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Deng Y, Zhang J, Liu X, Jiang Q, Xing Y, Xu Y, Zhao G, Sha S, Liang S, Hu C. Construction and verification of risk prediction model for suicidal attempts of mood disorder based on machine learning. J Affect Disord 2025; 380:279-287. [PMID: 40139405 DOI: 10.1016/j.jad.2025.03.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2024] [Revised: 03/13/2025] [Accepted: 03/19/2025] [Indexed: 03/29/2025]
Abstract
BACKGROUND Mood disorders (MD) are closely related to suicide attempt (SA). Developing an effective prediction model for SA in MD patients could play a crucial role in the early identification of high-risk groups. METHODS 1099 patients with MD were collected to Model construction. 387 MD patients were enrolled for external validate. The least absolute shrinkage and selection operator (LASSO) regression was used to screen features that may be related to SA as predictors. Ten machine learning algorithms were applied to the training set to construct the SA prediction model. The machine learning model with the best sensitivity and stability was selected according to AUC, F1 score, accuracy and other indicators. The locally explanatory technique of Shapley Additive Explanations (SHAP) was used to rank and interpret the importance of features collected in best model to analyze the potential impact of each feature on SA. Meanwhile, to further validate the stability of the model, the sensitivity analysis utilizing k-fold cross-validation and external validate in another center were performed. RESULTS This study incorporates 8 features. Prediction models was constructed based on 10 different machine learning methods. The results showed that the prediction model constructed by Random Forest (RF) method had good discriminant ability and stability (AUC of Testing = 0.741, AUC of Training = 0.786, AUC of validation = 0.788) and acceptable discriminant. Further, the prediction model showed that the most valuable features for predicting SA were Polarity and previous SA. CONCLUSION The RF method can better construct the risk prediction model of SA in MD patients.
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Affiliation(s)
- Yannan Deng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jinhe Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xinyu Liu
- Department of Clinical Psychology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Shandong, China
| | - Qitong Jiang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yujie Xing
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuxuan Xu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Guangwei Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sha Sha
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Sixiang Liang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Chen Hu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Tong F, Lederman R, D'Alfonso S. Clinical decision support systems in mental health: A scoping review of health professionals' experiences. Int J Med Inform 2025; 199:105881. [PMID: 40121768 DOI: 10.1016/j.ijmedinf.2025.105881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2024] [Revised: 03/04/2025] [Accepted: 03/17/2025] [Indexed: 03/25/2025]
Abstract
BACKGROUND Clinical decision support systems (CDSSs) have the potential to assist health professionals in making informed and cost-effective clinical decisions while reducing medical errors. However, compared to physical health, CDSSs have been less investigated within the mental health context. In particular, despite mental health professionals being the primary users of mental health CDSSs, few studies have explored their experiences and/or views on these systems. Furthermore, we are not aware of any reviews specifically focusing on this topic. To address this gap, we conducted a scoping review to map the state of the art in studies examining CDSSs from the perspectives of mental health professionals. METHOD In this review, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline, we systematically searched the relevant literature in two databases, PubMed and PsycINFO. FINDINGS We identified 23 articles describing 20 CDSSs Through the synthesis of qualitative findings, four key barriers and three facilitators to the adoption of CDSSs were identified. Although we did not synthesize quantitative findings due to the heterogeneity of the results and methodologies, we emphasize the issue of a lack of valid quantitative methods for evaluating CDSSs from the perspectives of mental health professionals. SIGNIFICANCE To the best of our knowledge, this is the first review examining mental health professionals' experiences and views on CDSSs. We identified facilitators and barriers to adopting CDSSs and highlighted the need for standardizing research methods to evaluate CDSSs in the mental health space.
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Affiliation(s)
- Fangziyun Tong
- School of Computing and Information Systems, University of Melbourne, Parkville 3010, Australia.
| | - Reeva Lederman
- School of Computing and Information Systems, University of Melbourne, Parkville 3010, Australia
| | - Simon D'Alfonso
- School of Computing and Information Systems, University of Melbourne, Parkville 3010, Australia
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Ghorbani S, Ghavidel F, Abdollahi S, Zarepour P, Dehestani F, Saatchi M, Pouragha H, Baigi V. Socioeconomic inequality in mental health disorders: A cross-sectional study from the Tehran University of Medical Sciences employees' cohort study. Sci Rep 2025; 15:17796. [PMID: 40404803 PMCID: PMC12098881 DOI: 10.1038/s41598-025-02192-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2024] [Accepted: 05/12/2025] [Indexed: 05/24/2025] Open
Abstract
Understanding socioeconomic inequalities in health helps identify vulnerable groups and guide targeted interventions. Mental health disorders significantly affect well-being and productivity. This study assessed the prevalence and socioeconomic inequalities in depression, anxiety, and stress among employees of the Tehran University of Medical Sciences. This cross-sectional study analyzed data from the Tehran University of Medical Sciences Employees' Cohort (TEC) baseline phase, comprising 4,442 individuals. The Depression, Anxiety, and Stress Scale-42 (DASS-42) was utilized to measure mental health disorders. Education level and wealth index were considered as socioeconomic indicators. The Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) were employed to estimate socioeconomic inequality. The age-adjusted prevalence of depression, anxiety, and stress was 8.7%, 8.6%, and 11.5%, respectively. The relative wealth-related inequality analysis revealed that, after adjusting for age, sex, marital status, and education level, the prevalence of depression, anxiety, and stress in the lowest wealth index was 2.54, 2.89, and 1.65 times higher than in the highest wealth index, respectively. Additionally, the relative education-related inequality analysis indicated that, adjusted for age, sex, marital status, and wealth index, individuals with primary education or no formal education had 2.58, 2.99, and 2.14 times higher prevalence of depression, anxiety, and stress compared to those with a doctoral degree, respectively. Significant disparities in the prevalence of mental health disorders were found across educational and wealth index levels. Targeted interventions and policies should aim to achieve and sustain long-term benefits for vulnerable and disadvantaged groups.
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Affiliation(s)
- Sheida Ghorbani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ghavidel
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sedigheh Abdollahi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Pardis Zarepour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - FatemehZahra Dehestani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamidreza Pouragha
- Department of Environmental Engineering, MehrAlborz University (MAU), Tehran, Iran
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Vali Baigi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Toro GVR, Arias P, de la Torre-Luque A, Singer JB, Lagunas N. Depression, Anxiety, and Suicide Among Adolescents: Sex Differences and Future Perspectives. J Clin Med 2025; 14:3446. [PMID: 40429440 PMCID: PMC12112747 DOI: 10.3390/jcm14103446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2025] [Revised: 05/13/2025] [Accepted: 05/13/2025] [Indexed: 05/29/2025] Open
Abstract
Depression and anxiety are two disorders that significantly increase the risk of suicidal behavior. The disparity between females and males in the prevalence of these disorders becomes more pronounced from adolescence onwards. Specifically, risk factors associated with suicidal behavior in adolescent females are often linked to anxiety and depression, whereas in males, these behaviors are more frequently associated with other types of disorders, such as disruptive behavior. Furthermore, there are notable sex differences in the efficacy and acceptance of treatments aimed at preventing suicidal behavior. This review examines the sex differences in the relationship between depression, anxiety disorders, and suicidal risk in adolescents. Specifically, it aims to identify key risk factors influencing suicide vulnerability across sexes and assess the efficacy of current treatment approaches in mitigating these sex specific risks.
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Affiliation(s)
- Giovana V. R. Toro
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, Ciudad Universitaria, 28040 Madrid, Spain; (G.V.R.T.)
| | - Paula Arias
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, Ciudad Universitaria, 28040 Madrid, Spain; (G.V.R.T.)
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, Ciudad Universitaria, 28040 Madrid, Spain; (G.V.R.T.)
| | - Jonathan B. Singer
- School of Social Work, Loyola University Chicago, Maguire Hall, 5th Floor, 820 North Michigan Avenue, Chicago, IL 60611, USA;
| | - Natalia Lagunas
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, Ciudad Universitaria, 28040 Madrid, Spain; (G.V.R.T.)
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Peppel L, Lai RY, Rummey C, Opal P, Schmahmann JD, Gomez CM, Paulson H, Zesiewicz TA, Perlman S, Wilmot G, Ying SH, Onyike CU, Bushara KO, Geschwind MD, Figueroa KP, Pulst SM, Subramony SH, Duquette A, Ashizawa T, Hamedani AG, Davis MY, Srinivasan SR, Burns MR, Amokrane N, Moore LR, Shakkottai VG, Rosenthal LS, Kuo SH, Lin CYR. Suicidal Ideation in Spinocerebellar Ataxia. J Neuropsychiatry Clin Neurosci 2025:appineuropsych20250006. [PMID: 40350965 DOI: 10.1176/appi.neuropsych.20250006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2025]
Abstract
OBJECTIVE Suicidal ideation has not been extensively studied in spinocerebellar ataxias (SCAs). The authors examined whether individuals with SCAs have increased suicidal ideation and related factors. METHODS The authors studied patients with genetically confirmed SCAs enrolled in the Clinical Research Consortium for the Study of Cerebellar Ataxia cohort, examining the percentages of patients with SCA subtypes 1, 2, 3, and 6 who reported suicidal ideation and comparing findings with nationally representative data from the National Survey on Drug Use and Health (NSDUH). Clinical characteristics that may contribute to suicidal ideation in SCAs, including age, disease duration, sex, ataxia severity, depression, and SCA subtype, were also studied. RESULTS Suicidal ideation was present among 12% of 769 patients with SCAs and 4.3% of individuals in the general population recorded in the NSDUH. Compared with individuals in the general population, SCA patients had higher odds of suicidal ideation (OR=2.72). Compared with patients with SCA without suicidal ideation, patients with SCA and suicidal ideation had a longer disease duration (mean±SD=13.1±8.2 years vs. 11.2±9.4 years), more severe ataxia (Scale for the Assessment and Rating of Ataxia mean score=15.9±8.6 vs. 12.9±7.6), and more severe depression. Having suicidal ideation at baseline significantly increased the odds of suicidality later in the disease course (OR=58.73, 95% CI=36.00-98.40). CONCLUSIONS Suicidal ideation was more prevalent among patients with SCAs than in the general population. The findings of this study underscore the importance of continuous suicidal risk screening among individuals with SCAs and the need for effective depression management.
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Affiliation(s)
- Levi Peppel
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Ruo-Yah Lai
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Christian Rummey
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Puneet Opal
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Jeremy D Schmahmann
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Christopher M Gomez
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Henry Paulson
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Theresa A Zesiewicz
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Susan Perlman
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - George Wilmot
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Sarah H Ying
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Chiadi U Onyike
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Khalaf O Bushara
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Michael D Geschwind
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Karla P Figueroa
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Stefan M Pulst
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Sub H Subramony
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Antoine Duquette
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Tetsuo Ashizawa
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Ali G Hamedani
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Marie Y Davis
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Sharan R Srinivasan
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Matthew R Burns
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Nadia Amokrane
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Lauren R Moore
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Vikram G Shakkottai
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Liana S Rosenthal
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Sheng-Han Kuo
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
| | - Chi-Ying R Lin
- Department of Neurology, Baylor College of Medicine, Houston (Peppel, Lin); Department of Neurology and Initiative of Columbia Ataxia and Tremor, Columbia University Medical Center, New York City (Lai, Amokrane, Kuo); Clinical Data Science GmbH, Basel, Switzerland (Rummey); Department of Neurology, Northwestern University, Chicago (Opal); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (Schmahmann); Department of Neurology, University of Chicago, Chicago (Gomez); Department of Neurology, University of Michigan, Ann Arbor (Paulson, Srinivasan); Department of Neurology, University of South Florida, Tampa (Zesiewicz); Department of Neurology, University of California, Los Angeles, Los Angeles (Perlman); Department of Neurology, Emory University, Atlanta (Wilmot); Departments of Psychiatry and Behavioral Sciences (Ying, Onyike) and Neurology (Rosenthal), Johns Hopkins University, Baltimore; Department of Neurology, University of Minnesota, Minneapolis (Bushara); Department of Neurology, University of California, San Francisco, San Francisco (Geschwind); Department of Neurology, University of Utah, Salt Lake City (Figueroa, Pulst); Department of Neurology, University of Florida, Gainesville (Subramony, Burns); Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal (Duquette); Houston Methodist Research Institute, Houston (Ashizawa); Departments of Neurology, Ophthalmology, and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Hamedani); Department of Neurology, University of Washington, Seattle (Davis); National Ataxia Foundation, Minneapolis (Moore); Department of Neurology, University of Texas Southwestern Medical Center, Dallas (Shakkottai)
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Yuen ASC, Chen B, Chan AYL, Hayes JF, Osborn DPJ, Besag FMC, Lau WCY, Wong ICK, Wei L, Man KKC. Use of gabapentinoid treatment and the risk of self-harm: population based self-controlled case series study. BMJ 2025; 389:e081627. [PMID: 40306941 DOI: 10.1136/bmj-2024-081627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2025]
Abstract
OBJECTIVE To estimate the effect of gabapentinoid treatment on self-harm. DESIGN A population based self-controlled case series study. SETTING UK Clinical Practice Research Datalink Aurum database linked to the Hospital Episode Statistics and Office for National Statistics databases. PARTICIPANTS 10 002 adults (aged ≥18 years), with gabapentinoid prescriptions, who had an incident event of self-harm between 1 January 2000 and 31 December 2020. Individual censoring occurred on the date of epilepsy, substance misuse, or cancer diagnosis. MAIN OUTCOME MEASURES Crude incidence rates of self-harm in different risk periods: 90 days before gabapentinoid treatment, gabapentinoid treatment period, 14 days after treatment periods, and reference periods were calculated. Conditional Poisson regression derived the incidence rate ratio and 95% confidence intervals (CIs) to evaluate the risk of self-harm in different risk periods, compared with reference period for each individual. RESULTS 1 503 597 individuals received gabapentinoid prescriptions and 10 002 individuals were included in the analysis. The incidence rate of self-harm per 100 person years was 16.79 (95% CI 16.65 to 16.92) in the 90 days before treatment period, 9.66 (9.62 to 9.70) in the treatment period, 29.60 (29.09 to 30.11) in the 14 days after treatment period, and 6.75 (6.74 to 6.77) in the reference period. The results yielded an increased risk of self-harm during the 90 day period before treatment, with an adjusted incidence rate ratio of 1.69 (95% CI 1.55 to 1.85). The spline based analysis showed that the risk of self-harm declined gradually around the time of treatment initiation and returned to reference level during the treatment period (adjusted incidence rate ratio 1.06 (0.98 to 1.13)). Adjusted incidence rate ratio for self-harm increased within 14 days after treatment cessation (3.02 (2.53 to 3.60)). The findings remained consistent throughout a series of subgroups and sensitivity analyses. CONCLUSIONS The association between gabapentinoids and risk of self-harm seems to be multifaceted: an elevated risk of self-harm is present before initiation of gabapentinoid treatment, which persists during the initial phase of the treatment period, and rises again shortly after treatment discontinuation. These findings do not support a direct effect of gabapentinoid treatment on self-harm but underscore the necessity for close patient monitoring of self-harm throughout the gabapentinoid treatment journey.
