiley & Sons, Ltd.

Nocturnal Wakefulness as a Previously Unrecognized Risk Factor for Suicide.

Science.gov (United States)

Perlis, Michael L; Grandner, Michael A; Brown, Gregory K; Basner, Mathias; Chakravorty, Subhajit; Morales, Knashawn H; Gehrman, Philip R; Chaudhary, Ninad S; Thase, Michael E; Dinges, David F

2016-06-01

Suicide is a major public health problem and the 10th leading cause of death in the United States. The identification of modifiable risk factors is essential for reducing the prevalence of suicide. Recently, it has been shown that insomnia and nightmares significantly increase the risk for suicidal ideation, attempted suicide, and death by suicide. While both forms of sleep disturbance may independently confer risk, and potentially be modifiable risk factors, it is also possible that simply being awake at night represents a specific vulnerability for suicide. The present analysis evaluates the frequency of completed suicide per hour while taking into account the percentage of individuals awake at each hour. Archival analyses were conducted estimating the time of fatal injury using the National Violent Death Reporting System for 2003-2010 and the proportion of the American population awake per hour across the 24-hour day using the American Time Use Survey. The mean ± SD incident rate from 06:00-23:59 was 2.2% ± 0.7%, while the mean ± SD incident rate from 00:00-05:59 was 10.3% ± 4.9%. The maximum incident rate was from 02:00-02:59 (16.3%). Hour-by-hour observed values differed from those that would be expected by chance (P < .001), and when 6-hour blocks were examined, the observed frequency at night was 3.6 times higher than would be expected by chance (P < .001). Being awake at night confers greater risk for suicide than being awake at other times of the day, suggesting that disturbances of sleep or circadian neurobiology may potentiate suicide risk. © Copyright 2016 Physicians Postgraduate Press, Inc.

Alexithymia and Suicide Risk in Psychiatric Disorders: A Mini-Review

Directory of Open Access Journals (Sweden)

Domenico De Berardis

2017-08-01

Full Text Available It is well known that alexithymic individuals may show significantly higher levels of anxiety, depression, and psychological suffering than non-alexithymics. There is an increasing evidence that alexithymia may be considered a risk factor for suicide, even simply increasing the risk of development of depressive symptoms or per se. Therefore, the purpose of this narrative mini-review was to elucidate a possible relationship between alexithymia and suicide risk. The majority of reviewed studies pointed out a relationship between alexithymia and an increased suicide risk. In several studies, this relationship was mediated by depressive symptoms. In conclusion, the importance of alexithymia screening in everyday clinical practice and the evaluation of clinical correlates of alexithymic traits should be integral parts of all disease management programs and, especially, of suicide prevention plans and interventions. However, limitations of studies are discussed and must be considered.

Latina Adolescents Health Risk Behaviors and Suicidal Ideation and Suicide Attempts: Results from the National Youth Risk Behavior Survey 2001-2013.

Science.gov (United States)

Price, James H; Khubchandani, Jagdish

2017-06-01

Suicidal ideation and suicide attempts are more common in Latina adolescents than White or African-American adolescents. Several health risk behaviors have been identified as being associated with Latina adolescent suicides. However, to date, no study has identified the consistency and stability of these risk behaviors over time. This study utilized the national Youth Risk Behaviors Survey from 2001 to 2013 to estimate the prevalence of suicidal ideation, suicide attempts, and health risk behaviors associated with suicidal behaviors in Latina adolescents. Our analysis found the prevalence of suicidal ideation and suicide attempts varied significantly over the 13-year study span, decreasing from 2001 to 2009 and increased from 2011 to 2013. The analyses found 11 health risk behaviors that were significantly associated with both suicidal ideation and suicide attempts that did not vary over time. The stability of these 11 health risk behaviors associated with suicidal behaviors could be useful to school personnel to identify early at risk Latina adolescents who may benefit from school and community mental health resources.

Using Hospitalization and Mortality Data to Identify Areas at Risk for Adolescent Suicide.

Science.gov (United States)

Chen, Kun; Aseltine, Robert H

2017-08-01

The purpose of this study is to use statewide data on inpatient hospitalizations for suicide attempts and suicide mortality to identify communities and school districts at risk for adolescent suicide. Five years of data (2010-2014) from the Office of the Connecticut Medical Examiner and the Connecticut Hospital Inpatient Discharge Database were analyzed. A mixed-effects Poisson regression model was used to assess whether suicide attempt/mortality rates in the state's 119 school districts were significantly better or worse than expected after adjusting for 10 community-level characteristics. Ten districts were at significantly higher risk for suicidal behavior, with suicide mortality/hospitalization rates ranging from 154% to 241% of their expected rates, after accounting for their community characteristics. Four districts were identified as having significantly lower risk for suicide attempts than expected after accounting for community-level advantages and disadvantages. Data capturing hospitalization for suicide attempts and suicide deaths can inform prevention activities by identifying high-risk areas to which resources should be allocated, as well as low-risk areas that may provide insight into the best practices in suicide prevention. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Suicide Risk Associated with Experience of Violence and Impulsivity in Alcohol Dependent Patients

OpenAIRE

Khemiri, Lotfi; Jokinen, Jussi; Runeson, Bo; Jayaram-Lindstr?m, Nitya

2016-01-01

Alcohol dependence (AD) and aggression-impulsivity are both associated with increased suicide risk. There is a need to evaluate clinical tools in order to improve suicide risk assessment of AD patients. The present study consisted of 95 individuals with a diagnosis of AD, consecutively admitted for addiction treatment, compared with 95 healthy controls. Suicidal risk was assessed together with exposure of violence and impulsivity. AD patients reported significantly higher rates of exposure to...

Impulsivity, aggression and suicide risk among male schizophrenia patients.

Science.gov (United States)

Iancu, Iulian; Bodner, Ehud; Roitman, Suzana; Piccone Sapir, Anna; Poreh, Amir; Kotler, Moshe

2010-01-01

Impulsivity has been shown to be a major variable in the etiology of suicide and aggression, but has not been researched as much in the schizophrenic population, which is characterized by serious suicide and aggression risks. 68 male schizophrenia patients responded to a battery of measures including the Positive and Negative Syndrome Scale (PANSS), the impulsivity control scale (IS), the Suicide Risk Scale (SRS) and the Overt Aggression Scale. We divided our subjects into those who received scores above and below the median on the IS. The high-impulsivity group had higher present and past rates of suicidal ideation and showed a trend for more lifetime suicidal attempts than the low-impulsivity group. The impulsivity score correlated positively with the SRS score and with some of the scores of the PANSS (the positive symptoms score, the general psychopathology score and the total score). A multiple regression analysis revealed that an older age, higher levels of aggression, high impulsivity and an elevated score on the general psychopathology subscale of the PANSS contributed positively and significantly to the explained variance of the SRS. Our study supports the contention that high impulsivity in schizophrenia patients is significant in the etiology of suicide in schizophrenia. However, the relationship between impulsivity and aggression in schizophrenia patients, and also the amelioration of impulsivity by pharmacological interventions, require further study. Copyright (c) 2010 S. Karger AG, Basel.

Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003-2011.

Science.gov (United States)

Mezuk, Briana; Lohman, Matthew; Leslie, Marc; Powell, Virginia

2015-07-01

We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. Data come from the Virginia Violent Death Reporting System (2003-2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. LTC may be an important point of engagement in suicide prevention.

Loneliness and Suicidal Risk in Young Adults: Does Believing in a Changeable Future Help Minimize Suicidal Risk Among the Lonely?

Science.gov (United States)

Chang, Edward C; Wan, Liangqiu; Li, Pengzi; Guo, Yuncheng; He, Jiaying; Gu, Yu; Wang, Yingjie; Li, Xiaoqing; Zhang, Zhan; Sun, Yingrui; Batterbee, Casey N-H; Chang, Olivia D; Lucas, Abigael G; Hirsch, Jameson K

2017-07-04

This study examined loneliness and future orientation as predictors of suicidal risk, namely, depressive symptoms and suicide ideation, in a sample of 228 college students (54 males and 174 females). Results of regression analyses indicated that loneliness was a significant predictor of both indices of suicidal risk. The inclusion of future orientation was found to significantly augment the prediction model of both depressive symptoms and suicide ideation, even after accounting for loneliness. Noteworthy, beyond loneliness and future orientation, the Loneliness × Future Orientation interaction term was found to further augment both prediction models of suicidal risk. Consistent with the notion that future orientation is an important buffer of suicidal risk, among lonely students, those with high future orientation, compared to low future orientation, were found to report significantly lower levels of depressive symptoms and suicide ideation. Some implications of the present findings for studying both risk and protective factors associated with suicidal risk in young adults are discussed.

Suicide risk in schizophrenia: an analysis of 17 consecutive suicides.

Science.gov (United States)

Saarinen, P I; Lehtonen, J; Lönnqvist, J

1999-01-01

The aim of this study was to investigate interactional factors related to the recognition of suicide risk in patients with schizophrenia. The study focused on 17 schizophrenia patients who had committed suicide during the National Suicide Prevention Project in Finland between April 1, 1987, and March 31, 1988, in the province of Kuopio. Consensus case reports were assembled by using the psychological autopsy method. Study methods included structured and in-depth interviews of next of kin and interviews of health care or social services workers who had treated the suicide victims. Male and female patients with schizophrenia committed suicide in equal proportions. Most had suffered from schizophrenia for more than 15 years; all but one had been receiving psychiatric treatment at the time of suicide. Retrospective assessment indicated that 59 percent of the patients were clinically depressed at the time of suicide. In 76 percent of the cases, the mental health professionals involved in treatment had not believed that there was a risk of suicide during their last contact with the patient. In 29 percent of the cases, the patient's paranoid ideas concerning treatment personnel had increased. Patients' withdrawal from human relationships because of depression was related to loss of the treatment professionals' concern for the patients. The findings in this descriptive study suggest that withdrawal by a patient with schizophrenia and an increase in the patient's paranoid behavior should be regarded as signals of risk of suicide.

Suicidal ideation and the risk of suicide in patients with fibromyalgia: a comparison with non-pain controls and patients suffering from low-back pain

Directory of Open Access Journals (Sweden)

Jimenez-Rodriguez I

2014-04-01

higher among patients with fibromyalgia than in patients with low-back pain or in controls (P<0.0001. The likelihood for suicidal ideation and the risk of suicide were higher among patients with fibromyalgia (odds ratios of 26.9 and 48.0, respectively than in patients with low-back pain (odds ratios 4.6 and 4.7, respectively. Depression was the only factor associated with suicidal ideation or the risk of suicide.Keywords: chronic low-back pain, suicidal risk, depression

Domestic Violence as a Risk Factor for Attempted Suicide in Married Women.

Science.gov (United States)

Indu, Pankajakshan Vijayanthi; Remadevi, Sivaraman; Vidhukumar, Karunakaran; Shah Navas, Peer Mohammed; Anilkumar, Thekkethayyil Viswanathan; Subha, Nanoo

2017-08-01

High rates of suicide attempts and domestic violence (DV) in women of reproductive age group have been reported from South India, but the association between them was not studied. Hence, this study was undertaken to assess whether DV is a risk factor for attempted suicide in married women of reproductive age group. A hospital-based case-control study with 77 incident cases of attempted suicide in married women of the age group of 18 to 45 years and 153 controls belonging to the same age group, without history of suicide attempt, was undertaken over a period of 6 months. Univariate and multivariate analyses were done. The crude odds ratio (cOR) for DV was found to be 6.15 (95% confidence interval [95% CI] = [2.95, 12.82], p value = .0001). Other statistically significant risk factors included younger age group (below 30 years); gross family income > Rs. 5,000; higher occupational status of spouse; having poor social support; having a family history of psychiatric disorders, substance use disorders, and suicide/suicide attempt; higher impulsiveness scores; having higher scores of stressful life events over the past 12 months, and alcohol use disorder in husband. Islamic faith was found to be a significant protective factor. On logistic regression, DV was found to be an independent risk factor for attempted suicide in this study population (adjusted OR = 3.79, 95% CI = [1.35, 10.62], p value = .011). Age groups, stressful life events, impulsiveness, and alcohol use disorder in husband were the confounders adjusted for in logistic regression along with other significant risk and protective factors. Significant dose-response relationship was also observed between DV and attempted suicide. In accordance with the stress-diathesis model for suicidal behavior, DV is found to be a stressor which precipitates suicide attempt in those with diathesis like family history of psychiatric disorders. Clinical, research, and policy implications of the findings are discussed.

Suicide Risk Screening Tools and the Youth Population.

Science.gov (United States)

Patterson, Sharon

2016-08-01

The use of suicide risk screening tools is a critical component of a comprehensive approach to suicide risk assessment. Since nurses frequently spend more time with patients than any other healthcare professional, they are in key positions to detect and prevent suicidal behavior in youth. To inform nurses about suicide risk screening tools for the youth population. Suicide risk screening tools are research-based standardized instruments that are used to identify people who may be at risk for suicide. A literature search was performed using the Athabasca University Library Resource, the databases of the Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, and Google Scholar. Nurses are cautioned to utilize suicide risk screening tools as only part of the suicide risk assessment in youth populations and avoid the danger of relying on tools that may result in a blind application of evidence to the detriment of clinical experience and judgement. © 2016 Wiley Periodicals, Inc.

Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide

DEFF Research Database (Denmark)

Madsen, Trine; Erlangsen, Annette; Nordentoft, Merete

2017-01-01

trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during......People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time...... admission. Most studies are based on low power, thus compromising quality and generalisability. The few studies with sufficient statistical power mainly identified non-modifiable risk predictors such as male gender, diagnosis, or recent deliberate self-harm. Also, the predictive value of these predictors...

Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide

DEFF Research Database (Denmark)

Madsen, Trine; Erlangsen, Annette; Nordentoft, Merete

2017-01-01

People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time...... trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during...... is low. It would be of great benefit if future studies would be based on large samples while focusing on modifiable predictors over the course of an admission, such as hopelessness, depressive symptoms, and family/social situations. This would improve our chances of developing better risk assessment...

Neurocognitive impairment and suicide risk among prison inmates.

Science.gov (United States)

Vadini, Francesco; Calella, Giulio; Pieri, Alessandro; Ricci, Elena; Fulcheri, Mario; Verrocchio, Maria Cristina; De Risio, Alfredo; Sciacca, Antonina; Santilli, Francesca; Parruti, Giustino

2018-01-01

Worldwide, prisoners are at high risk of suicide. Reducing the number of suicides in jails and prisons is an international priority. Several risk factors for suicide attempts, such as historical, prison-related, psychosocial and clinical factors, have been found in prisoners. We assessed whether demographic, conviction-related and neuro-behavioral variables might be associated with current suicide risk and lifetime suicide attempts in two large central Italy prisons. On a preliminary sample of 254 detainees within an ongoing project, we assessed whether demographic, conviction-related, psychiatric, cognitive variables and illness comorbidity might be associated with current suicide risk and lifetime suicide attempts in two large central Italy prisons. Psychiatric disorders and suicide risk was evaluated using the Mini International Neuropsychiatric Interview. We also have identified the detainees with clear-cut previous suicide attempts. The cognitive function was assessed with a brief neuropsychological battery including trail making A, trail making B, Digit Span, and Symbol Digit test. Impulsivity was assessed with the Barratt Impulsiveness Scale. Cumulative illness was evaluated with Charlson Comorbidity Index. Impairment in global cognitive function was the strongest predictor of both high suicide risk and lifetime suicide attempts (both p impulsivity, and illness comorbidity. Limitation LIMITATION: Cross-sectional study design and relatively small sample size. Cognitive deficits may improve our understanding of the suicidal vulnerability and should be systematically included in the assessment of suicide risk, as potential predictors of suicidal acts and targets of preventive interventions. Copyright © 2017 Elsevier B.V. All rights reserved.

Suicide risk and exposure to mobbing.

Science.gov (United States)

Pompili, Maurizio; Lester, David; Innamorati, Marco; De Pisa, Eleonora; Iliceto, Paolo; Puccinno, Marianna; Fiori Nastro, Paolo; Tatarelli, Roberto; Girardi, Paolo

2008-01-01

The aim of this study was to study suicide risk in subjects exposed to mobbing, that is, systematic psychological harassment in the workplace. Such psychological harassment, unique to the workplace, threatens both the emotional well-being and professional ability of its victims. The items of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) that assess suicide risk were studied in 102 individuals who were exposed to mobbing. The results indicated that individuals exposed to mobbing had clear differences on the MMPI-2 from normative samples. In addition, those who appeared to be at risk for suicide differed in their scores from those not at risk. Implications for psychopathology and suicide preventions are discussed.

Men's sexual orientation and suicide: evidence for U.S. adolescent-specific risk.

Science.gov (United States)

Russell, Stephen T; Toomey, Russell B

2012-02-01

There is strong consensus in the research literature that adolescent and adult men who report same-sex sexual orientations, identities, and behaviors are at higher risk for suicide. Recent studies of general adolescent suicide risk have identified developmental trajectories that peak during the teenage years. Because the adolescent years are characterized by the development and heightened awareness of gender roles and sexual scripts closely tied to dominant cultural ideals of masculinity and heterosexuality, an adolescent-focused developmental trajectory for suicide risk might be particularly relevant for males with adolescent same-sex sexual orientations. We provide the first prospective examination of adolescent-specific risk for suicidality based on adolescent same-sex sexual orientation using data from the United States, the National Longitudinal Study of Adolescent Health. Tracing suicide ideation and attempts across four assessments from adolescence (Wave 1 average age 15.3 years) to young adulthood (Wave 4 average age 28.2), we documented that the risk for suicidal thoughts and attempts for adolescent same-sex attracted males is developmental in nature. Specifically, the risk for suicidal thoughts and attempts for males with same-sex attractions is largely limited to the adolescent years. These results offer new insights for suicide prevention and intervention for male adolescents and adults with same-sex sexual orientations. Copyright © 2010 Elsevier Ltd. All rights reserved.

Suicide in married couples in Sweden: Is the risk greater in same-sex couples?

Science.gov (United States)

Björkenstam, Charlotte; Andersson, Gunnar; Dalman, Christina; Cochran, Susan; Kosidou, Kyriaki

2016-07-01

Minority sexual orientation is a predictor of suicide ideation and attempts, though its association with suicide mortality is less clear. We capitalize on Sweden's extensively linked databases, to investigate whether, among married individuals, same-sex marriage is associated with suicide. Using a population-based register design, we analyzed suicide risk among same-sex married women and men (n = 6456), as compared to different-sex married women and men (n = 1181723) in Sweden. We selected all newly partnered or married individuals in the intervening time between 1/1/1996 and 12/31/2009 and followed them with regard to suicide until 12/31/2011. Multivariate Poisson regression was used to calculate adjusted incidence risk ratios (IRR) with 95 % confidence intervals (CI). The risk of suicide was higher among same-sex married individuals as compared to different-sex married individuals (IRR 2.7, 95 % CI 1.5-4.8), after adjustment for time at risk and socioeconomic confounding. Sex-stratified analyses showed a tentatively elevated risk for same-sex married women (IRR 2.5, 95 % CI 0.8-7.7) as compared to different-sex married women. Among same-sex married men the suicide risk was nearly three-fold greater as compared to different-sex married (IRR 2.895 % CI 1.5-5.5). This holds true also after adjustment for HIV status. Even in a country with a comparatively tolerant climate regarding homosexuality such as Sweden, same-sex married individuals evidence a higher risk for suicide than other married individuals.

Sensation seeking as risk factor for suicidal ideation and suicide attempts in adolescence.

Science.gov (United States)

Ortin, Ana; Lake, Alison M; Kleinman, Marjorie; Gould, Madelyn S

2012-12-20

High sensation seeking in adolescence is associated with engagement in risk-taking behaviors, especially substance use. Although depressed adolescents are prone to increased risk-taking, and suicidal behavior can be considered within the spectrum of risk-taking behaviors, the relationships between sensation seeking, depression, and suicidal behavior have not been explored. A self-report questionnaire assessing sensation seeking, depression, substance use problems, and suicidal ideation and suicide attempts was completed by 9th- through 12th-grade students (n=2189) in six New York State high-schools from 2002 through 2004. Logistic regression analyses were conducted to examine main and interaction effects between sensation seeking and the four clinical variables. High sensation seeking was positively associated with depressive symptoms and substance use problems. The main effects of sensation seeking on suicidal ideation and suicide attempts remained significant after controlling for depression and substance use. The association between sensation seeking and suicide attempts was moderated by substance use problems. The schools were suburban and predominantly white, limiting the generalizability of the results. Other mental disorders with potential implications for sensation seeking and for suicidal behavior, such as bipolar disorders, were not assessed. The finding that sensation seeking makes an independent contribution to the risk of suicidal ideation and attempts is consistent with findings in literature on novelty seeking and impulsivity. The associations between sensation seeking, depressive symptoms and suicidal behavior may be compatible with the presence of an underlying temperamental dysregulation. Screening for sensation seeking may contribute to the reduction of adolescent suicide risk. Copyright © 2012 Elsevier B.V. All rights reserved.

Risk Factors and Prevention Strategies for Suicide among the Elderly

Science.gov (United States)

Franks, Rebecca; Burnett, Donna O.; Evans, Retta R.

2012-01-01

Suicide is a preventable public health concern affecting the nation as the 10th leading cause of death. The prevalence of suicide among the elderly is higher than any other group. Risk factors attributed to this phenomenon are depression, social isolation, substance abuse, poor physical health or function, financial stress, and access to lethal…

Suicide and mental illness in parents and risk of suicide in offspring: a birth cohort study

DEFF Research Database (Denmark)

Sørensen, Holger J; Mortensen, Erik L; Wang, August G

2009-01-01

BACKGROUND: A family history of completed suicide and psychiatric illness has been identified as risk factors for suicide. AIMS: To examine the risk of offspring suicide in relation to parental history of suicide and other parental risk factors. METHOD: The study population consisted of 7,177 adult...... the Danish Psychiatric Central Research Register. RESULTS: Forty-eight cohort members, 77 mothers and 133 fathers had committed suicide during the follow-up. Independent of parental psychiatric illness and social status, parental suicide significantly increased suicide risk in offspring (hazard ratio 4...

Suicide and mental illness in parents and risk of suicide in offspring : A birth cohort study

DEFF Research Database (Denmark)

Sørensen, Holger; Mortensen, Erik Lykke; Wang, August

2009-01-01

BACKGROUND: A family history of completed suicide and psychiatric illness has been identified as risk factors for suicide. AIMS: To examine the risk of offspring suicide in relation to parental history of suicide and other parental risk factors. METHOD: The study population consisted of 7,177 adult...... the Danish Psychiatric Central Research Register. RESULTS: Forty-eight cohort members, 77 mothers and 133 fathers had committed suicide during the follow-up. Independent of parental psychiatric illness and social status, parental suicide significantly increased suicide risk in offspring (hazard ratio 4...

Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003–2011

Science.gov (United States)

Lohman, Matthew; Leslie, Marc; Powell, Virginia

2015-01-01

Objectives. We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. Methods. Data come from the Virginia Violent Death Reporting System (2003–2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. Results. Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. Conclusions. LTC may be an important point of engagement in suicide prevention. PMID:25973805

Religion and the risk of suicide: longitudinal study of over 1 million people.

Science.gov (United States)

O'Reilly, Dermot; Rosato, Michael

2015-06-01

Durkheim's seminal historical study demonstrated that religious affiliation reduces suicide risk, but it is unclear whether this protective effect persists in modern, more secular societies. To examine suicide risk according to Christian religious affiliation and by inference to examine underlying mechanisms for suicide risk. If church attendance is important, risk should be lowest for Roman Catholics and highest for those with no religion; if religiosity is important, then 'conservative' Christians should fare best. A 9-year study followed 1 106 104 people aged 16-74 years at the 2001 UK census, using Cox proportional hazards models adjusted for census-based cohort attributes. In fully adjusted models analysing 1119 cases of suicide, Roman Catholics, Protestants and those professing no religion recorded similar risks. The risk associated with conservative Christians was lower than that for Catholics (HR = 0.71, 95% CI 0.52-0.97). The relationship between religious affiliation and suicide established by Durkheim may not pertain in societies where suicide rates are highest at younger ages. Risks are similar for those with and without a religious affiliation, and Catholics (who traditionally are characterised by higher levels of church attendance) do not demonstrate lower risk of suicide. However, religious affiliation is a poor measure of religiosity, except for a small group of conservative Christians, although their lower risk of suicide may be attributable to factors such as lower risk behaviour and alcohol consumption. © The Royal College of Psychiatrists 2015.

Suicide risk in schizophrenia: learning from the past to change the future.

Science.gov (United States)

Pompili, Maurizio; Amador, Xavier F; Girardi, Paolo; Harkavy-Friedman, Jill; Harrow, Martin; Kaplan, Kalman; Krausz, Michael; Lester, David; Meltzer, Herbert Y; Modestin, Jiri; Montross, Lori P; Mortensen, Preben Bo; Munk-Jørgensen, Povl; Nielsen, Jimmi; Nordentoft, Merete; Saarinen, Pirjo Irmeli; Zisook, Sidney; Wilson, Scott T; Tatarelli, Roberto

2007-03-16

Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5-13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Although, there is general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the result of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. This is the first attempt to present a consensus report as well as the development of a set of guidelines for reducing suicide risk among schizophrenia

Suicide risk in schizophrenia: learning from the past to change the future

Directory of Open Access Journals (Sweden)

Nielsen Jimmi

2007-03-01

Full Text Available Abstract Suicide is a major cause of death among patients with schizophrenia. Research indicates that at least 5–13% of schizophrenic patients die by suicide, and it is likely that the higher end of range is the most accurate estimate. There is almost total agreement that the schizophrenic patient who is more likely to commit suicide is young, male, white and never married, with good premorbid function, post-psychotic depression and a history of substance abuse and suicide attempts. Hopelessness, social isolation, hospitalization, deteriorating health after a high level of premorbid functioning, recent loss or rejection, limited external support, and family stress or instability are risk factors for suicide in patients with schizophrenia. Suicidal schizophrenics usually fear further mental deterioration, and they experience either excessive treatment dependence or loss of faith in treatment. Awareness of illness has been reported as a major issue among suicidal schizophrenic patients, yet some researchers argue that insight into the illness does not increase suicide risk. Protective factors play also an important role in assessing suicide risk and should also be carefully evaluated. The neurobiological perspective offers a new approach for understanding self-destructive behavior among patients with schizophrenia and may improve the accuracy of screening schizophrenics for suicide. Although, there is general consensus on the risk factors, accurate knowledge as well as early recognition of patients at risk is still lacking in everyday clinical practice. Better knowledge may help clinicians and caretakers to implement preventive measures. This review paper is the results of a joint effort between researchers in the field of suicide in schizophrenia. Each expert provided a brief essay on one specific aspect of the problem. This is the first attempt to present a consensus report as well as the development of a set of guidelines for reducing suicide

Depressive symptoms and other risk factors predicting suicide in middle-aged men: a prospective cohort study among Korean Vietnam War veterans

Directory of Open Access Journals (Sweden)

Sang-Wook Yi

2015-07-01

Full Text Available Background. Few studies have prospectively examined whether depressive symptoms and other risk factors are associated with a higher risk of suicide death in individuals other than high-risk populations such as psychiatric patients and individuals with self-harm histories. The purpose of the study is to prospectively examine whether depressive symptoms assessed by the Beck Depression Inventory (BDI are associated with greater risk of suicide death and whether depressive symptoms and other risk factors are independent predictors of suicide in general-risk populations. Another aim is to evaluate the sensitivity of the BDI for predicting suicide death.Methods. 10,238 Korean Vietnam War veterans (mean age: 56.3 years who participated in two surveys in 2001 were followed up for suicide mortality over 7.5 years.Results. 41 men died by suicide. Severely depressed participants had a higher adjusted hazard ratio (aHR = 3.4; 95% CI [1.5–7.7] of suicide than non-to-moderately depressed ones. Higher suicide risk was associated with more severe depressive symptoms (p for trend = 0.009. After adjustment for depressive symptoms and other factors, very poor health, low education, and past drinking were associated with higher suicide risk, while good health, body mass index, and marital status were not associated with suicide. The sensitivity at the cut-off score of 31 for detecting suicide was higher during the earlier 3.5 years of the follow-up (75%; 95% CI [50–90] than during the latter 4 years (60%; 95% CI [41–76].Conclusions. Depressive symptoms are a strong independent predictor and very poor health, low education, and drinking status may be independent predictors of future suicide. The BDI may have acceptable diagnostic properties as a risk assessment tool for identifying people with depression and suicidal potential among middle-aged men.

Depressive symptoms and other risk factors predicting suicide in middle-aged men: a prospective cohort study among Korean Vietnam War veterans.

Science.gov (United States)

Yi, Sang-Wook; Hong, Jae-Seok

2015-01-01

Background. Few studies have prospectively examined whether depressive symptoms and other risk factors are associated with a higher risk of suicide death in individuals other than high-risk populations such as psychiatric patients and individuals with self-harm histories. The purpose of the study is to prospectively examine whether depressive symptoms assessed by the Beck Depression Inventory (BDI) are associated with greater risk of suicide death and whether depressive symptoms and other risk factors are independent predictors of suicide in general-risk populations. Another aim is to evaluate the sensitivity of the BDI for predicting suicide death. Methods. 10,238 Korean Vietnam War veterans (mean age: 56.3 years) who participated in two surveys in 2001 were followed up for suicide mortality over 7.5 years. Results. 41 men died by suicide. Severely depressed participants had a higher adjusted hazard ratio (aHR = 3.4; 95% CI [1.5-7.7]) of suicide than non-to-moderately depressed ones. Higher suicide risk was associated with more severe depressive symptoms (p for trend = 0.009). After adjustment for depressive symptoms and other factors, very poor health, low education, and past drinking were associated with higher suicide risk, while good health, body mass index, and marital status were not associated with suicide. The sensitivity at the cut-off score of 31 for detecting suicide was higher during the earlier 3.5 years of the follow-up (75%; 95% CI [50-90]) than during the latter 4 years (60%; 95% CI [41-76]). Conclusions. Depressive symptoms are a strong independent predictor and very poor health, low education, and drinking status may be independent predictors of future suicide. The BDI may have acceptable diagnostic properties as a risk assessment tool for identifying people with depression and suicidal potential among middle-aged men.

[Risk factors found in suicide attempters].

Science.gov (United States)

Villa-Manzano, Alberto Iram; Robles-Romero, Miguel Angel; Gutiérrez-Román, Elsa Armida; Martínez-Arriaga, María Guadalupe; Valadez-Toscano, Francisco Javier; Cabrera-Pivaral, Carlos E

2009-01-01

A better understanding of risk factors for suicide in general population is crucial for the design of suicide prevention programs. Our objective was to identify personal and family risk factors in suicide attempters. Case-control design. We searched in patients with an acute intoxication, those subjects with and intoxication attributable to suicide attempt. These patients were matched with controls by gender and the date of intoxication. We use a structured questionnaire to identify personal characteristics, family features and network support. Odds ratio (OR) and 95 % confidence interval were obtained. 25 cases and 25 controls were evaluated. The risk factors associated with suicide attempt adjusted by age, were being a student and smoking habits. Family violence background showed OR = 3.8 (IC 95 % = 1.1-13), family disintegration a OR = 8.5 (IC 95 % = 2.1-35), critical events background OR = 8.8 (IC 95 % = 2.1-36), poor self-esteem OR = 8.2 (IC 95 % 2-35), depression OR = 22 (IC 95 % = 3-190), anxiety OR = 9 (IC 95 % = 2-47), family dysfunction OR = 25 (IC 95 % = 4-151). The principal risk factor for suicide attempt was family dysfunction and psychological traits.

Melancholic features and hostility are associated with suicidality risk in Asian patients with major depressive disorder.

Science.gov (United States)

Jeon, Hong Jin; Peng, Daihui; Chua, Hong Choon; Srisurapanont, Manit; Fava, Maurizio; Bae, Jae-Nam; Man Chang, Sung; Hong, Jin Pyo

2013-06-01

Suicide rates are higher in East-Asians than other populations, and especially high in Koreans. However, little is known about suicidality risk and melancholic features in Asian patients with major depressive disorder (MDD). Drug-free MDD outpatients were included from 13 centers across five ethnicities consisting of Chinese (n=290), Korean (n=101), Thai (n=102), Indian (n=27), and Malay (n=27). All were interviewed using the Mini-International Neuropsychiatric Interview (M.I.N.I.), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Symptoms Checklist 90-Revised (SCL-90-R). Of 547 subjects, 177 MDD patients showed melancholic features (32.4%). These melancholic MDD patients revealed significantly higher suicidality risk (pdepression (pdifference in higher hostility. Adjusted odds ratios of melancholic features and hostility for moderate to high suicidality risk were 1.79 (95% CI=1.15-2.79) and 2.45 (95% CI=1.37-4.38), after adjusting for age, sex, education years, and depression severity. Post-hoc analyses showed that suicidality risk was higher in Korean and Chinese than that of Thai, Indian and Malay in MDD subjects with melancholic features, although depression severity showed no significant differences among the ethnicities. Suicidality risk is associated with both melancholic features and hostility and it shows cross-ethnic differences in Asian MDD patients, independent of depression severity. Copyright © 2013 Elsevier B.V. All rights reserved.

Self-esteem and suicide risk

OpenAIRE

perrot, Clémence

2015-01-01

Introduction: Suicide is a major Public Health concern and self-esteem is given growing interest in our society.Objectives: To assess the correlation between self-esteem and suicidal intent, independently of depression, and to examine the relationship between the different dimensions of self-esteem (total, general, familial, professional and social). We also studied whether poor self-esteem was predictive of suicidal risk.Methods: Two studies were conducted among a Suicide Prevention Departme...

Mental Health Professionals' Suicide Risk Assessment and Management Practices.

Science.gov (United States)

Roush, Jared F; Brown, Sarah L; Jahn, Danielle R; Mitchell, Sean M; Taylor, Nathanael J; Quinnett, Paul; Ries, Richard

2018-01-01

Approximately 20% of suicide decedents have had contact with a mental health professional within 1 month prior to their death, and the majority of mental health professionals have treated suicidal individuals. Despite limited evidence-based training, mental health professionals make important clinical decisions related to suicide risk assessment and management. The current study aimed to determine the frequency of suicide risk assessment and management practices and the association between fear of suicide-related outcomes or comfort working with suicidal individuals and adequacy of suicide risk management decisions among mental health professionals. Mental health professionals completed self-report assessments of fear, comfort, and suicide risk assessment and management practices. Approximately one third of mental health professionals did not ask every patient about current or previous suicidal thoughts or behaviors. Further, comfort, but not fear, was positively associated with greater odds of conducting evidence-based suicide risk assessments at first appointments and adequacy of suicide risk management practices with patients reporting suicide ideation and a recent suicide attempt. The study utilized a cross-sectional design and self-report questionnaires. Although the majority of mental health professionals report using evidenced-based practices, there appears to be variability in utilization of evidence-based practices.

Diagnostic profile and suicide risk in schizophrenia spectrum disorder.

Science.gov (United States)

Reutfors, Johan; Bahmanyar, Shahram; Jönsson, Erik G; Ekbom, Anders; Nordström, Peter; Brandt, Lena; Ösby, Urban

2010-11-01

Earlier studies of patients with schizophrenia have investigated suicide risk in relation to specific psychiatric symptoms, but it remains to be better understood how suicide risk relates to the diagnostic profile in these patients. We identified all patients with a first clinical ICD-diagnosis of schizophrenia, schizophreniform or schizoaffective disorder in Stockholm County between 1984 and 2000. Patients who died by suicide within five years from diagnosis were defined as cases (n=84) and were individually matched with a similar number of living controls from the same population. Sociodemographic and clinical variables were retrieved from hospital records through a blind process. DSM-IV lifetime diagnoses for cases and controls were derived using the OPCRIT algorithm. A schizophrenia spectrum diagnosis (i.e. schizophrenia, schizophreniform or schizoaffective disorder) was assigned by OPCRIT to 50% of the suicide cases and 62% of the controls. Criteria for schizophrenia were met by 41% of the cases and 51% of the controls; for schizoaffective disorder by 8% of the cases and 10% of the controls; for other psychosis by 23% of the cases and 25% of the controls; and for mood disorder by 26% of the cases and 12% of the controls. Using the schizophrenia diagnosis as a reference, suicide risk was significantly higher in patients meeting criteria for a mood disorder diagnosis with an adjusted odds ratio of 3.3 (95% CI 1.2-9.0). In patients with a clinical schizophrenia spectrum diagnosis, a DSM-IV mood disorder diagnosis increases the suicide risk more than three-fold. Copyright © 2010 Elsevier B.V. All rights reserved.

Risk of suicide in high risk pregnancy: an exploratory study.

Science.gov (United States)

Benute, Gláucia Rosana Guerra; Nomura, Roseli Mieko Yamamoto; Jorge, Vanessa Marques Ferreira; Nonnenmacher, Daniele; Fráguas Junior, Renério; Lucia, Mara Cristina Souza de; Zugaib, Marcelo

2011-01-01

To identify the risk of suicidal behavior in high-risk pregnant women at a public hospital in São Paulo. We conducted a semi-structured interview with each of the participants (n = 268) through a previously prepared questionnaire. Risk of suicidal behavior was assessed by the Portuguese version of PRIME-MD. The mean age of patients was 29 years (SD = 0.507) and gestation period was 30 weeks (SD = 0.556). Of the total sample, specific risk of suicide was found in 5% (n = 14). Of these, 85% have a stable relationship (married or cohabitating), the pregnancy was planned in 50% of cases, and 71% have no religion or professional activities. The correlation of risk of suicide with data from marital status, planned birth, age, education, professional practice, risk of prematurity, and religion showed that having a religion is statistically significant (p = 0.012). There were no positive associations for any of the other selected variables when compared with the risk of suicide. By correlating the risk of suicide with other characteristic symptoms of major depression, there was statistical significance in the sample with regard to insomnia or hypersomnia (p = 0.003), fatigue or loss of energy (p = 0.001), decreased or increased appetite (p = 0.005), less interest in daily activities (p = 0.000), depressed mood (p = 0.000), feelings of worthlessness or guilt (p = 0.000), decreased concentration (p = 0.002), and agitation or psychomotor retardation (p = 0.002). We found that religion can be a protective factor against suicidal behavior. Besides providing a social support network needed by women during pregnancy, religion supports belief in life after death and in a loving God, giving purpose to life and self esteem and providing models for coping with crises. The results show the importance of prevention and early diagnosis of suicidal behavior, since suicide is an attempt to move from one sphere to another by force, seeking to solve what seems impossible.

Explanatory risk factors in the relations between schizotypy and indicators of suicide risk.

Science.gov (United States)

Jahn, Danielle R; DeVylder, Jordan E; Hilimire, Matthew R

2016-04-30

Schizotypy has been linked to suicide risk, but it is not known whether established suicide-related risk factors mediate this relation. The aim of this study was to assess the mediating effects of depressive symptoms, social anxiety, self-esteem, and intimate disclosure in peer relationships in the relation between interpersonal schizotypy and suicide ideation or lifetime suicide attempts. This aim was tested in 590 young adults using a nonparametric bootstrapping procedure. After inclusion of the mediators, interpersonal schizotypy was no longer directly associated with either suicide ideation or lifetime suicide attempts. Depression and self-esteem mediated the relation between interpersonal schizotypy and suicide ideation. No variables mediated the relation between interpersonal schizotypy and lifetime suicide attempts, and there were no significant direct relations when mediators were included. Schizotypy appears to be a distal risk factor for suicidal behavior; assessing depressive symptoms and self-esteem may provide more proximal information about suicide risk, and may be targets for mitigating suicide risk in individuals with schizotypy. Published by Elsevier Ireland Ltd.

Work expectations, cultural sensitivity, schizophrenia, and suicide risk in male patients.

Science.gov (United States)

Lewine, Richard; Shriner, Brooke

2009-04-01

This study examines the relationship between "vocational lost potential" and suicide risk in a mixed sample of severely and persistently mentally ill psychiatric patients. We hypothesized that increased lost potential would be associated with increased suicide risk indicator ratings and that this relationship would be moderated by patients' social class of origin. One hundred sixty-seven psychiatric patients rated a range of clinical symptoms and vocational expectations, as well as providing sociodemographic information including their parents' years of education (used as a proxy for social class of origin). Contrary to our prediction, the results suggest that individuals from higher social class who experience minimal lost potential may be at a higher risk for suicide than their counterparts with maximal lost potential; this is especially true when based on fathers' educational level. In discussing the clinical implications of our findings, we suggest that a subgroup of individuals' vocational success may depend on first addressing the cognitive conflict inherent in the phenomenon of lost potential.

Risk Factors Associated With Suicide Completions Among US Enlisted Marines.

Science.gov (United States)

Phillips, Christopher J; LeardMann, Cynthia A; Vyas, Kartavya J; Crum-Cianflone, Nancy F; White, Martin R

2017-09-15

US enlisted Marines have experienced a substantial increase in suicide rates. We sought to identify risk factors for suicide completions among male Marines who entered basic training in San Diego, California, between June 2001 and October 2010. Suicides that occurred during active-duty military service were counted from June 1, 2001, through June 30, 2012. A total of 108,930 male Marines (66,286 deployers and 42,644 never deployed) were followed for 467,857 person-years of active-duty service time. Of the 790 deaths, 123 (15.6%) were suicides. In the final multivariate hazard model, preservice characteristics of not being a high-school graduate (hazard ratio (HR) = 2.17, 95% confidence interval (CI): 1.28, 3.68) and being a smoker at the time of enlistment (HR = 1.91, 95% CI: 1.32, 2.76) were significantly associated with a higher risk for suicide completion. Diagnosed with traumatic brain injury (HR = 4.09, 95% CI: 2.08, 8.05), diagnosed with depression (HR = 2.36, 95% CI: 1.22, 4.58), and received relationship counseling (HR = 3.71, 95% CI: 1.44, 9.54) during military service were significant risks for suicide death. Deployment alone was not significantly associated with a risk for suicide death (HR = 0.53, 95% CI: 0.26, 1.05). Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Sex difference in risk period for completed suicide following prior attempts: Korea National Suicide Survey (KNSS).

Science.gov (United States)

Kim, Bora; Lee, Joongyub; Kim, Eun-Young; Hyun Kim, Se; Ha, Kyooseob; Shin Kim, Young; Leventhal, Bennett L; Min Ahn, Yong

2018-02-01

We provide an opportunity for implementing preventive interventions to decrease suicide mortality among prior suicide attempters. We aim to identify sex-specific high risk periods and factors for later suicide death among suicide attempters. 8537 suicide attempters of Korea National Suicide Survey were collected from January 1, 2007 to December 31, 2011 and data on suicide death was obtained as of December 31, 2012. The risk period and risk factors for later suicide death was computed by Kaplan-Meier survival estimates and by plotting the hazard function using the Epanechnikov Kernal smoothing method and cox proportional hazard regression modeling. The hazard for later suicide death was significant up to 10 months for females and 20 months for males. Age 50-69 years (HR, 3.29; [CI: 1.80-6.02] and not being intoxicated with alcohol (HR, 1.94 [1.27-2.97])) in male attempters were significant risk factors for later suicide death. Risk for later suicide death was significantly increased during the first full year following index attempts for all with an addition 8 months of risk for males, especially those of advanced age who were sober at the time of attempt. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk factors of suicide attempt among people with suicidal ideation in South Korea: a cross-sectional study

Directory of Open Access Journals (Sweden)

Soo Beom Choi

2017-06-01

Full Text Available Abstract Background Suicide is a serious public health concern worldwide, and the fourth leading cause of death in Korea. Few studies have focused on risk factors for suicide attempt among people with suicidal ideation. The aim of the present study was to investigate the risk factors and develop prediction models for suicide attempt among people with suicidal ideation in the Korean population. Method This study included 1567 men and 3726 women aged 20 years and older who had suicidal ideation from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Among them, 106 men and 188 women attempted suicide. Multivariate logistic regression analysis with backward stepwise elimination was performed to find risk factors for suicide attempt. Sub-group analysis, dividing participants into under 50 and at least 50 years old was also performed. Results Among people with suicidal ideation, age, education, cancer, and depressive disorder were selected as risk factors for suicide attempt in men. Age, education, national basic livelihood security, daily activity limitation, depressive disorder, stress, smoking, and regular exercise were selected in women. Area under curves of our prediction models in men and women were 0.728 and 0.716, respectively. Conclusions It is important to pay attention to populations with suicidal ideation and the risk factors mentioned above. Prediction models using the determined risk factors could be useful to detect high-risk groups early for suicide attempt among people with suicidal ideation. It is necessary to develop specific action plans for these high-risk groups to prevent suicide.

Risk factors of suicide attempt among people with suicidal ideation in South Korea: a cross-sectional study.

Science.gov (United States)

Choi, Soo Beom; Lee, Wanhyung; Yoon, Jin-Ha; Won, Jong-Uk; Kim, Deok Won

2017-06-15

Suicide is a serious public health concern worldwide, and the fourth leading cause of death in Korea. Few studies have focused on risk factors for suicide attempt among people with suicidal ideation. The aim of the present study was to investigate the risk factors and develop prediction models for suicide attempt among people with suicidal ideation in the Korean population. This study included 1567 men and 3726 women aged 20 years and older who had suicidal ideation from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Among them, 106 men and 188 women attempted suicide. Multivariate logistic regression analysis with backward stepwise elimination was performed to find risk factors for suicide attempt. Sub-group analysis, dividing participants into under 50 and at least 50 years old was also performed. Among people with suicidal ideation, age, education, cancer, and depressive disorder were selected as risk factors for suicide attempt in men. Age, education, national basic livelihood security, daily activity limitation, depressive disorder, stress, smoking, and regular exercise were selected in women. Area under curves of our prediction models in men and women were 0.728 and 0.716, respectively. It is important to pay attention to populations with suicidal ideation and the risk factors mentioned above. Prediction models using the determined risk factors could be useful to detect high-risk groups early for suicide attempt among people with suicidal ideation. It is necessary to develop specific action plans for these high-risk groups to prevent suicide.

Incidence and Risk Factors of Homicide–Suicide in Swiss Households: National Cohort Study

Science.gov (United States)

Panczak, Radoslaw; Zwahlen, Marcel; Spoerri, Adrian; Tal, Kali; Killias, Martin; Egger, Matthias

2013-01-01

Background Homicide–suicides are rare but catastrophic events. This study examined the epidemiology of homicide-suicide in Switzerland. Methods The study identified homicide–suicide events 1991–2008 in persons from the same household in the Swiss National Cohort, which links census and mortality records. The analysis examined the association of the risk of dying in a homicide–suicide event with socio-demographic variables, measured at the individual-level, household composition variables and area-level variables. Proportional hazards regression models were calculated for male perpetrators and female victims. Results are presented as age-adjusted hazard ratios (HR) with 95% confidence intervals (95%CI). Results The study identified 158 deaths from homicide–suicide events, including 85 murder victims (62 women, 4 men, 19 children and adolescents) and 68 male and 5 female perpetrators. The incidence was 3 events per million households and year. Firearms were the most prominent method for both homicides and suicides. The risk of perpetrating homicide-suicide was higher in divorced than in married men (HR 3.64; 95%CI 1.56–8.49), in foreigners without permanent residency compared to Swiss citizens (HR 3.95; 1.52–10.2), higher in men without religious affiliations than in Catholics (HR 2.23; 1.14–4.36) and higher in crowded households (HR 4.85; 1.72–13.6 comparing ≥2 with homicide-suicide events in Switzerland. PMID:23326491

SSRIs and risk of suicide attempts in young people

DEFF Research Database (Denmark)

Christiansen, Erik; Agerbo, Esben; Bilenberg, Niels

2016-01-01

BACKGROUND: SSRIs are widely used in the treatment of mental illness for both children and adults. Studies have found a slightly increased risk of suicidal thoughts and suicide attempts in young people using SSRIs but SSRIs' impact on risk for suicides in youth is not well-established. AIM......: Is there indication that SSRIs might raise risk for suicide attempts in young people? METHODS: We used an observational register-based historical cohort design, a large cohort of all Danish individuals born in 1983-1989 (n = 392,458) and a propensity score approach to analyse the impact from SSRIs on risk for suicide...... attempts. Every suicide attempt and redeemed prescription of SSRIs was analysed by Cox regression. RESULTS: We found a significant overlap between redeeming a prescription on SSRIs and subsequent suicide attempt. The risk for suicide attempt was highest in the first 3 months after redeeming the first...

[Risk factors and protective factors relating to suicide in the Netherlands and Flanders].

Science.gov (United States)

Reynders, A; Kerkhof, A J F M; Molenberghs, G; van Audenhove, C

2016-01-01

The suicide rate is 82% higher in the Flanders region of Belgium than in the Netherlands. To investigate to what extent Flanders and the Netherlands differ with regard to the risk factors and protective factors relating to suicide and attempted suicide. By means of a structured postal questionnaire, we collected data on the following topics from 2999 Flemish and Dutch people between 18 and 64 years: mental well-being and earlier attempts to commit suicide, the help they had received and their intention to seek help for psychological problems, awareness of the mental health care available, satisfaction with the help received, and attitudes to suicide. The incidence of psychological problems and suicidality did not differ significantly between Flanders and the Netherlands. Compared to Flemish people, Dutch people with psychological problems had received more psychological help and more often expressed the intention to seek help in the future. Furthermore, the Dutch were better informed about mental health care, and patient satisfaction was higher in the Netherlands. Compared to the Flemish people, the Dutch had more positive and understanding attitude to suicide. In general, risk factors for suicide were similar in the Netherlands and Flanders. However, the Dutch were characterised by more protective factors. We attempt to explain these differences and suggest ways of improving suicidal prevention policy.

Suicide Attempt Risk in Youths: Utility of the Harkavy-Asnis Suicide Scale for Monitoring Risk Levels

Science.gov (United States)

Asarnow, Joan; McArthur, David; Hughes, Jennifer; Barbery, Veronica; Berk, Michele

2012-01-01

The Harkavy-Asnis Suicide Scale (HASS), one of the few self-report scales assessing suicidal behavior was evaluated and ideation, was evaluated and predictors of suicide attempts (SAs) were identified with the goal of developing a model that clinicians can use for monitoring SA risk. Participants were 131 pediatric emergency department (ED)…

Age as a risk factor for suicide

Directory of Open Access Journals (Sweden)

Kocić Sanja S.

2008-01-01

Full Text Available Background/Aim. World Health Organization (WHO in its plan for health policy until the year 2010, has taken reduction of risk factors of suicide as its 12th aim. Because of the fact that the problem of suicide is also significant health problem in our society, the aim of this study was to examine the influence of life period as a risk factor for suicide in the area of the town of Kragujevac. Methods. In total 211 persons, both sexes, aged between 17 and 91 years, from the area of the town of Kragujevac, who had been committed a suicide during the period from 1996 to 2005, were included in a retrospective study. This study included the analysis of: conditions prior to suicide, locations of suicide, motives for suicide, the ways of committing suicide. For statistical analysis χ2 test and univariante regression model were used. Results. Average rate of suicide, in analyzed period, moved from 8.7 to 27 with a mean value of 14.6± 6.9. Suicide rates were the lowest in the age group from 15 to 24 years and the highest in the age group above 65 years (p < 0.05. Among the presuicidal conditions, within any age groups the presence of mental disease dominated as a factor for suicide, but within the oldest one in which organic diseases prevailed as a factor for suicide (p < 0.05. Statistically significant fact is that a house (flat was the main location for committing suicide in any age groups. Motives for suicide were significantly different within the groups and they were mostly unknown. Committing suicide by hanging was the most frequent way of suicide among any age groups. Univariant regression analysis failed to show any impact of age on the analyzed factors. Conclusion. Because of the fact that an average rate of suicide in elderly increases it is obligatory to primarily determine risk factors for suicide among people more than 65 years of age. Physicians should play the most important role in that.

Suicide attempt history, self-esteem, and suicide risk in a sample of 116 depressed voluntary inpatients.

Science.gov (United States)

Palmer, Charles James

2004-12-01

116 consecutively admitted depressed inpatients were divided into three groups based on self-reported history of suicidal ideation and history of suicide attempt. Participants in Group 1 (M age 34.0, SD= 14.0), 13 men and 24 women, reported no history of suicidal ideation or history of suicide attempt. Group 2 (M age 34.0, SD= 8.6), 14 men and 25 women, reported having a history of suicidal ideation but no history of suicide attempt. Group 3 (M age 34.0 yr., SD=6.3), 14 men and 26 women, reported a history of suicidal ideation and at least one suicide attempt. Each participant completed the Suicide Risk Scale and the Self-esteem Scale. Analysis of variance with Tukey post hoc comparisons yielded a significant difference between Groups 1 and 2, between Groups 1 and 3, and between Groups 2 and 3 on the Suicide Risk Scale. There was a significant difference between Group 1 and Group 2 and between Group 1 and Group 3 on the Self-esteem Scale. These data indicated that suicide ideation and suicide attempt history significantly elevated suicide risk. Self-esteem was significantly decreased by suicide ideation and suicide attempt history.

Familial risk of early suicide: variations by age and sex of children and parents

NARCIS (Netherlands)

Garssen, Joop; Deerenberg, Ingeborg; Mackenbach, Johan P.; Kerkhof, Ad; Kunst, Anton E.

2011-01-01

To determine familial risk of early suicide, data on cause of death of all Dutch residents aged 20-55 years who died between 1995 and 2001 were linked to data of their parents. Men whose father died by suicide had a higher odds of suicide themselves, relative to men whose father died of other causes

Risk factors and characteristics of suicide attempts among 381 suicidal adolescents

DEFF Research Database (Denmark)

Hedeland, Rikke Lindgaard; Teilmann, Grete; Jørgensen, Marianne Hørby

2016-01-01

AIM: This study explored the relationships between suicidal adolescents and their parents, siblings and friends. It examined how much adolescents talked to their parents before suicide attempts, the frequency of self-mutilation, the extent of suicidal ideation, previous suicide attempts and suici...... this feeling and the duration of suicidal ideation (p = 0.01) and self-mutilation (p = 0.003). CONCLUSION: Early risk factors for suicide were dissociated relationships with parents, siblings and friends, feeling unheard, self-mutilation and extended suicidal ideation........ The study used questionnaires and medical and child psychiatric records. RESULTS: The study group were ten times more likely to report dissociated parental relationships than the control group (41.5% versus 4%), and there were significant relationships between these reports and feelings of not being heard...

Exposure to suicide is associated with increased risk for suicidal thoughts and behaviors among National Guard military personnel.

Science.gov (United States)

Bryan, Craig J; Cerel, Julie; Bryan, AnnaBelle O

2017-08-01

Research suggests that individuals who know someone who died by suicide are at increased risk for posttraumatic stress disorder (PTSD), depression, and recent suicidal thoughts. Studies have not yet investigated the association of suicide exposure with suicide attempts, however, especially among high-risk subgroups of military personnel such as the National Guard. An anonymous online survey was completed by 971 military personnel assigned to the National Guard in Utah and Idaho. Weighted analyses were conducted to ensure demographic matching to the full population. Univariate and multivariate logistic regression was used to test the association of suicide exposure with psychiatric condition, suicide ideation, and suicide attempts. 65.4% of National Guard personnel reported knowing someone who had died by suicide. On average, participants knew 3.0 (SD=2.0) suicide decedents. Total number of known suicide decedents was associated with significantly increased risk for PTSD (OR=1.18, p=.008), depression (OR=1.19, p=.003), and suicide ideation (OR=2.48, p<.001), but not suicide attempt (OR=1.34, p=.472). Perceived closeness to the suicide decedent was associated with significantly increased risk for PTSD (OR=1.54, p<.001), depression (OR=1.36, p=.031), suicide ideation (OR=1.24, p=.039), and suicide attempt (OR=1.69, p=.026). The majority of participants who experienced suicidal thoughts and attempts after the suicide exposure had a previous history of suicide ideation. Suicide exposure is common among National Guard personnel, and is associated with increased risk for PTSD, depression, and suicidal thoughts and behaviors. Risk is highest for those personnel who know multiple suicide decedents and were closer to the suicide decedent. Copyright © 2017 Elsevier Inc. All rights reserved.

Systematic Suicide Risk Assessment for Patients With Schizophrenia

DEFF Research Database (Denmark)

Pedersen, Charlotte Gjørup; Wallenstein Jensen, Signe Olrik; Gradus, Jaimie

2013-01-01

Objectives: Systematic suicide risk assessment is recommended for patients with schizophrenia; however, little is known about the implementation of suicide risk assessment in routine clinical practice. The study aimed to determine the use of systematic suicide risk assessment at discharge...... and predictors of suicide attempt among hospitalized patients with schizophrenia in Denmark. Methods: A one-year follow-up study was conducted of 9,745 patients with schizophrenia who were discharged from psychiatric wards and registered in a national population-based schizophrenia registry between 2005 and 2009....... Results: The proportion of patients receiving suicide risk assessment at discharge from a psychiatric ward increased from 72% (95% confidence interval [CI]=71%-74%) in 2005, when the national monitoring began, to 89% (CI.89%-90%) in 2009. Within one year after discharge, 1% of all registered patients had...

Suicide risk in youth with intellectual disabilities: the challenges of screening.

Science.gov (United States)

Ludi, Erica; Ballard, Elizabeth D; Greenbaum, Rachel; Pao, Maryland; Bridge, Jeffrey; Reynolds, William; Horowitz, Lisa

2012-06-01

Children and adolescents with intellectual disabilities (IDs), often diagnosed with comorbid psychiatric disorders, are a vulnerable population who may be at risk for developing suicidal thoughts and behaviors. Previous research has demonstrated that direct suicide screening can rapidly and effectively detect suicide risk and facilitate further clinical evaluation and management. Currently, there are no measures that screen for suicide risk designed specifically for individuals with ID. A review of the literature was conducted to (1) estimate the prevalence of suicidal thoughts, behaviors, and deaths by suicide in children and adolescents with ID; (2) describe associations between youth with ID and suicide risk; and (3) identify the limitations of commonly used suicide screening measures developed for non-ID youth. The literature review confirms that suicide risk exists in this population; youth with ID think about, attempt, and die by suicide. Standardized suicide risk screening is challenged by the lack of measures developed for this population. A summary of the findings is followed by a discussion of the practical clinical considerations surrounding the assessment of suicide risk in youth with ID.

Suicide Risk in Youth with Intellectual Disability: The Challenges of Screening

Science.gov (United States)

Ludi, Erica; Ballard, Elizabeth D.; Greenbaum, Rachel; Pao, Maryland; Bridge, Jeffrey; Reynolds, William; Horowitz, Lisa

2012-01-01

Children and adolescents with intellectual disabilities (ID), often diagnosed with co-morbid psychiatric disorders, are a vulnerable population who may be at risk for developing suicidal thoughts and behaviors. Previous research has demonstrated that direct suicide screening can rapidly and effectively detect suicide risk and facilitate further clinical evaluation and management. Currently, there are no measures that screen for suicide risk designed specifically for individuals with ID. A review of the literature was conducted: 1) to estimate the prevalence of suicidal thoughts, behaviors and deaths by suicide in children and adolescents with ID; 2) to describe associations between youth with ID and suicide risk; 3) to identify the limitations of commonly used suicide screening measures developed for non-ID youth. The literature review confirms that suicide risk exists in this population; youth with ID think about, attempt and die by suicide. Standardized suicide risk screening is challenged by the lack of measures developed for this population. A summary of the findings is followed by a discussion of the practical clinical considerations surrounding the assessment of suicide risk in youth with ID. PMID:22668827

[Concurrent validation of the suicidal risk assessment scale (R.S.D.) with the Beck's suicidal ideation scale].

Science.gov (United States)

Ducher, J-L; Daléry, J

2004-01-01

The prevention of suicide is a top priority in mental health. The determination of high risk suicidal groups is not sufficient. The expressing suicidal ideas is not a protective factor, but in contrary a risk factor to take into account, or even to search and to quantify: 80% of the subjects who attempt to commit suicide or commit suicide express such ideas months before. Several evaluation instruments try to help the practitioners or the research workers in this reasoning. The suicidal risk assessment scale RSD can be cited in particular. It is composed of eleven sections. The 0 level corresponds to the absence of particular ideas of death or suicide. Levels 1 and 2, the presence of ideas of death. Levels 3-4-5, the presence of suicidal ideas. The difference compared to the majority of the other scales consecrated to the same subject, the passif desire of death, occupies a place totally particular in the RSD (level 6). From the level 7, the risk of acting out seems to become more important. It stops being a simple idea of suicide, but becomes a real will of dying, firstly retained by something or someone (level 7), the fear of causing suffering to dear ones or a religious belief., then determined (level 8). Finally, the patient has elaborated a concrete plan (level 9) or he has already started the preparation of acting out (level 10). It is just necessary to evaluate and to note the highest level of the scale. The inclusion of the suicidal risk assessment scale RSD and of the Suicidal Ideation Scale by Beck in an international multicenters, phase IV, double-blind study, according to two parallel groups, with a fixed dose of fluoxétine or fluvoxamine for six weeks, allowed to search correlations which could exist between the two scales. The ana-lysis before the beginning of the treatment was done on 108 outpatients depressive, male and female, aged 18 or over. It finds a satisfactory concurrent validity between the suicidal risk assessment scale RSD and the

[Not enough help for themselves--the risk of physicians to commit suicide].

Science.gov (United States)

Püschel, Klaus; Schalinski, Sarah

2006-01-01

Physicians seem unwilling to deal with their own suicidal problems professionally. Suicide is a repressed topic. According to international studies, medical students and physicians are clearly over-represented among suicide victims. Committing suicide stands in sharp contrast to the positive image physicians enjoy as competent, strong helpers transmitting positive energy. Various studies and meta-analyses show that physicians use knowledge specific to their profession and are therefore "more successful" than the general population in committing suicide. Moreover, the data reveal a number of risk factors specifically correlating with medical practice. This is confirmed by an increased number of suicides during medical training and professional life in comparison with the general population. Gender-specific analyses show an even higher suicide risk for female physicians. In this context it cannot be excluded that out of "professional respect" cardiovascular causes of death are sometimes falsely documented in death certificates instead of suicide. Despite their special education, physicians are not very good at diagnosing their own emotional disorders and asking colleagues for adequate professional help. They rather tend to camouflage their own psychological problems also because they are afraid of occupational and personal discrimination.

Clinically relevant risk factors for suicide: Comparison between clinical group with passive suicidal ideation, active suicidal ideation and without suicidal ideation

OpenAIRE

Miloseva, Lence; Cuijpers, Pim; Stojcev, Saso; Niklewski, Gunter; Richter, Kneginja; Jovevska, Svetlana; Arsova, Roza; Serafimov, Aleksandar

2015-01-01

Introduction: In recent years, researchers and clinicians do not treat passive suicidal ideation as a clinically relevant risk factor for suicide, while underestimating the strength of this desire to die, compared with making a plan for suicide in individuals having active suicidal ideation. This research study is clinically prospective, cross-sequential, but also partly retrospective because it involves also variables from the past, such as patients’ history data (number of suicidal attempts...

Perceived risks and use of psychotherapy via telemedicine for patients at risk for suicide.

Science.gov (United States)

Gilmore, Amanda K; Ward-Ciesielski, Erin F

2017-01-01

Introduction Suicide is a major public health problem and its human, emotional, and economic costs are significant. Individuals in rural areas are at highest risk for suicide. However, telemedicine services are typically not rendered to individuals who are actively suicidal. The goals of the current study were to identify the risks of using telemedicine for mental healthcare from the perspective of licensed mental health providers and to determine factors associated with the use of telemedicine with patients who are at high risk for suicide. Methods A total of 52 licensed mental health providers were recruited online through several professional organization listservs and targeted emails. Providers completed online questionnaires regarding demographics, caseload of suicidal patients, perceived risks for using telemedicine with patients at risk for suicide, attitudes towards telemedicine, and use of telemedicine with patients at risk for suicide. Results Three key perceived risks associated with using telemedicine were identified, including assessment, lack of control over patient, and difficulties triaging patients if needed. It was also found that individuals who had more positive attitudes towards telemedicine, younger providers, and more experienced providers were more likely to use telemedicine with patients who are at high risk for suicide. Discussion To our knowledge, this is the first study to examine the perceived risks and use of telemedicine with patients at high risk for suicide. It is essential to continue this line of research to develop protocols for the provision of evidence-based therapy via telemedicine for this high-risk group.

Exposure to suicidal behaviors: A common suicide risk factor or a personal negative life event?

Science.gov (United States)

Harris, Keith M; Bettiol, Silvana

2017-02-01

Numerous suicide risk factors have been proposed but not adequately validated for epidemiology, treatment and prevention efforts. Exposures to suicidal behaviors (ESB), from family and friend suicide attempts and completions, were tested for validity as a suicidal risk factor and also for measurement and construct adequacy. An anonymous online survey yielded 713 participants (aged 18-71), who reported ESB, completed the Suicidal Affect-Behavior-Cognition Scale (SABCS), and comprised a broad spectrum on those variables. Tests of dimensionality and internal consistency showed the four ESB variables (attempts/completions through family/friends) were independent and did not form a common factor or an identifiable ESB latent trait. ESB variables were, however, associated with demographic and psychiatric histories. A battery of tests revealed no meaningful associations between ESB and total suicidality or suicide risk factors (social support, depression, anxiety, stress, satisfaction with life and emotional stability). In addition, in contrast to previous reports, young adults ( n = 200; aged 18-20) showed no increased suicidality due to ESB. Results showed no validity for ESB as a common risk factor for suicidality or other psychopathology, or as a latent trait. ESB showed evidence as a personal negative life event with individual effects and interpretations.

[Stigma - risk factor and consequence of suicidal behavior : Implications for suicide prevention].

Science.gov (United States)

Oexle, N; Rüsch, N

2017-11-16

Mental illness, previous suicidal behavior and loss of a relative by suicide are strong risk factors for suicidality. Both mental illness and suicide are stigmatized, which is a burden for those affected and potentially contributes to suicidality among stigmatized individuals. Many consequences of stigma, e. g. social isolation, low self-esteem and hopelessness, are well-known predictors of suicidality. Interventions to reduce stigmatization might therefore be an important component of successful suicide prevention. This paper discusses the currently available knowledge regarding this hypothesis. Many studies confirmed the association between the stigmatization of mental illness and suicidality and there is initial evidence for the influence of suicide stigma and suicidality. Nevertheless, the effectiveness of anti-stigma interventions to reduce suicidality and prevent suicide has not yet been tested. Reducing stigma among members of the general population and mental health care professionals as well as programs to support individuals in coping with stigmatization could be important components of successful suicide prevention.

Alexithymia and suicidality in panic disorder.

Science.gov (United States)

Iancu, I; Dannon, P N; Poreh, A; Lepkifker, E; Grunhaus, L

2001-01-01

To evaluate the prevalence of suicidal behavior in patients with panic disorder (PD) and to study the role of alexithymia (AL), an affect component, as a predictor of suicidal behavior in PD, we compared 42 patients with PD with or without agoraphobia with 24 healthy controls with regards to depression, AL and suicide risk. Only 5% of the PD patients reported previous suicide attempts. A higher frequency of positive AL (score > 73) was found among the PD patients (39% v 4% among the controls). PD patients had a higher suicide risk and AL as compared to controls, but only the increased suicide risk reached statistical significance. AL subjects had higher suicide risk scores as compared to non-AL subjects. Significant correlations were found between the AL score and suicide risk, although the most significant correlation was, as expected, between the depression level and the suicide risk. A low rate of previous suicide attempts was found in the PD group, perhaps reflecting the low comorbidity in our sample. We suggest that AL may have a role in the causation of suicidal behavior in PD patients, although further studies should re-examine this issue with larger samples. Copyright 2001 by W.B. Saunders Company

Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations

Science.gov (United States)

Haas, Ann P.; Eliason, Mickey; Mays, Vickie M.; Mathy, Robin M.; Cochran, Susan D.; D'Augelli, Anthony R.; Silverman, Morton M.; Fisher, Prudence W.; Hughes, Tonda; Rosario, Margaret; Russell, Stephen T.; Malley, Effie; Reed, Jerry; Litts, David A.; Haller, Ellen; Sell, Randall L.; Remafedi, Gary; Bradford, Judith; Beautrais, Annette L.; Brown, Gregory K.; Diamond, Gary M.; Friedman, Mark S.; Garofalo, Robert; Turner, Mason S.; Hollibaugh, Amber; Clayton, Paula J.