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Affiliation(s)
- Andrew S C Yuen
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UK
| | - Boqing Chen
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UK
| | - Adrienne Y L Chan
- School of Pharmacy, Aston University, Birmingham, UK
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
| | - Joseph F Hayes
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - David P J Osborn
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Frank M C Besag
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- East London Foundation NHS Trust, Bedfordshire, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Wallis C Y Lau
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UK
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Pak Shek Kok, Hong Kong
| | - Ian C K Wong
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- School of Pharmacy, Aston University, Birmingham, UK
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Pak Shek Kok, Hong Kong
- Advance Data Analytics for Medical Science Limited, Hong Kong, Hong Kong
- School of Pharmacy, Medical Sciences Division, Macau University of Science and Technology, Taipa, Macau
| | - Li Wei
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UK
| | - Kenneth K C Man
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- Centre for Medicines Optimisation Research and Education, University College London Hospitals NHS Foundation Trust, London, UK
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Pak Shek Kok, Hong Kong
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7
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Pak TK, Ayvaci ER, Carmody T, Jamma L, Feng Z, Nekovei A, Emslie G, Trivedi MH. Peripheral biological correlates of suicidality in children and adolescents: A systematic review and meta-analysis. iScience 2025; 28:112290. [PMID: 40264798 PMCID: PMC12013498 DOI: 10.1016/j.isci.2025.112290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 12/16/2024] [Accepted: 03/21/2025] [Indexed: 04/24/2025] Open
Abstract
A systematic review and meta-analysis were conducted to identify peripheral biological correlates of suicidality in children and adolescents. The review was pre-registered through PROSPERO (CRD42023417128) and included four databases (PubMed, Cochrane Library, Embase, and PsycINFO). From 27,977 non-duplicated articles, 102 full-text studies were selected. Studies investigated suicide attempts (n = 52), suicidal ideation (n = 42), or individuals with suicidal ideation or attempts grouped together (n = 22). Seropositive toxoplasmosis, cortisol, neutrophil, and neutrophil to lymphocyte ratio (NLR) exhibited significant effect size after Bonferroni correction. Effect sizes for biological correlates of suicidality were pooled using Cohen's d (effect size = -0.04, 95% confidence interval [CI]: -1.36 to 1.27) and odds ratio (effect size = -0.31, 95% CI: -1.06 to 0.42). Meta-regression analysis revealed that type of suicidality, type of control, means collected, and sample size significantly impacted the pooled effect size. Analysis showed significant publication bias and heterogeneity, as well as notable moderators and potential biomarkers for future research.
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Affiliation(s)
- Thomas K. Pak
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Emine Rabia Ayvaci
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Children’s Health, Children’s Medical Center, Dallas, TX, USA
| | - Thomas Carmody
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Health Data Science and Biostatistics, Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Limi Jamma
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Zihang Feng
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Arya Nekovei
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Graham Emslie
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Children’s Health, Children’s Medical Center, Dallas, TX, USA
| | - Madhukar H. Trivedi
- Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute and Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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McVittie J, Ansloos J. Feeling the Structural: School-Based Educators' Perspectives on Indigenous Child Suicidality in Canada. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2025:27551938251327904. [PMID: 40207783 DOI: 10.1177/27551938251327904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2025]
Abstract
Suicide is a critical public health issue disproportionately affecting Indigenous communities in Canada, especially children. Research on child suicide remains scarce, resulting in a limited understanding of its risk and protective factors. Identified risk dimensions include mental and behavioral health, relational issues, and significant adverse childhood experiences like abuse, and bullying. Studies on Indigenous youth and adults also emphasize the effects of colonization, public policy on child welfare, and systemic racism. The lack of research specifically addressing Indigenous child suicidality underscores the urgent need for tailored research. This article presents findings from a study engaging First Nations and Inuit educators, revealing factors linked to suicidal distress among Indigenous children. Through reflexive thematic analysis, three major themes emerged: the proximal emotional toll of distal risk factors, the impact of adverse childhood experiences, and the role of material deprivation in enhancing risk. Insights from educators are vital for developing targeted interventions to improve prevention efforts.
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Ang SH, Venkateswaran S, Goda MB, Naidu KNC, Kundadak GK, Subramaniam M. Prevalence of suicidal behaviour in adolescents and youth at ultra-high risk for psychosis: A systematic review and meta-analysis. Eur Psychiatry 2025; 68:e56. [PMID: 40175283 PMCID: PMC12090029 DOI: 10.1192/j.eurpsy.2025.2444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2025] [Revised: 03/26/2025] [Accepted: 03/30/2025] [Indexed: 04/04/2025] Open
Abstract
BACKGROUND Suicide remains a major risk factor for individuals suffering from schizophrenia and its prodromal state (i.e., Ultra-High Risk for Psychosis). However, less is known about the prevalence of suicidal behaviour among the adolescent and youth UHR population, a demographic vulnerable to the psychosocial and environmental risk factors of suicide. This review aims to synthesise existing literature on the prevalence of suicidal ideation and behaviour in the adolescent and youth at Ultra-High Risk for Psychosis (UHR), and the associations between suicidal behaviour and its correlates. METHODS The databases PsycINFO, PubMed, Embase, Cochrane Library, Web of Science, and Scopus were accessed up to July 2024. A meta-analysis of prevalence was subsequently performed for lifetime suicidal ideation, lifetime non-suicidal self-injury, lifetime suicidal attempt, and current suicidal ideation. A narrative review was also carried out for the correlates of suicidal behaviour amongst adolescents and youth in the UHR population. RESULTS Studies were included in this meta-analysis. Meta-analysis revealed a high prevalence of lifetime suicidal ideation (58%), lifetime non-suicidal self-injury (37%), lifetime suicidal attempt (25%), and current (2 week) suicidal ideation (56%). The narrative review revealed that a personal transition to psychosis and a positive family history of psychosis were associated with suicidal attempts, while depression was associated with both suicidal attempts and suicidal ideation. CONCLUSION The prevalence of suicidal ideation and behaviour among UHR adolescents and youth is high and comparable to that of the general UHR population. Existing measures that mitigate suicide risk in the general UHR population should be adopted for the youth context.
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Affiliation(s)
- Shi Han Ang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Kuhanesan N. C. Naidu
- Department of Psychological Medicine, National University Hospital, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ganesh Kudva Kundadak
- Department of Psychological Medicine, National University Hospital, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mythily Subramaniam
- Department of Psychological Medicine, National University Hospital, Singapore
- Research Division, Institute of Mental Health, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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10
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Faulkner P, Gibson EL, Dyall SC. Long-chain omega-3 polyunsaturated fatty acids are associated with brain connectivity and mood in young adults with subthreshold depression: A preliminary study. Prostaglandins Leukot Essent Fatty Acids 2025; 204:102664. [PMID: 39827541 DOI: 10.1016/j.plefa.2025.102664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2024] [Revised: 01/15/2025] [Accepted: 01/15/2025] [Indexed: 01/22/2025]
Abstract
BACKGROUND The long-chain omega-3 polyunsaturated fatty acids (PUFAs) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have beneficial effects in depression, and these effects may be mediated via changes in functional brain connectivity. However, little is known about these effects in those with subthreshold depression. METHODS 15 Participants aged 18-29 years with Patient Health Questionnaire-8 (PHQ-8) scores ≥ 4 and Generalised Anxiety Disorder Assessment-7 (GAD-7) scores ≥ 5, underwent resting-state functional magnetic resonance imaging. Whole-brain, seed-based connectivity analyses were performed using bilateral orbitofrontal cortex (OFC) and amygdala seeds. Omega-3 and -6 PUFA status was assessed from dried bloodspot analysis of %DHA, %EPA, Omega-3 Index (calculated as the sum of DHA plus EPA expressed as a percentage of the total measured fatty acids and a correction applied as dried blood spot samples were used instead of erythrocytes) and ratio of the omega-6 PUFA arachidonic acid (ARA) to EPA (ARA/EPA). RESULTS PHQ-8 scores indicated subthreshold depression (mean = 10.0; SD = 4.2) and were negatively associated with DHA levels and Omega-3 Index. Significant negative associations were also identified between connectivity of the OFC with the angular gyrus and DHA and Omega-3 Index, while weaker connectivity of these regions was associated with lower PHQ-8 and GAD-7 scores. DHA and Omega-3 Index values were significantly associated with greater connectivity of the amygdala with the posterior cingulate cortex, which was also associated with lower PHQ-8 scores. CONCLUSIONS Higher omega-3 PUFA status in young adults with moderate, but mean subthreshold depression was associated with lower depression rating scores and altered functional connectivity of brain regions shown to play a role in the neurobiology of depression.
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Affiliation(s)
- Paul Faulkner
- Department of Psychology, Queen Mary University of London, London, UK; Combined Universities Brain Imaging Centre, London, UK; School of Psychology, University of Roehampton, London, UK
| | - E Leigh Gibson
- School of Psychology, University of Roehampton, London, UK
| | - Simon C Dyall
- School of Life and Health Sciences, University of Roehampton, London, UK.
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Azalee M, Othman S, Wan Yuen C, Che Ha N, Mohd Zain N. Wounded Healers: Exploring Coping With Intimate Partner Violence Among Health Care Workers in Malaysia. Asia Pac J Public Health 2025:10105395251328421. [PMID: 40116416 DOI: 10.1177/10105395251328421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2025]
Abstract
Intimate partner violence (IPV) can affect individuals across various professions, including health care workers (HCWs). Therefore, this qualitative study aimed to explore the coping strategies of HCWs experiencing IPV in Malaysia, providing insights to inform workplace support mechanisms. In-depth interviews were conducted among six HCWs in a tertiary hospital who were also the survivors of IPV. The findings revealed that the survivors employed diverse coping strategies, including seeking help, inclining toward spirituality, avoiding abusive situations, engaging in self-harm, and staying or leaving abusive relationships. Survivors primarily relied on coworkers for support and only sought formal support assistance when situations became critical. While some supportive workplace responses were reported, some hesitated to seek help due to misconceptions about IPV, concerns about privacy, and fear of workplace gossip. To address these barriers, workplaces should make efforts to raise IPV awareness among employees and implement dedicated support policies tailored to the IPV survivors' coping needs.
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Affiliation(s)
- Mastura Azalee
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Professional Nursing Studies, Kulliyyah of Nursing, International Islamic University Malaysia, Kuantan, Malaysia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Choo Wan Yuen
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Norbani Che Ha
- Department of Management & Marketing, Faculty of Business and Economics, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Norhasmah Mohd Zain
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Sarwar R, Asmat A. Mental health expert's perspective on risk and protective factors of suicide ideation in Patients with OCD and depression. BMC Psychiatry 2025; 25:266. [PMID: 40119391 PMCID: PMC11927107 DOI: 10.1186/s12888-024-06404-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 12/12/2024] [Indexed: 03/24/2025] Open
Abstract
BACKGROUND Suicidal ideation and behavior present profound challenges in mental health care, particularly among individuals contending with Depression and Obsessive-Compulsive Disorder (OCD). While existing research has elucidated the intricate pathways through which depression and OCD independently contribute to suicide risk, there remains a critical gap in understanding the interplay between these disorders in shaping suicidal tendencies. AIM This qualitative study aims to address this gap by exploring expert's perspective about the risk and protective factors associated with suicidal ideation among individuals diagnosed with depression and OCD. METHOD Through semi-structured interviews with mental health experts, thematic analysis was employed to uncover the cognitive, emotional, and environmental stressors influencing suicidal thoughts and behaviors in this clinical population. RESULTS Findings reveal multifaceted cognitive vulnerabilities, adverse childhood experiences, and familial factors as prominent risk factors, while coping skills, social support, and religious beliefs emerged as key protective factors. CONCLUSION By illuminating the complex interplay of factors contributing to suicidal ideation in the context of comorbid depression and OCD, this study provides valuable insights for the development of targeted interventions aimed at mitigating suicide risk and improving outcomes for affected individuals.
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Affiliation(s)
- Roma Sarwar
- Department of Psychology, University of Central Punjab, Lahore, Pakistan.
| | - Alia Asmat
- Department of Psychology, University of Central Punjab, Lahore, Pakistan
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Abu-Farha R, Alzoubi KH, Gharaibeh L, Al-Ameri M, Nawasreh A, Binsaleh AY, Shilbayeh SAR. Roles and perceptions of community pharmacists in suicide prevention in Jordan: A cross-sectional study. J Am Pharm Assoc (2003) 2025:102388. [PMID: 40120810 DOI: 10.1016/j.japh.2025.102388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Revised: 03/09/2025] [Accepted: 03/17/2025] [Indexed: 03/25/2025]
Abstract
BACKGROUND Suicide is a major global public health issue, with mental health disorders closely linked to suicidal behaviors. Community pharmacists, as accessible health care providers, can play a key role in prevention but face challenges like limited training and societal stigma. OBJECTIVES This study aimed to evaluate community pharmacists' awareness regarding suicide warning signs, identify perceived barriers to engaging in suicide prevention, and assess their attitudes and perceptions regarding their role in mental health support in Jordan. METHODS A cross-sectional survey was conducted from August to September 2024 among practicing community pharmacists registered with the Jordanian Pharmacy Association. The study survey was distributed electronically through social media and professional networks, included questions on demographics, knowledge of suicide warning signs, training, experiences with suicidal patients, and perceptions of their role in mental health support. Data were analyzed using SPSS version 26 (IBM Corp.). RESULTS A total of 412 pharmacists participated in this study. Regarding familiarity with suicide warning signs, 150 (36.4%) reported being familiar; however, confidence in identifying suicide warning signs was low, with only 73 (17.7%) feeling very confident. Among the 208 (50.5%) pharmacists who encountered patients with suicidal thoughts, common warning signs included withdrawal from activities (181, 87.0%) and feelings of hopelessness (179, 86.1%). In response to these situations, 187 (89.9%) pharmacists provided empathetic support, 172 (82.7%) encouraged seeking professional help, and 167 (80.3%) assessed the seriousness of the situation. Barriers to effective intervention included cultural barriers (329, 79.9%), lack of training (327, 79.4%), and fear of offending patients (323, 78.4%). CONCLUSION Community pharmacists in Jordan recognize the importance of their role in suicide prevention but face barriers such as lack of training and cultural sensitivities. Enhancing training and providing clear guidelines can improve their effectiveness in supporting mental health and suicide prevention efforts.
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Fornaro M, Ricci C, Zotti N, Caiazza C, Viacava L, Rubinshtain Tal A, Calati R, Gonda X, Szabo G, De Prisco M, Oliva V, Fico G, Solmi M, Vieta E, Carvalho AF, Primavera D, Carta MG, de Bartolomeis A. Mental health during the 2022 Russo-Ukrainian War: A scoping review and unmet needs. J Affect Disord 2025; 373:12-27. [PMID: 39706484 DOI: 10.1016/j.jad.2024.12.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 11/29/2024] [Accepted: 12/14/2024] [Indexed: 12/23/2024]
Abstract
INTRODUCTION The Russo-Ukrainian War (RUW) poses a significant mental health burden, warranting a scoping review of the evidence to shed light on the unmet needs. METHODS MEDLINE/PubMed and EMBASE databases were inquired from inception until September 1st, 2023, to address the following a-priori-formulated questions: i) "Which psychiatric population has been assessed? How did the conflict affect the functioning of people with established mental health conditions (e.g., treatment adherence, hospitalization rates, and use of illicit substances)?" ii) "Did any psychiatric symptoms or disorders arise because of the RUW? If so, among which groups (e.g., civilians, combatants, refugees, caregivers) and in what geographical regions?", iii) "The impact of the Russo-Ukrainian war: what evidence focused on pre- and post-mental health status?", iv) "Did the conflict affect the rates of suicidal ideation or behaviors (e.g., attempt and death by suicide)? How did the war affect mental status, especially among vulnerable populations?", v) "What psychosocial or medical interventions have been adopted for internally displaced people or refugees complaining of mental health disturbances?", vi) "What rating tools or ad-hoc measures have been developed/adopted?", vii) "How did the existing evidence compare the RUW with other conflicts in different geographical regions or periods?". RESULTS Twenty-seven records addressed questions 1-3 and 5-6, with the female gender facing the highest burden. Reliable records about the Russian side of the conflict are needed. CONCLUSION Cohort studies across different phases of the RUW and populations are required to deliver effective clinical and public health interventions, especially to at-risk populations.
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Affiliation(s)
- Michele Fornaro
- Department of Neuroscience, Reproductive Science and Dentistry, Section of Psychiatry, Federico II University of Naples, Italy.
| | - Claudio Ricci
- Department of Neuroscience, Reproductive Science and Dentistry, Section of Psychiatry, Federico II University of Naples, Italy
| | - Nicolas Zotti
- Department of Neuroscience, Reproductive Science and Dentistry, Section of Psychiatry, Federico II University of Naples, Italy
| | - Claudio Caiazza
- Department of Neuroscience, Reproductive Science and Dentistry, Section of Psychiatry, Federico II University of Naples, Italy
| | - Luca Viacava
- Department of Neuroscience, Reproductive Science and Dentistry, Section of Psychiatry, Federico II University of Naples, Italy; "Mediterranea Saving Humans" (https://mediterranearescue.org/en), Italy
| | | | - Raffaella Calati
- Department of Psychology, University of Milan-Bicocca, Milan, Italy; Department of Adult Psychiatry, Nimes University Hospital, Nimes, France
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
| | - Georgina Szabo
- Buda Family-Centered Mental Health Center, North-Central Buda Center New Saint John Hospital and Outpatient Clinic, Budapest, Hungary; Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
| | - Michele De Prisco
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Vincenzo Oliva
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanna Fico
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada; Regional Centre for the Treatment of Eating Disorders and On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ontario, Canada; Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, Ontario, Canada; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Eduard Vieta
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Barcelona, Spain
| | - André Ferrer Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Diego Primavera
- Department of Public Health, University of Cagliari, Cagliari, CA, Italy
| | | | - Andrea de Bartolomeis
- Department of Neuroscience, Reproductive Science and Dentistry, Section of Psychiatry, Federico II University of Naples, Italy; Staff UNESCO - Chair for Health Education and Sustainable Development at Federico II University of Naples, Naples, Italy
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15
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Makiuchi T, Kakizaki M, Sobue T, Kitamura T, Yatsuya H, Yamaji T, Iwasaki M, Inoue M, Tsugane S, Sawada N. Mortality After Partner's Cancer Diagnosis or Death: A Population-based Prospective Cohort Study in Japan. J Epidemiol 2025; 35:118-128. [PMID: 39183033 PMCID: PMC11821380 DOI: 10.2188/jea.je20240114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 07/23/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND The health statuses of closely connected individuals are interdependent. Little is known about mortality risk associated with partner's cancer diagnosis and cause-specific mortality risk associated with partner's death. METHODS Relative risks for all-cause and cause-specific mortality following a partner's cancer diagnosis or death compared to the period when the partner is cancer-free and alive were investigated in the population-based prospective cohort study that enrolled 140,420 people at the age between 40-69 years in 1990-1994. RESULTS 55,050 participants (27,665 men and 27,385 women) who were identified as married couples were followed-up for 1,073,746.1 (518,368.5 in men and 555,377.6 in women) person-years, during which 9,816 deaths were observed (7,217 in men and 2,599 in women). After a partner's cancer diagnosis, the mortality rate ratio (MRR) of all-cause mortality was not increased among both men and women, while an increase of externally-caused MRR was observed. The suicide MRR significantly increased among men (MRR 2.90; 95% confidence interval, 1.70-4.93), and it persisted for more than 5 years. After a partner's death, the MRRs of all-cause, cardiovascular disease (CVD), respiratory disease (RD), and externally-caused mortality significantly increased only among men. Stratified analysis by smoking status among men showed significantly increased MRRs of CVD and RD mortality among former/current smokers, but not among never-smokers. CONCLUSION Partner's cancer diagnosis did not increase all-cause mortality risk, but increased externally-caused mortality risk, especially suicide among men. The impact of partner's death on mortality risk differed by the mortality causes and sex, and smoking affected some of cause-specific mortality risk.
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Affiliation(s)
- Takeshi Makiuchi
- Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masako Kakizaki
- Department of Medical Education, Nagoya City University School of Medicine, Aichi, Japan
| | - Tomotaka Sobue
- Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Taiki Yamaji
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Motoki Iwasaki
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Manami Inoue
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- International University of Health and Welfare Graduate School of Public Health, Tokyo, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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16
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Younis MS, Kamal MM, Arafat SMY. Suicidal Ideation Among Persons With Psychiatric Disorders: A Cross-Sectional Study at Outpatient Clinics in Iraq. Health Sci Rep 2025; 8:e70517. [PMID: 40051489 PMCID: PMC11882388 DOI: 10.1002/hsr2.70517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Revised: 12/11/2024] [Accepted: 02/11/2025] [Indexed: 03/09/2025] Open
Abstract
Background and Aims Mental illness is an important risk factor for suicidal ideation. However, little has been known about the burden and associated factors of suicidal ideation among persons with psychiatric disorders in Iraq. We aim to investigate the rate and the associated demographic and clinical factors of suicidal ideation among persons with mental illness in Iraq. Methods Data were collected from 388 persons with mental disorders from psychiatric outpatient clinics in Baghdad in 2023 for this cross-sectional study. The instrument contained socio-demographic and clinical variables, and the Columbia-Suicide Severity Rating Scale (C-SSRS). A descriptive analysis was conducted using the Chi-square test to determine the relationships in which a significance level of 0.05 was considered. Results Among the 388 respondents, 67% were males, and about half of the patients were younger than 40 years old. Affective (49.8%) and psychotic disorders (17.5%) were the most common mental disorders. The prevalence of suicidal ideation was 37.1% in the last year. The majority of suicidal ideation fell into a low severity range on the C-SSRS, particularly for patients who had no prior history of suicidal behavior. Suicidal ideation was significantly associated with female gender, crowded accommodations experiencing recent psychological trauma, presence of a family history of mental disorder, and family history of suicidal behavior. Conclusions Suicidal ideation was present in more than one-third of persons with psychiatric disorders. Policy-level implications could be warranted during regular appointments of psychiatric patients to identify risky individuals in outpatient settings.
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Affiliation(s)
| | - Marwa Mohamed Kamal
- The Scientific Council of Psychiatry, The Iraqi Council of Medical SpecializationsBaghdadIraq
| | - S. M. Yasir Arafat
- Department of PsychiatryBangladesh Specialized HospitalDhakaBangladesh
- Biomedical Research FoundationDhakaBangladesh
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17
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Güleç S. The role of intrinsic spirituality, emotion dysregulation, and resilience on post-traumatic stress disorder symptoms in university students who survived earthquake. Acta Psychol (Amst) 2025; 253:104755. [PMID: 39881458 DOI: 10.1016/j.actpsy.2025.104755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 01/22/2025] [Accepted: 01/22/2025] [Indexed: 01/31/2025] Open
Abstract
PURPOSE The study aimed to explore the relationship between intrinsic spirituality, emotion dysregulation, resilience, and PTSD in Turkish university students who were earthquake survivors. In addition, the validity and reliability of the Brief Emotion Dysregulation Scale (BEDS) were evaluated among Turkish university students who were earthquake survivors. METHODS A sample of 651 Turkish university students who were earthquake survivors participated in an online survey distributed via WhatsApp, completing the Intrinsic Spirituality Scale (ISS), the Brief Emotion Dysregulation Scale (BEDS), the Brief Resilience Scale (BRS), and the Post-Traumatic Stress Disorder Checklist for DSM-5. Structural equation modeling and mediation analysis were employed to explore the predictive relationships between these psychological variables and PTSD symptoms. RESULTS The findings confirmed that the BEDS is a valid and reliable scale for assessing emotion dysregulation levels in Turkish university students who were earthquake survivors. Intrinsic spirituality had a negative correlation between emotion dysregulation and PTSD, indicating that higher levels of PTSD are associated with lower intrinsic spirituality. A positive correlation was found between intrinsic spirituality and resilience, suggesting that increased intrinsic spirituality is linked to higher levels of resilience. Furthermore, emotion dysregulation and resilience were found to mediate the relationship between intrinsic spirituality and PTSD. Moreover, emotion dysregulation has a mediating effect in the relationship between resilience and PTSD. CONCLUSIONS The study highlights the determinant effects of intrinsic spirituality on emotional dysregulation, resilience and PTSD in Turkish university students who survived the earthquake. Interventions and support programs designed to reduce PTSD symptoms should benefit from the results of this research, and future research should include longitudinal studies to assess the long-term effects of intrinsic spirituality on PTSD. It is also crucial to examine the effects on various demographic groups, including differences in age, education level, and socio-economic status.