2011-01-01

Despite strong indications of elevated risk of suicidal behavior in lesbian, gay, bisexual, and transgender people, limited attention has been given to research, interventions or suicide prevention programs targeting these populations. This article is a culmination of a three-year effort by an expert panel to address the need for better understanding of suicidal behavior and suicide risk in sexual minority populations, and stimulate the development of needed prevention strategies, interventions and policy changes. This article summarizes existing research findings, and makes recommendations for addressing knowledge gaps and applying current knowledge to relevant areas of suicide prevention practice. PMID:21213174

Reassessing the long-term risk of suicide after a first episode of psychosis.

Science.gov (United States)

Dutta, Rina; Murray, Robin M; Hotopf, Matthew; Allardyce, Judith; Jones, Peter B; Boydell, Jane

2010-12-01

The long-term risk of suicide after a first episode of psychosis is unknown because previous studies often have been based on prevalence cohorts, been biased to more severely ill hospitalized patients, extrapolated from a short follow-up time, and have made a distinction between schizophrenia and other psychoses. To determine the epidemiology of suicide in a clinically representative cohort of patients experiencing their first episode of psychosis. Retrospective inception cohort. Geographic catchment areas in London, England (between January 1, 1965, and December 31, 2004; n = 2056); Nottingham, England (between September 1, 1997, and August 31, 1999; n = 203); and Dumfries and Galloway, Scotland (between January 1, 1979, and December 31, 1998; n = 464). All 2723 patients who presented for the first time to secondary care services with psychosis in the 3 defined catchment areas were traced after a mean follow-up period of 11.5 years. Deaths by suicide and open verdicts according to the International Classification of Diseases (seventh through tenth editions). The case fatality from suicide was considerably lower than expected from previous studies (1.9% [53/2723]); the proportionate mortality was 11.9% (53/444). Although the rate of suicide was highest in the first year after presentation, risk persisted late into follow-up, with a median time to suicide of 5.6 years. Suicide occurred approximately 12 times more than expected from the general population of England and Wales (standardized mortality ratio, 11.65; 95% confidence interval, 8.73-15.24), and 49 of the 53 suicides were excess deaths. Even a decade after first presentation-a time when there may be less intense clinical monitoring of risk-suicide risk remained almost 4 times higher than in the general population (standardized mortality ratio, 3.92; 95% confidence interval, 2.22-6.89). The highest risk of suicide after a psychotic episode occurs soon after presentation, yet physicians should still be

Early risk factors for suicide in an epidemiological first episode psychosis cohort.

Science.gov (United States)

Dutta, Rina; Murray, Robin M; Allardyce, Judith; Jones, Peter B; Boydell, Jane

2011-03-01

Much remains unknown about whether there are early risk factors for suicide in psychosis. The aim of the study was to determine whether there are any identifiable early symptom clusters, aetiological factors or illness course markers for suicide in first episode psychosis. A total of 2132 patients with first episode psychosis presenting to secondary care services in London (1965-2004; n=1474), Nottingham (1997-1999; n=195) and Dumfries and Galloway (1979-1998; n=463) were traced after up to 40 years (mean 13 years) following first presentation. Risk factors were identified from the Operational Checklist for Psychotic Disorders rated for the first year following presentation. Overall, there were 51 suicides and 373 deaths from other causes. Male gender (RR 2.84, 95% CI 1.20-6.69, p=0.02) and a cumulative threshold effect of symptoms early in the illness (RR 6.81, 95% CI 2.33-19.85, p<0.001) were associated with a higher propensity for later completed suicide. There was also a suggestion that early manic symptoms might increase the risk of later suicide irrespective of initial diagnosis. Suicide risk was associated with a cumulative threshold effect of symptoms and manic symptoms. As suicide is a relatively rare event in psychotic disorders, general population-based prevention strategies may have more impact in this vulnerable group as well as the wider population. Copyright © 2010 Elsevier B.V. All rights reserved.

Suicide Risk Among Holocaust Survivors Following Psychiatric Hospitalizations: A Historic Cohort Study.

Science.gov (United States)

Lurie, Ido; Gur, Adi; Haklai, Ziona; Goldberger, Nehama

2018-01-01

The association between Holocaust experience, suicide, and psychiatric hospitalization has not been unequivocally established. The aim of this study was to determine the risk of suicide among 3 Jewish groups with past or current psychiatric hospitalizations: Holocaust survivors (HS), survivors of pre-Holocaust persecution (early HS), and a comparison group of similar European background who did not experience Holocaust persecution. In a retrospective cohort study based on the Israel National Psychiatric Case Register (NPCR) and the database of causes of death, all suicides in the years 1981-2009 were found for HS (n = 16,406), early HS (n = 1,212) and a comparison group (n = 4,286). Age adjusted suicide rates were calculated for the 3 groups and a logistic regression model was built to assess the suicide risk, controlling for demographic and clinical variables. The number of completed suicides in the study period was: HS-233 (1.4%), early HS-34 (2.8%), and the comparison group-64 (1.5%). Age adjusted rates were 106.7 (95% CI 93.0-120.5) per 100,000 person-years for HS, 231.0 (95% CI 157.0-327.9) for early HS and 150.7 (95% CI 113.2-196.6) for comparisons. The regression models showed significantly higher risk for the early HS versus comparisons (multivariate model adjusted OR = 1.68, 95% CI 1.09-2.60), but not for the HS versus comparisons. These results may indicate higher resilience among the survivors of maximal adversity compared to others who experienced lesser persecution.

Predictors of Suicide Ideation in a Random Digit Dial Study: Exposure to Suicide Matters.

Science.gov (United States)

van de Venne, Judy; Cerel, Julie; Moore, Melinda; Maple, Myfanwy

2017-07-03

Suicide is an important public health concern requiring ongoing research to understand risk factors for suicide ideation. A dual-frame, random digit dial survey was utilized to identify demographic and suicide-related factors associated with suicide ideation in a statewide sample of 1,736 adults. The PH-Q 9 Depression scale suicide ideation question was used to assess current suicide ideation in both the full sample and suicide exposed sub-sample. Being non-married and having previous suicide exposure were separately associated with higher risks of suicide ideation in the full sample. Being male, having increased suicide exposures, and having increased perceptions of closeness to the decedent increased risks, while older age decreased risks for the suicide exposed. Implications for future screening and research are discussed.

Family history of suicide and exposure to interpersonal violence in childhood predict suicide in male suicide attempters.

Science.gov (United States)

Rajalin, Mia; Hirvikoski, Tatja; Jokinen, Jussi

2013-05-15

Family studies, including twin and adoption designs, have shown familial transmission of suicidal behaviors. Early environmental risk factors have an important role in the etiology of suicidal behavior. The aim of the present study was to assess the impact of family history of suicide and childhood trauma on suicide risk and on severity of suicide attempt in suicide attempters. A total of 181 suicide attempters were included. Family history of suicide was assessed with the Karolinska Suicide History Interview or through patient records. Childhood trauma was assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to violence and expressed violent behavior in childhood (between 6 and 14 years of age) and during adult life (15 years or older). Suicide intent was measured with the Freeman scale. Male suicide attempters with a positive family history of suicide made more serious and well planned suicide attempts and had a significantly higher suicide risk. In logistic regression, family history of suicide and exposure to interpersonal violence as a child were independent predictors of suicide in male suicide attempters. The information about family history of suicide and exposure to interpersonal violence as a child derives from the patients only. In the first part of the inclusion period the information was collected from patient records. The results of this study imply that suicides among those at biological risk might be prevented with the early recognition of environmental risks. Copyright © 2012 Elsevier B.V. All rights reserved.

Wisconsin Card Sorting Test performance and impulsivity in patients with temporal lobe epilepsy: suicidal risk and suicide attempts.

Science.gov (United States)

Garcia Espinosa, Arlety; Andrade Machado, René; Borges González, Susana; García González, María Eugenia; Pérez Montoto, Ariadna; Toledo Sotomayor, Guillermo

2010-01-01

The goal of the study described here was to determine if executive dysfunction and impulsivity are related to risk for suicide and suicide attempts in patients with temporal lobe epilepsy. Forty-two patients with temporal lobe epilepsy were recruited. A detailed medical history, neurological examination, serial EEGs, Mini-International Neuropsychiatric Interview, executive function, and MRI were assessed. Multiple regression analysis was carried out to examine predictive associations between clinical variables and Wisconsin Card Sorting Test measures. Patients' scores on the Risk for Suicide Scale (n=24) were greater than 7, which means they had the highest relative risk for suicide attempts. Family history of psychiatric disease, current major depressive episode, left temporal lobe epilepsy, and perseverative responses and total errors on the Wisconsin Card Sorting Test increased by 6.3 and 7.5 suicide risk and suicide attempts, respectively. Executive dysfunction (specifically perseverative responses and more total errors) contributed greatly to suicide risk. Executive performance has a major impact on suicide risk and suicide attempts in patients with temporal lobe epilepsy. 2009 Elsevier Inc. All rights reserved.

Nurses' Psychosocial Barriers to Suicide Risk Management

Directory of Open Access Journals (Sweden)

Sharon Valente

2011-01-01

Full Text Available Suicide remains a serious health care problem and a sentinel event tracked by The Joint Commission. Nurses are pivotal in evaluating risk and preventing suicide. Analysis of nurses' barriers to risk management may lead to interventions to improve management of suicidal patients. These data emerged from a random survey of 454 oncology nurses' attitudes, knowledge of suicide, and justifications for euthanasia. Instruments included a vignette of a suicidal patient and a suicide attitude questionnaire. Results. Psychological factors (emotions, unresolved grief, communication, and negative judgments about suicide complicate the nurse's assessment and treatment of suicidal patients. Some nurses (=122 indicated that euthanasia was never justified and 11 were unsure of justifications and evaluated each case on its merits. Justifications for euthanasia included poor symptom control, poor quality of life, incurable illness or permanent disability, terminal illness, and terminal illness with inadequate symptom control or impending death, patient autonomy, and clinical organ death. The nurses indicated some confusion and misconceptions about definitions and examples of euthanasia, assisted suicide, and double effect. Strategies for interdisciplinary clinical intervention are suggested to identify and resolve these psychosocial barriers.

Suicide Interventions Targeted toward At-Risk Youth

Science.gov (United States)

Langhinrichsen-Rohling, Jennifer; Lamis, Dorian A.; McCullars, Adrianne

2012-01-01

Suicide is currently the third leading cause of death among youth; it has been named a public health concern. A number of programs have been developed to prevent suicide; many of these involve intervening with youth who are known to be at-risk because of their depression, expressed suicide ideation, or previous suicide attempts. This paper serves…

Physical victimization, gender identity and suicide risk among transgender men and women

Directory of Open Access Journals (Sweden)

Gia Elise Barboza, PhD

2016-12-01

Full Text Available We investigated whether being attacked physically due to one's gender identity or expression was associated with suicide risk among trans men and women living in Virginia. The sample consisted of 350 transgender men and women who participated in the Virginia Transgender Health Initiative Survey (THIS. Multivariate multinomial logistic regression was used to explore the competing outcomes associated with suicidal risk. Thirty-seven percent of trans men and women experienced at least one physical attack since the age of 13. On average, individuals experienced 3.97 (SD = 2.86 physical attacks; among these about half were attributed to one's gender identity or expression (mean = 2.08, SD = 1.96. In the multivariate multinomial regression, compared to those with no risk, being physically attacked increased the odds of both attempting and contemplating suicide regardless of gender attribution. Nevertheless, the relative impact of physical victimization on suicidal behavior was higher among those who were targeted on the basis of their gender identity or expression. Finally, no significant association was found between multiple measures of institutional discrimination and suicide risk once discriminatory and non-discriminatory physical victimization was taken into account. Trans men and women experience high levels of physical abuse and face multiple forms of discrimination. They are also at an increased risk for suicidal tendencies. Interventions that help transindividuals cope with discrimination and physical victimization simultaneously may be more effective in saving lives.

Physical victimization, gender identity and suicide risk among transgender men and women.

Science.gov (United States)

Barboza, Gia Elise; Dominguez, Silvia; Chance, Elena

2016-12-01

We investigated whether being attacked physically due to one's gender identity or expression was associated with suicide risk among trans men and women living in Virginia. The sample consisted of 350 transgender men and women who participated in the Virginia Transgender Health Initiative Survey (THIS). Multivariate multinomial logistic regression was used to explore the competing outcomes associated with suicidal risk. Thirty-seven percent of trans men and women experienced at least one physical attack since the age of 13. On average, individuals experienced 3.97 (SD = 2.86) physical attacks; among these about half were attributed to one's gender identity or expression (mean = 2.08, SD = 1.96). In the multivariate multinomial regression, compared to those with no risk, being physically attacked increased the odds of both attempting and contemplating suicide regardless of gender attribution. Nevertheless, the relative impact of physical victimization on suicidal behavior was higher among those who were targeted on the basis of their gender identity or expression. Finally, no significant association was found between multiple measures of institutional discrimination and suicide risk once discriminatory and non-discriminatory physical victimization was taken into account. Trans men and women experience high levels of physical abuse and face multiple forms of discrimination. They are also at an increased risk for suicidal tendencies. Interventions that help transindividuals cope with discrimination and physical victimization simultaneously may be more effective in saving lives.

Estimating the risk for suicide following the suicide deaths of 3 Asian entertainment celebrities: a meta-analytic approach.

Science.gov (United States)

Fu, King-Wa; Yip, Paul S F

2009-06-01

Evidence suggests that there is an increase in the suicide rate following incidents of celebrity suicide in different countries, but there are no data on the overall suicide risk across countries. The duration of increased suicide rates is usually assumed to be on a monthly basis, but the weekly increase remains uncertain. This study aims at estimating the risk for suicide after the suicide deaths of entertainment celebrities in Asia during the first 4 weeks after the celebrity suicides and on a weekly basis. An ecological, retrospective time-series analysis and a meta-analysis of the suicide deaths in 3 Asian regions: Hong Kong (from 2001 to 2003), Taiwan, and South Korea (both from 2003 to 2005). The combined risks for suicide were found to be 1.43 (95% CI = 1.23 to 1.66), 1.29 (95% CI = 1.12 to 1.50), and 1.25 (95% CI = 1.08 to 1.45) in the first, second, and third week, respectively, after suicides of entertainment celebrities, while adjusting for secular trends, seasonality, economic situation, and temporal autocorrelation. The same-gender and same-method specific increases suggest that as people identify more with the celebrity, their risk for suicide rises. A medium-term rise in suicides up to 24 weeks after the incidents of celebrity suicide is also evident. This study is the first to estimate risk for suicides following celebrity suicides across 3 Asian regions. The results provide important information for public health policy makers in assessing the elevated risk associated with excessive media coverage of celebrity suicide and developing timely evidence-based interventions. Copyright 2009 Physicians Postgraduate Press, Inc.

Sadness, suicide, and sexual behavior in Arkansas: results from the youth risk behavior survey 2011.

Science.gov (United States)

Kindrick, Clint; Gathright, Molly; Cisler, Josh M; Messias, Erick

2013-12-01

We used the 2011 Arkansas Youth Risk Behavior Survey to estimate the prevalence of risky sexual behavior and sexual assault and to measure its association with teen suicidality. In Arkansas, 50.3% of students reported ever having sexual intercourse, 26% onset at 14 or younger, 36 % having had more than one partner, and 10.2% having been physically forced to have sex. "Being forced to have sex" was a risk factor for depression and all components of the suicide continuum. Additionally, early onset of sexual activity and having more than one partner increased the risk for depression, suicidal ideation, plan, and attempt. Suicide is a grievous and preventable tragedy, sadly standing among the leading causes of death for teens.' In this series, we examine risk factors for suicidality among Arkansas high school students; in this installment, we examine sexual behavior. A previous study utilizing the Rhode Island Youth Risk Behavior Survey (YRBS) found an association between having forced sexual intercourse and suicide. Furthermore, an association between psychiatric disorders and risky sexual behaviors, including both early onset and number of partners was found in a birth cohort study revealed. We hypothesize that Arkansas' teens reporting risky sexual behavior and sexual assault are at higher risk of depression and suicidality as well.

Risk factors of suicide attempts by poisoning: review

Directory of Open Access Journals (Sweden)

Maria Cláudia da Cruz Pires

2014-04-01

Full Text Available Introduction: Suicide, a complex and universal human phenomenon, is a major public health problem. This study reviewed the literature about the major risk factors associated with suicide attempts by poisoning. Methods: An integrative review of the literature was performed in databases (LILACS, PubMed and MEDLINE to search for studies published between 2003 and 2013, using the following keywords: suicide, attempted; poisoning; risk factors. Inclusion criteria were: original study with abstract, sample of adults, and attempted suicide by poisoning in at least 50% of the study population. Results: Two hundred and nineteen studies were retrieved and read by two independent examiners, and 22 were included in the study. The main risk factors for suicide attempts by poisoning were female sex, age 15-40 years, single status, little education, unemployment, drug or alcohol abuse or addiction, psychiatric disorder and psychiatric treatment using antidepressants. Conclusion: Further prospective studies should be conducted to confirm these risk factors or identify others, and their findings should contribute to planning measures to prevent suicide attempts.

Risk and protective factors for suicidal ideation among Taiwanese adolescents.

Science.gov (United States)

Wang, Ruey-Hsia; Lai, Hsiao-Jung; Hsu, Hsiu-Yueh; Hsu, Min-Tao

2011-01-01

: Suicide is the ninth leading cause of death in adolescents aged 15-19 years in Taiwan. Suicidal ideation is an important predictor of committing suicide among adolescents. : The aim of this study was to examine the important risk factors, the protective factors, and the role of protective factors on the relationship of risk factors to suicidal ideation among Taiwanese adolescents aged 15-19 years. : By adopting a cross-sectional study, senior high school students (n = 577) aged 15-19 years in southern Taiwan were recruited for this study. An anonymous self-reported questionnaire was used to collect demographic characteristics, risk factors, protective factors, and suicidal ideation of the sample. Hierarchical logistic regression was used to identify the important risk and protective factors and the interaction between risk and protective factors on suicidal ideation. : Nearly 18% (n = 101) of the participants reported having suicidal ideation during the past 12 months. Gender (female; odds ratio [OR] = 4.23), life stress (OR = 1.03), depression (OR = 3.44), peer suicidal ideation (OR = 4.15), and bullying victimization (OR = 1.81) were important risk factors of suicidal ideation among the targeted sample. In addition, self-esteem (OR = 0.92) and emotional adaptation (OR = 0.88) were important protective factors of suicidal ideation. Self-esteem and emotional adaptation were not used to moderate the negative effects of life stress, depression, perceived peer suicidal ideation, and bullying victimization on suicidal ideation. The final model explained 40.6% of the total variance in suicidal ideation and correctly predicted 86.1% of participants with suicidal ideation. : Suicidal ideation prevention programs should be targeted to female adolescents. School-based efforts that provide adolescents with self-esteem enhancement, emotional regulation skills training, positive peer norms for life, coping skills for managing stress and depression, and antibullying programs

Bullying, Depression, and Suicide Risk in a Pediatric Primary Care Sample.

Science.gov (United States)

Kodish, Tamar; Herres, Joanna; Shearer, Annie; Atte, Tita; Fein, Joel; Diamond, Guy

2016-05-01

Suicide is a serious public health concern for US youth. Research has established an association between bullying and suicide risk. However, several questions remain regarding this relationship. The present study examined (a) whether experiences of verbal, physical, and cyber bullying were uniquely associated with general suicide risk; (b) whether each specific form of bullying was related to suicide attempt; and (c) whether depression moderated the relationship between each type of bullying and suicide risk. The sample included medical records of 5,429 youth screened in primary care when providers had mental health concerns. Patients were screened using the Behavioral Health Screen (BHS), which assessed a range of mental health problems and behaviors, including bullying, depression, and suicide. All types of bullying were associated with suicide risk, but verbal bullying was uniquely associated with suicide attempt. Depression significantly moderated the relationship between each type of bullying and suicide risk. The study's limitations include the use of cross-sectional and self-data reports. When medical providers evaluate suicide risk, bullying should be considered as a possible precipitant, especially if the patient is depressed. Verbal bullying may be particularly important in understanding severity of suicide risk.

Therapeutic risk management of the suicidal patient: safety planning.

Science.gov (United States)

Matarazzo, Bridget B; Homaifar, Beeta Y; Wortzel, Hal S

2014-05-01

This column is the fourth in a series describing a model for therapeutic risk management of the suicidal patient. Previous columns presented an overview of the therapeutic risk management model, provided recommendations for how to augment risk assessment using structured assessments, and discussed the importance of risk stratification in terms of both severity and temporality. This final column in the series discusses the safety planning intervention as a critical component of therapeutic risk management of suicide risk. We first present concerns related to the relatively common practice of using no-suicide contracts to manage risk. We then present the safety planning intervention as an alternative approach and provide recommendations for how to use this innovative strategy to therapeutically mitigate risk in the suicidal patient.

Predisposing and Precipitating Risk Factors for Suicide Ideations and Suicide Attempts In Young and Adolescent Girls

Directory of Open Access Journals (Sweden)

K.S KHUSHABI

2006-11-01

Full Text Available Background:To investigate the predisposing and precipitating risk factors for suicide ideations and suicide attempts in young and adolescent females,we tried to introduce a holistic model of suicidal behavior in young and adolescent girls. Methods: This study is based on the survey studies and was cross-sectional. Considering high rates of suicide attempts in provinces of Iran,three provinces (Kermanshah, Hamedan,Ilam which had the highest rates of completed suicide were selected. Then among female high school students (aged 14 to 21 years, in two stages a representative sample was selected by a multi-clusteral and simple randomized sampling methods. The research data were gathered by administering (1 The inventory of predisposing and precipitating factors of suicide, demographic and family characteristics (based on the literature review (2 Symptom Check List (SCL 90-R (3Suicidality Subscale of the Depressive Symptom Index (DSI-SS (4 Center for Epidemiological Studies (CED- SSI (5 Beck Hopelessness Scale (BHS and (6 Child Abuse Self Report Scale (CASRS.Then,subjects were characterized by dividing them in to two categories: at risk,and low risk. The scores of 2 categories were analyzed and discussed. Results: Relationships were found between suicide ideations and psychological problems and disorders (especially depression.Also,the students who reported suicide ideation and suicide attempt had a history of being abused. Based on the results,predisposing and precipitating risk factors and also some protective factors of suicide ideations and suicide attempts were found and a theoretical model was presented.Conclusion: Some predisposing,precipitating and protective factors can predict suicide ideation and suicide attempts significantly.

[Clinical features of suicide occurring in schizophrenia (I). Risk-factors identification].

Science.gov (United States)

Besnier, N; Gavaudan, G; Navez, A; Adida, M; Jollant, F; Courtet, P; Lançon, C

2009-04-01

Suicide is the leading cause of premature death in schizophrenia. Approximately 10 to 13% of deaths in schizophrenia are explained by suicide, despite widespread availability of generally effective antipsychotic treatments and suicide attempts have been reported among 20 to 50% of patients. This relatively low ratio of attempts/suicide is consistent with greater lethality of means - more violent - and intents - less ambivalence - in this population. Many studies have focused on risk factors and clinical characteristics for completed and/or attempted suicide. Commonly, sociodemographic risk factors for suicide are male sex, younger age and, among women, being unmarried, divorced or widowed. Previous suicidal behaviour is a strong risk factor for suicide and contrary to the common view, schizophrenic patients often communicate their suicidal intents shortly before death. Moreover, family history of suicide is associated with a heightened risk of suicide and is independent of the diagnosis, according to the growing literature that shows that vulnerability to suicidal behaviour is independent of psychiatric diagnosis. Suicide can occur throughout the entire course of schizophrenia. This is particularly true in those high-risk periods: early phase of the disease, active illness phase, period of relapse or during a depressive episode. The role of insight and positive symptoms remains unclear and probably needs further studies. Although not specifically for people with schizophrenia, hopelessness is a major risk factor and tragic loss is often presented as a trigger for suicide. It has been suggested that treatment side-effects, such as akathisia are associated with suicidal behaviour. A better knowledge of risk and protective factors is necessary to prevent suicide and suicidality.

Familial Risk of Early Suicide: Variations by Age and Sex of Children and Parents

Science.gov (United States)

Garssen, Joop; Deerenberg, Ingeborg; Mackenbach, Johan P.; Kerkhof, Ad; Kunst, Anton E.

2011-01-01

To determine familial risk of early suicide, data on cause of death of all Dutch residents aged 20-55 years who died between 1995 and 2001 were linked to data of their parents. Men whose father died by suicide had a higher odds of suicide themselves, relative to men whose father died of other causes (Odds Ratio (OR): 2.5; 95% confidence interval:…

Risk of Suicide Attempt in Poststroke Patients: A Population-Based Cohort Study.

Science.gov (United States)

Harnod, Tomor; Lin, Cheng-Li; Kao, Chia-Hung

2018-01-10

This nationwide population-based cohort study evaluated the risk of and risk factors for suicide attempt in poststroke patients in Taiwan. The poststroke and nonstroke cohorts consisted of 713 690 patients and 1 426 009 controls, respectively. Adults (aged >18 years) who received new stroke diagnoses according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM ; codes 430-438) between 2000 and 2011 were included in the poststroke cohort. We calculated the adjusted hazard ratio for suicide attempt ( ICD-9-CM codes E950-E959) after adjustment for age, sex, monthly income, urbanization level, occupation category, and various comorbidities. Kaplan-Meier analysis was used to measure the cumulative incidence of suicide attempt, and the Fine and Gray method was used as a competing event when estimating death subhazard ratios and 95% confidence intervals between groups. The cumulative incidence of suicide attempt was higher in the poststroke cohort, and the adjusted hazard ratio of suicide attempt was 2.20 (95% confidence interval, 2.04-2.37) compared with that of the controls. The leading risk factors for poststroke suicide attempt were earning low monthly income (US dollars), living in less urbanized regions, doing manual labor, and having a stroke before age 50 years. The attempted suicide risk did not differ significantly between male and female patients in this study. These results convey crucial information to clinicians and governments for preventing suicide attempt in poststroke patients in Taiwan and other Asian countries. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Risk of Suicide Attempt in Adopted and Nonadopted Offspring

DEFF Research Database (Denmark)

Keyes, M. A.; Malone, S. M.; Sharma, A.

2013-01-01

OBJECTIVE: We asked whether adoption status represented a risk of suicide attempt for adopted and nonadopted offspring living in the United States. We also examined whether factors known to be associated with suicidal behavior would mediate the relationship between adoption status and suicide att...... of the risk of suicide attempt in adopted offspring may inform the larger investigation of suicidality in all adolescents and young adults.......OBJECTIVE: We asked whether adoption status represented a risk of suicide attempt for adopted and nonadopted offspring living in the United States. We also examined whether factors known to be associated with suicidal behavior would mediate the relationship between adoption status and suicide...... attempt. METHODS: Participants were drawn from the Sibling Interaction and Behavior Study, which included 692 adopted and 540 nonadopted offspring and was conducted at the University of Minnesota from 1998 to 2008. Adoptees were systematically ascertained from records of 3 large Minnesota adoption...

Suicide in high security hospital patients.

Science.gov (United States)

Jones, Roland M; Hales, Heidi; Butwell, Martin; Ferriter, Mike; Taylor, Pamela J

2011-08-01

People with mental disorder and people who are violent are separately recognised as being at high risk of suicide. People detained in high security hospitals are recognised for their violence to others, but perhaps less so for their suicide potential. We aimed to investigate suicide rates among such patients during and after their high security hospital residency, and to establish risk factors for suicide. We extracted data from the Special Hospitals' Case Register on each person resident at any time between 1 January 1972 and 31 December 2000. Suicide rates were calculated for the whole period. We compared rates to the general population using standardised mortality ratios (SMRs). We used poisson regression to estimate the effects of gender, legal category of detention, offending history and length of admission on the suicide rate. Of the 5,955 individuals, 218 completed suicide. The suicide rate was nearly 7 times higher among resident men (SMR 662, 95% CI 478-845) and over 40 times higher in resident women (SMR 4,012, 95% CI 2,526-5,498) than in the general population; it was 23 times higher (SMR 2,325, 95% CI 1,901-2,751) and 45 times higher (SMR 4,486, 95% CI 2,727-6,245) among post-discharge men and women, respectively. The suicide rate was significantly higher among women than men inside high security but not after discharge. The suicide rate among high security hospital patients was significantly higher than in the general population. Women were especially at risk while resident, whereas for men, the risk was higher after discharge.

Risk factors of suicide attempt among people with suicidal ideation in South Korea: a cross-sectional study

OpenAIRE

Soo Beom Choi; Wanhyung Lee; Jin-Ha Yoon; Jong-Uk Won; Deok Won Kim

2017-01-01

Background Suicide is a serious public health concern worldwide, and the fourth leading cause of death in Korea. Few studies have focused on risk factors for suicide attempt among people with suicidal ideation. The aim of the present study was to investigate the risk factors and develop prediction models for suicide attempt among people with suicidal ideation in the Korean population. Method This study included 1567 men and 3726 women aged 20?years and older who had suicidal ideation from the...

Soldiers suicides risk factors in the Serbian Army Forces

Directory of Open Access Journals (Sweden)

Dedić Gordana

2010-01-01

Full Text Available Background/Aim. Analyses of suicide risk factors enable to undertake appropriate preventive measures within the Suicide Prevention Program in Military Environment, which was fully applied in 2003 in the Serbian Army Forces. The aim of our study was to identify the most important suicide risk factors in soldiers within the period from 1998 to 2007. Methods. Analysis of suicide risk factors was carried out on the basis of data obtained by psychological suicide autopsy. The control group was matched with adapted soldiers by socio-demographic factors. A descriptive statistical analysis was used. Comparison of groups of soldiers was done by the t-test and Pearson's χ2-test. Results. A total of 35 soldiers aged 22-49 years (21.76 ± 1.76 years on average committed suicide within the period 1999-2007, the 2/3 within, and 1/3 out of a military compound. More than one half soldiers committed suicide after transferring to a different post. Soldiers who committed suicide had come from uncompleted, dysfunctional families (p < 0.05. In comparison with the adapted soldiers, in premilitary period they had more interpersonal problems with their comrades (p < 0.001 and problems with law (p < 0.05. During military service, alcohol consumption was less presented; they used to have fewer separation problems (p < 0.05 and to be rarely awarded (p < 0.001 in comparison with the adapted soldiers. A soldier who committed suicide was emotionally and socially immature persons. The commonest motives for suicide were: decreased capacity of adaptation to military service, actual psychic disturbance, emotional interruption, fear of environment judgment, actual family problems, but in the one fifth, motive stayed unrecognized. Conclusion. Suicide risk factors in soldiers are primary in their immature personality organization, its relation with family and military environment factors which, in coexistence with actual life accidents, result in suicide as a consequence. A

Suicidal ideation and suicide attempts among human immunodeficiency virus-infected adults: differences in risk factors and their implications.

Science.gov (United States)

Kang, Cho Ryok; Bang, Ji Hwan; Cho, Sung-Il; Kim, Kui Nam; Lee, Hee-Jin; Ryu, Bo Yeong; Cho, Soo Kyung; Lee, Young Hwa; Oh, Myoung-Don; Lee, Jong-Koo

2016-01-01

Many studies have investigated risk factors for suicidal ideation and suicide attempt; however, most have failed to show differences in risk factors between suicidal ideation and suicide attempt among the human immunodeficiency virus (HIV)-infected population. This study was designed to identify differences in risk factors between suicidal ideation and suicide attempts among HIV-infected adults in Seoul. A face-to-face survey of 457 HIV-infected adults was conducted by the Seoul Metropolitan Government in 2013. Multivariate logistic regression analysis was used to identify factors associated with suicidal ideation and suicide attempt. Among 422 participants, 44% had suicidal ideation, and 11% had suicide attempts. The independent risk factors for suicidal ideation were young and middle age, living with someone, history of AIDS-defining opportunistic disease, history of treatment for depression, lower social support, and psychological status. Beneficiaries of National Medical Aid, economic barriers to treatment, history of treatment for depression, and lower psychological status were independently associated with suicide attempts. Patients with HIV in Korea were treated without cost in some centers. Thus, experiencing an economic barrier to treatment might be due in part to ignorance of HIV care policies. Our findings indicate that suicide attempts are associated with socioeconomic factors and information inequality regarding medical care. In conclusion, suicidal ideation closely associated with the psychosocial factors, whereas suicide attempt demonstrates a stronger association with socioeconomic factors. Suicide prevention measures should be implemented to provide information to help HIV-infected patients.

Assessing suicidal risk with antiepileptic drugs

Directory of Open Access Journals (Sweden)

Marco Mula

2010-09-01

Full Text Available Marco Mula2, Gail S Bell1, Josemir W Sander1,31Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, and National Hospital for Neurology and Neurosurgery, UCL Hospitals NHS Foundation Trust, London, United Kingdom; 2Department of Clinical and Experimental Medicine, Division of Neurology, Amedeo Avogadro University, University Hospital Maggiore della Carità, Novara, Italy; 3SEIN – Epilepsy Institute in the Netherlands Foundation, Heemstede, The NetherlandsAbstract: Recently, the US Food and Drug Administration issued an alert about an increased risk for suicidality during treatment with antiepileptic drugs (AEDs for different indications, including epilepsy. We discuss the issue of suicide in epilepsy with special attention to AEDs and the assessment of suicide in people with epilepsy. It has been suggested that early medical treatment with AEDs might potentially reduce suicide risk of people with epilepsy, but it is of great importance that the choice of drug is tailored to the mental state of the patient. The issue of suicidality in epilepsy is likely to represent an example of how the underdiagnosis of psychiatric symptoms, the lack of input from professionals (eg, psychologists, social workers, and psychiatrists, and the delay in an optimized AED therapy may worsen the prognosis of the condition with the occurrence of severe complications such as suicide.Keywords: epilepsy, suicide, adverse effect, depression

The roles of culture and gender in the relationship between divorce and suicide risk: a meta-analysis.