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Affiliation(s)
- Sezen Güleç
- Sivas Cumhuriyet University, Department of Psychology, Applied Psychology, Sivas, Turkey.
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18
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Palamar JJ, Jewell JS, El-Shahawy O, Black JC. Trends in poisonings involving ketamine in the United States, 2019-2023. Drug Alcohol Depend 2025; 268:112549. [PMID: 39827824 PMCID: PMC11832312 DOI: 10.1016/j.drugalcdep.2025.112549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Revised: 12/04/2024] [Accepted: 01/05/2025] [Indexed: 01/22/2025]
Abstract
BACKGROUND Off-label prescribing of ketamine to treat psychiatric disorders has been increasing, as has recreational use and availability of illicit ketamine. It is important to examine trends in ketamine-related poisonings to inform public health efforts. METHODS We examined data from poisonings (exposures) involving ketamine reported to Poison Centers in the US between 2019 and 2023 (n = 1519). Annual trends were examined for number of exposures and characteristics of exposures, and we delineated correlates of major (life-threatening) adverse effects and death compared to less severe outcomes. RESULTS The number of reported ketamine exposures increased from 205 in 2019 to 414 in 2023. Most cases involved ketamine ingestion (57.2 %), and a plurality involved misuse or "abuse" (36.2 %) and moderate effects (44.8 %). The percentage of cases involving suspected suicide attempts doubled from 12.7 % in 2019 to 25.9 % (a 103.9 % increase; P < 0.001); ingestion use increased from 46.0 % to 65.2 % (a 41.7 % increase; P < 0.001), and cases involving ketamine in liquid form decreased from 65.1 % to 41.2 % (a 36.7 % decrease; P < 0.001). Cases with major effects or death decreased from 23.4 % in 2019 to 15.6 % in 2023 (a 33.2 % decrease; P = 0.039). A major event or death was experienced by 18.6 % of cases, but prevalence was lower for those who inhaled ketamine (aPR=0.49, 95 % CI:0.29-0.85) compared to those who did not inhale. DISCUSSION Poisonings involving ketamine are at their highest in reporting history. Both medical and recreational ketamine use and related adverse events need to be monitored, especially as off-label prescribing of take-home oral formulations appears to be increasing.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
| | - Jennifer S Jewell
- Rocky Mountain Poison & Drug Safety (RMPDS), A Division of Denver Health, Denver, CO, USA
| | - Omar El-Shahawy
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Joshua C Black
- Rocky Mountain Poison & Drug Safety (RMPDS), A Division of Denver Health, Denver, CO, USA
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Sun J, Lin R, Wang S, Huang Y, Lam ST, Wang N, Zhao Y, Guo H, He Y, Peng H, Chen H, Wang X. The impact of workplace violence on the risk of suicide among Chinese correctional personnel: A chain mediation model with insomnia and depression as mediating variables. Int J Soc Psychiatry 2025:207640251317023. [PMID: 39995166 DOI: 10.1177/00207640251317023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2025]
Abstract
BACKGROUND Prison correctional personnel often experience increased workplace violence (WPV) and higher risk of suicide, but the link between the two is not yet clear. This study aims to explore the specific mediating variables and mediating paths between WPV and suicide. METHODS This is a cross-sectional study of 472 Chinese correctional personnel conducted through an online survey. We used the Workplace Violence Scale (WVS), the Athens Insomnia Scale (AIS), the Chinese version of the Depression Anxiety Stress Scale (DASS), and the revised Beck Suicidal Ideation scale (BSI) to quantify the WPV experienced by subjects and their mental health status. Data analysis, including mediation and network analysis, was performed using SPSS and R software. RESULTS Presence of insomnia and/or depression mediated the relationship between WPV and suicide risk, which accounted for 36.62% of the total effect. Insomnia alone accounted for 9.87%, depression alone accounted for 12.73%, whereas both put together accounted for 14.03%. Male personnel experienced more WPV than their female counterparts, and WPV in men had a stronger association with suicide risk. Network analysis indicated that daytime dysfunction and downheartedness were important nodes in mediating pathways. CONCLUSIONS Experiencing WPV may lead to an increased risk of suicide among correctional personnel, particularly men, with insomnia and depression mediating the experienced risk. Correctional institutions should take measures to reduce the occurrence of WPV experienced by correctional personnel mitigate the impact of this occupational hazard, and prioritise the mental health of correctional personnel, particularly those already experiencing worrying symptoms.
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Affiliation(s)
- Jingyan Sun
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for mental disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ruihan Lin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for mental disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Siyuan Wang
- Pingtang Compulsory Isolation Detoxification Institute in Hunan Province, Changsha, China
| | - Ying Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for mental disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Sze Tung Lam
- National University of Singapore, Saw Sweet Hock School of Public Health, Singapore
- Institute of Mental Health, Buangkok Green, Medical Park, Singapore
| | - Nan Wang
- Institute of Mental Health, Buangkok Green, Medical Park, Singapore
| | - Yixin Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for mental disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Huijuan Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for mental disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yuqiong He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for mental disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hanrui Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for mental disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hui Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for mental disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoping Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for mental disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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Rojo-Romero MA, Gutiérrez-Nájera NA, Cruz-Fuentes CS, Romero-Pimentel AL, Mendoza-Morales R, García-Dolores F, Morales-Marín ME, Castro-Martínez X, González-Sáenz E, Torres-Campuzano J, Medina-Sánchez T, Hernández-Fonseca K, Nicolini-Sánchez H, Jiménez-García LF. Proteome analysis of the prefrontal cortex and the application of machine learning models for the identification of potential biomarkers related to suicide. Front Psychiatry 2025; 15:1429953. [PMID: 40051599 PMCID: PMC11882514 DOI: 10.3389/fpsyt.2024.1429953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 12/24/2024] [Indexed: 03/09/2025] Open
Abstract
Introduction Suicide is a significant public health problem, with increased rates in low- and middle-income countries such as Mexico; therefore, suicide prevention is important. Suicide is a complex and multifactorial phenomenon in which biological and social factors are involved. Several studies on the biological mechanisms of suicide have analyzed the proteome of the dorsolateral prefrontal cortex (DLPFC) in people who have died by suicide. The aim of this work was to analyze the protein expression profile in the DLPFC of individuals who died by suicide in comparison to age-matched controls in order to gain information on the molecular basis in the brain of these individuals and the selection of potential biomarkers for the identification of individuals at risk of suicide. In addition, this information was analyzed using machine learning (ML) algorithms to propose a model for predicting suicide. Methods Brain tissue (Brodmann area 9) was sampled from male cases (n=9) and age-matched controls (n=7). We analyzed the proteomic differences between the groups using two-dimensional polyacrylamide gel electrophoresis and mass spectrometry. Bioinformatics tools were used to clarify the biological relevance of the differentially expressed proteins. In addition, this information was analyzed using machine learning (ML) algorithms to propose a model for predicting suicide. Results Twelve differentially expressed proteins were also identified (t 14 ≤ 0.5). Using Western blotting, we validated the decrease in expression of peroxiredoxin 2 and alpha-internexin in the suicide cases. ML models were trained using densitometry data from the 2D gel images of each selected protein and the models could differentiate between both groups (control and suicide cases). Discussion Our exploratory pathway analysis highlighted oxidative stress responses and neurodevelopmental pathways as key processes perturbed in the DLPFC of suicides. Regarding ML models, KNeighborsClassifier was the best predicting conditions. Here we show that these proteins of the DLPFC may help to identify brain processes associated with suicide and they could be validated as potential biomarkers of this outcome.
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Affiliation(s)
- Manuel Alejandro Rojo-Romero
- Programa de Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
- National Institute of Psychiatry “Ramón de la Fuente Muñíz”, Mexico City, Mexico
| | - Nora Andrea Gutiérrez-Nájera
- Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | | | - Ana Luisa Romero-Pimentel
- Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Roberto Mendoza-Morales
- Institute of Expert Services and Forensic Sciences of Mexico City (INCIFO), Mexico City, Mexico
| | - Fernando García-Dolores
- Institute of Expert Services and Forensic Sciences of Mexico City (INCIFO), Mexico City, Mexico
| | - Mirna Edith Morales-Marín
- Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Xóchitl Castro-Martínez
- Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | | | - Jonatan Torres-Campuzano
- Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Tania Medina-Sánchez
- National Institute of Psychiatry “Ramón de la Fuente Muñíz”, Mexico City, Mexico
| | | | - Humberto Nicolini-Sánchez
- Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Luis Felipe Jiménez-García
- Cell Nanobiology Laboratory, Faculty of Sciences, National Autonomous University of Mexico, Mexico City, Mexico
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21
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Ponce-Regalado MD, Becerril-Villanueva E, Maldonado-García JL, Moreno-Lafont MC, Martínez-Ramírez G, Jacinto-Gutiérrez S, Arreola R, Sánchez-Huerta K, Contis-Montes de Oca A, López-Martínez KM, Bautista-Rodríguez E, Chin-Chan JM, Pavón L, Pérez-Sánchez G. Comprehensive view of suicide: A neuro-immune-endocrine approach. World J Psychiatry 2025; 15:98484. [PMID: 39974471 PMCID: PMC11758041 DOI: 10.5498/wjp.v15.i2.98484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 11/26/2024] [Accepted: 12/23/2024] [Indexed: 01/14/2025] Open
Abstract
Suicide is defined as the act of a person attempting to take their own life by causing death. Suicide is a complex phenomenon that is influenced by a multitude of factors, including psychosocial, cultural, and religious aspects, as well as genetic, biochemical, and environmental factors. From a biochemical perspective, it is crucial to consider the communication between the endocrine, immune, and nervous systems when studying the etiology of suicide. Several pathologies involve the bidirectional communication between the peripheral activity and the central nervous system by the action of molecules such as cytokines, hormones, and neurotransmitters. These humoral signals, when present in optimal quantities, are responsible for maintaining physiological homeostasis, including mood states. Stress elevates the cortisol and proinflammatory cytokines levels and alter neurotransmitters balance, thereby increasing the risk of developing a psychiatric disorder and subsequently the risk of suicidal behavior. This review provides an integrative perspective about the neurochemical, immunological, and endocrinological disturbances associated with suicidal behavior, with a particular focus on those alterations that may serve as potential risk markers and/or indicators of the state preceding such a tragic act.
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Affiliation(s)
- María D Ponce-Regalado
- Departamento de Ciencias de la Salud, Centro Universitario de los Altos, Universidad de Guadalajara, Tepatitlán de Morelos 47620, Jalisco, Mexico
| | - Enrique Becerril-Villanueva
- Laboratorio de Psicoinmunología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 11340, Mexico
| | - José Luis Maldonado-García
- Laboratorio de Psicoinmunología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 11340, Mexico
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Ciudad de México 04510, Mexico
- Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 11350, Mexico
| | - Martha C Moreno-Lafont
- Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 11350, Mexico
| | - Gabriela Martínez-Ramírez
- Laboratorio de Psicoinmunología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 11340, Mexico
- Facultad de Medicina, Facultad de Estudios Superiores Iztacala, Universidad Nacional autónoma de México, Tlalnepantla 54090, Mexico
| | - Salomón Jacinto-Gutiérrez
- Laboratorio de Psicoinmunología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 11340, Mexico
| | - Rodrigo Arreola
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 11340, Mexico
| | - Karla Sánchez-Huerta
- Laboratorio de Neurociencias, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Ciudad de México 04530, Mexico
| | - Arturo Contis-Montes de Oca
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
| | | | | | - José Miguel Chin-Chan
- Facultad de Ciencias Químico-Biológicas, Universidad Autónoma de Campeche, Campeche 24039, Mexico
| | - Lenin Pavón
- Laboratorio de Psicoinmunología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 11340, Mexico
| | - Gilberto Pérez-Sánchez
- Laboratorio de Psicoinmunología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México 11340, Mexico
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Barbaree HE, Perlman C, Ham E, Brown GP, Hirdes JP. Validation of a composite outcome measure for inpatient psychiatry using scales from the interRAI-MH. Front Psychiatry 2025; 16:1486734. [PMID: 39980981 PMCID: PMC11839811 DOI: 10.3389/fpsyt.2025.1486734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 01/09/2025] [Indexed: 02/22/2025] Open
Abstract
Background Inpatient psychiatry is a critical service in a community-based care system for persons with serious mental illness (SMI). Currently, there are few generally accepted or widely used outcomes to assess the effectiveness of inpatient treatment. Method Following a Donabedian Model of Health Care Quality, we utilized eight scales from the RAI Mental Health assessment to derive a clinician-scored outcome measure consisting of 4 domains (Psychosis, Depression, Impairment, and Aggression). We combined subscales measuring these domains into a Composite Measure. We used this measure to assess the entire population (N=719) of our large specialized mental health hospital at the beginning (T1) and end (T2) of three months in the hospital (or admission to discharge in shorter stays). We evaluated the content validity of the measure by comparing items and scales with a list of putative contributors to hospital admission (symptoms and complications). To evaluate concurrent validity, we compared mean scores among hospital units with varying lengths of stay and clinical complexity (acute versus chronic versus complex chronic). We used ROC analysis to evaluate the CIIMHS's ability to predict discharge from the hospital. To evaluate construct validity, we examined the measure's responsiveness to changes among patients after treatment in the hospital. Results We found strong evidence for all four kinds of validity. Conclusions The composite measure represents a valid measure of inpatient mental health status and will serve as a valuable measure of the quality of care for inpatient psychiatry.