Science.gov (United States)

Yip, Paul S F; Yousuf, Saman; Chan, Chee Hon; Yung, Tiffany; Wu, Kevin C-C

2015-03-01

With some exceptions, literature has consistently shown that divorced populations are at higher risk for suicide than married ones. Here we make use of coefficients of aggravation (COAs), suicide rate ratios of the divorcees over the married, to study patterns of COAs and test the contribution of international sociocultural factors and gender to the relationship between divorce and suicide. We conducted a systematic search of electronic databases to identify ecological studies reporting suicide rates and ratios of those rates within different marital statuses between Jan 1, 2000 and Dec 31, 2013. In total, ten studies consisting in suicide statistics of eleven countries/areas were selected. Using random-effect modeling, we noted that the pooled COA for men and women were 3.49 (95% CI 2.43-4.56) and 3.15 (95% CI 1.74-4.56), suggesting both divorced men and women exhibited a greater risk of suicide than their married counterparts. Subgroup analyses revealed that COAs in Asian countries are significantly higher than those in non-Asian ones. Among the sociocultural measures retrieved from the HOFSTEDE index and the World Values Surveys, we noted significant associations between COA and four measures, including the individualism-collectivism score, the long-term orientation scores, the survival/self-expression score, and the gender inequality indices. The magnitudes and the directions of the associations however differ by sex. The results confirm that overall divorced people have an aggregate higher suicide risk than married ones. The method used in our research could reveal what cultural indicators are exerting effect on the relationship between divorce and suicide risk, which might change with sociocultural transition. More investigation into the relationships and then the construction of culturally appropriate suicide prevention policy is recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

Risk Factors of Attempted Suicide in Bipolar Disorder

Science.gov (United States)

Cassidy, Frederick

2011-01-01

Suicide rates of bipolar patients are among the highest of any psychiatric disorder, and improved identification of risk factors for attempted and completed suicide translates into improved clinical outcome. Factors that may be predictive of suicidality in an exclusively bipolar population are examined. White race, family suicide history, and…

Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey).

Science.gov (United States)

Carrieri, Maria Patrizia; Marcellin, Fabienne; Fressard, Lisa; Préau, Marie; Sagaon-Teyssier, Luis; Suzan-Monti, Marie; Guagliardo, Valérie; Mora, Marion; Roux, Perrine; Dray-Spira, Rosemary; Spire, Bruno

2017-01-01

Suicide risk is high among people living with HIV (PLHIV). This study aimed to identify major correlates of suicide risk in a representative sample of PLHIV in France, in order to help target individuals who would benefit from suicide risk screening and psychiatric care. The ANRS VESPA2 cross-sectional survey (April 2011-January 2012) collected socio-demographic, medical and behavioral data from 3,022 PLHIV recruited in 73 French HIV hospital departments. The study sample comprised the 2,973 participants with available self-reported data on suicide risk (defined as having either thought about and planned to commit suicide during the previous 12 months or attempted suicide during the same period of time) and medical data on comorbidities. Weighted Poisson models adjusted for HCV co-infection and significant clinical variables were used to estimate the relationship between suicide risk and HIV transmission groups, experience with HIV disease and other psychosocial factors. Suicide risk was reported by 6.3% of PLHIV in the study sample. After adjustment for HIV immunological status and HCV co-infection, women (IRR [95%CI]:1.93 [1.17; 3.19]) and men who have sex with men (MSM) (1.97 [1.22; 3.19]) had a higher suicide risk than the rest of the sample. Moreover, the number of discrimination-related social contexts reported (1.39 [1.19; 1.61]), homelessness (4.87 [1.82; 13.02]), and reporting a feeling of loneliness (4.62 [3.06; 6.97]) were major predictors of suicide risk. Reducing the burden of precarious social conditions and discrimination is an important lever for preventing suicide risk among PLHIV in France. Comprehensive care models involving peer/community social interventions targeted at women and MSM need to be implemented to lower the risk of suicide in these specific subgroups of PLHIV.

Suicide risk in a representative sample of people receiving HIV care: Time to target most-at-risk populations (ANRS VESPA2 French national survey.

Directory of Open Access Journals (Sweden)

Maria Patrizia Carrieri

Full Text Available Suicide risk is high among people living with HIV (PLHIV. This study aimed to identify major correlates of suicide risk in a representative sample of PLHIV in France, in order to help target individuals who would benefit from suicide risk screening and psychiatric care.The ANRS VESPA2 cross-sectional survey (April 2011-January 2012 collected socio-demographic, medical and behavioral data from 3,022 PLHIV recruited in 73 French HIV hospital departments. The study sample comprised the 2,973 participants with available self-reported data on suicide risk (defined as having either thought about and planned to commit suicide during the previous 12 months or attempted suicide during the same period of time and medical data on comorbidities. Weighted Poisson models adjusted for HCV co-infection and significant clinical variables were used to estimate the relationship between suicide risk and HIV transmission groups, experience with HIV disease and other psychosocial factors.Suicide risk was reported by 6.3% of PLHIV in the study sample. After adjustment for HIV immunological status and HCV co-infection, women (IRR [95%CI]:1.93 [1.17; 3.19] and men who have sex with men (MSM (1.97 [1.22; 3.19] had a higher suicide risk than the rest of the sample. Moreover, the number of discrimination-related social contexts reported (1.39 [1.19; 1.61], homelessness (4.87 [1.82; 13.02], and reporting a feeling of loneliness (4.62 [3.06; 6.97] were major predictors of suicide risk.Reducing the burden of precarious social conditions and discrimination is an important lever for preventing suicide risk among PLHIV in France. Comprehensive care models involving peer/community social interventions targeted at women and MSM need to be implemented to lower the risk of suicide in these specific subgroups of PLHIV.

Suicide Clusters: A Review of Risk Factors and Mechanisms

Science.gov (United States)

Haw, Camilla; Hawton, Keith; Niedzwiedz, Claire; Platt, Steve

2013-01-01

Suicide clusters, although uncommon, cause great concern in the communities in which they occur. We searched the world literature on suicide clusters and describe the risk factors and proposed psychological mechanisms underlying the spatio-temporal clustering of suicides (point clusters). Potential risk factors include male gender, being an…

Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk

Science.gov (United States)

2017-10-01

assessing behavioral and cognitive markers of risk for suicide among U.S. Army National Guard personnel. Journal of Environmental Research and Public Policy...effective ways to prevent injury and death from suicide • No reliable method for predicting suicide risk in military personnel • Behavioral (e.g...AWARD NUMBER: W81XWH-15-1-0632 TITLE: Technologies for Assessing Behavioral and Cognitive Markers of Suicide Risk PRINCIPAL INVESTIGATOR: Brian

A School-Based Suicide Risk Assessment Protocol

Science.gov (United States)

Boccio, Dana E.

2015-01-01

Suicide remains the third leading cause of death among young people in the United States. Considering that youth who contemplate suicide generally exhibit warning signs before engaging in lethal self-harm, school-based mental health professionals can play a vital role in identifying students who are at risk for suicidal behavior. Nevertheless, the…

Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities.

Science.gov (United States)

O'Riley, Alisa; Nadorff, Michael R; Conwell, Yeates; Edelstein, Barry

2013-06-01

Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents' responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting.

Evaluation of the quality of life and risk of suicide

Directory of Open Access Journals (Sweden)

Verônica de Medeiros Alves

2016-03-01

Full Text Available OBJECTIVE: To identify the socio-demographic profiles, suicidal ideation, the presence of mental disorders and the quality of life of patients using mental health services in Arapiraca, Alagoas, Brazil. METHOD: Interviews were conducted in family health units and the Psychosocial Attention Center. The sample included 202 mental disorder patients with a risk of suicide attempts, 207 mental disorder patients without a risk of suicide attempts and 196 controls. This study used an identification questionnaire, the abbreviated World Health Organization Quality of Life questionnaire, Beck‘s Suicidal Ideation Scale and the Mini International Neuropsychiatric Interview. RESULTS: Patients who had a mental disorder and a risk of suicide attempts tended to be single, had less education and lower family income, were not working and showed lower scores in quality of life domains; 73 of these patients had suicidal ideation in the previous week. Depressive disorders, manic episodes, hypomanic episodes, social phobias, obsessive compulsive disorder, post-traumatic stress disorder, psychotic syndromes and generalized anxiety disorder were more frequent and statistically significant for patients at risk for suicide attempts. CONCLUSION: The management of patients with a risk of suicide attempts must focus on individual patients because this risk is directly linked to changes in quality of life and the improvement of these patients’ prognosis.

Ambient particulate matter as a risk factor for suicide.

Science.gov (United States)

Kim, Changsoo; Jung, Sang Hyuk; Kang, Dae Ryong; Kim, Hyeon Chang; Moon, Ki Tae; Hur, Nam Wook; Shin, Dong Chun; Suh, Il

2010-09-01

The authors assessed the relationship between exposure to ambient particulate matter and suicide in urban settings during a 1-year period. The association between particulate matter and suicide was determined using a time-stratified case-crossover approach in which subjects served as their own controls. All suicide cases (4,341) in 2004 that occurred in seven cities in the Republic of Korea were included. Hourly mean concentrations of particulate matter suicide risk associated with an interquartile range increase in particulate matter was determined by conditional logistic regression analysis after adjusting for national holidays and meteorological factors. Subgroup analysis was performed after stratification by underlying disease (cardiovascular disease, diabetes mellitus, chronic obstructive pulmonary disease, cancer, and psychiatric illness). The largest associations were a 9.0% increase (95% CI=2.4-16.1) and a 10.1% (95% CI=2.0-19.0) increase in suicide risk related to an interquartile range increase in particulate matter suicide) and particulate matter suicide), respectively. Among individuals with cardiovascular disease, a significant association between particulate matter suicide) and suicide was observed (18.9%; 95% CI=3.2-37.0). Conclusions: A transient increase in particulate matter was associated with increased suicide risk, especially for individuals with preexisting cardiovascular disease.

Risk and Protective Factors for Suicide in Patients with Alcoholism

Directory of Open Access Journals (Sweden)

Leo Sher

2006-01-01

Full Text Available Alcoholism is associated with a high risk for suicidal behavior. Up to 40% of persons with alcoholism attempt suicide at some time and 7% end their lives by committing suicide. Risk factors include being male, older than 50 years of age, living alone, being unemployed, poor social support, interpersonal losses, continued drinking, consumption of a greater amount of alcohol when drinking, a recent alcohol binge, previous alcohol treatment, a family history of alcoholism, a history of comorbid substance abuse (especially cocaine, a major depressive episode, serious medical illness, suicidal communication, and prior suicidal behavior. Suicidal behavior is especially frequent in patients with comorbid alcoholism and major depression. However, all patients with alcoholism should be evaluated for suicide risk. Understanding of risk and vulnerability to suicidal behavior in alcoholism still outweighs our knowledge of protective factors and resilience. Knowledge of protective factors for suicide may help to prevent and/or predict suicidal behavior. Protective factors for suicide in alcoholism are quite varied and include an individual's biological and behavioral characteristics, as well as attributes of the environment and culture. Protective factors include effective clinical care for psychiatric (including alcoholism and drug abuse and physical disorders, easy access to a variety of clinical interventions and support for seeking help, restricted access to highly lethal means of suicide, strong connections to family and community support, skills in problem solving and conflict resolution, cultural and religious beliefs that discourage suicide and support self-preservation. Future studies are necessary to determine which interventions may reduce suicidal behavior in alcoholism.

Serious Suicide Attempts: Systematic Review of Psychological Risk Factors

Directory of Open Access Journals (Sweden)

Yari Gvion

2018-03-01

Full Text Available BackgroundOne of the main obstacles in studying suicide risk factors is the difference between cases in which the individual died by suicide and those in which the individual engaged in suicidal behavior. A promising strategy that overcomes this obstacle is the study of survivors of serious suicide attempt (SSA, i.e., an attempt that would have been lethal had it not been for the provision of rapid and effective emergency treatment. Serious suicide attempters are epidemiologically very much like those who died by suicide, and thus may serve as valid proxies for studying suicides. This paper aims to define the specific risk factors for SSAs by conducting a qualitative data synthesis of existing studies.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic search of the literature in PubMed, ProQuest, and Psychlit electronic research-literature databases. Search terms were “serious” “OR” “near lethal,” combined with the Boolean “AND” operator with “suicide*.” In addition, we performed a manual search on Google Scholar for further studies not yet identified.ResultsThe preliminary search identified 683 citations. A total of 39 research reports that met the predefined criteria were analyzed. Mental pain, communication difficulties, decision-making impulsivity, and aggression, as well as several demographic variables, were found to be major risk factors for SSAs.LimitationsWe found a variability of definitions for SSA that hamper the ability to draw a model for the risk factors and processes that facilitate it. Moreover, the role of suicide intent and planning in SSA is still unclear. Further studies should aim to clarify and refine the concepts and measures of SSA, thereby enabling more specific and concrete modeling of the psychological element in its formation.ConclusionSSA is a distinguishable phenomenon that needs to be addressed specifically within the scope

Religion as a Risk Factor for Suicide Attempt and Suicide Ideation Among Depressed Patients.

Science.gov (United States)

Lawrence, Ryan E; Brent, David; Mann, J John; Burke, Ainsley K; Grunebaum, Michael F; Galfalvy, Hanga C; Oquendo, Maria A

2016-11-01

We aimed to examine the relationship between religion and suicide attempt and ideation. Three hundred twenty-one depressed patients were recruited from mood-disorder research studies at the New York State Psychiatric Institute. Participants were interviewed using the Structured Clinical Interview for DSM Disorders, Columbia University Suicide History form, Scale for Suicide Ideation, and Reasons for Living Inventory. Participants were asked about their religious affiliation, importance of religion, and religious service attendance. We found that past suicide attempts were more common among depressed patients with a religious affiliation (odds ratio, 2.25; p = 0.007). Suicide ideation was greater among depressed patients who considered religion more important (coefficient, 1.18; p = 0.026) and those who attended services more frequently (coefficient, 1.99; p = 0.001). We conclude that the relationship between religion and suicide risk factors is complex and can vary among different patient populations. Physicians should seek deeper understanding of the role of religion in an individual patient's life in order to understand the person's suicide risk factors more fully.

[Burnout syndrome and suicide risk among primary care nurses].

Science.gov (United States)

Tomás-Sábado, Joaquín; Maynegre-Santaulària, Montserrat; Pérez-Bartolomé, Meritxell; Alsina-Rodríguez, Marta; Quinta-Barbero, Roser; Granell-Navas, Sergi

2010-01-01

To observe the prevalence of the burnout syndrome and the relationship with suicide risk, self-esteem, anxiety and depression, in a sample of primary care nurses. Observational, cross-sectional and correlational study. The sample consisted of 146 nursing professionals, 131 women and 15 men, with an average age of 44.02 years (SD=10.89). Participants responded to a questionnaire which included the Spanish forms of the Maslach burnout inventory (MBI), the Plutchik Suicide Risk Scale (SR), the Kuwait University Anxiety Scale (KUAS), the Self-Rating Depression Scale (SDS) and the Rosenberg Self-esteem Scale (RSES). In the inferential statistical analysis, Pearson's r coefficients and multiple linear regression were calculated. Significant correlations between suicidal risk and anxiety, depression, self-esteem, emotional exhaustion and personal performance, were obtained. In the multiple regression analysis, depression was the main predictor of suicidal risk, followed by anxiety and emotional exhaustion. The scores obtained in burnout and suicidal risk were, in general, lower than those observed in other studies, emphasising the high level observed in personal performance, which reflects reasonable professional satisfaction. The results show the important role of working atmosphere and early recognition of mental disorders in burnout and suicidal risk prevention. Copyright (c) 2009 Elsevier España, S.L. All rights reserved.

Schizophrenia--A High-Risk Factor for Suicides: Clues to Risk Reduction.

Science.gov (United States)

Caldwell, Constance B.; Gottesman, Irving I.

1992-01-01

Notes that suicide is chief cause of premature death among schizophrenic persons, with lifetime incidence of suicide for patients with schizophrenia at 10-13% compared to general population estimate of 1%. Discusses salient risk factors for suicide in schizophrenics and types of especially vulnerable patients identified by research. Notes that…

Suicide Risk at Young Adulthood: Continuities and Discontinuities from Adolescence

Science.gov (United States)

Hooven, Carole; Snedker, Karen A.; Thompson, Elaine Adams

2012-01-01

Young adult suicide is an important social problem, yet little is known about how risk for young adult suicide develops from earlier life stages. In this study the authors report on 759 young adults who were potential high school dropouts as youth. At both adolescence and young adulthood, measures of suicide risk status and related suicide risk…

Comorbid panic disorder as an independent risk factor for suicide attempts in depressed outpatients.

Science.gov (United States)

Nam, Yoon-Young; Kim, Chan-Hyung; Roh, Daeyoung

2016-05-01

Although comorbid panic disorder is associated with more severe symptoms and poorer therapeutic response in depressive patients, the relationship between panic disorder and risk of suicide attempt has not been confirmed. This study aimed to examine the relationship between comorbid panic disorder and clinical characteristics associated with suicidal risk as well as the likelihood of suicide attempt. A total of 223 outpatients with current major depressive disorder participated in the study. Both subjects with panic disorder (33%) and those without panic disorder (67%) were compared based on history of suicide attempts, current psychopathologies, and traits of impulsivity and anger. Subjects with panic disorder had higher levels of impulsivity, depression, and hopelessness and were more likely to report a history of suicide attempts. Subjects with panic disorder were younger at the time of first suicide attempt than those without panic disorder. Logistic regression analyses indicated that comorbid panic disorder was significantly associated with a history of suicide attempts after adjusting for other clinical correlates (odds ratio = 2.8; p depressive disorder may be associated with a more severe burden of illness and may independently increase the likelihood of suicide attempt. Copyright © 2016 Elsevier Inc. All rights reserved.

Risk of self-harm and nonfatal suicide attempts, and completed suicide in patients with psoriasis

DEFF Research Database (Denmark)

Egeberg, A; Hansen, P. R.; Gislason, G. H.

2016-01-01

Background: Psoriasis is a common inflammatory skin disease, and inflammation may affect suicidal behaviour. Current data on the incidence and risk of suicidal behaviour in patients with psoriasis are scarce. Objectives: We investigated the association between psoriasis and the risk of self......-harm and suicide attempts and suicides. Methods: All Danish patients aged ≥ 18 years with mild or severe psoriasis (cases) from 1 January 1997 to 31 December 2011 were matched on age, sex and calendar time 1 : 5 with healthy controls. The outcome was a diagnosis of self-harm or a nonfatal suicide attempt......, or completed suicide. Incidence rates per 10 000 person-years were calculated, and incidence rate ratios (IRRs) and confidence intervals (CIs) were estimated by Poisson regression models. Results: The study cohort comprised 408 663 individuals, including 57 502 and 11 009 patients with mild and severe...

Youth Suicide Risk: Evaluation and Crisis Intervention

Directory of Open Access Journals (Sweden)

Catarina Pereira

2013-11-01

Full Text Available Suicide attempts and suicidal behaviours represent a complex problem, with high prevalence in adolescence. The management of youth suicidal behaviour may occur in diverse contexts of child and adolescent psychiatric activity, not only in the emergency room, but also in liaison work and ambulatory consultation. In suicidal crisis intervention it ́s fundamental to involve the youth and the family as this represents a crucial moment for clinical assessment and treatment compliance. This review on child and adolescent suicidal behaviour focuses on characterizing and understanding the developmental features of these behaviours, risk and protection factors and it offers orientations about assessment and acute management of children and adolescents who present with suicidal behaviour.

Are Smoking Cessation Treatments Associated with Suicidality Risk? An Overview

Directory of Open Access Journals (Sweden)

J. Kim Penberthy

2016-01-01

Full Text Available Risk of suicidality during smoking cessation treatment is an important, but often overlooked, aspect of nicotine addiction research and treatment. We explore the relationship between smoking cessation interventions and suicidality and explore common treatments, their associated risks, and effectiveness in promoting smoking reduction and abstinence. Although active smokers have been reported to have twofold to threefold increased risk of suicidality when compared to nonsmokers, 1 4 research regarding the safest way to stop smoking does not always provide clear guidelines for practitioners wishing to advise their patients regarding smoking cessation strategies. In this article, we review pharmacological and cognitive behavioral therapy (CBT options that are available for people seeking to quit smoking, focusing on the relationship between the ability of these therapies to reduce smoking behavior and promote abstinence and suicidality risks as assessed by reported suicidality on validated measures, reports of suicidal ideation, behaviors, actual attempts, or completed suicides. Pharmacotherapies such as varenicline, bupropion, and nicotine replacement, and CBTs, including contextual CBT interventions, have been found to help reduce smoking rates and promote and maintain abstinence. Suicidality risks, while present when trying to quit smoking, do not appear to demonstrate a consistent or significant rise associated with use of any particular smoking cessation pharmacotherapy or CBT/contextual CBT intervention reviewed.

Adolescent Suicide Risk Today: A Paradox.

Science.gov (United States)

Lester, David

1998-01-01

A review of international statistics indicates that youth suicide rates are not increasing in all nations. Furthermore, it is suggested that the quality of life in nations is improving and that this improvement itself may increase the risk of suicide, especially in youth with narcissistic personality traits and antisocial personality disorder…

Suicide mortality and risk factors in the 12 months after discharge from psychiatric inpatient care in Korea: 1989-2006.

Science.gov (United States)

Park, Subin; Choi, Jae Won; Kyoung Yi, Ki; Hong, Jin Pyo

2013-07-30

This study aimed to determine the suicide mortality within 1 year after discharge from psychiatric inpatient care and identify the risk factors for suicide completion during this period. A total of 8403 patients were admitted to general hospitals in Seoul, Korea, for psychiatric disorders from January 1989 to December 2006. The suicide mortality risk of these patients within 1 year of discharge was compared with that of gender- and age-matched subjects from the general population of Korea. The standardized mortality ratios (SMR) for suicide in the year following discharge were 49.7 for males and 45.5 for females. Patients aged 15-24 years had the highest risk for suicide. Among the different diagnostic groups, patients with personality disorders, schizophrenia, or affective disorders had the highest risk for suicide completion. Suicidal ideation at admission and inpatient stay more than 1 month were also associated with increased risk of suicide. In Korean psychiatric patients, the SMR is much higher in young female patients, a high percentage of patients commit suicide by jumping, and there is a stronger association of long duration of hospitalization and suicide. These factors should be considered in the development and implementation of suicide prevention strategies for Korean psychiatric patients. Copyright © 2013. Published by Elsevier Ireland Ltd.

Hope as a Predictor of Interpersonal Suicide Risk

Science.gov (United States)

Davidson, Collin L.; Wingate, LaRicka R.; Rasmussen, Kathy A.; Slish, Meredith L.

2009-01-01

The current study hypothesized that (1) hope would negatively predict burdensomeness, thwarted belongingness, and acquired capability to enact lethal injury; (2) hope would negatively predict suicidal ideation; and (3) the interpersonal suicide risk factors would predict suicidal ideation. Results indicated that hope negatively predicted…

Risk Factors for Suicidality among Clients with Schizophrenia.

Science.gov (United States)

Schwartz, Robert C.; Cohen, Benjamin N.

2001-01-01

Investigates risk factors for current suicidality in clients diagnosed with schizophrenia (N=223). Results indicate that severity of depressive symptoms most strongly correlated with degree of suicidality. Younger age and recent traumatic stress each significantly predicted suicidality independent of depressive symptoms. Suggests that the…

Behavioral Risk Assessment of the Guarded Suicidal Patient

Science.gov (United States)

Simon, Robert I.

2008-01-01

Psychiatrists and other mental health professionals are trained to assess patients by direct observation and examination. Short inpatient length of stay, brief outpatient visits, emergency room evaluations, and other time-limited clinical settings require rapid assessment of suicide risk. Recognition of behavioral suicide risk factors can assist…

Suicide risk in long-term care facilities: a systematic review.

Science.gov (United States)

Mezuk, Briana; Rock, Andrew; Lohman, Matthew C; Choi, Moon

2014-12-01

Suicide risk is highest in later life; however, little is known about the risk of suicide among older adults in long-term care facilities (e.g., nursing homes and assisted living facilities). The goal of this paper is to review and synthesize the descriptive and analytic epidemiology of suicide in long-term care settings over the past 25 years. Four databases (PubMed, CINAHL Plus, Web of Knowledge, and EBSCOHost Academic Search Complete) were searched for empirical studies of suicide risk in nursing homes, assisted living, and other residential facilities from 1985 to 2013. Of the 4073 unique research articles identified, 37 were selected for inclusion in this review. Of the included reports, 21 were cross-sectional, 8 cohort, 3 qualitative, and 5 intervention studies. Most studies indicate that suicidal thoughts (active and passive) are common among residents (prevalence in the past month: 5-33%), although completed suicide is rare. Correlates of suicidal thoughts among long-term care residents include depression, social isolation, loneliness, and functional decline. Most studies examined only individual-level correlates of suicide, although there is suggestive evidence that organizational characteristics (e.g., bed size and staffing) may also be relevant. Existing research on suicide risk in long-term care facilities is limited but suggests that this is an important issue for clinicians and medical directors to be aware of and address. Research is needed on suicide risk in assisted living and other non-nursing home residential settings, as well as the potential role of organizational characteristics on emotional well-being for residents. Copyright © 2014 John Wiley & Sons, Ltd.

Antiepileptic drugs and risk of suicide: a nationwide study

DEFF Research Database (Denmark)

Olesen, J.B.; Hansen, Peter Riis; Erdal, Jesper

2010-01-01

Purpose Patients with epilepsy or psychiatric diseases have increased risk of suicide, but whether the risk is influenced by antiepileptic drug (AED) treatment is unclear. Studies have suggested that AEDs in general increase the risk of suicidal behaviour shortly after initiation. This study inve...

Early dementia diagnosis and the risk of suicide and euthanasia.

Science.gov (United States)

Draper, Brian; Peisah, Carmelle; Snowdon, John; Brodaty, Henry

2010-01-01

Diagnosis of dementia is occurring earlier, and much research concerns the identification of predementia states and the hunt for biomarkers of Alzheimer's disease. Reports of suicidal behavior and requests for euthanasia in persons with dementia may be increasing. We performed a selective literature review of suicide risk in persons with dementia and the ethical issues associated with euthanasia in this population. In the absence of any effective treatments for Alzheimer's disease or other types of dementia, there is already evidence that persons with mild cognitive change and early dementia are at risk of suicidal behavior, often in the context of comorbid depression. The ensuing clinical, ethical, and legal dilemmas associated with physician-assisted suicide and euthanasia in the context of dementia are a subject of intense debate. By analogy, the preclinical and early diagnoses of Huntington's disease are associated with an increased risk of suicidal behavior. Thus there is the potential for a preclinical and early diagnosis of Alzheimer's disease (through biomarkers, neuroimaging, and clinical assessment) to result in increased suicide risk and requests for physician-assisted suicide. Although dementia specialists have long recognized the importance of a sensitive approach to conveying bad news to patients and families and the possibility of depressive reactions, suicidal behavior has not been regarded as a likely outcome. Such preconceptions will need to change, and protocols to monitor and manage suicide risk will need to be developed for this population. 2010 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Risk of Suicide Attempt among Adolescents with Conduct Disorder: A Longitudinal Follow-up Study.

Science.gov (United States)

Wei, Han-Ting; Lan, Wen-Hsuan; Hsu, Ju-Wei; Bai, Ya-Mei; Huang, Kai-Lin; Su, Tung-Ping; Li, Cheng-Ta; Lin, Wei-Chen; Chen, Tzeng-Ji; Chen, Mu-Hong

2016-10-01

To assess the independent or comorbid effect of conduct and mood disorders on the risk of suicide. The Taiwan National Health Insurance Research Database was used to derive data for 3711 adolescents aged 12-17 years with conduct disorder and 14 844 age- and sex-matched controls between 2001 and 2009. The participants were followed up to the end of 2011, and those who attempted suicide during the follow-up period were identified. Adolescents with conduct disorder had a higher incidence of suicide (0.9% vs 0.1%; P suicide at a younger age (17.38 ± 2.04 vs 20.52 ± 1.70 years of age) than did the controls. The Cox proportional hazards regression model, after adjustment for demographic data and psychiatric comorbidities, determined that conduct disorder was an independent risk factor for subsequent suicide attempts (hazard ratio, 5.17; 95% CI, 2.29-11.70). The sensitivity after those with other psychiatric comorbidities were excluded revealed a consistent finding (hazard ratio, 10.32; 95% CI, 3.71-28.71). Adolescents with conduct disorder had an increased risk of suicide attempts over the next decade. Future studies are required to clarify the underlying pathophysiology and elucidate whether prompt intervention for conduct disorder could reduce this risk. Copyright © 2016 Elsevier Inc. All rights reserved.

Suicide ideation among high-risk adolescent females: Examining the interplay between parasympathetic regulation and friendship support

Science.gov (United States)

GILETTA, MATTEO; HASTINGS, PAUL D.; RUDOLPH, KAREN D.; BAUER, DANIEL J.; NOCK, MATTHEW K.; PRINSTEIN, MITCHELL J.

2018-01-01

Poor physiological self-regulation has been proposed as a potential biological vulnerability for adolescent suicidality. This study tested this hypothesis by examining the effect of parasympathetic stress responses on future suicide ideation. In addition, drawing from multilevel developmental psychopathology theories, the interplay between parasympathetic regulation and friendship support, conceptualized as an external source of regulation, was examined. At baseline, 132 adolescent females (M age = 14.59, SD = 1.39) with a history of mental health concerns participated in an in vivo interpersonal stressor (a laboratory speech task) and completed self-report measures of depressive symptoms and perceived support within a close same-age female friendship. Respiratory sinus arrhythmia (RSA) was measured before and during the speech task. Suicide ideation was assessed at baseline and at 3, 6, and 9 months follow-up. The results revealed that females with greater relative RSA decreases to the laboratory stressor were at higher risk for reporting suicide ideation over the subsequent 9 months. Moreover, parasympathetic responses moderated the effect of friendship support on suicide ideation; among females with mild changes or higher relative increases in RSA, but not more pronounced RSA decreases, friendship support reduced risk for future suicide ideation. Findings highlight the crucial role of physiological and external regulation sources as protective factors for youth suicidality. PMID:28031059

Risk factors for adolescents' attempted suicide

DEFF Research Database (Denmark)

Christoffersen, Mogens; Poulsen, Henrik Day; Nielsen, Anne

was also found among adolescents who had psychiatric disorder or a physical handicap, those who had been sentenced, were addicted to drugs, or had unstable education and unemployment records. A common feature of these significant risk factors seemed to be stigmatisation or social exclusion......This paper has been submitted to a journal for consideration, so please do not quote without permission. Adolescents' first-time suicide attempt tends to be characterized by parental psychiatric disorder or suicidal behaviour, family violence, especially child abuse and neglect. An increased risk...

Depression and suicide risk of outpatients at specialized hospitals for substance use disorder: comparison with depressive disorder patients at general psychiatric clinics.

Science.gov (United States)

Matsumoto, Toshihiko; Matsushita, Sachio; Okudaira, Kenichi; Naruse, Nobuya; Cho, Tetsuji; Muto, Takeo; Ashizawa, Takeshi; Konuma, Kyohei; Morita, Nobuaki; Ino, Aro

2011-12-01

The present study used a self-reporting questionnaire to compare suicide risk in outpatients being treated for substance use disorder at specialized hospitals to suicide risk in outpatients being treated for depressive disorder at general psychiatric clinics. Although patients in both groups exhibited an equal severity of depression, the patients with drug use disorder had a higher suicide risk than those with depressive disorder. These findings indicate that drug-abusing patients at specialized hospitals may have a severe risk of committing suicide, suggesting that carefully assessing the comorbidity of depression with drug abuse may be required for preventing suicide in drug-abusing patients.

Do schools differ in suicide risk? the influence of school and neighbourhood on attempted suicide, suicidal ideation and self-harm among secondary school pupils

Directory of Open Access Journals (Sweden)

Young Robert

2011-11-01

Full Text Available Abstract Background Rates of suicide and poor mental health are high in environments (neighbourhoods and institutions where individuals have only weak social ties, feel socially disconnected and experience anomie - a mismatch between individual and community norms and values. Young people spend much of their time within the school environment, but the influence of school context (school connectedness, ethos and contextual factors such as school size or denomination on suicide-risk is understudied. Our aim is to explore if school context is associated with rates of attempted suicide and suicide-risk at age 15 and self-harm at age 19, adjusting for confounders. Methods A longitudinal school-based survey of 1698 young people surveyed when aged 11, (primary school, 15 (secondary school and in early adulthood (age 19. Participants provided data about attempted suicide and suicide-risk at age 15 and deliberate self-harm at 19. In addition, data were collected about mental health at age 11, social background (gender, religion, etc., and at age 15, perception of local area (e.g. neighbourhood cohesion, safety/civility and facilities, school connectedness (school engagement, involvement, etc. and school context (size, denomination, etc.. A dummy variable was created indicating a religious 'mismatch', where pupils held a different faith from their school denomination. Data were analysed using multilevel logistic regression. Results After adjustment for confounders, pupils attempted suicide, suicide-risk and self-harm were all more likely among pupils with low school engagement (15-18% increase in odds for each SD change in engagement. While holding Catholic religious beliefs was protective, attending a Catholic school was a risk factor for suicidal behaviours. This pattern was explained by religious 'mismatch': pupils of a different religion from their school were approximately 2-4 times more likely to attempt suicide, be a suicide-risk or self

Suicide risk in patients treated with lithium

DEFF Research Database (Denmark)

Kessing, Lars Vedel; Søndergård, Lars; Kvist, Kajsa

2005-01-01

CONTEXT: Prior observational studies suggest that treatment with lithium may be associated with reduced risk of suicide in bipolar disorder. However, these studies are biased toward patients with the most severe disorders, and the relation to sex and age has seldom been investigated. OBJECTIVE......: To investigate whether treatment with lithium reduces the risk of suicide in a nationwide study. DESIGN: An observational cohort study with linkage of registers of all prescribed lithium and recorded suicides in Denmark during a period from January 1, 1995, to December 31, 1999. SETTING: All patients treated...... with lithium in Denmark, ie, within community psychiatry, private specialist practice settings, and general practice. PARTICIPANTS: A total of 13 186 patients who purchased at least 1 prescription of lithium and 1.2 million subjects from the general population. MAIN OUTCOME MEASURE: All suicides identified...