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Affiliation(s)
| | - Christopher Perlman
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Elke Ham
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
| | - Gregory P. Brown
- Criminal Justice Department, Nipissing University, North Bay, ON, Canada
| | - John P. Hirdes
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Albrecht S, Rickwood D, Telford N, Privitera G, Palfrey N. Suicidality in Primary Care, Youth Mental Health Services: Prevalence, Risk Factors and Implications for Practice. Early Interv Psychiatry 2025; 19:e70020. [PMID: 39932100 PMCID: PMC11812076 DOI: 10.1111/eip.70020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 11/26/2024] [Accepted: 01/28/2025] [Indexed: 02/14/2025]
Abstract
INTRODUCTION Youth suicide is a concern worldwide, and suicidality-the presence of suicidal ideation or intent-is a critical risk for youth mental health services. This study aimed to determine the prevalence of suicidality in primary care, youth mental health services, along with its correlates and the course of treatment offered to clients. METHODS Routinely collected data from Australia's headspace National Youth Mental Health Foundation, which has over 160 centres across Australia providing mental health care to young people aged 12-25 years, were analysed for new clients who started and completed their first episode of care between 1 July 2022 and 30 June 2023. This included 30 437 young people/episodes of care and 74 393 occasions of service. RESULTS Results showed that suicidality was evident in almost one-quarter of young people, although it was rarely reported as a primary presenting issue. When present, it was usually identified at first visit. Those most at risk were young people in unstable accommodation, who identified as LGBTIQA+ or who were indigenous. CONCLUSIONS The findings show that suicidality should be anticipated in young people presenting to primary care mental health settings, and youth services need to be able to competently deal with suicide risk rather than using this as exclusion criteria.
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Affiliation(s)
- Sabina Albrecht
- Evaluation and Monitoring, Headspace National Youth Mental Health FoundationMelbourneAustralia
| | - Debra Rickwood
- Evaluation and Monitoring, Headspace National Youth Mental Health FoundationMelbourneAustralia
- Faculty of HealthUniversity of CanberraCanberraAustralia
| | - Nic Telford
- Evaluation and Monitoring, Headspace National Youth Mental Health FoundationMelbourneAustralia
| | - Georgia Privitera
- Evaluation and Monitoring, Headspace National Youth Mental Health FoundationMelbourneAustralia
| | - Nicola Palfrey
- Clinical LeadershipHeadspace National Youth Mental Health FoundationMelbourneAustralia
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Movahed E, Afsharmanesh A, Aqarabi H, Raesi R, Hushmandi K, Daneshi S. Comparison of the trend of suicide before and after the COVID-19 pandemic in Southeast Iran from 2016 to 2023. BMC Public Health 2025; 25:66. [PMID: 39773728 PMCID: PMC11706065 DOI: 10.1186/s12889-024-21265-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2024] [Accepted: 12/31/2024] [Indexed: 01/11/2025] Open
Abstract
BACKGROUND Suicide, as one of the most important psychological consequences of the COVID-19 pandemic, can be a threat to public health. Understanding the changes in suicide rates before and after the pandemic provides insights into the psychological effects of such crises on communities. This study aimed to compare the trends in suicide and suicide attempt rates in Southeast Iran before and after the COVID-19 pandemic, covering the period from 2016 to 2023. METHODS This descriptive-analytical study was conducted through a census method on 5676 individuals who attempted suicide from 2016 to 2023. Medical records of those who attempted suicide were collected from the integrated system of the Ministry of Health (SIB) during the specified years. The data was collected using a checklist and analyzed with descriptive and inferential statistical tests at the significance level of P < 0.05. RESULTS The findings indicate a significant increase in suicide rates after the COVID-19 pandemic, with 61.8% of the total 5,676 cases occurring post-pandemic compared to 38.2% before. The most affected demographic was young adults aged 19 to 34, whose suicide rates increased by a factor of 9.8, while women experienced a notable rise of 28.2 times in suicide rates after the pandemic. Additionally, uneducated individuals had the highest suicide rates, with a dramatic increase of 35.8 times among illiterate individuals after COVID-19, highlighting the urgent need for targeted mental health interventions and support systems. CONCLUSION A significant increase in suicide rates after the COVID-19 pandemic, particularly among young adults and women, highlights the urgent need for targeted mental health interventions, especially for vulnerable groups such as housewives and single individuals. Additionally, the correlation between education levels and suicide rates underscores the importance of addressing educational disparities as part of comprehensive mental health strategies.
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Affiliation(s)
- Ehsan Movahed
- Department of Public Health, School of Public Health, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Asma Afsharmanesh
- School of Medicine, Imam Khomeini Hospital, Jiroft University of Medical Science, Jiroft, Iran
| | - Hadiseh Aqarabi
- School of Medicine, Imam Khomeini Hospital Jiroft University of Medical Sciences, Jiroft, Iran
| | - Rasoul Raesi
- Department of Public Health, School of Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
- Department of Health Services Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiavash Hushmandi
- Nephrology and Urology Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Salman Daneshi
- Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran.
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Rushendran R, Chitra V. Exploring infodemiology: unraveling the intricate relationships among stress, headaches, migraines, and suicide through Google Trends analysis. Front Big Data 2025; 7:1365417. [PMID: 39839157 PMCID: PMC11747232 DOI: 10.3389/fdata.2024.1365417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 12/13/2024] [Indexed: 01/23/2025] Open
Abstract
Introduction Google Trends has emerged as a vital resource for understanding public information-seeking behavior. This study investigates the interconnected search trends of stress, headaches, migraines, and suicide, highlighting their relevance to public health and mental well-being. By employing infodemiology, the study explores temporal and geographical patterns in search behavior and examines the impact of global events like the COVID-19 pandemic. Methods Data mining was conducted using Google Trends for the search terms "stress," "headache," "migraine," and "suicide." Relative Search Volume (RSV) data from October 2013 to October 2023 was collected and adjusted for time and location. Statistical analyses, including Pearson correlation tests, linear regression, and seasonal Mann-Kendall tests, were applied to identify correlations, trends, and seasonal variations. Geographical differences were also analyzed to understand regional disparities. Results Significant correlations were observed among the search terms, with "migraine" and "suicide" showing the strongest association. Seasonal variations revealed a peak in search volumes during winter months. Geographical analysis highlighted consistently high RSV in the Philippines for all terms. During the COVID-19 pandemic, searches for stress, headaches, and migraines showed notable increases, reflecting heightened public interest in mental health-related topics during this period. Discussion The study underscores the interconnected nature of stress, headaches, migraines, and suicide in public search behavior. Seasonal patterns and regional variations emphasize the need for targeted interventions. The observed surge in search volume during the COVID-19 pandemic highlights the profound impact of global crises on mental health and the importance of timely public health responses. Conclusion Google Trends provides valuable insights into the public's interest in health-related topics, demonstrating the intricate relationship between stress, headaches, migraines, and suicide. The findings highlight the need for increased mental health awareness and interventions, particularly during times of heightened stress. Further research is essential to develop strategies that mitigate the impact of these stressors on public health.
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Affiliation(s)
| | - Vellapandian Chitra
- Department of Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India
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Guo Z, Han X, Kong T, Wu Y, Kang Y, Liu Y, Wang F. Assessment and analysis of factors influencing suicidal ideation in young adults: a large cohort study using an elastic network logistic regression model. BMC Psychiatry 2025; 25:15. [PMID: 39762774 PMCID: PMC11705669 DOI: 10.1186/s12888-024-06415-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 12/17/2024] [Indexed: 01/11/2025] Open
Abstract
OBJECTIVES This study aims to review and analyze factors associated with suicidal ideation to provide a rationale for subsequent effective interventions. METHODS Data from this study were obtained from the Assessing Nocturnal Sleep/Wake Effects on Risk of Suicide (ANSWERS). The University of Arizona evaluated 404 young adults aged 18-25 years using different scales. Then, general demographic data was recorded. An elastic network (EN) was used to optimize feature selection, combined with logistic regression, to determine the influencing factors associated with SI in young adults. RESULTS The EN regression retained 11 potential influencing factors with nonzero coefficients. In the multivariate logistic regression analysis, INQ-15 perceived burdensomeness (PB) scores (OR: 1.10, 95% CI: 1.04-1.17), CESD depression mood scores (OR: 1.16, 95% CI: 1.07-1.26), and age (OR: 0.72, 95% CI: 0.55-0.94) were significant factors for SI. CONCLUSIONS This is the first study to use an Elastic Network logistic regression model to assess the factors affecting suicidal ideation in young adults. Perceived Burdensome, depression, and age play an important risk role and are the best predictor combination of suicidal ideation in young adults, with depression being the most significant risk factor. Increased focus on Perceived Burdensome and negative emotions, along with simultaneous interventions for other potentially influential factors, can be more effective in preventing suicidal behavior in young adults.
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Affiliation(s)
- Zixuan Guo
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China
| | - Xiaoli Han
- Clinical Nutrition Department, Friendship hospital of Urumqi, Urumqi, 830049, China
| | - Tiantian Kong
- Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830063, China
| | - Yan Wu
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China
| | - Yimin Kang
- Medical Neurobiology Lab, Inner Mongolia Medical University, Hohhot, 010110, China.
- Inner Mongolia Medical University, Hohhot, 010110, China.
| | - Yanlong Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China.
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China.
- Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830063, China.
- The Second Affiliated Hospital, Xinjiang Medical University, Urumqi, 830063, China.
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Moon JY, Kim SY, Yang S, Yoon S. Validity and Reliability of the Korean Version of Gotland Male Depression Scale. Psychiatry Investig 2025; 22:102-109. [PMID: 39885797 PMCID: PMC11788832 DOI: 10.30773/pi.2024.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 09/09/2024] [Accepted: 11/17/2024] [Indexed: 02/01/2025] Open
Abstract
OBJECTIVE Despite lower depression rates in men than in women, men's suicide rates are significantly higher, suggesting potential gaps in depression screening. Rutz et al. developed the Gotland Male Depression Scale (GMDS), which includes symptoms commonly associated with male depression. This study was conducted to validate the Korean version of the GMDS (K-GMDS). METHODS The K-GMDS, Patient Health Questionnaire-9 (PHQ-9), and outpatient records of 233 new patients at the outpatient psychiatry department of Catholic University Hospital in Daegu from February and May 2022 were retrospectively reviewed. Internal consistency was measured using Cronbach's α, and external validity was tested by analyzing the scale's correlation with the PHQ-9. The screening capacity of the K-GMDS was tested based on the receiver operating characteristic (ROC) curve, sensitivity, specificity, and overall accuracy. RESULTS Of 233 patients, 42.6% (n=98) were classified to the depression group. Cronbach's α was 0.92, and external validity was established with a Pearson's correlation coefficient of 0.83 between the total score of the K-GMDS and the PHQ-9. While there were no significant differences in the area under the ROC curve between the K-GMDS and the PHQ-9, the K-GMDS had better sensitivity, specificity, and overall accuracy in screening depressive symptoms among men compared to the PHQ-9. CONCLUSION The K-GMDS exhibits satisfactory reliability and validity in psychiatric outpatient settings and outperforms the PHQ-9 in screening for depression among men. This study will be useful in developing male depression scales that are currently unavailable in South Korea.
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Affiliation(s)
- Jung Yeon Moon
- Department of Psychiatry, Daegu Catholic University School of Medicin, Daegu, Republic of Korea
| | - Seong Yoon Kim
- Department of Psychiatry, Daegu Catholic University School of Medicin, Daegu, Republic of Korea
| | - Seungheon Yang
- Department of Psychiatry, Daegu Catholic University School of Medicin, Daegu, Republic of Korea
| | - Seoyoung Yoon
- Department of Psychiatry, Daegu Catholic University School of Medicin, Daegu, Republic of Korea
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Jidong DE, Ike TJ, Murshed M, Nyam PP, Husain N, Jidong JE, Pwajok JY, Francis C, Mwankon SB, Okoli E. Interventions for Self-Harm and Suicidal Ideation in Africa: A Systematic Review. Arch Suicide Res 2025; 29:1-25. [PMID: 38506246 DOI: 10.1080/13811118.2024.2316168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND Self-harm and suicidal ideation are increasing public health concerns globally and are paramount in Africa. Therefore, a review of suicidal ideation and self-harm interventions would be beneficial in identifying culturally appropriate interventions for the African context. METHOD The Population, phenomenon of Interest and Context (PICo) model was adopted to formulate the review strategy. Thus, the Population (Africans), phenomenon of Interest (intervention) and Context (self-harm and suicidal ideation). We used this PICo strategy which is a modified version of PICO for qualitative studies. Framework with Boolean operators (AND/OR/NOT) was further used to ensure rigor through search terms such as ("Suicide" OR "suicidal ideation") AND ("Intervention" OR "Treatment" OR "Therapy" OR "Psychological" OR "Psychosocial" OR "Culturally adapted") AND "Africa" OR "African countries." Six databases were searched (Embase, PsycINFO, ProQuest Central, Cochrane Controlled Trials Register, Medline, and Web of Science) for published articles between 2000 and March 2023. N = 12 studies met the inclusion criteria, and the relevant data extracted were synthesized and thematically analyzed. The review protocol was pre-registered on the PROSPERO Registry (no. CRD42021283795). RESULTS N = 12 studies met the inclusion criteria, and the following themes emerged from the synthesized literature and analyses of current African approaches to curbing self-harm and suicidal ideation: (a) Western medical and compassion-focused intervention (b) the helpful role of traditional healing and healers (c) psychoeducation and self-help techniques (d) use of technology and a nation-wide approach. CONCLUSION Self-harm and suicidal ideation are global health concerns. To address this health concern in Africa, the authors recommend culturally adapted psychological interventions to be tested via randomized control trials.