A study on the effect of exclusion period on the suicidal risk among the insured.

Science.gov (United States)

Yip, Paul S F; Chen, Feng

2014-06-01

An exclusion period (usually from 12 months to 2 years) is usually found in life insurance policies as a precautionary measure to prohibit people from insuring their lives with the intent to kill themselves shortly thereafter. Several studies have been conducted to investigate the effect of exclusion periods on the risk of suicide among the insured in the US and Australia. However, while Hong Kong has experienced an increase in the number of suicides among the insured, little is known about the dynamic between the exclusion period and suicide in Asia. Here we make use of death claims data from one of the major life insurance companies in Hong Kong to ascertain the impact of a 12-month exclusion period on suicide risk. We also use utility functions derived from economic theory to better understand individual choices regarding suicide among the insured. More specifically, we sought to determine whether there is a greater risk of suicide immediately following the 12-month exclusion period. We also examined whether the risk of suicide claims was higher than that of other non-suicidal claims. The study period for this investigation was from January 1, 1997 to December 31, 2011, during which time there were 1935 claims based on 1243 deaths. Of these, 197 were suicide-related claims for 106 suicide deaths. The mean number of life policies held by suicidal claimants and non-suicidal claimants was 1.6 and 1.4, respectively. The average/median size of the claims (total payment made on all policies held by the insured life) was HK$665,800/426,600 and HK$497,700/276,200 for suicidal and non-suicidal deaths, respectively. The policy lifetime of the claims, or the number of days from policy issuance to suicide occurrence, ranged from 38 to 7561 days, with a mean of 2209 days, a median of 1941 days, and a standard deviation of 1544 days. The peak density of suicide claims occurred on day 1039 of the policy. Our results revealed that suicide claims tend to occur earlier than other

A multidisciplinary approach to therapeutic risk management of the suicidal patient

Directory of Open Access Journals (Sweden)

Grant CL

2015-06-01

Full Text Available Cynthia L Grant,1,2 Jaimie L Lusk3 1Arapahoe/Douglas Mental Health Network, Englewood, CO, 2School of Education and Human Development, University of Colorado Denver, Denver, CO, 3Mental Health Service, VA Portland Health Care System, Portland, OR, USA Abstract: As health care trends toward a system of care approach, providers from various disciplines strive to collaborate to provide optimal care for their patients. While a multidisciplinary approach to suicide risk assessment and management has been identified as important for reducing suicidality, standardized clinical guidelines for such an approach do not yet exist. In this article, the authors propose the adoption of the therapeutic risk management of the suicidal patient (TRMSP to improve suicide risk assessment and management within multidisciplinary systems of care. The TRMSP, which has been fully articulated in previous articles, involves augmenting clinical risk assessment with structured instruments, stratifying risk in terms of both severity and temporality, and developing and documenting a safety plan. Augmenting clinical risk assessments with reliable and valid structured instruments serves several functions, including ensuring important aspects of suicide are addressed, establishing a baseline for suicidal thoughts and behaviors, facilitating interprofessional communication, and mitigating risk. Similarly, a two-dimensional risk stratification qualifying suicide risk in terms of both severity and temporality can enhance communication across providers and settings and improve understanding of acute crises in the context of chronic risk. Finally, safety planning interventions allow providers and patients to collaboratively create a personally meaningful plan for managing a suicidal crisis that can be continually modified across time with multiple providers in different care settings. In a busy care environment, the TRMSP can provide concrete guidance on conducting clinically and

Treating Iraq and Afghanistan War Veterans with PTSD Who Are at High Risk for Suicide

Science.gov (United States)

Jakupcak, Matthew; Varra, Edward M.

2011-01-01

Iraq and Afghanistan War veterans diagnosed with psychiatric disorders commit suicide at a higher rate than the general population (Kang & Bullman, 2008). Posttraumatic stress disorder (PTSD) has been identified as a risk factor for suicide in veterans (Bullman & Kang, 1994) and is the most common mental disorder among Iraq and Afghanistan…

Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA.

Science.gov (United States)

McCall, W Vaughn; Benca, Ruth M; Rosenquist, Peter B; Riley, Mary Anne; McCloud, Laryssa; Newman, Jill C; Case, Doug; Rumble, Meredith; Krystal, Andrew D

2017-01-01

Insomnia is associated with increased risk for suicide. The Food and Drug Administration (FDA) has mandated that warnings regarding suicide be included in the prescribing information for hypnotic medications. The authors conducted a review of the evidence for and against the claim that hypnotics increase the risk of suicide. This review focused on modern, FDA-approved hypnotics, beginning with the introduction of benzodiazepines, limiting its findings to adults. PubMed and Web of Science were searched, crossing the terms "suicide" and "suicidal" with each of the modern FDA-approved hypnotics. The FDA web site was searched for postmarketing safety reviews, and the FDA was contacted with requests to provide detailed case reports for hypnotic-related suicide deaths reported through its Adverse Event Reporting System. Epidemiological studies show that hypnotics are associated with an increased risk for suicide. However, none of these studies adequately controlled for depression or other psychiatric disorders that may be linked with insomnia. Suicide deaths have been reported from single-agent hypnotic overdoses. A separate concern is that benzodiazepine receptor agonist hypnotics can cause parasomnias, which in rare cases may lead to suicidal ideation or suicidal behavior in persons who were not known to be suicidal. On the other hand, ongoing research is testing whether treatment of insomnia may reduce suicidality in adults with depression. The review findings indicate that hypnotic medications are associated with suicidal ideation. Future studies should be designed to assess whether increases in suicidality result from CNS impairments from a given hypnotic medication or whether such medication decreases suicidality because of improvements in insomnia.

Influence of psycho-social factors on the emergence of depression and suicidal risk in patients with schizophrenia.

Science.gov (United States)

Pješčić, Katarina Dokić; Nenadović, Milutin M; Jašović-Gašić, Miroslava; Trajković, Goran; Kostić, Mirjana; Ristić-Dimitrijević, Radmila

2014-09-01

The aim of this study was to investigate the influence of certain psychosocial factors - insight, psycho-education, family and social support, loneliness and social isolation - on the appearance of depression and suicidal risk in schizophrenia. This was a cross-sectional study that comprised hospitalized patients with schizophrenia in the initial remission phase. The assessment of depression and suicidal risk was made by applying a semi-structured psychiatric interview that included scrutinized factors (insight, psycho-education, family and social support, loneliness and social isolation), Positive and Negative Syndrome Scale (PANSS), and Calgary Depression Scale for Schizophrenia (CDSS). On the basis of the assessment results, the sample was divided into two groups: Group of patients with depression and suicidal risk in schizophrenia (N = 53) and Control group (N = 159) of patients with schizophrenia without depression and suicidal risk. In the Group of patients with depression and suicidal risk, compared with the Control group, there was significantly higher frequency of insight in the mental status (χ² = 31.736, p risk in schizophrenia. This study shows that considered psycho-social factors - insight in the mental status, lack of psycho-education, as well as social isolation - could be predictors for appearance of depression and suicidal risk in schizophrenia.

Effect of Exposure to Suicidal Behavior on Suicide Attempt in a High-Risk Sample of Offspring of Depressed Parents

Science.gov (United States)

Burke, Ainsley K.; Galfalvy, Hanga; Everett, Benjamin; Currier, Dianne; Zelazny, Jamie; Oquendo, Maria A.; Melhem, Nadine M.; Kolko, David; Harkavy-Friedman, Jill M.; Birmaher, Boris; Stanley, Barbara; Mann, J. John; Brent, David A.

2010-01-01

Objective: Exposure to suicidal behavior in peers and relatives is thought to increase risk for suicidal behavior in vulnerable individuals, possibly as a result of imitation or modeling. This study examines exposure to suicidal behavior and likelihood of suicide attempt in a high-risk cohort of offspring of a depressed parent. Method: A total of…

Personality disorder traits, risk factors, and suicide ideation among older adults.

Science.gov (United States)

Jahn, Danielle R; Poindexter, Erin K; Cukrowicz, Kelly C

2015-11-01

Personality disorder traits are relatively prevalent among older adults, and can be associated with complex and chronic difficulties, including suicide risk. However, there is a lack of research regarding personality disorders and suicide ideation in older adults. Depressive symptoms and hopelessness may be important to the relation between personality disorders and suicide risk. Additionally, variables from the interpersonal theory of suicide, perceived burdensomeness and thwarted belongingness, may be critical risk factors for suicide in this population. We hypothesized that perceived burdensomeness and thwarted belongingness, theory-based variables, would act as parallel mediators of the relation between personality disorder traits and suicide ideation, whereas depressive symptoms and hopelessness would not. The hypothesis was tested in a sample of 143 older adults recruited from a primary care setting. Participants completed self-report questionnaires of personality traits, suicide ideation, depressive symptoms, hopelessness, perceived burdensomeness, and thwarted belongingness. Findings from a non-parametric bootstrapping procedure indicated that perceived burdensomeness, thwarted belongingness, and depressive symptoms mediated the relation between total personality disorder traits and suicide ideation. Hopelessness did not act as a mediator. These findings indicate that perceived burdensomeness, thwarted belongingness, and depressive symptoms are likely important risk factors for suicide ideation among older adults. Clinicians should be aware of these issues when assessing and treating suicide risk among older adults.

Impulsivity and Reasons for Living Among African American Youth: A Risk-Protection Framework of Suicidal Ideation

Directory of Open Access Journals (Sweden)

Temilola K. Salami

2015-05-01

Full Text Available This study aims to explore the impact of specific facets of impulsivity as measured by the UPPS Impulsive Behavior Scale (UPPS, as well as reasons for living in predicting suicidal ideation among African American college-aged students. The incremental validity of each facet of the UPPS interacting with reasons for living, a construct meant to buffer against risk for suicide, was explored in a sample of African American students (N = 130; ages 18–24. Results revealed significant interactions between reasons for living and two factors of impulsivity, (lack of premeditation and sensation seeking. Higher levels of sensation seeking and lack of premeditation in conjunction with lower reasons for living was associated with increased suicidal ideation. Neither urgency nor (lack of perseverance significantly interacted with reasons for living in association with suicidal ideation. These results suggest including elements of impulsivity, specifically sensation seeking and (lack of premeditation, when screening for suicidal ideation among African American youth. Future investigations should continue to integrate factors of both risk and protection when determining risk for suicide.

Impulsivity and reasons for living among African American youth: a risk-protection framework of suicidal ideation.

Science.gov (United States)

Salami, Temilola K; Brooks, Bianca A; Lamis, Dorian A

2015-05-15

This study aims to explore the impact of specific facets of impulsivity as measured by the UPPS Impulsive Behavior Scale (UPPS), as well as reasons for living in predicting suicidal ideation among African American college-aged students. The incremental validity of each facet of the UPPS interacting with reasons for living, a construct meant to buffer against risk for suicide, was explored in a sample of African American students (N = 130; ages 18-24). Results revealed significant interactions between reasons for living and two factors of impulsivity, (lack of) premeditation and sensation seeking. Higher levels of sensation seeking and lack of premeditation in conjunction with lower reasons for living was associated with increased suicidal ideation. Neither urgency nor (lack of) perseverance significantly interacted with reasons for living in association with suicidal ideation. These results suggest including elements of impulsivity, specifically sensation seeking and (lack of) premeditation, when screening for suicidal ideation among African American youth. Future investigations should continue to integrate factors of both risk and protection when determining risk for suicide.

Decision Tree Identified Risk Groups with High Suicidal Ideation in South Korea: A Population-Based Study.

Science.gov (United States)

Kim, Hyun Kyung; Kim, Ji Young; Kim, Jong Hyen; Hyoung, Hee Kyoung

2016-01-01

The aim of this study was to identify risk groups with high suicidal ideation among South Korean adults. A descriptive cross-sectional design was adopted using secondary data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 5,963 adults aged 19 years and older who participated in the 2011 KNHANES served as participants. The prevalence of suicidal ideation and its related factors, including physical, psychological, health behavioral, and sociodemographic characteristics, were examined. Descriptive statistics and a decision tree were used for data analysis. Nine groups with high suicidal ideation were identified. The coexistence of depression and high levels of stress increased the prevalence of suicidal ideation. The highest risk group was widowed or divorced adults with depression and high levels of stress, and 82.5% of these participants had suicidal ideation (the prevalence rate of this group was 5.7 times higher than the mean suicidal ideation prevalence rate in this study). Public health nurses and community mental health professionals should recognize risk groups with high suicidal ideation, and target these groups when implementing preventive interventions. © 2015 Wiley Periodicals, Inc.

Gender-specific suicide risk factors: a case-control study of individuals with major depressive disorder.

Science.gov (United States)

Dalca, Ioana Mioara; McGirr, Alexander; Renaud, Johanne; Turecki, Gustavo

2013-12-01

Available information on risk for suicide completion in females is limited and often extrapolated from studies conducted in males. However, the validity of extending to females risk factors identified among male suicide cases is unclear. In this study, we aimed to investigate clinical and behavioral risk factors for suicide among female depressed patients and compare them to similar factors among male depressed patients. We identified 201 suicide completers (160 male and 41 female) who died during an episode of major depressive disorder (MDD). Cases were compared to 127 living patients with MDD (88 male and 39 female). All subjects were characterized for Axis I and II diagnoses using the Structured Clinical Interview for DSM-IV Axis I Disorders and Structured Clinical Interview for DSM-IV Axis II Personality Disorders according to the DSM-IV, as well as behavioral and temperament dimensions using proxy-based interviews. The primary outcome was measures of impulsive and impulsive-aggressive behaviors. Compared to controls, male, but not female suicide cases had higher levels of impulsive aggression (P suicide cases from controls. However, nonimpulsive aggression and impulsive aggression were correlated constructs in males (r = 0.297; P suicide, such as alcohol and substance dependence, cluster B disorders, and elevated hostility and aggression, were replicated in the pooled-sex analyses, and, though not statistically significant in discriminating between suicide cases and controls by gender, maintained strong group differences. Males and females share many risk factors for suicide in MDD, yet alcohol dependence is much more specific though less sensitive among depressed females. Nonimpulsive aggression is part of a diathesis for suicide in females, which is distinct from the well-characterized impulsive aggression that is consistently reported in a portion of male suicide cases. © Copyright 2013 Physicians Postgraduate Press, Inc.

A Review of Eating Disorders and Suicide Risk in Adolescence

Directory of Open Access Journals (Sweden)

Ida F. Dancyger

2005-01-01

Full Text Available This review examines the literature during the past 10 years about suicide risk and suicide during adolescence and young adulthood of individuals with eating disorders. Epidemiological surveys are summarized, including suicide rates, parasuicidal behaviors, associated risk factors, and comorbid psychopathology. Critical implications for the comprehensive assessment and treatment planning, including safety considerations, are discussed. Two clinical cases of women with long-standing eating disorders are described to highlight both the pragmatic considerations and the complex clinical challenges of working with patients with eating disorders who become suicidal. The potentially life-threatening issues of safety have not received sufficient attention, neither in the medical literature nor by the treating clinicians. All health care professionals who are treating patients with an eating disorder must be keenly aware of the serious risks of suicidal behavior and of suicide in this population.

Assessing Suicide Risk in Veterans: The Role of the Nurse Practitioner

OpenAIRE

Kathy Puskar; Giuliana Mazza

2012-01-01

Background: Statistics have shown that veteran men and women are at greater risk for suicide than the general population. In order to decrease the incidence of suicide in veterans, nurse practitioners (NPs) and other health care professionals must not only become more aware of the risk factors for veteran suicides but also develop strong psychiatric interviewing skills. Purpose: To discuss the risk factors associated with veteran suicide, the assessment tools to ensure a comprehensive...

Burden of separation and suicide risk of prisoners with minor children.

Science.gov (United States)

Krüger, Sinja; Priebe, Stefan; Fritsch, Rosemarie; Mundt, Adrian P

The present study aimed to explore the burden of separation from children and its relationship with suicide risk in prisoners with minor children at the moment of admission into the penal justice system. Suicide risk was assessed using the Mini International Neuropsychiatric Interview in newly admitted female (n=198) and male (n=229) prisoners in Santiago de Chile. The burden of separation from minor children was rated on a numeric rating scale. Both genders showed high burden of separation from children at imprisonment. Mothers had significantly lower suicide risk than women without children. The relative risk was 0.31 (95% CI [0.16-0.6], psuicide risk'. There was no difference of suicide risk between imprisoned fathers and male prisoners without children. Within the group of fathers, the suicide risk associated with the burden of separation. Our study indicates that strengthening the parent role and facilitating parent-child contacts during imprisonment could be an important element of suicide prevention interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Pathways between stigma and suicidal ideation among people at risk of psychosis.

Science.gov (United States)

Xu, Ziyan; Müller, Mario; Heekeren, Karsten; Theodoridou, Anastasia; Metzler, Sibylle; Dvorsky, Diane; Oexle, Nathalie; Walitza, Susanne; Rössler, Wulf; Rüsch, Nicolas

2016-04-01

Mental illness stigma may contribute to suicidality and is associated with social isolation and low self-esteem among young people at risk of psychosis. However, it is unclear whether mental illness stigma contributes to suicidality in this population. We therefore examined the associations of self-labeling and stigma stress with suicidality among young people at risk. Self-labeling as "mentally ill", stigma stress, social isolation, self-esteem, symptoms and suicidal ideation were assessed in 172 individuals at risk of psychosis. Self-labeling and stigma stress were examined as predictors of suicidality by path analysis. Increased self-labeling as "mentally ill" was associated with suicidality, directly as well as indirectly mediated by social isolation. More stigma stress was related to social isolation which in turn was associated with low self-esteem, depression and suicidal ideation. Social isolation fully mediated the link between stigma stress and suicidal ideation. Interventions to reduce the public stigma associated with risk of psychosis as well as programs to facilitate non-stigmatizing awareness of at-risk mental state and to reduce stigma stress among young people at risk of psychosis might strengthen suicide prevention in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

Clinical epidemiology of long-term suicide risk in a nationwide population-based cohort study in South Korea.

Science.gov (United States)

Lee, Hyewon; Myung, Woojae; Lee, Chunsoo; Choi, Junbae; Kim, Ho; Carroll, Bernard J; Kim, Doh Kwan

2018-05-01

We investigated the effects of a large range of clinical factors on the long-term risk of suicide in the general population of South Korea. We analyzed the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database in South Korea. A total of 300,232 individuals were followed for up to 12 years. We obtained information on demographic variables (age and sex), lifestyle variables (cigarette smoking, alcohol drinking and exercise), psychiatric and physical disorders, laboratory examination results and physical examination findings. We conducted a competing risk survival analysis to estimate the risk of completed suicide. 725 individuals (241/100,000) died by suicide in the follow-up period. After Bonferroni correction, we found a significant suicide risk associated with 6 variables: Parkinson's disease, depressive disorder, obsessive-compulsive disorder (inverted association), elevated serum aspartate aminotransferase levels, male gender and age. Before Bonferroni correction, variables such as cigarette smoking, heavy alcohol drinking, psychotic disorder, other psychiatric disorder, benzodiazepine use and higher fasting glucose showed some significant association. In addition, body mass index and height were inversely related to completed suicide before Bonferroni correction. However, only the 6 variables listed above were robust predictors of suicide in the fully adjusted analyses with multiple test correction. Common medical conditions had no clear influence on suicide. Diverse clinical factors influenced the long-term risk of completed suicide in this general population sample. Comprehensive assessment of these risk factors will facilitate more focused suicide surveillance measures. Copyright © 2018. Published by Elsevier Ltd.

Differences in risk factors for self-harm with and without suicidal intent: Findings from the ALSPAC cohort

Science.gov (United States)

Mars, Becky; Heron, Jon; Crane, Catherine; Hawton, Keith; Kidger, Judi; Lewis, Glyn; Macleod, John; Tilling, Kate; Gunnell, David

2014-01-01

Background There is a lack of consensus about whether self-harm with suicidal intent differs in aetiology and prognosis from non-suicidal self-harm, and whether they should be considered as different diagnostic categories. Method Participants were 4799 members of the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based birth cohort who completed a postal questionnaire on self-harm with and without suicidal intent at age 16 years. Multinomial logistic regression analyses were used to examine differences in the risk factor profiles of individuals who self-harmed with and without suicidal intent. Results Many risk factors were common to both behaviours, but associations were generally stronger in relation to suicidal self-harm. This was particularly true for mental health problems; compared to those with non-suicidal self-harm, those who had harmed with suicidal intent had an increased risk of depression (OR 3.50[95% CI 1.64, 7.43]) and anxiety disorder (OR 3.50[95% CI 1.72, 7.13]). Higher IQ and maternal education were risk factors for non-suicidal self-harm but not suicidal self-harm. Risk factors that appeared specific to suicidal self-harm included lower IQ and socioeconomic position, physical cruelty to children in the household and parental self-harm. Limitations i) There was some loss to follow-up, ii) difficulty in measuring suicidal intent, iii) we cannot rule out the possibility of reverse causation for some exposure variables, iv) we were unable to identify the subgroup that had only ever harmed with suicidal intent. Conclusion Self-harm with and without suicidal intent are overlapping behaviours but with some distinct characteristics, indicating the importance of fully exploring vulnerability factors, motivations, and intentions in adolescents who self harm. PMID:25108277

Prevalence and risk factors of attempted suicide in adult war-affected population of eastern Uganda.

Science.gov (United States)

Kinyanda, Eugene; Weiss, Helen A; Mungherera, Margaret; Onyango-Mangen, Patrick; Ngabirano, Emmanuel; Kajungu, Rehema; Kagugube, Johnson; Muhwezi, Winston; Muron, Julius; Patel, Vikram

2013-01-01

There is conflicting evidence on the relationship between war trauma and suicidal behavior. Some studies point to an increased risk of suicidal behavior while others do not, with a paucity of such data from sub-Saharan Africa. To investigate the prevalence and risk factors of attempted suicide in war-affected Eastern Uganda. A cross-sectional survey was carried out in two districts of Eastern Uganda where 1,560 respondents (15 years and older) were interviewed. Multivariable logistic regression was used to assess risk factors of attempted suicide in this population. Lifetime attempted suicide was 9.2% (n = 142; 95% CI, 7.8%-10.8%), and 12-month attempted suicide was 2.6% (n = 41; 95% CI, 1.9-3.5%). Lifetime attempted suicide was significantly higher among females 101 (11.1%) than among males 43 (6.5%; OR = 1.80, 95% CI 1.21-2.65). Factors independently associated with lifetime rate of attempted suicide among females were subcounty, being a victim of intimate partner violence, having reproductive health complaints, and having major depressive disorder. Among males these were belonging to a war-vulnerable group, having a surgical complaint, and having a major depressive disorder. In both sexes, the lifetime rate of attempted suicide was not independently directly related to experiences of war trauma. It was, however, indirectly related to war trauma through its association with psychological, somatic, and psychosocial sequelae of war.

Suicide risk factors in the professional military personnel in the Army of Serbia

Directory of Open Access Journals (Sweden)

Dedić Gordana

2010-01-01

Full Text Available Background/Aim. Recognition of suicide risk factors is important in taking adequate suicide preventive measures, Suicide Prevention Program for Professional Military Personnel (PMP implemented in the Army of Serbia in 2003. The aim of our study was to establish suicide risk factors in PMP of the Army of Serbia. Methods. Analysis of suicide risk factors in PMP was carried out on the basis of data obtained by psychological suicide autopsy. The controls were demographically similar psychiatric outpatients with no history of suicidal behavior. A descriptive statistics method was used for risk factors analysis. The t-test was used for testing statistical hypotheses. Results. A total of 30 PMP, aged 22-49 years (30.53 ± 6.24 on average committed suicide within the period 1998-2007. Distal suicide risk factors in PMP were considered to be not being married, psychiatric heredity, having no outpatient psychiatric treatment, gambling, regular physical practice (bodybuilding, less transfer to a different post, low motivation for military service (p < 0.001, not having children, parental loss in early childhood, alcohol abuse (p < 0.005, low salary (p < 0.01 uncompleted military school, debts in the family (p < 0.05. The commonest proximal suicide risk factors were: actual family problems (36.6%, actual mental problems (13.3%, burnout (13.3%, negative balance of accounts (13.3%, professional problems (6.7%, behavioral model while for 10.0% PMP suicide risk factors could not be established. Conclusion. According to the presence of multiple suicide risk factors, Suicide Prevention Program for PMP in the Army of Serbia is directed to the prevention of both proximal and distal suicide risk factors.

Body dysmorphic disorder symptoms and risk for suicide: The role of depression.

Science.gov (United States)

Shaw, A M; Arditte Hall, K A; Rosenfield, E; Timpano, K R

2016-12-01

Body dysmorphic disorder (BDD) is associated with elevated suicidality. Little is known about why BDD patients are at increased risk. The interpersonal-psychological theory of suicide (IPTS) could clarify suicidality in BDD, and theorizes that perceived burdensomeness and thwarted belongingness lead to suicidal desire, while an acquired capability for suicide is necessary to attempt suicide. No study has investigated how BDD symptoms relate to IPTS constructs or mediators of the relationship between BDD and suicidality. Individuals (N=235) enrolled in Amazon.com's Mechanical Turk (MTurk), who had appearance concerns, completed questionnaires about BDD, depression, eating pathology, and suicide risk. MTurk is an online data collection platform in which participants complete surveys for payment. BDD symptoms predicted suicidal desire, but not acquired capability for suicide. Depression mediated the relationship between BDD and suicidal desire. Research should examine how fluctuations in BDD affect suicide risk. Replication in a clinical sample may inform treatments for BDD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Obesity and suicide risk in adults--a systematic review.

Science.gov (United States)

Klinitzke, G; Steinig, J; Blüher, M; Kersting, A; Wagner, B

2013-03-05

There is evidence from prospective studies that obesity is positively associated with depression. In contradiction to this, however, a number of studies have revealed that the number of completed suicides decreases with increasing BMI. The objective of this systematic review is to elucidate this ambiguous research field, providing an overview of literature examining the relationship between obesity and risk of suicide in adults (>18 years). Literature searches of the databases PubMed/Medline, PsychInfo, and Web of Sciences were conducted. Fifteen studies concerning completed suicide, suicide attempts and suicidal ideation met the inclusion criteria (seven prospective and eight cross-sectional studies). Eight studies evaluating completed suicide reported an inverse relationship between BMI and suicide, meaning that obese people are less likely to commit suicide than people of low or normal weight, whereas one study showed no association and one showed a positive association. Studies about suicide attempts and ideation, on the other hand, found results that differed depending on gender. While obese woman reported more suicide attempts and suicidal ideation, obese men reported less attempts and thoughts. The role of confounding variables such as age or psychiatric illness on suicide risk are discussed and remaining research questions are outlined, especially regarding the role of different underlying biological pathways and consideration of different classes of obesity. Copyright © 2012 Elsevier B.V. All rights reserved.

Risk factors for suicide completion in major depression: a case-control study of impulsive and aggressive behaviors in men.

Science.gov (United States)

Dumais, A; Lesage, A D; Alda, M; Rouleau, G; Dumont, M; Chawky, N; Roy, M; Mann, J J; Benkelfat, C; Turecki, Gustavo

2005-11-01

Major depression is a major risk factor for suicide. However, not all individuals with major depression commit suicide. Impulsive and aggressive behaviors have been proposed as risk factors for suicide, but it remains unclear whether their effect on the risk of suicide is at least partly explained by axis I disorders commonly associated with suicide, such as major depression. With a case-control design, a comparison of the level of impulsive and aggressive behaviors and the prevalence of associated psychopathology was carried out with control for the presence of primary psychopathology. One hundred and four male suicide completers who died during an episode of major depression and 74 living depressed male comparison subjects were investigated with proxy-based interviews by using structured diagnostic instruments and personality trait assessments. The authors found that current (6-month prevalence) alcohol abuse/dependence, current drug abuse/dependence, and cluster B personality disorders increased the risk of suicide in individuals with major depression. Also, higher levels of impulsivity and aggression were associated with suicide. An analysis by age showed that these risk factors were more specific to younger suicide victims (ages 18-40). A multivariate analysis indicated that current alcohol abuse/dependence and cluster B personality disorder were two independent predictors of suicide. Impulsive-aggressive personality disorders and alcohol abuse/dependence were two independent predictors of suicide in major depression, and impulsive and aggressive behaviors seem to underlie these risk factors. A developmental hypothesis of suicidal behavior, with impulsive and aggressive behaviors as the starting point, is discussed.

[Risk factors for suicide attempt among college students at Central South University].

Science.gov (United States)

Xu, Hui-lan; Xiao, Shui-yuan; Feng, Shan-shan; Chen, Xi-xi

2004-04-01

To understand the prevalence and risk factors for suicidal ideation among college students and to provide a scientific basis for promoting psychological health and suicide prevention. 623 college students at Central South University were selected using stratified cluster sampling and administered a suicide ideation questionnaire, a Symptom Check List (SCL-90), an Adolescent Self-Rating Life Events Check List (ASLEC), a Social Support Rating Scale (SSRS) and a questionnaire about background information. Multivariate logistic regression analysis was employed to identify risk factors for suicide ideation. One year prior to our investigation, 14.6% of respondents had suicide ideation, 2.5% had made a specific suicide plan, and 1.8% had made a suicide attempt. The main risk factors for suicide ideation were dissatisfaction with the selected major of study, limited social support, recent negative life events and depressive tendency. The prevalence of suicide ideation among these college students was high. Appropriate measures focusing on the risk factors identified in this study should be urgently developed to prevent suicides in college students.

Risk of suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in university students.

Science.gov (United States)

McAuliffe, Carmel; Corcoran, Paul; Keeley, Helen S; Perry, Ivan J

2003-01-01

The present paper investigates the risk of lifetime suicide ideation associated with problem-solving ability and attitudes toward suicidal behavior in a sample of 328 university students (41% male, 59% female). The response rate was 77% based on the total number of students registered for the relevant courses. A series of questions assessed lifetime suicide ideation, while problem solving and attitudes toward suicide were measured using the Self-Rating Problem Solving scale and four subscales of the Suicide Opinion Questionnaire, respectively (McLeavey, 1986; Domino et al., 1989). Almost one-third of the students surveyed had lifetime suicide ideation. Both genders were similar in terms of their suicide ideation history, problem solving, and attitudes toward suicidal behavior with the exception that male students were more in agreement with the attitude that suicidal behavior lacks real intent. Compared with 2% of nonideators and ideators, one in four planners reported that they would more than likely attempt suicide at some point in their life. Greater agreement with the attitude that suicidal behavior is normal was associated with significantly increased risk of being an ideator, as was poor problem solving and less agreement with the attitude that suicidal behavior is associated with mental illness.

Assessing the risk for suicide in patients with cancer.

Science.gov (United States)

Aiello-Laws, Lisa B

2010-12-01

The Joint Commission publishes its annual National Patient Safety Goals to guide accredited organizations in addressing high-risk, low-volume concerns related to patient safety. The 2010 list includes a goal to identify patients at risk for suicide, but do oncology nurses need to be concerned about the risk of suicide in patients with cancer?

Temperament traits in suicidal and non-suicidal mood disorder patients in Taiwan.

Science.gov (United States)

Liu, Shen-Ing; Huang, Yu-Hsin; Wu, Ying-Hui; Huang, Kuo-Yang; Huang, Hui-Chun; Sun, Fang-Ju; Huang, Chiu-Ron; Sung, Ming-Ru; Huang, Yo-Ping

2017-07-01

Suicide is a major social and clinical problem in Asia. Although studies have suggested that personality traits are possible risk factors for suicide, no study has been conducted among Chinese to compare the temperament traits of suicidal and non-suicidal mood disorder patients with those of healthy controls. This study compared temperament traits of two patient groups, those with a mood disorder who have attempted suicide (n=204), and those with a mood disorder who have not attempted suicide (n=160), and compared the traits of these patients to those of healthy controls (n=178), assessed by Cloninger's Tridimensional Personality Questionnaire and the Brown-Goodwin Aggression Inventory. Patients with suicidal attempts had significantly higher novelty seeking and aggression scores than healthy controls and patients without suicidal attempts. Two groups of patients with mood disorder had significantly higher harm avoidance scores than the healthy controls. However, patients with suicidal attempts did not have higher harm avoidance scores than patients without suicidal attempts. This study confirms findings that harm avoidance and mood disorder are related, and extends them by suggesting that those with a mood disorder and suicide attempts have higher novelty seeking and lifetime aggression scores than those without suicidal attempt, either patients or healthy controls. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

The risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, psoriatic arthritis or ankylosing spondylitis

DEFF Research Database (Denmark)

Wu, J J; Penfold, R B; Primatesta, P

2017-01-01

BACKGROUND: Sparse information is available concerning mental health issues in psoriasis, psoriatic arthritis (PsA) and ankylosing spondylitis (AS) patients. OBJECTIVE: To estimate risk of depression, suicidal ideation and suicide attempt in patients with psoriasis, PsA and AS, respectively......, compared with the general population. METHODS: This population-based cohort study analysed 36 214 psoriasis patients, 5138 PsA patients and 1878 AS patients who were frequency-matched with a general population cohort. Annual incidence rate of depression, suicidal ideation and suicide attempt was calculated...... separately for psoriasis, PsA and AS. RESULTS: There was an increased risk of depression in the three cohorts; adjusted IRR: psoriasis, 1.14 (95% CI, 1.11, 1.17); PsA, 1.22 (95% CI, 1.16, 1.29); AS, 1.34 (95% CI, 1.23, 1.47). There was no significantly increased risk for suicidal ideations or suicide attempt...

Risk of Suicide and Dysfunctional Patterns of Personality among Bereaved Substance Users.

Science.gov (United States)

Masferrer, Laura; Caparrós, Beatriz

2017-03-20

Background : Research has shown that suicide is a phenomenon highly present among the drug dependent population. Different studies have demonstrated an upraised level of comorbidity between personality disorders (PD) and substance use disorders (SUD). This study aimed to describe which PDs are more frequent among those patients with a risk of suicide. Methods : The study was based on a consecutive non-probabilistic convenience sample of 196 bereaved patients attended to in a Public Addiction Center in Girona (Spain). Sociodemographic data, as well as suicide and drug related characteristics were recorded. The risk of suicide was assessed with the Spanish version of "Risk of suicide". Personality disorders were measured with the Spanish version of Millon Multiaxial Clinical Inventory. Results : The PDs more associated with the presence of risk of suicide were depressive, avoidant, schizotypal and borderline disorders. However, the histrionic, narcissistic and compulsive PDs are inversely associated with risk of suicide even though the narcissistic scale had no statistical correlation. Conclusions : The risk of suicide is a significant factor to take into account related to patients with SUD and especially with the presence of specific PDs. These findings underline the importance of diagnosing and treating rigorously patients with SUD.

Suicide risk in relation to psychiatric hospitalization: evidence based on longitudinal registers

DEFF Research Database (Denmark)

Qin, Ping; Nordentoft, Merete

2005-01-01

history increases suicide risk relatively more in women than in men; and suicide risk is substantial for substance disorders and for multiple admissions in women but not in men. CONCLUSIONS: Suicide risk peaks in periods immediately after admission and discharge. The risk is particularly high in persons...... with affective disorders and in persons with short hospital treatment. These findings should lead to systematic evaluation of suicide risk among inpatients before discharge and corresponding outpatient treatment, and family support should be initiated immediately after the discharge...

Suicide risk in the elderly: data from Brazilian public health care program.

Science.gov (United States)

Ciulla, Leandro; Lopes Nogueira, Eduardo; da Silva Filho, Irenio Gomes; Tres, Guilherme Levi; Engroff, Paula; Ciulla, Veronica; Cataldo Neto, Alfredo

2014-01-01

Examine prevalence and level of suicide risk, and its associations with sociodemographic factors and mood disorders. A cross-sectional study with a random sample of 530 individuals aged 60 years or more from Family Health Strategy of Porto Alegre, Brazil. Diagnosis was made by psychiatrists using the Mini International Neuropsychiatric Interview plus (MINIplus). Suicide risk was found in 15.7% of the sample. Female gender, elderly with no income or with no paid activity and those who have lost one or more of his sons presented association with suicide risk. Bipolar disorder shows association with suicide risk for those with or without current episode. For unipolar depression only elderly with a current episode shows association with suicide risk. The cross-sectional design limits the examination of causative relationships. The MINIplus questions are not broad enough to assess other important self-destructive behaviors. A high rate of suicide risk was found. As expected an increased rate of mood disorders were related to the risk of suicide. The loss of sons may partly explain a subtype of late-life risk of suicide or mood disorders especially in the oldest-old. These findings can be a useful to generate other research hypothesis and for health professionals who care older persons. Detecting characteristics linked to suicide, therefore opening up the possibility of preventing tragic outcomes providing a proper treatment. Crown Copyright © 2013 Published by Elsevier B.V. All rights reserved.

Past suicidal ideation as an independent risk factor for suicide behaviours in patients with depression.

Science.gov (United States)

Park, Eun-Hee; Hong, Narei; Jon, Duk-In; Hong, Hyun Ju; Jung, Myung Hun

2017-03-01

As South Korea has the highest incidence of completed suicides, the present study aimed to investigate the predictive power of the variables that have been associated with suicide attempts in Korean patients diagnosed with depression. Hundred participants were divided into two groups: suicide attempters (31%) and suicide non-attempters (69%). Participants with a history of more than one suicidal attempt were assigned to the suicide attempter group. A hierarchical logistic regression analysis was performed to determine the predictive strengths of the variables that were likely to be associated with suicide attempts. After controlling for the effects of such variables as the severity of depressive symptoms, life stress events and impulsivity, the severity of past suicidal ideation was the most important predictive factor for discriminating suicide attempters from suicide non-attempters. The odds ratio for attempting suicide relative to not attempting suicide increased by a factor of 4.408 for each unit of increase in suicidal ideation. The present study suggests that the most severe suicidal ideation throughout one's entire life should not be overlooked and may be a major predictor of the risk of suicide.

Antiepileptic drugs and risk of suicide: a nationwide study

DEFF Research Database (Denmark)

Olesen, Jonas Bjerring; Hansen, Peter Riis; Erdal, Jesper

2010-01-01

. The case-crossover analysis estimated AED treatment initiation to increase the risk of suicide (odds ratio (OR): 1.84, 95% confidence interval (CI): 1.36-2.49). Clonazepam (OR: 2.01, CI: 1.25-3.25), valproate (OR: 2.08, CI: 1.01-4.16), lamotrigine (OR: 3.15, CI: 1.35-7.34) and phenobarbital (OR: 1.96, CI...... that clonazepam, valproate, lamotrigine and phenobarbital relatively shortly after treatment initiation may increase the risk of suicide. The increased risk of suicide associated with these AEDs appears to be a consistent finding. Copyright (C) 2010 John Wiley & Sons, Ltd...

Adapting Interpersonal Psychotherapy for Older Adults at Risk for Suicide

Science.gov (United States)

Heisel, Marnin J.; Talbot, Nancy L.; King, Deborah A.; Tu, Xin M.; Duberstein, Paul R.

2014-01-01

Objective To pilot a psychological intervention adapted for older adults at-risk for suicide. Design A focused, uncontrolled, pre-to-post-treatment psychotherapy trial. All eligible participants were offered the study intervention. Setting Outpatient mental healthcare provided in the psychiatry department of an academic medical center in a mid-sized Canadian city. Participants Seventeen English-speaking adults 60 years or older, at- risk for suicide by virtue of current suicide ideation, death ideation, and/or recent self-injury. Intervention A 16-session course of Interpersonal Psychotherapy (IPT) adapted for older adults at-risk for suicide who were receiving medication and/or other standard psychiatric treatment for underlying mood disorders. Measurements Participants completed a demographics form, screens for cognitive impairment and alcohol misuse, a semi-structured diagnostic interview, and measures of primary (suicide ideation and death ideation), and secondary study outcomes (depressive symptom severity; social adjustment and support; psychological well-being), and psychotherapy process measures. Results Participants experienced significant reductions in suicide ideation, death ideation, and depressive symptom severity, and significant improvement in perceived meaning in life, social adjustment, perceived social support, and other psychological well-being variables. Conclusions Study participants experienced enhanced psychological well-being and reduced symptoms of depression and suicide ideation over the course of IPT adapted for older adults at-risk for suicide. Larger, controlled trials are needed to further evaluate the impact of this novel intervention and to test methods for translating and integrating focused interventions into standard clinical care with at-risk older adults. PMID:24840611

Adapting interpersonal psychotherapy for older adults at risk for suicide.

Science.gov (United States)

Heisel, Marnin J; Talbot, Nancy L; King, Deborah A; Tu, Xin M; Duberstein, Paul R

2015-01-01

To pilot a psychological intervention adapted for older adults at risk for suicide. A focused, uncontrolled, pre-to-post-treatment psychotherapy trial. All eligible participants were offered the study intervention. Outpatient mental health care provided in the psychiatry department of an academic medical center in a mid-sized Canadian city. Seventeen English-speaking adults 60 years or older, at risk for suicide by virtue of current suicide ideation, death ideation, and/or recent self-injury. A 16-session course of Interpersonal Psychotherapy (IPT) adapted for older adults at risk for suicide who were receiving medication and/or other standard psychiatric treatment for underlying mood disorders. Participants completed a demographics form, screens for cognitive impairment and alcohol misuse, a semi-structured diagnostic interview, and measures of primary (suicide ideation and death ideation) and secondary study outcomes (depressive symptom severity, social adjustment and support, psychological well-being), and psychotherapy process measures. Participants experienced significant reductions in suicide ideation, death ideation, and depressive symptom severity, and significant improvement in perceived meaning in life, social adjustment, perceived social support, and other psychological well-being variables. Study participants experienced enhanced psychological well-being and reduced symptoms of depression and suicide ideation over the course of IPT adapted for older adults at risk for suicide. Larger, controlled trials are needed to further evaluate the impact of this novel intervention and to test methods for translating and integrating focused interventions into standard clinical care with at-risk older adults. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Which Kids Are at Highest Risk for Suicide?

Science.gov (United States)

... Share Which Kids are at Highest Risk for Suicide? Page Content Article Body No child is immune, ... who have lost a friend or relative to suicide. Studies show that a considerable number of youth ...

Suicide detection in Chile: proposing a predictive model for suicide risk in a clinical sample of patients with mood disorders

Directory of Open Access Journals (Sweden)

Jorge Barros

Full Text Available Objective: To analyze suicidal behavior and build a predictive model for suicide risk using data mining (DM analysis. Methods: A study of 707 Chilean mental health patients (with and without suicide risk was carried out across three healthcare centers in the Metropolitan Region of Santiago, Chile. Three hundred forty-three variables were studied using five questionnaires. DM and machine-learning tools were used via the support vector machine technique. Results: The model selected 22 variables that, depending on the circumstances in which they all occur, define whether a person belongs in a suicide risk zone (accuracy = 0.78, sensitivity = 0.77, and specificity = 0.79. Being in a suicide risk zone means patients are more vulnerable to suicide attempts or are thinking about suicide. The interrelationship between these variables is highly nonlinear, and it is interesting to note the particular ways in which they are configured for each case. The model shows that the variables of a suicide risk zone are related to individual unrest, personal satisfaction, and reasons for living, particularly those related to beliefs in one’s own capacities and coping abilities. Conclusion: These variables can be used to create an assessment tool and enables us to identify individual risk and protective factors. This may also contribute to therapeutic intervention by strengthening feelings of personal well-being and reasons for staying alive. Our results prompted the design of a new clinical tool, which is fast and easy to use and aids in evaluating the trajectory of suicide risk at a given moment.

Suicide risk assessment: Trust an implicit probe or listen to the patient?

Science.gov (United States)

Harrison, Dominique P; Stritzke, Werner G K; Fay, Nicolas; Hudaib, Abdul-Rahman

2018-05-21

Previous research suggests implicit cognition can predict suicidal behavior. This study examined the utility of the death/suicide implicit association test (d/s-IAT) in acute and prospective assessment of suicide risk and protective factors, relative to clinician and patient estimates of future suicide risk. Patients (N = 128; 79 female; 111 Caucasian) presenting to an emergency department were recruited if they reported current suicidal ideation or had been admitted because of an acute suicide attempt. Patients completed the d/s-IAT and self-report measures assessing three death-promoting (e.g., suicide ideation) and two life-sustaining (e.g., zest for life) factors, with self-report measures completed again at 3- and 6-month follow-ups. The clinician and patient provided risk estimates of that patient making a suicide attempt within the next 6 months. Results showed that among current attempters, the d/s-IAT differentiated between first time and multiple attempters; with multiple attempters having significantly weaker self-associations with life relative to death. The d/s-IAT was associated with concurrent suicidal ideation and zest for life, but only predicted the desire to die prospectively at 3 months. By contrast, clinician and patient estimates predicted suicide risk at 3- and 6-month follow-up, with clinician estimates predicting death-promoting factors, and only patient estimates predicting life-sustaining factors. The utility of the d/s-IAT was more pronounced in the assessment of concurrent risk. Prospectively, clinician and patient predictions complemented each other in predicting suicide risk and resilience, respectively. Our findings indicate collaborative rather than implicit approaches add greater value to the management of risk and recovery in suicidal patients. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Risk Factors for Suicide Ideation Among Adolescents: Five-Year National Data Analysis.

Science.gov (United States)

Im, Yeojin; Oh, Won-Oak; Suk, Minhyun

2017-06-01

This study identified risk factors for suicide ideation among adolescents through a secondary analysis using data collected over five years from the 5th-9th Korea Youth Risk Behavior Survey. We analyzed 370,568 students' responses to questions about suicidality. The risk factors for suicide ideation included demographic characteristics, such as gender (girls), low grades, low economic status, and not living with one or both parents. Behavioral and mental health risk factors affecting suicide ideation were depression, low sleep satisfaction, high stress, alcohol consumption, smoking, and sexual activity. Health care providers should particularly target adolescents manifesting the above risk factors when developing suicide prevention programs for them. Copyright © 2017 Elsevier Inc. All rights reserved.

Use of the Suicide Status Form-II to investigate correlates of suicide risk factors in psychiatrically hospitalized children and adolescents.

Science.gov (United States)

Romanowicz, Magdalena; O'Connor, Stephen S; Schak, Kathryn M; Swintak, Cosima C; Lineberry, Timothy W

2013-11-01

Suicide is the third leading cause of death in the United States for youth 12-17 years or age. Acute psychiatric hospitalization represents a clear worst point clinically and acute suicide risk is the most common reason for psychiatric admission. We sought to determine factors associated with differences in individual suicide risk assessment for children and adolescents during acute psychiatric admission. Study participants were 1153 youth consecutively admitted to an inpatient psychiatry unit who completed a self-administered Suicide Status Form (SSF) within 24h of admission. Additional information on suicide risk factors was obtained through medical chart abstraction. Females reported significantly greater psychological pain, stress, hopelessness, and self-hate on the SSF and were significantly more likely to have made a suicide attempt just prior to the index hospital admission (OR=1.59, SE=0.29; CI=1.12-2.26), report a family history of suicide (OR=2.02, SE=0.33; CI=1.47-2.78), and had experienced a greater number of inpatient psychiatry admissions related to suicidal ideation (RR=1.33, SE=0.13; CI=1.10-1.61). High school aged youth and those with a primary diagnosis of depression displayed consistently elevated SSF scores and risk factors for suicide compared to comparison groups. Diagnosis was determined through chart abstraction. Responses to access to firearm question had missing data for 46% of the total sample. Systematic administration of a suicide-specific measure at admission may help clinicians improve identification of suicide risk factors in youth in inpatient psychiatry settings. © 2013 Elsevier B.V. All rights reserved.

The moderating role of social support on the relationship between impulsivity and suicide risk.

Science.gov (United States)

Kleiman, Evan M; Riskind, John H; Schaefer, Karen E; Weingarden, Hilary

2012-01-01

Suicide is the second leading cause of death among college students. There has been considerable research into risk factors for suicide, such as impulsivity, but considerably less research on protective factors. The present study examines the role that social support plays in the relationship between impulsivity and suicide risk. Participants were 169 undergraduates who completed self-report measures of impulsivity and social support. Suicide risk was assessed using an interview measure. Social support moderates the relationship between impulsivity and suicide risk, such that those who are highly impulsive are less likely to be at risk for suicide if they also have high levels of social support. Social support can be a useful buffer to suicide risk for at-risk individuals who are highly impulsive.

Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children.

Science.gov (United States)

Becker, Stephen P; Withrow, Amanda R; Stoppelbein, Laura; Luebbe, Aaron M; Fite, Paula J; Greening, Leilani

2016-12-01

Although identified as a significant public health concern, few studies have examined correlates of suicide risk in school-aged children. Recent studies show a relation between sluggish cognitive tempo (SCT) symptoms and a range of adverse outcomes linked to suicidal ideation, including depression, emotion dysregulation, lowered self-esteem, and peer problems/social withdrawal, yet no study to date has examined SCT in relation to suicide risk. We tested the hypothesis that SCT would be associated with suicide risk in a sample of 95 psychiatrically hospitalized children (74% male; 62% black) between the ages of 8 and 12 (M = 10.01, SD = 1.50). Parents completed measures of their child's psychiatric symptoms, including SCT and depression, as well as a measure of their own psychopathology. Children completed measures assessing loneliness and depression. Both parents and children completed measures of suicide risk. White children reported greater suicide risk than nonwhite children. After controlling for demographic characteristics, loneliness, parental psychopathology, and correlated psychiatric symptoms, including both parent- and child self-reported depressive symptoms, SCT remained uniquely associated with children's suicide risk. Results were consistent across both parent and child measures of suicide risk. This multi-informant study provides strong preliminary support for an association between SCT symptoms and suicide risk in psychiatrically hospitalized children, above and beyond loneliness, depression, and demographic characteristics. Findings are discussed in the context of the interpersonal theory of suicide. Additional studies are needed to replicate and extend these findings, with a particular need for studies that examine the cognitive processes and daydreaming content of individuals displaying elevated SCT symptomatology. © 2016 Association for Child and Adolescent Mental Health.

Effect of hopelessness on the links between psychiatric symptoms and suicidality in a vulnerable population at risk of suicide.

Science.gov (United States)

Gooding, Patricia; Tarrier, Nicholas; Dunn, Graham; Shaw, Jennifer; Awenat, Yvonne; Ulph, Fiona; Pratt, Daniel

2015-12-15

The aim of this study was to examine the impact of two risk factors working together on a measure of suicide probability in a highly vulnerable group who were male prisoners identified as being at risk of self harm. The first risk factor was psychiatric symptoms, including general psychiatric symptoms and symptoms of personality disorder. The second risk factor was psychological precursors of suicidal thoughts and behaviours which were defeat, entrapment, and hopelessness. Sixty-five male prisoners from a high secure prison in NW England, UK, were recruited, all of whom were considered at risk of suicide by prison staff. General psychiatric symptoms and symptoms of personality disorders predicted the probability of suicide. Hopelessness amplified the strength of the positive relationship between general psychiatric symptoms and suicide probability. These amplification effects acted most strongly on suicidal ideation as opposed to negative self evaluations or hostility. In contrast, defeat, entrapment and hopelessness did not affect the relationship between personality disorders and suicide probability. Clinical assessments of highly vulnerable individuals, as exemplified by prisoners, should include measures of a range of general psychiatric symptoms, together with measures of psychological components, in particular perceptions of hopelessness. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Posttraumatic Growth Moderates Suicide Risk among Trauma Exposed Undergraduates

Science.gov (United States)

Sheline, Kelly T.; Rosén, Lee A.

2017-01-01

We assessed the moderating role of posttraumatic growth on the relationship between traumatic life events and suicidal ideation and behavior, suicide risk, and college adjustment. The sample of 557 college students completed questionnaires measuring their severity and number of traumatic life events, posttraumatic growth, suicidal thoughts,…

Screening youth for suicide risk in medical settings: time to ask questions.

Science.gov (United States)

Horowitz, Lisa M; Bridge, Jeffrey A; Pao, Maryland; Boudreaux, Edwin D

2014-09-01

This paper focuses on the National Action Alliance for Suicide Prevention's Research Prioritization Task Force's Aspirational Goal 2 (screening for suicide risk) as it pertains specifically to children, adolescents, and young adults. Two assumptions are forwarded: (1) strategies for screening youth for suicide risk need to be tailored developmentally; and (2) we must use instruments that were created and tested specifically for suicide risk detection and developed specifically for youth. Recommendations for shifting the current paradigm include universal suicide screening for youth in medical settings with validated instruments. Published by Elsevier Inc.

Predictive Validity of the Columbia-Suicide Severity Rating Scale for Short-Term Suicidal Behavior: A Danish Study of Adolescents at a High Risk of Suicide.

Science.gov (United States)

Conway, Paul Maurice; Erlangsen, Annette; Teasdale, Thomas William; Jakobsen, Ida Skytte; Larsen, Kim Juul

2017-07-03

Using the Columbia-Suicide Severity Rating Scale (C-SSRS), we examined the predictive and incremental predictive validity of past-month suicidal behavior and ideation for short-term suicidal behavior among adolescents at high risk of suicide. The study was conducted in 2014 on a sample of 85 adolescents (90.6% females) who participated at follow-up (85.9%) out of the 99 (49.7%) baseline respondents. All adolescents were recruited from a specialized suicide-prevention clinic in Denmark. Through multivariate logistic regression analyses, we examined whether baseline suicidal behavior predicted subsequent suicidal behavior (actual attempts and suicidal behavior of any type, including preparatory acts, aborted, interrupted and actual attempts; mean follow-up of 80.8 days, SD = 52.4). Furthermore, we examined whether suicidal ideation severity and intensity incrementally predicted suicidal behavior at follow-up over and above suicidal behavior at baseline. Actual suicide attempts at baseline strongly predicted suicide attempts at follow-up. Baseline suicidal ideation severity and intensity did not significantly predict future actual attempts over and above baseline attempts. The suicidal ideation intensity items deterrents and duration were significant predictors of subsequent actual attempts after adjustment for baseline suicide attempts and suicidal behavior of any type, respectively. Suicidal ideation severity and intensity, and the intensity items frequency, duration and deterrents, all significantly predicted any type of suicidal behavior at follow-up, also after adjusting for baseline suicidal behavior. The present study points to an incremental predictive validity of the C-SSRS suicidal ideation scales for short-term suicidal behavior of any type among high-risk adolescents.

Loss of partner and suicide risks among oldest old

DEFF Research Database (Denmark)

Erlangsen, Annette; Jeune, Bernard; Bille-Brahe, Unni

2004-01-01

BACKGROUND: while mortality among the oldest old has improved over recent decades, these improvements are not reflected in the suicide mortality of this age group. We do not know the reasons why the suicide mortality is still very high among the oldest old. OBJECTIVE: the aim is to analyse...... the impact that loss of a partner has on the suicide risks of the oldest old (80+) compared to younger age groups. SUBJECTS: the entire Danish population aged 50 during 1994-1998 (n = 1,978,527). METHODS: we applied survival analysis to calculate the changes in relative risk of suicide after a loss by using...... individual-level data. RESULTS: the majority of older persons who commit suicide are widowed, although only a relatively small proportion of the oldest old who commit suicide have experienced a recent loss of partner (men: 18%, women: 6%). In absolute terms, the oldest old men experience the highest increase...

The influence of media coverage of a celebrity suicide on subsequent suicide attempts.

Science.gov (United States)

Cheng, Andrew T A; Hawton, Keith; Chen, Tony H H; Yen, Amy M F; Chen, Chung-Ying; Chen, Lin-Chen; Teng, Po-Ren

2007-06-01

To investigate the impact of media reporting of a celebrity suicide on subsequent suicide attempts. A Poisson time series autoregression analysis was conducted to examine whether there was a significant increase in suicide attempts during the 3-week period after the start of extensive media reporting of a celebrity suicide. The reporting began on May 2, 2005, and lasted about 17 days. To investigate the influence of media reporting on suicide attempts, a structured interview was conducted with 124 suicide attempters identified from 2 counties in Mid Taiwan who had exposure to the media reporting. After controlling for seasonal variation, calendar year, temperature, and humidity, there was a marked increase in the number of suicide attempts during the 3-week period after media reporting began (adjusted relative risk = 1.55, 95% CI = 1.26 to 1.91). Among 124 suicide attempters exposed to the media reports, 23.4% reported an influence from them. There was no relationship between the attempters' ages and the age of the celebrity or the method, but male attempters had a significantly higher risk for such influence. A considerably higher risk for such influence was found among subjects with a history of suicide attempt(s) in the previous year (odds ratio = 52.3, 95% CI = 5.96 to 459.1). The extensive media reporting of the suicide of a celebrity was followed by an increase in suicide attempts. The effect was particularly marked in individuals with a recent history of a suicide attempt. The results provide further support for the need for more restrained reporting of suicides as part of suicide prevention strategies and for special vigilance for contagious effects of such reporting on people who have carried out recent suicidal acts.

Disparities in Treatment of Older Adults with Suicide Risk in the Emergency Department.

Science.gov (United States)

Arias, Sarah A; Boudreaux, Edwin D; Segal, Daniel L; Miller, Ivan; Camargo, Carlos A; Betz, Marian E

2017-10-01

We described characteristics and treatment received for older (≥60 years) vs younger (adult emergency department (ED) patients with suicide risk. Retrospective chart review. An ED with universal screening for suicide risk. Eligible charts included a random sample of adults (≥18 years) who screened positive for suicidal ideation (SI) in past 2 weeks and/or a suicide attempt (SA) within the past 6 months. Visit dates were from May 2014 to September 2016. A total of 800 charts were reviewed, with oversampling of older adults. Of the 200 older adults sampled, fewer older adults compared to younger adults (n = 600) had a chief complaint involving psychiatric behavior (53% vs 70%) or self-harm behavior (26% vs 36%). Although a higher number of older adults (93%) had documentation of current SI compared to younger adults (79%), fewer older adults (17%) reported SA in the past 2 weeks compared to younger adults (23%). Of those with a positive suicide screen who were discharged home, less than half of older adults received a mental health evaluation during their visit (42%, 95% CI 34-52) compared to 66% (95% CI 61-70) of younger adults who met the same criteria. Similarly, fewer older, than younger, adult patients with current SI/SA received referral resources (34%; 95% CI 26-43; vs 60%; 95% CI 55-65). Significantly fewer suicidal older adult patients who were discharged home received a mental health evaluation when compared to similar younger adults. These findings highlight an important area for improvement in the treatment of older adults at risk for suicide. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

The Risk of Repetition of Attempted Suicide Among Iranian Women with Psychiatric Disorders as Quantified by the Suicide Behaviors Questionnaire

Directory of Open Access Journals (Sweden)

Jalal Shakeri

2015-05-01

Full Text Available Objectives: The factors associated with repetition of attempted suicide are poorly categorized in the Iranian population. In this study, the prevalence of different psychiatric disorders among women who attempted suicide and the risk of repetition were assessed. Methods: Participants were women admitted to the Poisoning Emergency Hospital, Kermanshah University of Medical Sciences following failed suicide attempts. Psychiatric disorders were diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV symptom checklist. Risk of repetition was evaluated using the Suicide Behaviors Questionnaire-Revised (SBQ-R. Results: About 72% of individuals had a SBQ-R score >8 and were considered to be at high risk for repeated attempted suicide. Adjustment disorders were the most common psychiatric disorders (40.8%. However, the type of psychiatric disorder was not associated with the risk of repetition (p=0.320. Marital status, educational level, employment, substance use, history of suicide among family members, and motivation were not determinant factors for repetition of suicide attempt (p=0.220, 0.880, 0.220, 0.290, 0.350 and 0.270, respectively. Younger women were associated with violent methods of attempted suicide, such as self-cutting, whereas older individuals preferred consumption of poison (p<0.001. Drug overdose was more common among single and married women whereas widows or divorcees preferred self-burning (p=0.004. Conclusion: About 72% of patients with failed suicide attempts were at high risk for repeated attempts. Age, marital status, and type of psychiatric disorder were the only determinants of suicide method. Adjustment disorders were the most common psychiatric disorders among Iranian women. However, this did not predict the risk of further attempts.

A Review of Eating Disorders and Suicide Risk in Adolescence

OpenAIRE

Ida F. Dancyger; Victor M. Fornari

2005-01-01

This review examines the literature during the past 10 years about suicide risk and suicide during adolescence and young adulthood of individuals with eating disorders. Epidemiological surveys are summarized, including suicide rates, parasuicidal behaviors, associated risk factors, and comorbid psychopathology. Critical implications for the comprehensive assessment and treatment planning, including safety considerations, are discussed. Two clinical cases of women with long-standing eating dis...

Lithium levels in the public drinking water supply and risk of suicide: A pilot study.

Science.gov (United States)

Liaugaudaite, Vilma; Mickuviene, Narseta; Raskauskiene, Nijole; Naginiene, Rima; Sher, Leo

2017-09-01

Suicide is a major public health concern affecting both the society and family life. There are data indicating that higher level lithium intake with drinking water is associated with lower suicide rate. This pilot study examined the relationship between lithium levels in drinking water and suicide rates in Lithuania. Twenty-two samples from public drinking water systems were taken in 9 cities of Lithuania. The lithium concentration in these samples was determined by inductively coupled plasma mass spectrometry (ICP-MS). The suicide data were obtained from the Lithuania Database of Health Indicators, and comprised all registered suicides across all ages and gender within the 5-year period from 2009 to 2013. The study demonstrated an inverse correlation between levels of lithium (log natural transformed), number of women for 1000 men and standardized mortality rate for suicide among total study population. After adjusting for confounder (the number of women for 1000 men), the lithium level remained statistically significant in men, but not in women. Our study suggested that higher levels of lithium in public drinking water are associated with lower suicide rates in men. It might have a protective effect on the risk of suicide in men. Copyright © 2017 The Authors. Published by Elsevier GmbH.. All rights reserved.

Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population.

Science.gov (United States)

Li, Haiyan; Luo, Xinni; Ke, Xiaoyin; Dai, Qing; Zheng, Wei; Zhang, Chanjuan; Cassidy, Ryan M; Soares, Jair C; Zhang, XiangYang; Ning, Yuping

2017-01-01

Somatic complaints are often the presenting symptoms of major depressive disorder (MDD) in the outpatient context, because this may go unrecognized. It is well understood that MDD carries an increased risk of suicide. This study aimed to identify the risk factors and association with both MDD and suicidality among Han Chinese outpatients. A multicenter study was carried out in 5189 outpatient adults (≥18 years old) in four general hospitals in Guangzhou, China. The 1392 patients who had the Patient Health Questionnaire-9 (PHQ-9) score ≥ 5, indicating depressive symptoms were offered an interview with a psychiatrist by the Mini International Neuropsychiatric Interview (MINI); 819 patients consented and completed the MINI interview. MINI module B was used to assess suicidality. Stepwise binary logistic models were used to estimate the relationship between a significant risk factor and suicide or MDD. According to with or without MDD, the secondary analysis was performed using the logistic regression model for the risk of suicidility. The current prevalence of MDD and the one month prevalence of suicidality were 3.7% and 2.3% respectively. The odds ratio of suicidality in women was more than twice that in men (OR = 2.62; 95% CI 1.45-4.76). Other risk factors which were significantly associated with suicidality were: living alone, higher education, self-reported depression, getting psychiatric diagnoses (MDD, anxiety disorders, and bipolar disorders). Significant risk factors for MDD were also noticed, such as comorbid anxiety disorders, self-reported anxiety, insomnia, suicidal ideation. It's a cross-sectional study in outpatient clinics using self-report questionnaires. This study provides valuable data about the risk factors and association of MDD and suicide risk in adult outpatients in Han Chinese. Those factors allow better the employment of preventative measures.

Parent-Child Connectedness and Long-Term Risk for Suicidal Ideation in a Nationally Representative Sample of US Adolescents.

Science.gov (United States)

Kuramoto-Crawford, S Janet; Ali, Mir M; Wilcox, Holly C

2017-09-01

Few studies have addressed on the role of parent-child connectedness (PCC) on adolescents' risk for suicidal ideation from a longitudinal, developmental perspective. This study examined PCC during adolescence and risk of suicidal ideation into adulthood among a nationally representative sample of American adolescents. The study includes 13,234 adolescents aged 11-18 from the National Longitudinal Study of Adolescent to Adult Health (Add Health) who were surveyed during adolescence (1994-1995) and then again in early adulthood (2008-2009). Multinomial logistic regression estimated the association between PCC during adolescence and having ideation during the adolescence period only, in adulthood only, and in both adolescence and adulthood as compared with those without suicidal ideation. After adjusting for depressive symptoms and other parent and adolescent characteristics, adolescents in two-parent households who reported higher PCC during adolescence had lower relative risk of having ideation during adolescence alone and in both adolescence and adulthood. In mother-only households, higher mother connectedness was also associated with decreased risk of having adolescent ideation. PCC is an important modifiable target for the prevention of suicidal ideation from adolescence into adulthood.

Adolescent suicide and health risk behaviors: Rhode Island's 2007 Youth Risk Behavior Survey.

Science.gov (United States)

Jiang, Yongwen; Perry, Donald K; Hesser, Jana E

2010-05-01

Suicide is the third-leading cause of death among high school students in the U.S. This study examined the relationships among indicators of depressed mood, suicidal thoughts, suicide attempts, and demographics and risk behaviors in Rhode Island high school students. Data from Rhode Island's 2007 Youth Risk Behavior Survey were utilized for this study. The statewide sample contained 2210 randomly selected public high school students. Data were analyzed in 2008 to model for each of five depressed mood/suicide indicators using multivariable logistic regression. By examining depressed mood and suicide indicators through a multivariable approach, the strongest predictors were identified, for multiple as well as specific suicide indicators. These predictors included being female, having low grades, speaking a language other than English at home, being lesbian/gay/bisexual/unsure of sexual orientation, not going to school as a result of feeling unsafe, having been a victim of forced sexual intercourse, being a current cigarette smoker, and having a self-perception of being overweight. The strength of associations between three factors (immigrant status, feeling unsafe, and having forced sex) and suicide indicators adds new information about potential predictors of suicidal behavior in adolescents. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Childhood Maltreatment, Pathological Personality Dimensions, and Suicide Risk in Young Adults.

Science.gov (United States)

Falgares, Giorgio; Marchetti, Daniela; Manna, Giovanna; Musso, Pasquale; Oasi, Osmano; Kopala-Sibley, Daniel C; De Santis, Sandro; Verrocchio, Maria C

2018-01-01

Several studies have demonstrated that child maltreatment (psychological, physical, and sexual abuse, and neglect) may be a significant factor in the development of pathological personality traits that increase the risk for suicidal ideation and behavior from adolescence to adulthood. Currently, the challenge is to understand how different forms of early negative experiences render an individual prone to develop specific personality traits and, in turn, be more vulnerable to suicide risk. To understand the relationship between childhood maltreatment and personality dimensions in suicide risk, our study aims to explore the role of self-criticism and dependency, two different pathological personality traits, as potential mediators of the link between different types of childhood maltreatment and suicide risk in young adults. For this purpose, 306 students from three Italian public universities were recruited. We used the Italian version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q) to assess experiences of lack of care by parents (i.e., antipathy and neglect) as well as psychological and physical abuse before the age of 17 years. The Depressive Experiences Questionnaire (DEQ) was used to assess the personality dimensions of self-criticism and dependency, and the Suicide History Self-Rating Screening Scale was administered to assess suicide risk. Results revealed that lack of care and psychological abuse were significantly associated with suicide risk and this association was partially mediated by the maladaptive personality dimension of self-criticism. These findings suggest that the combined effect of specific forms of dysfunctional parental behavior during childhood and the development of rigid and dysfunctional negative personality traits may increase the risk for suicidal ideation and behavior during adulthood.

Curiosity improves coping efficacy and reduces suicidal ideation severity among military veterans at risk for suicide.