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Tanaka S, Matsubayashi T. The light of life: The effects of sunlight on suicide. JOURNAL OF HEALTH ECONOMICS 2025; 99:102947. [PMID: 39671959 DOI: 10.1016/j.jhealeco.2024.102947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 07/18/2024] [Accepted: 11/26/2024] [Indexed: 12/15/2024]
Abstract
This study examines the causal effects of sunlight exposure on suicide rates. Leveraging county-month-year data on solar insolation and suicide rates in the U.S. from 1979 to 2004, we provide first robust evidence that insufficient sunlight increases suicide rates. We also find that insufficient sunlight increases Google searches containing depressive language, suggesting a potential adverse impact on mental well-being. Importantly, our findings favor a biological pathway over alternative mechanisms. The estimated effect of sunlight on suicide, often exceeding other interventions in magnitude, sheds new light on sunlight as a significant risk factor in suicide incidence.
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Affiliation(s)
- Shinsuke Tanaka
- University of Connecticut, 1376 Storrs Road, Unit 4021 Storrs, CT 06269, USA.
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30
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Persechino ST, Morin D, Bardon C. An Exploratory Study on the Suicidal Behaviours of People With Intellectual Disability or Autism: Examining Their Understanding of Suicide and Death, and the Perceptions of Their Direct Support Staff. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2025; 38:e13318. [PMID: 39469817 DOI: 10.1111/jar.13318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 10/02/2024] [Accepted: 10/14/2024] [Indexed: 10/30/2024]
Abstract
BACKGROUND Individuals with intellectual disability or autism exhibit suicidal behaviours at an equal or greater rate than the general population, yet little is known about associated risk factors. This study explores suicidality in these populations, focusing on their understanding of suicide and death and perceptions of their direct support staff regarding their suicidality. METHOD Semi-structured interviews from 23 suicidal and non-suicidal participants and their support staff were analysed qualitatively to extract common themes and compare between groups. RESULTS A breadth of suicidal behaviours was documented. Generally, suicidal participants demonstrated a more elaborate understanding of suicide and death than non-suicidal participants. While staff often acknowledged never having discussed the topic with their client, most assumed they understood death accurately. CONCLUSION Results suggest interactions between conceptions of death and suicidal behaviour and a need for discussion around death and suicide in clinical settings. Implications for future research and clinical practice are discussed.
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Affiliation(s)
| | - Diane Morin
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Cécile Bardon
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
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Le GH, Wong S, Au H, Badulescu S, Gill H, Vasudeva S, Teopiz KM, Rhee TG, Ho R, Kwan ATH, Mansur RB, Rosenblat JD, McIntyre RS. Association between rumination, suicidal ideation and suicide attempts in persons with depressive and other mood disorders and healthy controls: A systematic review and meta-analysis. J Affect Disord 2025; 368:513-527. [PMID: 39303880 DOI: 10.1016/j.jad.2024.09.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 09/11/2024] [Accepted: 09/16/2024] [Indexed: 09/22/2024]
Abstract
INTRODUCTION Suicidal ideation and behaviors are a leading cause of disability worldwide. Approximately 90 % of suicide completers have a diagnosable mood disorder. Extant literature reports rumination mediates functional impairment across mood disorders. Herein, we report the association between rumination and suicidality amongst persons with psychiatric disorders and healthy controls. METHODS Our systematic review and meta-analysis included relevant articles retrieved from Web of Science, OVID and PubMed from inception to March 20, 2024. Random effects model was used to calculate the correlation between rumination, suicidal ideation and attempt. RESULTS A total of 27 eligible studies were included in our systematic review and meta-analysis. Rumination (r = 0.25 [95 % CI: -0.03, 0.49]), reflection (r = 0.15 [-0.71, 0.83]) and brooding (r = 0.13 [-0.58, 0.73]) were nonsignificantly correlated with suicidal ideation in mood disorders. Suicide attempt history was significantly associated with greater odds of rumination in persons with depressive disorders (OR = 1.13 [0.42, 3.02]). In healthy controls, rumination (r = 0.30 [0.21, 0.38]), reflection (r = 0.23 [0.13, 0.32]) and brooding (r = 0.24 [0.12, 0.36]) were significantly correlated with suicidal ideation. Rumination also predicted lifetime history of suicide attempts in healthy controls (OR = 1.70 [1.16, 2.49]). LIMITATIONS There were inadequate sample sizes of persons with different mood and psychiatric disorders which may have underpowered our ability to detect clinically meaningful associations. DISCUSSION Our study reports a transdiagnostic association between measures of rumination and suicidality. Future research vistas should parse the neurobiological substrates subserving rumination and identify targeted therapies and their association with general cognition and treatment response.
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Affiliation(s)
- Gia Han Le
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada.
| | - Sabrina Wong
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada.
| | - Hezekiah Au
- Brain and Cognition Discovery Foundation, Toronto, Canada.
| | - Sebastian Badulescu
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada.
| | - Hartej Gill
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada.
| | - Shreya Vasudeva
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada.
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, Canada.
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore; Institute for Health Innovation and Technology (iHealthtech), National University of Singapore; Division of Life Science (LIFS), Hong Kong University of Science and Technology, Hong Kong.
| | - Angela T H Kwan
- Brain and Cognition Discovery Foundation, Toronto, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Rodrigo B Mansur
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada.
| | - Joshua D Rosenblat
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada.
| | - Roger S McIntyre
- Mood Disorder and Psychopharmacology Unit, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Brain and Cognition Discovery Foundation, Toronto, Canada; Department of Pharmacology & Toxicology, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
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Ali SAEZ, Saleem T, Arafat SMY. Risk Factors for Suicide in Pakistan: A Mixed Methods Study of Psychological Autopsies and Perspectives of Health Professionals. Arch Suicide Res 2024:1-20. [PMID: 39688387 DOI: 10.1080/13811118.2024.2436635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2024]
Abstract
BACKGROUND Suicide is a significant but understudied public health concern in developing nations like Pakistan, where risks factors have not been investigated by mixed methods studies. Hence, we aimed to explore the risk factors for suicide based on a mixed methodology. METHODS This study followed a mixed methods convergent component design. A retrospective case-control psychological autopsy with a semistructured interview protocol was performed. Additionally, health professionals' opinions on the psychiatric risk factors for suicide were assessed through qualitative interviews. Data were collected between 2021 and 2022 and analyzed by SPSS (V-25) and thematic analysis (NVIVO-12 Plus). RESULTS Based on the mixed methods meta-inferences, suicidal ideation; depression; hopelessness; social isolation; previous history of self-harm and traumatic experiences; lack of motivation; purposelessness; feeling like a burden; substance abuse; impulsivity; anger; anxiety; psychiatric disorders such as personality disorders, bipolar disorder, schizophrenia, gaming addiction, and eating disorders; and family history of psychiatric illness were identified as risk factors for suicide. CONCLUSION More must be learned about the mental health components contributing to suicide and the culturally appropriate prevention methods used in Pakistan. This study reveals novel targets for suicide prevention and may aid policymaking by providing a better understanding of predictors and specific psychiatric characteristics of suicide in Pakistan.
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Park HJ, Han B, Kim B, Han K, Kim S, Kim H, Youn K, Park HJ, Roh YK, Choi YS, Nam GE, Kim SM. Relationship between smoking experience and risk of suicide mortality in South Korean adults: A nationwide population-based retrospective cohort study. J Affect Disord 2024; 367:67-74. [PMID: 39222855 DOI: 10.1016/j.jad.2024.08.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 08/27/2024] [Accepted: 08/30/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Korea has one of the highest suicide rates in the world. Many factors associated with suicidal thoughts or behaviors are known. This study examines the association between 1) smoking status or intensity (pack-years) and 2) risk of suicide mortality in South Korea. METHODS We analyzed data from 3,966,305 individuals aged ≥20 who underwent health examinations conducted by the South Korean National Health Insurance Service in 2009 and were followed until December 2021. Participants were categorized based on their baseline smoking status and intensity. We performed a Multivariate Cox proportional hazards regression analysis with subgroup analysis by age, sex, body mass index, alcohol consumption, regular exercise, and depression. RESULTS During an 11.1-year follow-up period, 12,326 individuals died by suicide. Compared with never-smokers, increased hazard ratios of suicide mortality were observed in current smokers (1.64, 95 % CI = 1.56-1.72), but not in ex-smokers. The suicide mortality risk of current smokers increased for all types of smoking intensity without a dose-response relationship. The association between smoking and suicide mortality risk was stronger among women, non-drinkers, adults aged <40 years, non-obese patients, and individuals without depression. LIMITATION Given that the study used retrospective data, the causal relationship remains unclear. CONCLUSION Current smoking is associated with a significant increased risk of suicide mortality. Smoking cessation is crucial to prevent suicide, especially among young adults, non-obese individuals, non-drinkers, women, and those without depression. Government policies in South Korea should focus on raising awareness about smoking hazards and providing cessation education to reduce the suicide mortality.
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Affiliation(s)
- Hyo Jin Park
- Department of Family Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Byoungduck Han
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Bongseong Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Seohwan Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyunjoo Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyoungjoon Youn
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyun Jin Park
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Kyun Roh
- Department of Family Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Youn Seon Choi
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ga Eun Nam
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seon Mee Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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Soraci P, Bevan N, Griffiths MD, Pisanti R, Servidio R, Ferrari A, Di Bernardo C, Pakpour AH. The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): an Italian validation using confirmatory factor analysis and Rasch analysis. BMC Psychol 2024; 12:680. [PMID: 39574182 PMCID: PMC11580197 DOI: 10.1186/s40359-024-02177-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 11/07/2024] [Indexed: 11/25/2024] Open
Abstract
The present study examined the psychometric properties of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). A total of 742 Italian participants (84.6% female), with a mean age of 33.08 years (SD = 12.44) took part in a cross-sectional survey study. Confirmatory factor analysis and Rasch analysis were used to examine the psychometric properties. The CFA showed that the SWEMWBS had a unidimensional structure with robust psychometric properties and showed good internal consistencies (Cronbach's alpha 0.88; McDonald's omega 0.91). Overall, most items showed no substantial differential item functioning in the Rasch analysis, except for Item 7, indicating that female participants reported more difficulty with this item than the male participants. The SWEMWBS was positively associated with life satisfaction and negativity associated with general psychological distress (i.e., anxiety, stress, and depression). In sum, the SWEMWBS showed robust psychometric properties capable of assessing positive aspects of mental health and well-being among Italian-speaking adults.
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Affiliation(s)
- Paolo Soraci
- Department of Economic, Psychological and Communication Sciences, Niccolò Cusano University, Via Don Carlo Gnocchi 3, Rome, Italy.
| | - Nadia Bevan
- School of Social Sciences, Faculty of Arts, Monash University, Clayton, VIC, Australia
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Renato Pisanti
- Department of Economic, Psychological and Communication Sciences, Niccolò Cusano University, Via Don Carlo Gnocchi 3, Rome, Italy
| | - Rocco Servidio
- Department of Culture, Education and Society, University of Calabria, Arcavacata di Rende, 87036, Italy
| | - Ambra Ferrari
- Play Better Associazione, via della Libertà 57/D, Agliana (PT), 51031, Italy
| | | | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
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Akins GKH, Furtado JM, Smith JR. Diseases Caused by and Behaviors Associated with Toxoplasma gondii Infection. Pathogens 2024; 13:968. [PMID: 39599521 PMCID: PMC11597819 DOI: 10.3390/pathogens13110968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 10/22/2024] [Accepted: 10/28/2024] [Indexed: 11/29/2024] Open
Abstract
Toxoplasma gondii is an Apicomplexan parasite that is estimated to infect at least one-third of the global human population. T. gondii infection may be transmitted horizontally or vertically. The main risk factors for transmission to humans are related to diet, especially the consumption of undercooked meat, along with soil contact. In immunocompetent persons, the acute infection may go undetected as it typically produces minor, non-specific symptoms that are self-limited. After infection is established, recurrent retinochoroiditis is the most common clinical disease. In contrast, severe systemic or cerebral toxoplasmosis may be life-threatening for immunocompromised individuals. Furthermore, congenital toxoplasmosis acquired in utero may have devastating consequences if not recognized and promptly treated. A growing body of research has identified associations between latent T. gondii infection, and personality traits and risk-taking behaviors. Other studies have documented associations between latent infection and psychiatric conditions that include schizophrenia and bipolar affective disorder. With no current treatment regimens being curative of T. gondii infection, effective prevention measures at both the public health and individual levels are vitally important.