Science.gov (United States)

Denneson, Lauren M; Smolenski, Derek J; Bush, Nigel E; Dobscha, Steven K

2017-03-01

Curiosity, the tendency to engage in novel and challenging opportunities, may be an important source of resilience for those at risk for suicide. We hypothesized that curiosity would have a buffering effect against risk conferred by multiple sources of distress, whereby curiosity would be associated with reduced suicidal ideation and increased coping efficacy. As part of a larger intervention trial designed to improve coping skills and reduce suicidal ideation, 117 military veterans with suicidal ideation completed measures of curiosity and distress (perceived stress, depression, anxiety, and sleep disturbances) at baseline, and completed measures of suicidal ideation and coping efficacy (to stop negative thoughts, to enlist support from friends and family) at baseline and 3-, 6-, and 12-week follow up. Growth curve models showed that curiosity moderated the association between distress and suicidal ideation at baseline and that curiosity moderated the association between distress and increased coping efficacy to stop negative thoughts over time. Findings suggest that curiosity may buffer against the effect of heightened levels of distress on suicidal ideation and help facilitate stronger gains in coping efficacy over time. Additional work should further examine the role of curiosity as a protective factor for veterans with suicidal ideation. Published by Elsevier B.V.

[Study on the detection rate and risk factors regarding non-suicidal self-injurious behavior in middle school students].

Science.gov (United States)

Yan, Jing; Zhu, Cui-zhen; Situ, Ming-jing; DU, Na; Huang, Yi

2012-01-01

To understand the prevalence and risk factors of non-suicidal self-injury in middle school students. 1312 middle school students of Pengzhou and Santai were selected to fill in a Risky Behavior Questionnaire for Adolescence (RBQ-A), Family Environment Scale (FES), Center for Epidemiological Survey, Depression Scale (CES-D), Adolescent Self-Rating Life Events Check List (ASLEC), Social Support Scale for Adolescents (SSSA) and self-administered questionnaire. In all the research subjects, 1288 were qualified for the study in April 2011 before the risk factors for non-suicidal self-injury were identified by logistic regression. In 1288 middle school students, 22.67% had a history of non-suicidal self-injury, with 22.70% in boys and 22.64% in girls. 63.36% of students had injured themselves through variously ways, more seen in boys (26.88%) than in girls (11.36%) who cut or burnt themselves. The scores of ASLEC and CES-D in non-suicidal self-injury group appeared higher than that in the control group and the score of SSSA was found higher in the control group. The main risk factors for non-suicidal self-injuries were family conflict, depressive emotion, negative life events and receiving less social support. The prevalence of non-suicidal self-injury among middle school students in Pengzhou was high, which called for more attention.

Risk factors related to suicidal ideation and attempted suicide: comparative study of Korean and American youth.

Science.gov (United States)

Chung, Sung Suk; Joung, Kyoung Hwa

2012-12-01

Suicidal trends and related characteristics such as sociodemographic factors, psychological factors, and health behaviors can differ between countries. This study investigated the predictors of suicidal ideation and attempted suicide including health behaviors among American and Korean youth from two national representative data sets. In both countries, depression was the most predominant predictor to suicidal ideation and attempted suicide. Unique predictors of suicidal youth in each country were also found. In America, attempted suicide was predicted by poor body image, whereas in Korea attempted suicide was predicted by medical diagnosis such as asthma, concern about weight, and alcohol consumption. The value of our approach lies in the comparative analysis of analogous and unique characteristics of suicidal youths in these two huge data sets from different countries. These results should be helpful for school and mental health care providers to plan interventions for youth at risk of suicide to prevent suicidal completion in these nations.

Suicidal ideation among Métis adult men and women--associated risk and protective factors: findings from a nationally representative survey.

Science.gov (United States)

Kumar, Mohan B; Walls, Melissa; Janz, Teresa; Hutchinson, Peter; Turner, Tara; Graham, Catherine

2012-08-06

To determine the prevalence of suicidal ideation among Métis men and women (20-59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006). Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.

Suicidal ideation among Métis adult men and women - associated risk and protective factors: findings from a nationally representative survey.

Science.gov (United States)

Kumar, Mohan B; Walls, Melissa; Janz, Teresa; Hutchinson, Peter; Turner, Tara; Graham, Catherine

2012-01-01

To determine the prevalence of suicidal ideation among Métis men and women (20-59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006). Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.

MYPLAN - A Mobile Phone Application for Supporting People at Risk of Suicide

DEFF Research Database (Denmark)

Skovgaard Larsen, Jette L; Frandsen, Hanne; Erlangsen, Annette

2016-01-01

describes MYPLAN, a mobile phone application designed to support people at risk of suicide by letting them create a safety plan. METHOD: MYPLAN was developed in collaboration with clinical psychiatric staff at Danish suicide preventive clinics. The mobile application lets the user create an individualized......BACKGROUND: Safety plans have been suggested as an intervention for people at risk of suicide. Given the impulsive character of suicidal ideation, a safety plan in the format of a mobile phone application is likely to be more available and useful than traditional paper versions. AIMS: The study......,000 times. Users at risk of suicide as well as clinical staff have provided positive feedback on the mobile application. CONCLUSION: Support via mobile phone applications might be particularly useful for younger age groups at risk of suicide as well as in areas or countries where support options are lacking...

[Evaluation of Suicide Risk Levels in Hospitals: Validity and Reliability Tests].

Science.gov (United States)

Macagnino, Sandro; Steinert, Tilman; Uhlmann, Carmen

2018-05-01

Examination of in-hospital suicide risk levels concerning their validity and their reliability. The internal suicide risk levels were evaluated in a cross sectional study of in 163 inpatients. A reliability check was performed via determining interrater-reliability of senior physician, therapist and the responsible nurse. Within the scope of the validity check, we conducted analyses of criterion validity and construct validity. For the total sample an "acceptable" to "good" interrater-reliability (Kendalls W = .77) of suicide risk levels were obtained. Schizophrenic disorders showed the lowest values, for personality disorders we found the highest level of interrater-reliability. When examining the criterion validity, Item-9 of the BDI-II is substantial correlated to our suicide risk levels (ρ m  = .54, p validity check, affective disorders showed the highest correlation (ρ = .77), compatible also with "convergent validity". They differed with schizophrenic disorders which showed the least concordance (ρ = .43). In-hospital suicide risk levels may represent an important contribution to the assessment of suicidal behavior of inpatients experiencing psychiatric treatment due to their overall good validity and reliability. © Georg Thieme Verlag KG Stuttgart · New York.

Examining Physical and Sexual Abuse Histories as Correlates of Suicide Risk Among Firefighters.

Science.gov (United States)

Hom, Melanie A; Matheny, Natalie L; Stanley, Ian H; Rogers, Megan L; Cougle, Jesse R; Joiner, Thomas E

2017-12-01

Research indicates that physical and sexual abuse are associated with increased suicide risk; however, these associations have not been investigated among firefighters-an occupational group that has been shown to be at elevated suicide risk. This study examined whether physical and sexual abuse histories are associated with (a) career suicide ideation, plans, and attempts; and (b) current suicide risk (controlling for theoretically relevant symptoms) in this occupational group. A sample of 929 U.S. firefighters completed self-report surveys that assessed lifetime history of physical and sexual abuse; career suicide ideation, plans, and attempts; current suicide risk; and theoretically relevant symptoms. Logistic regression analyses revealed that individuals who reported a history of physical abuse were significantly more likely to report career suicide ideation, adjusted odds ratio [AOR] = 6.12, plans, AOR = 13.05, and attempts, AOR = 23.81, than those who did not. A similar pattern of findings emerged for individuals who reported a sexual abuse history, AORs = 7.83, 18.35, and 29.58 respectively. Linear regression analyses revealed that physical and sexual abuse histories each significantly predicted current suicide risk, even after controlling for theoretically relevant symptoms and demographics, pr 2 = .07 and .06, respectively. Firefighters with a history of physical and/or sexual abuse may be at increased risk for suicidal thoughts and behaviors. A history of physical and sexual abuse were each significantly correlated with current suicide risk in this population, even after accounting for the effects of theoretically relevant symptoms. Thus, when conceptualizing suicide risk among firefighters, factors not necessarily related to one's firefighter career should be considered. Copyright © 2017 International Society for Traumatic Stress Studies.

Risk factors for suicide in schizophrenia: systematic review and clinical recommendations.

Science.gov (United States)

Popovic, D; Benabarre, A; Crespo, J M; Goikolea, J M; González-Pinto, A; Gutiérrez-Rojas, L; Montes, J M; Vieta, E

2014-12-01

To identify risk factors associated with suicide of patients with schizophrenia and provide clinical recommendations, which integrate research findings into a consensus based on clinical experience and evidence. A task force formed of experts and clinicians iteratively developed consensus through serial revisions using the Delphi method. Initial survey items were based on systematic literature review published up to June 2013. Various risk factors were reported to be implicated in suicide in schizophrenia. Our findings indicate that suicide risk in schizophrenia is mainly related to affective symptoms, history of a suicide attempt and number of psychiatric admissions. Other risk factors identified are given by younger age, closeness to illness onset, older age at illness onset, male sex, substance abuse and period during or following psychiatric discharge. Integrating the evidence and the experience of the task force members, a consensus was reached on 14 clinical recommendations. Identification of risk factors for suicide in individuals diagnosed with schizophrenia is imperative to improve clinical management and develop strategies to reduce the incidence of suicide in this population. This study provides the critical overview of available data and clinical recommendations on recognition and management of the above-mentioned risk factors. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Suicidal changes in patients with first episode psychosis: clinical predictors of increasing suicidal tendency in the early treatment phase

DEFF Research Database (Denmark)

Madsen, Trine; Nordentoft, Merete

2012-01-01

significantly predicted developing a higher suicidal tendency, whereas a one-point increase score on delusions was preventive of this. Feeling hopeless was highly associated with suicide attempt in those with earlier suicide attempt. Conclusion: The risk of suicide attempt did not differ between patient groups......Aim: To identify predictors for developing a higher suicidal tendency during treatment of first-episode psychosis. Methods: In a prospective follow-up study, we examined clinical factors collected at treatment initiation as predictors for developing a higher suicidal tendency among patients...... in the first year of treatment of psychosis. Patients were grouped and ranked according to their highest suicidal tendency in the year before treatment: not suicidal, suicidal thoughts, suicidal plans or suicide attempt(s). Predictors for becoming more suicidal in the first year of treatment were examined...

Validation of the Beck Hopelessness Scale in patients with suicide risk.

Science.gov (United States)

Rueda-Jaimes, German Eduardo; Castro-Rueda, Vanessa Alexandra; Rangel-Martínez-Villalba, Andrés Mauricio; Moreno-Quijano, Catalina; Martinez-Salazar, Gustavo Adolfo; Camacho, Paul Anthony

Only a few scales have been validated in Spanish for the assessment of suicide risk, and none of them have achieved predictive validity. To determine the validity and reliability of the Beck Hopelessness Scale in patients with suicide risk attending the specialist clinic. The Beck Hopelessness Scale, reasons for living inventory, and the suicide behaviour questionnaire were applied in patients with suicide risk attending the psychiatric clinic and the emergency department. A new assessment was made 30 days later to determine the predictive validity of suicide or suicide attempt. The evaluation included a total of 244 patients, with a mean age of 30.7±13.2 years, and the majority were women. The internal consistency was .9 (Kuder-Richardson formula 20). Four dimensions were found which accounted for 50% of the variance. It was positively correlated with the suicidal behaviour questionnaire (Spearman .48, P<.001), number of suicide attempts (Spearman .25, P<.001), severity of suicide risk (Spearman .23, P<.001). The correlation with the reasons for living inventory was negative (Spearman -.52, P<.001). With a cut-off ≥12, the negative predictive value was 98.4% (95% CI: 94.2-99.8), and the positive predictive value was 14.8% (95% CI: 6.6-27.1). The Beck Hopelessness Scale in Colombian patients with suicidality shows results similar to the original version, with adequate reliability and moderate concurrent and predictive validity. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Protective effects of self-esteem and family support on suicide risk behaviors among at-risk adolescents.

Science.gov (United States)

Sharaf, Amira Y; Thompson, Elaine A; Walsh, Elaine

2009-08-01

If and how family support and self-esteem might interact to protect against adolescent suicide risk is not well understood. Hierarchical multiple regression was used to examine the moderating effect of family support on the relationship between self-esteem and suicide risk behaviors among potential high school dropouts (N = 849), using questionnaires and in-depth assessment interviews. Family support moderated the impact of self-esteem on suicide risk; the ameliorating effect of self-esteem was stronger among adolescents with low versus high family support. Self-esteem influences adolescent suicide risk behaviors for youth with low as well as high family support. Interventions designed to strengthen both self-esteem and support resources are appropriate.

[Self-esteem, resilience, locus of control and suicide risk in nursing students].

Science.gov (United States)

Montes-Hidalgo, Javier; Tomás-Sábado, Joaquín

2016-01-01

Assuming that suicide is the result of a series of factors acting cumulatively, the aim of this paper was to study the association of self-esteem, resilience and locus of control with the risk of suicidal behavior in a sample of nursing students. Observational, cross-sectional and correlational study with 186 nursing students who answered a questionnaire that contained, in addition to demographic data, the Spanish forms of Rosenberg self-esteem scale, the brief resilient coping scale, the Plutchik scale of suicide risk and the Rotter's internal-external locus of control scale. The scores of males and females are very similar on all scales except Locus of Control, where a significantly greater tendency of females attributed to external control. 6.4% of students have scores indicating suicide risk. Suicide risk scores correlated negatively and significantly with self-esteem and resilience and positively with locus of control. The multiple linear regression analysis identified self-esteem as the main variable related to suicide risk. The results suggest that students who have low self-esteem, have difficulty in adjusting to adverse situations and tend to the external attribution of the consequences of their actions may have an increased risk of suicidal behavior. Furthermore, the identification of self-esteem as the important factor involved in suicide risk can help in designing prevention programs. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Suicidality in chronic pain: predictors of suicidal ideation in fibromyalgia.

Science.gov (United States)

Triñanes, Yolanda; González-Villar, Alberto; Gómez-Perretta, Claudio; Carrillo-de-la-Peña, María T

2015-04-01

Fibromyalgia (FM) has been associated with a higher prevalence of suicidal behavior. Nevertheless, much remains unknown about suicide risk factors for this chronic pain disorder. In the present study, the relationship of suicidal ideation in FM with a number of sociodemographic, clinical, and psychological variables was analyzed. One hundred seventeen women with Fibromyalgia were assessed. The procedure included the exploration of sleep problems (Pittsburgh Sleep Quality Index), depression (Beck Depression Inventory [BDI]), health-related quality of life (SF-36 and Fibromyalgia Impact Questionnaire), the core symptoms of FM (visual analogue scales), and algometry of tender points. Suicidal ideation was evaluated by item 9 of the BDI. Patients with presence vs. absence of suicidal ideation were compared in all the variables studied. The prevalence of suicidal ideation among FM patients was 32.5%. Significant differences between patients with vs. without suicidal ideas emerged mainly for the various indices of depression. Patients with suicidal ideation also reported higher levels of anxiety, more day dysfunction due to sleepiness and more limitations due to emotional and physical problems. Logistic regression analysis revealed that cognitive depression symptoms such as BDI Self-Blame cluster are the more closely related to suicide ideation. The presence of suicidal ideation in FM patients is closely related to comorbid depression, anxiety and to a higher impact of the disease in daily life. © 2014 World Institute of Pain.

Risk for suicide and risk for violence: a case for separating the current violence diagnoses.

Science.gov (United States)

Smith, J E; Early, J A; Green, P T; Lauck, D L; Oblaczynski, C; Smochek, M R; Wright, G

1997-01-01

To identify accurate descriptive terms for risk for violence and risk for suicide and to provide operational definitions for these terms The Delphi technique, with two rounds, was used to differentiate the operational definitions that represent risk for suicide from those that represent risk for violence. The expert panel consisted of 23 healthcare professionals with a minimum of a master's degree. In addition to the expert panel, a control group (N = 11) participated to assess content validity. Thirty-six definitions were agreed upon for suicide, 39 for violence. These definitions represent the basic distinctions between the two behavioral manifestations.

Time trend by region of suicides and suicidal thoughts among Greenland Inuit

Directory of Open Access Journals (Sweden)

Peter Bjerregaard

2015-02-01

Full Text Available Background: Suicides remain a major public health problem in Greenland. Their increase coincides with the modernization since 1950. Serious suicidal thoughts are reported by a significant proportion of participants in countrywide surveys. Objective: To analyze the time trend by region of suicides and suicidal thoughts among the Inuit in Greenland. Design: Data included the Greenland registry of causes of death for 1970–2011 and 2 cross-sectional health surveys carried out in 1993–1994 and 2005–2010 with 1,580 and 3,102 Inuit participants, respectively. Results: Suicide rates were higher among men than women while the prevalence of suicidal thoughts was higher among women. Suicide rates for men and women together increased from 1960 to 1980 and have remained around 100 per 100,000 person-years since then. The regional pattern of time trend for suicide rates varied with an early peak in the capital, a continued increase to very high rates in remote East and North Greenland and a slow increase in villages relative to towns on the West Coast. Suicidal thoughts followed the regional pattern for completed suicides. Especially for women there was a noticeable increasing trend in the villages. The relative risk for suicide was highest among those who reported suicidal thoughts, but most suicides happened outside this high-risk group. Conclusion: Suicide rates and the prevalence of suicidal thoughts remain high in Greenland but different regional trends point towards an increased marginalization between towns on the central West Coast, villages and East and North Greenland. Different temporal patterns call for different regional strategies of prevention.

Clinical and epidemiological aspects of suicide in patients with schizophrenia.

Science.gov (United States)

Gómez-Durán, Esperanza L; Martin-Fumadó, Carles; Hurtado-Ruíz, Gemma

2012-01-01

Suicide is a major cause of death among patients with schizophrenia. Suicide phenomenon's characterization is the best available approach for improved prediction and prevention of suicide. Patients at high risk for suicide need a more intensive monitoring and intervention. The aim of this review is to characterize, from a clinical-epidemiological point of view, the phenomenon of completed suicide in schizophrenia. We performed a systematic review to identify the most relevant studies published between 1994 and 2009, by searching on the international database Medline and among previous reviews references. Patients with schizophrenia experience higher mortality rates than the general population, especially due to the suicide. Most patients with schizophrenia who commit suicide are likely to be young and males, with a higher risk around illness onset and hospitalization periods. Previous suicide attempts are an important risk factor for completed suicide. Suicide risk is associated to psychotic positive symptoms, affective symptoms, depression and substance abuse. Treatment adherence is as protective factor. Patients with schizophrenia are likely to commit suicide by violent means. Suicide prevention should focus on treating affective symptoms and syndromes, improving treatment compliance and providing intensive monitoring to those patients at high risk of suicide, specially around hospitalization periods. Further studies are needed to clarify differential characteristics between suicide behaviour and completed suicide.

Suicide and Suicidal Thoughts

Science.gov (United States)

... the best way to identify risk. Murder and suicide In rare cases, people who are suicidal are ... access to a firearm Starting antidepressants and increased suicide risk Most antidepressants are generally safe, but the ...

[Study on high-risk behaviour and suicide associated risk factors related to HIV/AIDS among gay or bisexual men].

Science.gov (United States)

Chen, Hong-quan; Li, Yang; Zhang, Bei-chuan; Li, Xiu-fang

2011-10-01

Characteristics on AIDS high-risk behaviors in gay or bisexual men with suicide ideas were explored and analyzed. A cross-sectional survey was conducted with the snowball sampling method adopted. Subjects with suicide ideas were collected from responses to the valid questionnaires and subjects with no suicide ideas were collected from the age comparable men. The overall rate of gays or bisexuals with suicide ideas was 20.2% in this survey. The attitude for homogeneity and marital status among the unmarried was more than that among the comparable group (P sexual harassment, bleeding during sexual intercourse in the last year, coitus with unfamiliar same-sex partners in cities, suffering from adult same-sex sexual abuse before the age of 16, having had sexual abuse and abusive behavior, having had active or passive anal kiss, having had active or passive coitus with fingers, alcohol consumption weekly at least once or more, hurt by gays because of attitude and/or same-sex sexual activity and hurt by heterosexual men because of attitude and/or same-sex sexual activity were significantly higher in gays and bisexual men with suicide ideas than those without (P men (Waldχ(2) = 5.835, P = 0.016) due to attitude on homosexual activity appear to be the risk factors causing the suicide ideas. Reducing the social discrimination and harm towards gays and bisexual men could reduce the occurrence of the suicide ideas and have a positive effect on curbing the prevalence of AIDS.

Maternal depression and suicide at immediate prenatal and early postpartum periods and psychosocial risk factors.

Science.gov (United States)

Shi, Peixia; Ren, Hui; Li, Hong; Dai, Qin

2018-03-01

Maternal depression has been intensively explored; however, less attention has been paid to maternal suicide. No studies to date have observed maternal depression and suicide at immediate prenatal and early postpartum stages. In total, 213 Chinese women were recruited in hospitals after they were admitted for childbirth. All completed a short-term longitudinal survey at perinatal stages. Women reported lower depression scores (6.65) and higher suicidal ideation incidence (11.74%) after childbirth. Prenatal depression raised the possibility of prenatal suicidal ideation, while prenatal depression and suicidal ideation increased postpartum depression and suicidal ideation. At immediate prenatal stage, marital satisfaction protected women from depression, while miscarriage experiences and self-esteem increased the risk. At early postpartum stage, in contrast, being first-time mother, marital satisfaction, and harmony with mother-in-law prevented them from depression. Our study is among the first to confirm that women have decreased depression but increased suicidal ideation at early postpartum, and a causal relationship between them, which are worthy of public attention. Potential protective (marital satisfaction, being first-time mother, and harmony with mother-in-law) or risk factors (miscarriage experiences and self-esteem) of maternal depression and suicidal ideation are identified at perinatal stages. This offers reliable guidance for clinical practice of health care. Copyright © 2018 Elsevier B.V. All rights reserved.

Suicide risk among young children after the Great East Japan Earthquake: A follow-up study.

Science.gov (United States)

Fujiwara, Takeo; Yagi, Junko; Homma, Hiroaki; Mashiko, Hirobumi; Nagao, Keizo; Okuyama, Makiko

2017-07-01

On 11 March 2011, the Great East Japan Earthquake and subsequent tsunami hit East Japan. We aim to investigate the impact of trauma experiences related to the earthquake on suicide risk among young children, stratified by child sex. Participants at baseline were children who were exposed to the 2011 disaster at preschool age (affected area, n=198; unaffected area, n=82, total n=280). From July 2013 to May 2014, suicide risk was assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a follow-up interview conducted by a child psychiatrist or psychologist (N=210, follow-up rate: 75%). Among young girls in the affected area, 12 out of 65 (18.5%) showed suicidal ideation, which is significantly higher than girls in the unaffected area (4.7%, p for chi-square=0.036). In the multivariate model adjusted for potential confounders and mediators, the odds ratio for 4 or more trauma experiences related to the earthquake was 5.74 (95% confidence interval: 0.83-39.6, p=0.076) compared to no trauma experience related to the earthquake. Among young boys, trauma exposure was not associated with suicidal ideation. Our findings showed that young girls who experienced earthquake-related trauma at preschool age had a higher suicidal ideation 3 years after the earthquake. Copyright © 2017. Published by Elsevier B.V.

Risk of Suicide and Dysfunctional Patterns of Personality among Bereaved Substance Users

Directory of Open Access Journals (Sweden)

Laura Masferrer

2017-03-01

Full Text Available Background: Research has shown that suicide is a phenomenon highly present among the drug dependent population. Different studies have demonstrated an upraised level of comorbidity between personality disorders (PD and substance use disorders (SUD. This study aimed to describe which PDs are more frequent among those patients with a risk of suicide. Methods: The study was based on a consecutive non-probabilistic convenience sample of 196 bereaved patients attended to in a Public Addiction Center in Girona (Spain. Sociodemographic data, as well as suicide and drug related characteristics were recorded. The risk of suicide was assessed with the Spanish version of “Risk of suicide”. Personality disorders were measured with the Spanish version of Millon Multiaxial Clinical Inventory. Results: The PDs more associated with the presence of risk of suicide were depressive, avoidant, schizotypal and borderline disorders. However, the histrionic, narcissistic and compulsive PDs are inversely associated with risk of suicide even though the narcissistic scale had no statistical correlation. Conclusions: The risk of suicide is a significant factor to take into account related to patients with SUD and especially with the presence of specific PDs. These findings underline the importance of diagnosing and treating rigorously patients with SUD.

Suicidal ideation among Malaysian adolescents.

Science.gov (United States)

Ahmad, NoorAni; Cheong, Siew Man; Ibrahim, Nurashikin; Rosman, Azriman

2014-09-01

Adolescence is the time of greatest risk for the first onset of suicidal behaviors. This study aimed to identify the risk and protective factors associated with suicidal ideation among Malaysian adolescents. Data from the 2012 Malaysia Global School-based Student Health Survey, a nationwide study using a 2-stage cluster sampling design, were analyzed. The survey used a self-administered validated bilingual questionnaire and the Depression Anxiety and Stress Scale. The prevalence of suicidal ideation was 7.9%. Analysis revealed that suicidal ideation was positively associated with depression, anxiety, stress, substance use, being bullied, and being abused at home, either physically or verbally. In addition, suicidal ideation was significantly higher among females and among the Indians and Chinese. Having close friends and married parents were strongly protective against suicidal ideation. Understanding the risk and protective factors is important in providing comprehensive management for suicidal ideation. © 2014 APJPH.

Risk Factors for Suicide Attempt in Drug Abusers

OpenAIRE

farideh faraji; Neda Kakayi; Mohammad Kazem Atef Vahid; Ahmad Sohraby; Samira Purghorbani

2015-01-01

Objective: The present study was conducted to identify risk and prediction factors of suicide attempts among drug abusers. Method: This causal-comparative study was conducted on 91 drug abusers that included 42 male and female suicide attempters and 49 male and female counterparts. Millon multi-axial personality inventory-II (MCMI-II), Dass-42 (depression, anxiety, stress), and coping styles inventory were used for data collection purposes. Results: The highest rate of suicide attempt was fou...

Body dissatisfaction and suicidal ideation among psychiatric inpatients with eating disorders.

Science.gov (United States)

Rufino, Katrina A; Viswanath, Humsini; Wagner, Rebecca; Patriquin, Michelle A

2018-04-06

The current study the relationship between eating disorders (EDs) and suicidal ideation and suicide attempt in adult inpatients. In particular, the present study investigated one potential mechanism, body dissatisfaction (BD), which may contribute to increased risk for suicide in adult ED patients. A sample of 432 psychiatric inpatients ranging from 18 to 65 years of age participated in the current study. Findings indicated that patients who have higher levels of BD also had higher levels of passive and active suicidal ideation and previous suicide attempts. Higher levels of BD were also related to increased suicidal ideation after controlling for depression and emotion dysregulation. Although additional risk factors for suicide should be investigated in adults with EDs, this study provides evidence regarding the relationship between BD and risk for suicide ideation and attempt. Copyright © 2018 Elsevier Inc. All rights reserved.

Traumatic Stress Interacts With Bipolar Disorder Genetic Risk to Increase Risk for Suicide Attempts.

Science.gov (United States)

Wilcox, Holly C; Fullerton, Janice M; Glowinski, Anne L; Benke, Kelly; Kamali, Masoud; Hulvershorn, Leslie A; Stapp, Emma K; Edenberg, Howard J; Roberts, Gloria M P; Ghaziuddin, Neera; Fisher, Carrie; Brucksch, Christine; Frankland, Andrew; Toma, Claudio; Shaw, Alex D; Kastelic, Elizabeth; Miller, Leslie; McInnis, Melvin G; Mitchell, Philip B; Nurnberger, John I

2017-12-01

Bipolar disorder (BD) is one of the most heritable psychiatric conditions and is associated with high suicide risk. To explore the reasons for this link, this study examined the interaction between traumatic stress and BD polygenic risk score in relation to suicidal ideation, suicide attempt, and nonsuicidal self-injury (NSSI) in adolescent and young adult offspring and relatives of persons with BD (BD-relatives) compared with adolescent and young adult offspring of individuals without psychiatric disorders (controls). Data were collected from 4 sites in the United States and 1 site in Australia from 2006 through 2012. Generalized estimating equation models were used to compare rates of ideation, attempts, and NSSI between BD-relatives (n = 307) and controls (n = 166) and to determine the contribution of demographic factors, traumatic stress exposure, lifetime mood or substance (alcohol/drug) use disorders, and BD polygenic risk score. After adjusting for demographic characteristics and mood and substance use disorders, BD-relatives were at increased risk for suicidal ideation and attempts but not for NSSI. Independent of BD-relative versus control status, demographic factors, or mood and substance use disorders, exposure to trauma within the past year (including bullying, sexual abuse, and domestic violence) was associated with suicide attempts (p = .014), and BD polygenic risk score was marginally associated with attempts (p = .061). Importantly, the interaction between BD polygenic risk score and traumatic event exposures was significantly associated with attempts, independent of demographics, relative versus control status, and mood and substance use disorders (p = .041). BD-relatives are at increased risk for suicide attempts and ideation, especially if they are exposed to trauma and have evidence of increased genetic vulnerability. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Risk Factors and Social Background Associated with Suicide in Japan: A Review.

Science.gov (United States)

Onishi, Kiichiro

2015-07-01

This study examines, from multiple perspectives, the risk factors associated with, and the social background of, individuals committing suicide in Japan. Effective suicide prevention measures are also proposed. An analysis of the risk factors for suicide, including the social background of suicide victims, suicide statistics, municipality surveys, interview surveys with bereaved families, mental health surveys, occupational injury inspections, and social resources available to victims, was conducted in the present study. Histories of both mental illnesses (especially depression) and previous suicide attempts are high-risk factors for suicide. Abuse and experience of violence were the remote causes of suicide. On average, more than three crisis factors were present prior to suicide. For example, overwork, problems with human relations, physical/mental disease, and poverty could form a chain that leads to suicide, regardless of gender. More than 40% of suicide attempts were the result of prescription medication overdose. Overall, 70-90% of suicide victims had medical treatment or an expert consultation before death. Staff and financial backing for voluntary telephone consultation were insufficient. Meanwhile, psychiatric social workers could not provide adequate services. Help seeking is the basis for suicide prevention. In addition to medication management and reducing work hours, communication with caregivers and healthcare providers as well as intervention for the prevention and treatment of mental illness are essential to suicide prevention. Psychotherapy by clinical psychologists is highly recommended. Active placement of psychiatric social workers for telephone consultations and for emergency hospitals' staff at the expense of the government will reduce suicides, suicide attempts, and the human and financial burden on hospitals.

Suicide among Arab-Americans.

Directory of Open Access Journals (Sweden)

Abdulrahman M El-Sayed

2011-02-01

Full Text Available Arab-American (AA populations in the US are exposed to discrimination and acculturative stress-two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US.ICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC, the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12% and women (16%.Suicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans.

Suicide among Arab-Americans.

Science.gov (United States)

El-Sayed, Abdulrahman M; Tracy, Melissa; Scarborough, Peter; Galea, Sandro

2011-02-17

Arab-American (AA) populations in the US are exposed to discrimination and acculturative stress-two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US. ICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC), the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12%) and women (16%). Suicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans.

Rural and urban suicide in South Korea.

Science.gov (United States)

Park, B C Ben; Lester, David

2012-10-01

Suicide rates in 2005 in South Korea were higher in rural areas than in urban areas. Those in rural areas more often used pesticides and chemicals as a method for suicide, and there was a greater proportion of men and the elderly, both groups at higher risk for suicide in South Korea. These three factors may account for the high rural suicide rate in South Korea.

Suicidal behavior and assisted suicide in dementia.

Science.gov (United States)

Draper, Brian M

2015-10-01

Concerns about suicide risk in people with dementia have been increasing in recent years along with a discourse about rational suicide and assisted suicide. A systematic narrative literature review of suicidal behavior and assisted suicide in persons with dementia. Most studies that have examined the spectrum of suicidal ideation, attempted suicide and suicide in dementia have methodological limitations but the overall suicide risk does not appear to be increased. When suicidal behavior does occur, common themes include the presence of psychiatric comorbidity, mainly depression; occurrence early in the dementia course with preserved insight and capacity; and an increased risk in younger people. The emerging discourse on rational and assisted suicide has been spurred by early and pre-symptomatic diagnosis and poses a number of ethical challenges for clinicians including the role of proxy decision-makers. Although dementia might not confer a significant overall risk for suicidal behavior, clinicians still need to consider the potential for suicide in vulnerable individuals particularly early in the dementia course.

Impact of disability status on suicide risks in South Korea: Analysis of National Health Insurance cohort data from 2003 to 2013.

Science.gov (United States)

Lee, Sang-Uk; Roh, Sungwon; Kim, Young-Eun; Park, Jong-Ik; Jeon, Boyoung; Oh, In-Hwan

2017-01-01

The elevated risk of suicide in people with disability has been suggested in the previous studies; however, the majority of study results have been limited to specific disability types, and there is a lack of research comparing the risk of suicide in people with disability in general. To examine the hazard ratio of suicide according to the presence and the types of disability and identify patterns in the results. In this study, we used National Health Insurance Service-National Sample Cohort data on 990,598 people, and performed analysis on the cause of death from 2003 through 2013. A Cox proportional hazard model was used to estimate the hazard ratio of suicide associated with disability and its types. The hazard ratio of suicide among people with disability was 1.9-folds higher compared to people without disability. The risk of suicide among different disability types was higher in mental disorder, renal failure, brain injury and physical disability. The hazard ratio of suicide in people with disability was not varied by income. The time to death by suicide for people with disability from the onset of their disability was 39.8 months on average. Our findings suggest that when the government plans suicide prevention policies, early and additional interventions specific to people with disability are needed. Disability due to mental disorder, renal failure should be given priority. Copyright © 2016 Elsevier Inc. All rights reserved.

Suicidal ideation among Métis adult men and women – associated risk and protective factors: findings from a nationally representative survey

Directory of Open Access Journals (Sweden)

Mohan B. Kumar

2012-08-01

Full Text Available Objective. To determine the prevalence of suicidal ideation among Métis men and women (20–59 years and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006. Study design. Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Results. Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively. Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. Conclusion. The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.