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Affiliation(s)
- Ginger K. H. Akins
- College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, SA 5042, Australia;
| | - João M. Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo 14049-900, Brazil;
| | - Justine R. Smith
- College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, SA 5042, Australia;
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, Adelaide, SA 5042, Australia
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Prevett A, Short M, Morrissey M, Wadham B. Examining Sex-Based Delays in Utilizing Advocacy Support Services Among Australian Military Veterans: Implications for Health Care Access and Suicide Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1467. [PMID: 39595734 PMCID: PMC11593570 DOI: 10.3390/ijerph21111467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 10/19/2024] [Accepted: 11/01/2024] [Indexed: 11/28/2024]
Abstract
This study explores the impact of sex on delays experienced by Australian military veterans in accessing advocacy support services within the veterans' non-profit sector. A detailed analysis of intake records from 150 injured veterans who entered the Returned and Services League of Australia's advocacy program in 2021 reveals significant disparities between male and female veterans in seeking assistance. On average, male veterans delay accessing support by 20.4 years post-service, compared to 9.1 years for female veterans. These prolonged delays hinder veterans' ability to secure financial and medical support from the Department of Veterans' Affairs, limiting timely access to essential healthcare services. As a result, delays can exacerbate physical and psychological symptoms, impede recovery, and increase the risk of suicide. The findings provide valuable insights for international healthcare professionals on the influence of military culture and traditional masculine norms in shaping veterans' help-seeking behaviors. By understanding these dynamics, healthcare practitioners can develop targeted, sex-sensitive interventions that address specific barriers faced by male and female veterans. Ensuring timely access to advocacy support is crucial for improving health outcomes and reducing suicide risk in this vulnerable population.
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Affiliation(s)
- Andrew Prevett
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA 5042, Australia;
- Open Door Initiative: Improving the Wellbeing of Veterans and Public Safety Personnel and Their Families, Flinders University, Adelaide, SA 5042, Australia
| | - Monica Short
- School of Social Work and Arts, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.S.)
| | - Maxwell Morrissey
- School of Social Work and Arts, Charles Sturt University, Wagga Wagga, NSW 2678, Australia; (M.S.)
| | - Ben Wadham
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA 5042, Australia;
- Open Door Initiative: Improving the Wellbeing of Veterans and Public Safety Personnel and Their Families, Flinders University, Adelaide, SA 5042, Australia
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Graziano TA, Fitzgerald HN, Ortiz J, Owen CK, Shook NJ. Internalized Phobia, Community Connectedness, Outness, and Mental Health Risk and Protection in LGBTQ Persons. Nurs Res 2024; 73:434-441. [PMID: 39103308 DOI: 10.1097/nnr.0000000000000759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Community connectedness, outness, and internalized phobia are potential protective and risk factors for mental health in lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. However, these interrelated factors have generally been examined in isolation and for the LGBTQ community in aggregate. As such, there may be undetected effects of factors on mental health for each LGBTQ group. OBJECTIVES We examined the associations between mental health (i.e., depression and anxiety) and risk/protective factors (i.e., internalized phobia, community connectedness, outness) in each LGBTQ subgroup separately. METHOD A large national U.S. sample ( N = 1,030) of individuals who identified as LGBTQ completed an anonymous Internet survey during fall 2019. Participants answered questionnaires about community connectedness, outness, internalized homophobia or transphobia, anxiety, and depression. RESULTS On average, most subgroups reported symptoms of depression and anxiety above clinical cutoffs. Less outness and greater internalized phobia were associated with more severe depression and anxiety, but this pattern was not consistent across LGBTQ subgroups. Greater community connectedness was generally associated with more severe anxiety and depression. DISCUSSION LGBTQ subgroups vary in how risk and protective factors relate to mental health outcomes. Our findings highlight the importance of examining LGBTQ subgroups separately and examining risk/protective factors simultaneously to identify the unique contribution of each factor. More research is needed to understand potential LGBTQ mental health risks and protective factors, and future researchers should examine the unique roles of risk and protective factors in separate LGBTQ subgroups.
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Huang S, Zhao W, Choi S, Gong H. Associations of composite dietary antioxidant index with suicidal ideation incidence and mortality among the U.S. population. Front Nutr 2024; 11:1457244. [PMID: 39434895 PMCID: PMC11492068 DOI: 10.3389/fnut.2024.1457244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Accepted: 09/23/2024] [Indexed: 10/23/2024] Open
Abstract
Background The relationship between CDAI and suicidal ideation is unclear. This study investigates the relationship between CDAI and suicidal ideation and examines the association between CDAI and all-cause mortality (ACM) or cardiovascular disease mortality (CVM) among participants with and without suicidal ideation. Methods Data from seven NHANES cycles (2005-2018) were analyzed using cross-sectional and prospective cohort studies. Weighted multivariable logistic regression models, restricted cubic spline (RCS) plots, and subgroup analyses explored the association between CDAI and suicidal ideation. Kaplan-Meier (KM) curves, weighted multivariable Cox proportional hazards models, and RCS assessed the relationship between CDAI and CVM or ACM. Results Among 30,976 participants aged over 20, 1,154 (3.72%) had suicidal ideation. Higher CDAI levels (Quartile 4) were associated with a 28% reduction in suicidal ideation compared to lower levels (Quartile 1). Over an average follow-up of 89 months, 3,267 participants (7.6%) died, including 808 (1.8%) from cardiovascular causes. Higher CDAI levels were linked to a 30, 68, and 28% reduction in ACM in the total population, those with suicidal ideation, and those without, respectively. CVM was reduced by 40% in the total population and by 41% in those without suicidal ideation. Conclusion CDAI is negatively associated with suicidal ideation and correlated with reduced ACM and CVM among participants with and without suicidal ideation.
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Affiliation(s)
- Shaoqun Huang
- Department of Oncology Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Weimin Zhao
- Department of Clinical Medicine, School of Medicine, Shihezi University, Shihezi, China
| | - Seok Choi
- Department of Physiology, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Hongyang Gong
- Department of Physiology, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Gong H, Huang S. Associations of overactive bladder (OAB) with suicidal ideation incidence and all-cause mortality among the U.S. population. BMC Psychiatry 2024; 24:641. [PMID: 39350063 PMCID: PMC11443948 DOI: 10.1186/s12888-024-06107-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Accepted: 09/23/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Few studies have explored the correlation between overactive bladder (OAB) and suicidal ideation. This study aims to investigate the association between OAB and suicidal ideation, as well as the relationship between OAB and all-cause mortality among individuals with suicidal ideation. METHODS Data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed using cross-sectional and cohort study designs. Weighted multivariable logistic regression models were used to examine the association between OAB and suicidal ideation. Kaplan-Meier curves and weighted multivariable Cox proportional hazards models assessed the relationship between OAB and all-cause mortality among those with suicidal ideation. Interaction analyses on subgroups were conducted to validate the findings. Mediation analysis was performed to examine the effect of depression on the relationship between OAB and suicidal ideation. RESULTS Among 33,426 participants aged ≥ 20 years, 1,290 (3.8%) reported suicidal ideation. After adjusting for potential confounders, participants with OAB were 2.57 times more likely to have suicidal ideation (P < 0.001). Over an average follow-up of 87 months, 197 participants with suicidal ideation died. The Cox model revealed that participants with OAB had a 3.08 times higher risk of death (P = 0.006). Kaplan-Meier curves indicated higher survival rates for non-OAB participants. Mediation analysis indicates that depression significantly mediates the relationship between OAB and suicidal ideation, with a mediation proportion of 75.25% (P < 0.001). CONCLUSIONS OAB is positively associated with the incidence of suicidal ideation and all-cause mortality among participants with suicidal ideation. Additionally, the association between OAB and suicidal ideation is mediated by depression.
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Affiliation(s)
- Hongyang Gong
- Department of Oncology Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, No.102 Gudong Road, Gulou District, Fuzhou City, 350001, Fujian Province, China
- Department of Physiology, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Shaoqun Huang
- Department of Oncology Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, No.102 Gudong Road, Gulou District, Fuzhou City, 350001, Fujian Province, China.
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Ortiz-Prado E, Izquierdo-Condoy JS, Fernandez-Naranjo R, Vásconez-González J, Encalada S, Mosquera J, Cordovez S, Camino N, Montenegro-Salazar D, Viscor G, Diaz AM, Paz C. The burden of suicide across different altitudes: 11-year geodemographic analysis conducted in 221 cantons in Ecuador ranging from 0 to 4300 m of elevation. BJPsych Open 2024; 10:e161. [PMID: 39313761 PMCID: PMC11457200 DOI: 10.1192/bjo.2024.736] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/09/2024] [Accepted: 06/18/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND The World Health Organization and the Global Burden of Disease study estimate that almost 800 000 people die from suicide yearly. The role of non-traditional risk factors such as climate and high-altitude exposure are poorly understood. AIMS This study aims to determine a potential relationship between altitude exposure and suicide rates among 221 cantons located at different altitudes ranging from 0 to 4300 m. METHOD We conducted an 11-year, country-wide, population-based analysis on age- and gender-standardised suicide rates in Ecuador, based on the official data from the National Institute of Statistics, using all available self-harm death codes (ICD-10 codes X60-X84). RESULTS A total of 11 280 cases of suicide were reported during 2011-2021. Suicide rates were higher among men (11.48/100 000). In terms of elevation, suicide rates were significantly higher among people from high-altitude cantons (3.7/100 000) versus those from low-altitude cantons. When applying the International Society Mountain Medicine categorisation, suicide rates were significantly higher at moderate- (4.3/100 000), high- (3.6/100 000) and very-high-altitude cantons (4.4/100 000) when compared with low-altitude locations (2.5/100 000). CONCLUSIONS Ecuador is one of the few countries that has a vast range of cantons located at different altitudes. We found that living at higher elevations is positively associated with greater suicide rates. Although the rates are significantly greater as elevation increases, a clear linear relationship is not apparent, likely because of the interplay of socioeconomic factors, including urbanicity. The effect of chronic hypobaric hypoxia on mood cannot be ruled out, although the existence of causal mechanisms remains to be elucidated.
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Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Ecuador
| | | | | | | | - Sebastián Encalada
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Ecuador
| | - Johanna Mosquera
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Ecuador
| | - Simone Cordovez
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Ecuador
| | - Nicole Camino
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Ecuador
| | | | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Universidad de Barcelona, Spain
| | - Ana María Diaz
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Ecuador
| | - Clara Paz
- Wellbeing, Health and Society Research Group, School of Psychology and Education, Universidad de Las Américas, Ecuador
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Pranckeviciene E, Kasperiuniene J. Global Suicide Mortality Rates (2000-2019): Clustering, Themes, and Causes Analyzed through Machine Learning and Bibliographic Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1202. [PMID: 39338085 PMCID: PMC11431541 DOI: 10.3390/ijerph21091202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 08/29/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024]
Abstract
Suicide research is directed at understanding social, economic, and biological causes of suicide thoughts and behaviors. (1) Background: Worldwide, certain countries have high suicide mortality rates (SMRs) compared to others. Age-standardized suicide mortality rates (SMRs) published by the World Health Organization (WHO) plus numerous bibliographic records of the Web of Science (WoS) database provide resources to understand these disparities between countries and regions. (2) Methods: Hierarchical clustering was applied to age-standardized suicide mortality rates per 100,000 population from 2000-2019. Keywords of country-specific suicide-related publications collected from WoS were analyzed by network and association rule mining. Keyword embedding was carried out using a recurrent neural network. (3) Results: Countries with similar SMR trends formed naturally distinct groups of high, medium, and low suicide mortality rates. Major themes in suicide research worldwide are depression, mental disorders, youth suicide, euthanasia, hopelessness, loneliness, unemployment, and drugs. Prominent themes differentiating countries and regions include: alcohol in post-Soviet countries; HIV/AIDS in Sub-Saharan Africa, war veterans and PTSD in the Middle East, students in East Asia, and many others. (4) Conclusion: Countries naturally group into high, medium, and low SMR categories characterized by different keyword-informed themes. The compiled dataset and presented methodology enable enrichment of analytical results by bibliographic data where observed results are difficult to interpret.
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Affiliation(s)
- Erinija Pranckeviciene
- Faculty of Informatics, Vytautas Magnus University, LT-53361 Akademija Kauno r., Lithuania
- Faculty of Medicine, Vilnius University, LT-08661 Vilnius, Lithuania
| | - Judita Kasperiuniene
- Faculty of Informatics, Vytautas Magnus University, LT-53361 Akademija Kauno r., Lithuania
- Education Research Institute, Vytautas Magnus University, LT-44248 Kaunas, Lithuania
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Thangada MS, Kasoju R. A systematic review of suicide risk management strategies in primary care settings. Front Psychiatry 2024; 15:1440738. [PMID: 39286394 PMCID: PMC11403327 DOI: 10.3389/fpsyt.2024.1440738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 07/29/2024] [Indexed: 09/19/2024] Open
Abstract
Introduction and Objective Suicide is a major public health concern. Recently, suicide rates have increased among traditionally low-risk groups (e.g., white, middle-aged males). Suicide risk assessments and prevention strategies should be tailored to specific at-risk populations. This systematic review examines suicide risk detection and management in primary care, focusing on treatments to reduce suicide rates and improve prevention efforts. Methodology A systematic review was conducted following PRISMA guidelines. Literature was collected and analyzed using Boolean operators with relevant keywords in databases (e.g., PubMed, Google Scholar, PsycINFO) to identify randomized and non-randomized studies focusing on suicide risk factors and management strategies in primary care, published in the past 10 years. The risk of bias 2.0 and Newcastle Ottawa scale was used to assess risk of bias, and data from moderate-quality studies were synthesized. Results Thirteen moderate-quality studies were reviewed. Key findings include the need for assessing modifiable risk factors like substance use and mental health. General practitioner (GP) engagement post-suicide attempt (SA) improves outcomes and reduces repeat SAs. Effective strategies include comprehensive risk assessments, collaborative treatment, and enhanced GP support. Barriers to effective suicide prevention include insufficient information, judgmental communication, lack of positive therapeutic relationships, and inadequate holistic assessments. These findings highlight the need for tailored suicide prevention strategies in primary care. However, the evidence sample size is small with reduced statistical power that limits generalizability. The included studies were also regional examinations, which restrict their broader relevance. Discussion Significant risk factors, barriers, and effective strategies for suicide prevention were identified. For children aged 12 or younger, preexisting psychiatric, developmental, or behavioral disorders, impulsive behaviors, aggressiveness, and significant stressful life events within the family were critical. For adults, loneliness, gaps in depression treatment, and social factors are significant. Barriers to suicide prevention included insufficient information, judgmental communication, lack of positive therapeutic relationships, inadequate holistic risk assessments, lack of individualized care, insufficient tangible support and resources, inconsistent follow-up procedures, variability in risk assessment, poor communication, stigma, and negative attitudes. Effective methods include the Postvention Assisting Bereaved by Suicide training program, continued education, comprehensive clinical assessments, individualized care, and community-based interventions like the SUPRANET program. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024550904.