Suicidal ideation among Métis adult men and women – associated risk and protective factors: findings from a nationally representative survey

Science.gov (United States)

Kumar, Mohan B.; Walls, Melissa; Janz, Teresa; Hutchinson, Peter; Turner, Tara; Graham, Catherine

2012-01-01

Objective To determine the prevalence of suicidal ideation among Métis men and women (20–59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006). Study design Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Results Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. Conclusion The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation. PMID:22901287

Suicide risk among Thai illicit drug users with and without mental/alcohol use disorders

Science.gov (United States)

Kittirattanapaiboon, Phunnapa; Suttajit, Sirijit; Junsirimongkol, Boonsiri; Likhitsathian, Surinporn; Srisurapanont, Manit

2014-01-01

Background It is not yet known if the increased risk of suicide in substance abusers is caused by the causal and/or coexisting relationship between substance use and psychiatric disorders. This study was designed to estimate the suicide risk among individuals with illicit drug use alone, illicit drug users with mental disorders, and illicit drug users with alcohol use disorders. Methods Subjects were participants of the 2008 Thai National Mental Health Survey. They were asked for their illicit drug use in the past year. The Mini International Neuropsychiatric Interview (MINI), current suicidality (1 month prior to assessment), mood episodes, anxiety disorders, psychotic disorders, and alcohol use disorders were used for assessing mental/alcohol use disorders. A score of 1 or more for the MINI–Suicidality module was defined as the presence of suicide risk. Results Of the total 17,140 respondents, 537 currently used illicit drugs, while 1,194 respondents had a suicide risk. Common illicit drugs were kratom (59%) and (meth)amphetamine (24%). Compared with 16,603 Thais without illicit drug use, the illicit drug users with or without mental/alcohol use disorders (n=537) had an increased risk of suicide (adjusted odds ratio [OR], 95% confidence interval [CI] =2.09, 1.55–2.81). While those who used illicit drugs alone (no mental/alcohol use disorder) (n=348) had no increased risk of suicide (adjusted OR, 95% CI =1.04, 0.66–1.65), the illicit drug users with mental or alcohol use disorders (n=27 and n=162, respectively) had significantly increased risk of suicide (adjusted ORs, 95% CIs =14.06, 6.50–30.3 and 3.14, 1.98–4.99, respectively). Conclusion A key limitation of this study was the combined suicidal behaviors as a suicidality risk. Mental or alcohol use disorders found in this population actually increased the suicide risk. These findings support the coexisting relationship that mental and alcohol use disorders play a vital role in increasing the suicide

Individual- and Structural-Level Risk Factors for Suicide Attempts Among Transgender Adults.

Science.gov (United States)

Perez-Brumer, Amaya; Hatzenbuehler, Mark L; Oldenburg, Catherine E; Bockting, Walter

2015-01-01

This study assessed individual (ie, internalized transphobia) and structural forms of stigma as risk factors for suicide attempts among transgender adults. Internalized transphobia was assessed through a 26-item scale including four dimensions: pride, passing, alienation, and shame. State-level structural stigma was operationalized as a composite index, including density of same-sex couples; proportion of Gay-Straight Alliances per public high school; 5 policies related to sexual orientation discrimination; and aggregated public opinion toward homosexuality. Multivariable logistic generalized estimating equation models assessed associations of interest among an online sample of transgender adults (N = 1,229) representing 48 states and the District of Columbia. Lower levels of structural stigma were associated with fewer lifetime suicide attempts (AOR 0.96, 95% CI 0.92-0.997), and a higher score on the internalized transphobia scale was associated with greater lifetime suicide attempts (AOR 1.18, 95% CI 1.04-1.33). Addressing stigma at multiple levels is necessary to reduce the vulnerability of suicide attempts among transgender adults.

An Investigation of Suicide Risk and Counseling Participation among College Students

Science.gov (United States)

Reis, Carli H.

2010-01-01

College suicide research consistently shows that fewer than 20 percent of college students who commit suicide were clients at their university counseling centers. Counseling participation is a known protective factor from suicide. However, to date, few studies have examined the differences between college students at risk of suicide who…

Community care of individuals at risk of suicide: the Life Promotion Clinic model

Directory of Open Access Journals (Sweden)

Kairi Kolves

2013-09-01

Full Text Available Assistance to suicidal patients is problematic both at the hospital and community care level. Inadequacy of facilities, pressured personnel, long waiting time, and professional and social stigmatization are just some of the many issues that interfere with successful treatment. The goal of this paper is to present the functioning of the Life Promotion Clinic (LPC, Australia, and describe its users. The LPC is the first specialized outpatient service in Australia dedicated to the treatment of individuals with suicidal thoughts and behaviors. A description of the service and characteristics of its clients (demographic, psychopathology, risk of suicide are herein presented. Data were collected for 63 male and 175 female patients who attended the LPC over a three-year period. Patients were mostly single females, aged up to 44 years, poorly educated, unemployed or on a pension/benefit. The majority of patients reported at least one suicide attempt, severe depression and anxiety scores, moderate-severe feelings of hopelessness, and high impulsiveness scores. Compared to females, male patients presented with more active desire to kill themselves and higher level of suicidal ideation. We can conclude that establishing a specialist service for treatment of individuals at increased risk for suicide requires consideration of both patient and clinicians needs. The LPC presents an innovative model of community service, capable of engaging patients with serious mental health issues, while making the service accessible to people from various social categories.

Chronotype differences in suicidal behavior and impulsivity among suicide attempters.

Science.gov (United States)

Selvi, Yavuz; Aydin, Adem; Atli, Abdullah; Boysan, Murat; Selvi, Fatih; Besiroglu, Lutfullah

2011-03-01

Morning- and evening-type individuals differ on a number of psychological and biological variables. There has been increasing interest in the relationship between chronotype and personality traits. The aim of this study was to investigate the relationship between impulsivity and chronotype in suicide attempters. Eighty-nine suicide attempters were included in the study, and systematic information on suicide attempts was recorded. The Morningness-Eveningness Questionnaire was applied to determine chronotype, and attempter impulsivity was measured by the total score of the Barratt Impulsiveness Scale. Significant differences between chronotype and impulsivity scores were found. Evening-type subjects reported significantly higher impulsivity scores than both neither- and morning-types. A significant association between chronotype and type of suicide attempt was detected. The largest proportion of violent suicide attempters were evening-type subjects. Violent suicide attempters also reported significantly higher impulsivity scores than nonviolent attempters. Previous studies have pointed out possible relations between eveningness and impulsivity. Current findings suggest that eveningness may be a risk factor for violent suicide attempts by increasing impulsivity.

Identification of Suicide Risk Among Rural Youth: Implications for the Use of HEADSS

Science.gov (United States)

Biddle, Virginia Sue; Sekula, L. Kathleen; Zoucha, Rick; Puskar, Kathryn R.

2009-01-01

Introduction Nurse practitioners have the power to detect suicide risk and prevent suicide, a problem plaguing rural areas of the United States. Suicide risk assessment can be completed using the HEADSS (Home, Education, Activities, Drug use and abuse, Sexual behavior, and Suicidality and depression) interview instrument. The purpose of this study was to determine if HEADSS is appropriate for guiding suicide risk assessment of rural adolescents. Method High school students in Southwestern Pennsylvania completed qualitative questions from the Child Behavior Checklist and Coping Response Inventory as part of the Intervention to Promote Mental Health in Rural Youth. Qualitative content analysis was performed. Results Prominent themes identified by participants included academic performance, relationships, dislikes about school, friends, death, mental health, and the future. Several minor themes concerned safety. Most known risk factors for suicide were concerns of participants. Discussion The expansion of HEADSS to include death and safety should be considered. The modified version—HEADDSSS— can be used to guide suicide risk assessment of youth in rural Pennsylvania, ensuring both thoroughness of assessment and safety. PMID:20417887

The Current Status of Graduate Training in Suicide Risk Assessment

Science.gov (United States)

Liebling-Boccio, Dana E.; Jennings, Heather R.

2013-01-01

Directors and coordinators (n = 75) of graduate programs in school psychology approved by the National Association of School Psychologists (NASP) were surveyed regarding their training practices in suicide risk assessment. Respondents viewed the assessment of suicide risk as an important part of graduate instruction, and most believed that…

Helping Callers to the National Suicide Prevention Lifeline Who Are at Imminent Risk of Suicide: Evaluation of Caller Risk Profiles and Interventions Implemented.

Science.gov (United States)

Gould, Madelyn S; Lake, Alison M; Munfakh, Jimmie Lou; Galfalvy, Hanga; Kleinman, Marjorie; Williams, Caitlin; Glass, Andrew; McKeon, Richard

2016-04-01

Crisis lines are settings where identifying individuals at imminent risk of suicidal behavior and intervening to keep them safe are critical activities. We examined clinical characteristics of crisis callers assessed by telephone crisis helpers as being at imminent risk of suicide, and the interventions implemented with these callers. Data were derived from 491 call reports completed by 132 helpers at eight crisis centers in the National Suicide Prevention Lifeline network. Helpers actively engaged the callers in collaborating to keep themselves safe on 76.4% of calls and sent emergency services without the callers' collaboration on 24.6% of calls. Four different profiles of imminent risk calls emerged. Caller profiles and some helper characteristics were associated with intervention type. Our findings provide a first step toward an empirical formulation of imminent risk warning signs and recommended interventions. © 2015 The American Association of Suicidology.

Suicide and related health risk behaviours among school learners in South Africa: results from the 2002 and 2008 national youth risk behaviour surveys.

Science.gov (United States)

Shilubane, Hilda N; Ruiter, Robert A C; van den Borne, Bart; Sewpaul, Ronel; James, Shamagonam; Reddy, Priscilla S

2013-10-04

Attempted and completed suicide constitute a major public health problem among young people world-wide, including South Africa (SA). Suicide attempt and completed suicide increase during the adolescent period. One in 5 adolescents considers attempting suicide, but statistics are frequently unreliable. Data for this study were derived from the 2002 and 2008 South African Youth Risk Behaviour Surveys (YRBS). The study population comprised grades 8, 9, 10 and 11 students in governmental schools in the nine provinces of SA (N = 10,699 in 2002 and 10,270 in 2008). Key outcome measures were suicide ideation and suicide attempts. Of the total sample, 18% of the students in 2002 and 19% in 2008 reported to have seriously considered and/or made a plan to commit suicide during the past six months (Suicide ideation), whereas 18.5% of students in 2002 and 21.8% in 2008 reported that they had attempted suicide at least 1 time during the past six months. On both suicide measures girls have higher prevalence scores than boys, and older school learners score higher than younger learners. In addition, 32% of the learners reported feelings of sadness or hopelessness. These feelings contributed significantly to the explanation of suicide ideation and suicide attempt next to being the victim or actor in violent acts and illegal substance use. The prevalence of suicide ideation and suicide attempts among South African adolescents is high and seems to be influenced by a wide spectrum of factors at the demographic, psychological and behavioural level. Hence, more research is needed to determine the behavioural and psychological determinants of suicide among youngsters in order to develop comprehensive intervention strategies for suicide prevention and care.

Children at Risk for Suicide Attempt and Attempt-related Injuries: Findings from the 2007 Youth Risk Behavior Survey

Directory of Open Access Journals (Sweden)

West, Bethany A

2010-08-01

Full Text Available Purpose: The current study examines the associations between a range of risk factors and reports of suicide attempts, and attempts requiring medical care in a nationally representative study of high school students. The goal is to examine sex differences in the risk factors that are associated with suicide attempts and attempt-related injuries requiring treatment by a health-care provider. Methods: Data from the 2007 Youth Risk Behavior Survey for students in grades 9-12 were used to assess the prevalence and risk factors for suicidal behavior as well as differences in these for boys and girls. Cross-sectional multivariate logistic regression analyses were computed to determine the most important risk factors for suicide attempts and for suicide attempts requiring medical care for the sample overall and also stratified for boys and for girls. Results: Overall, 6.9% of adolescents attempted suicide (9.3% of girls versus 4.6% of boys. Girls were more likely than boys to report a suicide attempt in the past year (Adj.OR=2.89. Among girls, sadness (Adj.OR=5.74, weapon carrying (Adj.OR=1.48, dating violence (Adj.OR=1.60, forced sex (Adj.OR=1.72, and huffing glue (Adj.OR=2.04 were significantly associated with suicide attempts. Among boys, sadness (Adj.OR=10.96, weapon carrying (Adj.OR=1.66, forced sex (Adj.OR=2.60, huffing glue (OR=1.63, hard drug use (Adj.OR=2.18, and sports involvement (Adj.OR=1.52 were significantly associated with suicide attempts. Conclusions: These findings demonstrate similarities and differences in terms of the modifiable risk factors that increase risk for suicide attempts among boys and girls. In terms of the differences between boys and girls, hard drug use and sports involvement may be important factors for suicide prevention strategies that are directed specifically towards boys, while dating violence victimization may be an important risk factor to address for girls. Overall, these findings can help guide prevention

Suicidal and online: how do online behaviors inform us of this high-risk population?

Science.gov (United States)

Harris, Keith M; McLean, John P; Sheffield, Jeanie

2014-01-01

To assist suicide prevention we need a better understanding of how suicidal individuals act in their environment, and the online world offers an ideal opportunity to examine daily behaviors. This anonymous survey (N = 1,016) provides first-of-its-kind empirical evidence demonstrating suicide-risk people (n = 290) are unique in their online behaviors. Suicidal users reported more time online, greater likelihood of developing online personal relationships, and greater use of online forums. In addition, suicide-risk women reported more time browsing/surfing and social networking. The authors conclude that suicide prevention efforts should respond to suicide-risk users' greater demands for online interpersonal communications.

Absolute risk of suicide after first hospital contact in mental disorder

DEFF Research Database (Denmark)

Nordentoft, Merete; Mortensen, Preben Bo; Pedersen, Carsten Bøcker

2011-01-01

Estimates of lifetime risk of suicide in mental disorders were based on selected samples with incomplete follow-up.......Estimates of lifetime risk of suicide in mental disorders were based on selected samples with incomplete follow-up....

Deliberate self-harm before psychiatric admission and risk of suicide

DEFF Research Database (Denmark)

Madsen, Trine; Agerbo, Esben; Mortensen, Preben Bo

2013-01-01

Psychiatric illness and deliberate self-harm (DSH) are major risk factors of suicide. In largely 15 % of psychiatric admissions in Denmark, the patient had an episode of DSH within the last year before admission. This study examined the survival and predictors of suicide in a suicidal high...

Assessing African American Adolescents' Risk for Suicide Attempts: Attachment Theory.

Science.gov (United States)

Lyon, Maureen E.; Benoit, Marilyn; O'Donnell, Regina M.; Getson, Pamela R.; Silber, Tomas; Walsh, Thomas

2000-01-01

Evaluates risk factors in African American adolescent suicide attempters (n=51) and nonsuicidal (n=124) adolescents. Results show that threat of separation from a parental figure, insomnia, neglect, substance abuse, suicidal ideation, and failing grades were the strongest predictors of suicide attempt. Unexpected findings include high levels of…

Risk Factors for Suicidality among a Nationally Representative Sample of High School Students

Science.gov (United States)

Epstein, Jennifer A.; Spirito, Anthony

2009-01-01

Using the 2005 Youth Risk Behavior Surveillance data (n = 13,917) of high school students, we examined the association between four domains of risk factors (alcohol/drug use, aggression, HIV risk-related behaviors, and health problems) and indicators of suicidality (considering a suicide attempt, making a plan to attempt suicide, and actually…

Anxiety sensitivity and suicide risk among firefighters: A test of the depression-distress amplification model.

Science.gov (United States)

Stanley, Ian H; Smith, Lia J; Boffa, Joseph W; Tran, Jana K; Schmidt, N Brad; Joiner, Thomas E; Vujanovic, Anka A

2018-04-07

Firefighters represent an occupational group at increased suicide risk. How suicidality develops among firefighters is poorly understood. The depression-distress amplification model posits that the effects of depression symptoms on suicide risk will be intensified in the context of anxiety sensitivity (AS) cognitive concerns. The current study tested this model among firefighters. Overall, 831 firefighters participated (mean [SD] age = 38.37 y [8.53 y]; 94.5% male; 75.2% White). The Center for Epidemiologic Studies Depression Scale (CES-D), Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess for depression symptoms, AS concerns (cognitive, physical, social), and suicide risk, respectively. Linear regression interaction models were tested. The effects of elevated depression symptoms on increased suicide risk were augmented when AS cognitive concerns were also elevated. Unexpectedly, depression symptoms also interacted with AS social concerns; however, consistent with expectations, depression symptoms did not interact with AS physical concerns in the prediction of suicide risk. In the context of elevated depression symptoms, suicide risk is potentiated among firefighters reporting elevated AS cognitive and AS social concerns. Findings support and extend the depression-distress amplification model of suicide risk within a sample of firefighters. Interventions that successfully impact AS concerns may, in turn, mitigate suicide risk among this at-risk population. Copyright © 2018 Elsevier Inc. All rights reserved.

Characteristics of Women Who Have Had Cosmetic Breast Implants That Could Be Associated with Increased Suicide Risk: A Systematic Review, Proposing a Suicide Prevention Model

Directory of Open Access Journals (Sweden)

Nikolaos Manoloudakis

2015-03-01

Full Text Available Literature indicates an increased risk of suicide among women who have had cosmetic breast implants. An explanatory model for this association has not been established. Some studies conclude that women with cosmetic breast implants demonstrate some characteristics that are associated with increased suicide risk while others support that the breast augmentation protects from suicide. A systematic review including data collection from January 1961 up to February 2014 was conducted. The results were incorporated to pre-existing suicide risk models of the general population. A modified suicide risk model was created for the female cosmetic augmentation mammaplasty candidate. A 2-3 times increased suicide risk among women that undergo cosmetic breast augmentation has been identified. Breast augmentation patients show some characteristics that are associated with increased suicide risk. The majority of women reported high postoperative satisfaction. Recent research indicates that the Autoimmune syndrome induced by adjuvants and fibromyalgia syndrome are associated with silicone implantation. A thorough surgical, medical and psycho-social (psychiatric, family, reproductive, and occupational history should be included in the preoperative assessment of women seeking to undergo cosmetic breast augmentation. Breast augmentation surgery can stimulate a systematic stress response and increase the risk of suicide. Each risk factor of suicide has poor predictive value when considered independently and can result in prediction errors. A clinical management model has been proposed considering the overlapping risk factors of women that undergo cosmetic breast augmentation with suicide.

Sexual violence, mood disorders and suicide risk: a population-based study

Directory of Open Access Journals (Sweden)

Thaíse Campos Mondin

2016-03-01

Full Text Available Abstract This article seeks to analyze the association between sexual violence, manic and depressive episodes, and suicide risk among young adults. This is a cross-sectional population-based study carried out with young people between 18 and 24 years of age in a town in southern Brazil. The sample was selected through clusters. The prevalence of sexual violence, manic, depressive and mixed episodes and suicide risk were evaluated, as well as the association between them. The chi-square test and Poisson regression were used for statistical analysis. The study sample comprised 1,560 subjects. Among these, 3.1% had suffered sexual violence at some point in their life. The prevalence of depressive, mixed episodes, and (hypomanic episodes were 10%, 2.4% and 2.3%, respectively. Suicide risk had a prevalence of 8.6% in the total sample. Young people who have suffered sexual violence are more likely to be subject to mood changes or suicide risk than those who have not (p < 0.05, except for the occurrence of (hypomanic episodes. These results revealed a strong association between sexual violence and depressive and mixed episodes and suicide risk.

A theory-based approach to understanding suicide risk in shelter-seeking women.

Science.gov (United States)

Wolford-Clevenger, Caitlin; Smith, Phillip N

2015-04-01

Women seeking shelter from intimate partner violence are at an increased risk for suicide ideation and attempts compared to women in the general population. Control-based violence, which is common among shelter-seeking women, may play a pivotal role in the development of suicide ideation and attempts. Current risk assessment and management practices for shelter-seeking women are limited by the lack of an empirically grounded understanding of increased risk in this population. We argue that in order to more effectively promote risk assessment and management, an empirically supported theory that is sensitive to the experiences of shelter-seeking women is needed. Such a theory-driven approach has the benefits of identifying and prioritizing targetable areas for intervention. Here, we review the evidence for the link between coercive control and suicide ideation and attempts from the perspective of Baumeister's escape theory of suicide. This theory has the potential to explain the role of coercive control in the development of suicide ideation and eventual attempts in shelter-seeking women. Implications for suicide risk assessment and prevention in domestic violence shelters are discussed. © The Author(s) 2014.

Incidence and risk factors for suicide attempts in a general population of young people

DEFF Research Database (Denmark)

Christiansen, Erik; Juul Larsen, Kim; Agerbo, Esben

2013-01-01

OBJECTIVE: To estimate the Danish epidemiological long-term incidence rates for suicide attempts in the general population of children and adolescents, and to analyze the impact from single and multiple risk factors on the risk of suicide attempts. METHOD: We used longitudinal register data from ...... on the increase in the period studied. Individuals exposed to multiple risk factors are at the highest risk for suicide attempts, and when spotted or in contact with authorities they should be given proper care and treatment to prevent suicide attempts and death.......OBJECTIVE: To estimate the Danish epidemiological long-term incidence rates for suicide attempts in the general population of children and adolescents, and to analyze the impact from single and multiple risk factors on the risk of suicide attempts. METHOD: We used longitudinal register data from...... a total cohort of all individuals born between 1983 and 1989 and living in Denmark to calculate incidence rates. From the cohort, we identified all who have attempted suicide, and matched 50 controls to each case. A nested case-control design was used to estimate the impact from risk factors on the risk...

Karolinska Interpersonal Violence Scale predicts suicide in suicide attempters.

Science.gov (United States)

Jokinen, Jussi; Forslund, Kaj; Ahnemark, Ewa; Gustavsson, J Petter; Nordström, Peter; Asberg, Marie

2010-08-01

Both childhood trauma and violent behavior are important risk factors for suicidal behavior. The aim of the present study was to construct and validate a clinical rating scale that could measure both the exposure to and the expression of violence in childhood and during adult life and to study the ability of the Karolinska Interpersonal Violence Scale (KIVS) to predict ultimate suicide in suicide attempters. A total of 161 suicide attempters and 95 healthy volunteers were assessed with the KIVS measuring exposure to violence and expressed violent behavior in childhood (between 6-14 years of age) and during adult life (15 years or older). The Buss-Durkee Hostility Inventory (BDHI), "Urge to act out hostility" subscale from the Hostility and Direction of Hostility Questionnaire (HDHQ), and the Early Experience Questionnaire (EEQ) were used for validation. All patients were followed up for cause of death and a minimum of 4 years from entering in the study. Five patients who committed suicide within 4 years had significantly higher scores in exposure to violence as a child, in expressed violent behavior as an adult, and in KIVS total score compared to survivors. Suicide attempters scored significantly higher compared to healthy volunteers in 3 of the 4 KIVS subscales. There were significant correlations between the subscales measuring exposure to and expression of violent behavior during the life cycle. BDHI, Urge to act out hostility, and EEQ validated the KIVS. Exposure to violence in childhood and violent behavior in adulthood are risk factors for completed suicide in suicide attempters. Behavioral dysregulation of aggression is important to assess in clinical work. The KIVS is a valuable new tool for case detection and long-term clinical suicide prevention. Copyright 2010 Physicians Postgraduate Press, Inc.

Time to hospitalization for suicide attempt by the timing of parental suicide during offspring early development

Science.gov (United States)

Kuramoto, S. Janet; Runeson, Bo; Stuart, Elizabeth A.; Lichtenstein, Paul; Wilcox, Holly C.

2013-01-01

Context Previous studies have suggested that children who experience parental suicide at earlier ages are at higher risk of future hospitalization for suicide attempt. However, how the trajectories of risk differ by offspring age at the time of parental suicide is currently unknown. Objective To study time at risk to hospitalization for suicide attempt among offspring after experiencing parental suicide or accidental death by offspring developmental period at the time of parental death. Design Population-based retrospective cohort study Setting Sweden Participants 26,096 offspring who experienced parental suicide and 32,395 offspring of accident decedents prior to age 25 from 1973-2003. Main Outcome Measures Hospitalization for suicide attempt. Parametric survival analysis was used to model the time to hospitalization for suicide attempt across offspring who lost a parent during early childhood (0-5 years old), later childhood (6-12), adolescence (13-17) and young adulthood (18-24). Results The risk in offspring who lost a parent during early or late childhood surpassed the other two age groups’ hazards approximately 5 years after the origin and, for the youngest group, continued to rise over the course of decades. Offspring who lost a parent during adolescence or young adulthood were at greatest risk within 1 to 2 years after parental suicide, and risk declined over time. The shape of hospitalization risk was similar among those who experienced parental fatal accident. When the shape of hospitalization for suicide attempt at each developmental period was fixed to be the same between the two groups, offspring who lost a parent to suicide had earlier risk to hospitalization for suicide attempt hospitalization than offspring who lost a parent to an accident. Conclusion The hospitalization risk for suicide attempt in offspring who lost a parent during their childhood is different from those who lost a parent during adolescence or young adulthood. The results suggest

Future orientation and suicide risk in Hungarian college students: Burdensomeness and belongingness as mediators.

Science.gov (United States)

Chang, Edward C; Chang, Olivia D; Martos, Tamás; Sallay, Viola

2017-01-01

We tested a model consistent with the notion that perceived burdensomeness and thwarted belongingness mediate the association between future orientation and suicide risk (viz., depressive symptoms and suicide ideation) in college students. The sample was comprised of 195 Hungarian college students. Results indicated that the negative associations found between future orientation and suicide risk outcomes were accounted for by both perceived burdensomeness and thwarted belongingness. The present findings highlight the importance of studying positive future cognitions in suicide risk and provide support for perceived burdensomeness and thwarted belongingness as potential proximal mechanisms associated with heighted suicide risk in adults.

Risk of Suicidal Events With Atomoxetine Compared to Stimulant Treatment: A Cohort Study.

Science.gov (United States)

Linden, Stephan; Bussing, Regina; Kubilis, Paul; Gerhard, Tobias; Segal, Richard; Shuster, Jonathan J; Winterstein, Almut G

2016-05-01

Antidepressant effects on increased suicidality in children have raised public concern in recent years. Approved in 2002 for attention-deficit/hyperactivity disorder treatment, the selective noradrenalin-reuptake-inhibitor atomoxetine was initially investigated for the treatment of depression. In post-hoc analyses of clinical trial data, atomoxetine has been associated with an increased risk of suicidal ideation in children and adolescents. We analyzed whether the observed increased risk of suicidal ideation in clinical trials translates into an increased risk of suicidal events in pediatric patients treated with atomoxetine compared with stimulants in 26 Medicaid programs. Employing a retrospective cohort design, we used propensity score-adjusted Cox proportional hazard models to evaluate the risk of suicide and suicide attempt in pediatric patients initiating treatment with atomoxetine compared with stimulants from 2002 to 2006. The first-line treatment cohort included 279 315 patients. During the first year of follow-up, the adjusted hazard ratio for current atomoxetine use compared with current stimulant use was 0.95 (95% CI 0.47-1.92, P = .88). The second-line treatment cohort included 220 215 patients. During the first year of follow-up, the adjusted hazard ratio for current atomoxetine use compared with current stimulant use was 0.71 (95% CI 0.30-1.67, P = .43). First- and second-line treatment of youths age 5 to 18 with atomoxetine compared with stimulants was not significantly associated with an increased risk of suicidal events. The low incidence of suicide and suicide attempt resulted in wide confidence intervals and did not allow stratified analysis of high-risk groups or assessment of suicidal risk associated with long-term use of atomoxetine. Copyright © 2016 by the American Academy of Pediatrics.

Suicide Risk Assessment and Prevention: A Systematic Review Focusing on Veterans.

Science.gov (United States)

Nelson, Heidi D; Denneson, Lauren M; Low, Allison R; Bauer, Brian W; O'Neil, Maya; Kansagara, Devan; Teo, Alan R

2017-10-01

Suicide rates in veteran and military populations in the United States are high. This article reviews studies of the accuracy of methods to identify individuals at increased risk of suicide and the effectiveness and adverse effects of health care interventions relevant to U.S. veteran and military populations in reducing suicide and suicide attempts. Trials, observational studies, and systematic reviews relevant to U.S. veterans and military personnel were identified in searches of MEDLINE, PsycINFO, SocINDEX, and Cochrane databases (January 1, 2008, to September 11, 2015), on Web sites, and in reference lists. Investigators extracted and confirmed data and dual-rated risk of bias for included studies. Nineteen studies evaluated accuracy of risk assessment methods, including models using retrospective electronic records data and clinician- or patient-rated instruments. Most methods demonstrated sensitivity ≥80% or area-under-the-curve values ≥.70 in single studies, including two studies based on electronic records of veterans and military personnel, but specificity varied. Suicide rates were reduced in six of eight observational studies of population-level interventions. Only two of ten trials of individual-level psychotherapy reported statistically significant differences between treatment and usual care. Risk assessment methods have been shown to be sensitive predictors of suicide and suicide attempts, but the frequency of false positives limits their clinical utility. Research to refine these methods and examine clinical applications is needed. Studies of suicide prevention interventions are inconclusive; trials of population-level interventions and promising therapies are required to support their clinical use.

Comorbid sleep disorders and suicide risk among children and adolescents with bipolar disorder.

Science.gov (United States)

Stanley, Ian H; Hom, Melanie A; Luby, Joan L; Joshi, Paramjit T; Wagner, Karen D; Emslie, Graham J; Walkup, John T; Axelson, David A; Joiner, Thomas E

2017-12-01

Children and adolescents with bipolar disorder are at increased risk for suicide. Sleep disturbances are common among youth with bipolar disorder and are also independently implicated in suicide risk; thus, comorbid sleep disorders may amplify suicide risk in this clinical population. This study examined the effects of comorbid sleep disorders on suicide risk among youth with bipolar disorder. We conducted secondary analyses of baseline data from the Treatment of Early Age Mania (TEAM) study, a randomized controlled trial of individuals aged 6-15 years (mean ± SD = 10.2 ± 2.7 years) with DSM-IV bipolar I disorder (N = 379). Sleep disorders (i.e., nightmare, sleep terror, and sleepwalking disorders) and suicide risk were assessed via the WASH-U-KSADS and the CDRS-R, respectively. We constructed uncontrolled logistic regression models as well as models controlling for trauma history, a generalized anxiety disorder (GAD) diagnosis, and depression symptoms. Participants with a current comorbid nightmare disorder versus those without were nearly twice as likely to screen positive for suicide risk in an uncontrolled model and models controlling for trauma history, a GAD diagnosis, and depression symptoms. Neither a current comorbid sleep terror disorder nor a sleepwalking disorder was significantly associated with suicide risk. This pattern of findings remained consistent for both current and lifetime sleep disorder diagnoses. Youth with bipolar I disorder and a comorbid nightmare disorder appear to be at heightened suicide risk. Implications for assessment and treatment are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Understanding suicide risk within the Research Domain Criteria (RDoC) framework: A meta-analytic review.

Science.gov (United States)

Glenn, Catherine R; Kleiman, Evan M; Cha, Christine B; Deming, Charlene A; Franklin, Joseph C; Nock, Matthew K

2018-01-01

The field is in need of novel and transdiagnostic risk factors for suicide. The National Institute of Mental Health's Research Domain Criteria (RDoC) provides a framework that may help advance research on suicidal behavior. We conducted a meta-analytic review of existing prospective risk and protective factors for suicidal thoughts and behaviors (ideation, attempts, and deaths) that fall within one of the five RDoC domains or relate to a prominent suicide theory. Predictors were selected from a database of 4,082 prospective risk and protective factors for suicide outcomes. A total of 460 predictors met inclusion criteria for this meta-analytic review and most examined risk (vs. protective) factors for suicidal thoughts and behaviors. The overall effect of risk factors was statistically significant, but relatively small, in predicting suicide ideation (weighted mean odds ratio: wOR = 1.72; 95% CI: 1.59-1.87), suicide attempt (wOR = 1.66 [1.57-1.76), and suicide death (wOR = 1.41 [1.24-1.60]). Across all suicide outcomes, most risk factors related to the Negative Valence Systems domain, although effect sizes were of similar magnitude across RDoC domains. This study demonstrated that the RDoC framework provides a novel and promising approach to suicide research; however, relatively few studies of suicidal behavior fit within this framework. Future studies must go beyond the "usual suspects" of suicide risk factors (e.g., mental disorders, sociodemographics) to understand the processes that combine to lead to this deadly outcome. © 2017 Wiley Periodicals, Inc.

Suicide risk in depression and bipolar disorder: Do impulsiveness-aggressiveness and pharmacotherapy predict suicidal intent?

Directory of Open Access Journals (Sweden)

Maurizio Pompili

2008-03-01

Full Text Available Maurizio Pompili1,2, Marco Innamorati3, Michele Raja4, Ilaria Falcone2, Giuseppe Ducci5, Gloria Angeletti2, David Lester6, Paolo Girardi2, Roberto Tatarelli2, Eleonora De Pisa21McLean Hospital, Harvard Medical School, Boston, MA, USA; 2Department of Psychiatry, Sant’Andrea Hospital, “Sapienza” University of Rome, Italy; 3Università Europea di Roma, Italy; 4Diagnostic and Therapeutic Psychiatric Services, Department of Mental Health, Santo Spirito Hospital, Rome, Italy; 5Diagnostic and Therapeutic Psychiatric Services, Department of Mental Health, San Filippo Neri Hospital, Rome, Italy; 6Center for the Study of Suicide, Blackwood, NJ, USAAbstract: The aims of the present study were to examine clinical, personality, and sociodemographic predictors of suicide risk in a sample of inpatients affected by major affective disorders. The participants were 74 inpatients affected by major depressive disorder or bipolar disorder-I. Patients completed a semi-structured interview, the Beck Hopelessness Scale, the Aggression Questionnaire, the Barratt Impulsiveness Scale, and the Hamilton scales for depression and anxiety. Over 52% of the patients were high suicide risks. Those at risk reported more severe depressive-anxious symptomatology, more impulsivity and more hostility. Impulsivity, the use of antidepressants, anxiety/somatization, and the use of mood stabilizers (a negative predictor resulted in accurate predicting of suicide intent. Impulsivity and antidepressant use were the strongest predictors even after controlling for several sociodemographic and clinical variables.Keywords: suicide, mood disorders, pharmacotherapy, impulsiveness, aggressiveness