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Affiliation(s)
| | - Rahul Kasoju
- Department of General Medicine, Sri Venkata Sai (SVS) Medical College, Mahbubnagar, TG, India
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Yang JH, Park CHK, Rhee SJ, Kang DH, Kim MJ, Lee HJ, Lee SY, Shim SH, Moon JJ, Cho SJ, Kim SG, Kim MH, Lee J, Kang WS, Yoo J, Lee WY, Ahn YM. Psychotropic Medications Promote Time-Dependent Reduction of Suicidal Ideation in Mood Disorder: A Prospective Cohort Study. J Korean Med Sci 2024; 39:e226. [PMID: 39137811 PMCID: PMC11319105 DOI: 10.3346/jkms.2024.39.e226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/24/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Despite a plethora of research on the topic, there is still no solid evidence that pharmacological treatment actually reduces the risk of suicide in patients with mental illness. In this study, we aimed to assess the effect of psychotropic medications on suicidal ideation in patients with major depressive disorder (MDD) and bipolar disorder (BPD) in two age groups: less than 25 years and 25 years and older. METHODS We analyzed 312 patients with mood disorders with current suicidal thoughts or recent suicide attempts. We followed the participants from baseline for 6 months and assessed changes in suicidal ideation with Columbia-Suicide Severity Rating Scale (C-SSRS). The effect of psychotropic drug administration on suicidal ideation over time was analyzed using a linear mixed model. RESULTS In patients aged 25 years and older with mood disorders, suicidal ideation was more severe when using psychotropic drugs than when not using them. However, suicidal ideation decreased rapidly over time. The time-dependent reduction in suicidal ideation was accelerated when using antidepressants and sedatives/hypnotics in adult MDD, and when using mood stabilizers in adult BPD. However, this effect was not observed in participants aged less than 25 years. CONCLUSION Adequate psychotropic medication may reduce suicidal ideation in patients with mood disorders aged 25 years and older. Additional research on psychotropic drugs is needed to effectively reduce the risk of suicide among children and adolescents with mood disorders.
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Affiliation(s)
- Jeong Hun Yang
- Department of Psychiatry, Chungnam National University Sejong Hospital, Sejong, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | | | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Dae Hun Kang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Min Ji Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Jeong Lee
- Cancer Survivorship Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Psychiatry and Behavioral Science, National Cancer Center, Goyang, Korea
| | - Sang Yeol Lee
- Department of Psychiatry, Wonkwang University Hospital, Iksan, Korea
| | - Se-Hoon Shim
- Department of Psychiatry, Soon Chun Hyang University Cheonan Hospital, Soon Chun Hyang University, Cheonan, Korea
| | - Jung-Joon Moon
- Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soon Chun Hyang University Bucheon Hospital, Bucheon, Korea
| | - Min-Hyuk Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jinhee Lee
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Won Sub Kang
- Department of Psychiatry, Kyung Hee University Hospital, Seoul, Korea
| | - Jieun Yoo
- College of Social Sciences, Yonsei University, Seoul, Korea
| | - Weon-Young Lee
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yong Min Ahn
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Korea.
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Vestin M, Blomqvist I, Henje E, Dennhag I. Psychometric validation of the Montgomery-åsberg Depression Rating Scale - Youth (MADRS-Y) in a clinical sample. Nord J Psychiatry 2024; 78:525-532. [PMID: 38967988 DOI: 10.1080/08039488.2024.2374417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 06/14/2024] [Accepted: 06/20/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Depression in adolescence is a serious major global health problem with increasing rates of prevalence. Measures of depression that are valid for young people are clearly needed in clinical contexts. METHODS The study included 577 patients from child and adolescent psychiatry (n = 471) and primary care (n = 106) aged 12-22 years in Sweden (Mage=16.7 years; 76% female). The reliability and validity for Montgomery-Åsberg Depression Rating Scale - Youth (MADRS-Y) were investigated. To confirm the latent structure, we used a single-factor confirmatory factor analysis (CFA). A Kruskal-Wallis test was performed to test total score differences between diagnostic groups. Using Spearman's rho correlations, we examine whether single items in the MADRS-Y correlate with suicidal ideation measured by The Suicidal Ideation Questionnaire-JR (SIQ-JR). RESULTS The internal consistency using McDonald's coefficient omega was excellent. The CFA of the 12-item MADRS-Y supported a one factor structure. Evidence of convergent and discriminant validity was shown. There was a significant difference in MADRS-Y scores across diagnostic groups, with higher results for depressive disorders. A strong correlation with suicidal ideation was found for two items. CONCLUSIONS The results support MADRS-Y as a brief, reliable, and valid self-report questionnaire of depressive symptoms for young patients in a clinical setting.
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Affiliation(s)
- Magnus Vestin
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Ida Blomqvist
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Eva Henje
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
| | - Inga Dennhag
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Umeå, Sweden
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Corponi F, Li BM, Anmella G, Valenzuela-Pascual C, Mas A, Pacchiarotti I, Valentí M, Grande I, Benabarre A, Garriga M, Vieta E, Young AH, Lawrie SM, Whalley HC, Hidalgo-Mazzei D, Vergari A. Wearable Data From Subjects Playing Super Mario, Taking University Exams, or Performing Physical Exercise Help Detect Acute Mood Disorder Episodes via Self-Supervised Learning: Prospective, Exploratory, Observational Study. JMIR Mhealth Uhealth 2024; 12:e55094. [PMID: 39018100 PMCID: PMC11292167 DOI: 10.2196/55094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 04/14/2024] [Accepted: 05/24/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Personal sensing, leveraging data passively and near-continuously collected with wearables from patients in their ecological environment, is a promising paradigm to monitor mood disorders (MDs), a major determinant of the worldwide disease burden. However, collecting and annotating wearable data is resource intensive. Studies of this kind can thus typically afford to recruit only a few dozen patients. This constitutes one of the major obstacles to applying modern supervised machine learning techniques to MD detection. OBJECTIVE In this paper, we overcame this data bottleneck and advanced the detection of acute MD episodes from wearables' data on the back of recent advances in self-supervised learning (SSL). This approach leverages unlabeled data to learn representations during pretraining, subsequently exploited for a supervised task. METHODS We collected open access data sets recording with the Empatica E4 wristband spanning different, unrelated to MD monitoring, personal sensing tasks-from emotion recognition in Super Mario players to stress detection in undergraduates-and devised a preprocessing pipeline performing on-/off-body detection, sleep/wake detection, segmentation, and (optionally) feature extraction. With 161 E4-recorded subjects, we introduced E4SelfLearning, the largest-to-date open access collection, and its preprocessing pipeline. We developed a novel E4-tailored transformer (E4mer) architecture, serving as the blueprint for both SSL and fully supervised learning; we assessed whether and under which conditions self-supervised pretraining led to an improvement over fully supervised baselines (ie, the fully supervised E4mer and pre-deep learning algorithms) in detecting acute MD episodes from recording segments taken in 64 (n=32, 50%, acute, n=32, 50%, stable) patients. RESULTS SSL significantly outperformed fully supervised pipelines using either our novel E4mer or extreme gradient boosting (XGBoost): n=3353 (81.23%) against n=3110 (75.35%; E4mer) and n=2973 (72.02%; XGBoost) correctly classified recording segments from a total of 4128 segments. SSL performance was strongly associated with the specific surrogate task used for pretraining, as well as with unlabeled data availability. CONCLUSIONS We showed that SSL, a paradigm where a model is pretrained on unlabeled data with no need for human annotations before deployment on the supervised target task of interest, helps overcome the annotation bottleneck; the choice of the pretraining surrogate task and the size of unlabeled data for pretraining are key determinants of SSL success. We introduced E4mer, which can be used for SSL, and shared the E4SelfLearning collection, along with its preprocessing pipeline, which can foster and expedite future research into SSL for personal sensing.
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Affiliation(s)
- Filippo Corponi
- School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Bryan M Li
- School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
- The Alan Turing Institute, London, United Kingdom
| | - Gerard Anmella
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Clàudia Valenzuela-Pascual
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Ariadna Mas
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Isabella Pacchiarotti
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Marc Valentí
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Iria Grande
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Benabarre
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Marina Garriga
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Allan H Young
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Stephen M Lawrie
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Heather C Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Generation Scotland, Institute for Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | - Diego Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Antonio Vergari
- School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
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Cattarinussi G, Meda N, Miola A, Sambataro F. The functional connectivity of the right superior temporal gyrus is associated with psychological risk and resilience factors for suicidality. J Affect Disord 2024; 357:51-59. [PMID: 38653349 DOI: 10.1016/j.jad.2024.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/13/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Suicide attempters show increased activation in the right superior temporal gyrus (rSTG). Here, we investigated the rSTG functional connectivity (FC) to identify a functional network involved in suicidality and its associations with psychological suicidality risk and resilience factors. METHODS The resting state functional magnetic resonance imaging data of 151 healthy individuals from the Human Connectome Project Young Adult database were used to explore the FC of the rSTG with itself and with the rest of the brain. The correlation between the rSTG FC and loneliness and purpose in life scores was assessed with the NIH Toolbox. The effect of sex was also investigated. RESULTS The rSTG had a positive FC with bilateral cortical and subcortical regions, including frontal, temporal, parietal, occipital, limbic, and cerebellar regions, and a negative FC with the medulla oblongata. The FC of the rSTG with itself and with the left central operculum were associated with loneliness scores. The within rSTG FC was also negatively correlated with purpose in life scores, although at a trend level. We did not find any effect of sex on FC and its associations with psychological factors. LIMITATIONS The cross-sectional design, the limited age range, and the lack of measures of suicidality limit the generalizability of our findings. CONCLUSIONS The rSTG functional network is associated with loneliness and purpose in life. Together with the existing literature on suicide, this supports the idea that the neural activity of rSTG may contribute to suicidality by modulating risk and resilience factors associated with suicidality.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Nicola Meda
- Department of Neuroscience, University of Padova, Padua, Italy; Padova University Hospital, Padua, Italy
| | - Alessandro Miola
- Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy; Casa di Cura Parco dei Tigli, Padova, Italy
| | - Fabio Sambataro
- Department of Neuroscience, University of Padova, Padua, Italy; Padova Neuroscience Center, University of Padova, Padua, Italy; Padova University Hospital, Padua, Italy.
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Nguyen BL, Lyons BH, Forsberg K, Wilson RF, Liu GS, Betz CJ, Blair JM. Surveillance for Violent Deaths - National Violent Death Reporting System, 48 States, the District of Columbia, and Puerto Rico, 2021. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2024; 73:1-44. [PMID: 38980822 PMCID: PMC11262823 DOI: 10.15585/mmwr.ss7305a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Problem/Condition In 2021, approximately 75,000 persons died of violence-related injuries in the United States. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths that occurred in 48 states, the District of Columbia, and Puerto Rico in 2021. Results are reported by sex, age group, race and ethnicity, method of injury, type of location where the injury occurred, circumstances of injury, and other selected characteristics. This report introduces additional incident and circumstance variables, which now include child victim-specific circumstance information. This report also incorporates new U.S. Census Bureau race and ethnicity categories, which now account for more than one race and Native Hawaiian or other Pacific Islander categories and include updated denominators to calculate rates for these populations. Period Covered 2021. Description of System NVDRS collects data regarding violent deaths from death certificates, coroner and medical examiner records, and law enforcement reports. This report includes data collected for violent deaths that occurred in 2021. Data were collected from 48 states (all states with exception of Florida and Hawaii), the District of Columbia, and Puerto Rico. Forty-six states had statewide data, two additional states had data from counties representing a subset of their population (31 California counties, representing 64% of its population, and 13 Texas counties, representing 63% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each violent death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident. Results For 2021, NVDRS collected information on 68,866 fatal incidents involving 70,688 deaths that occurred in 48 states (46 states collecting statewide data, 31 California counties, and 13 Texas counties), and the District of Columbia. The deaths captured in NVDRS accounted for 86.5% of all homicides, legal intervention deaths, suicides, unintentional firearm injury deaths, and deaths of undetermined intent in the United States in 2021. In addition, information was collected for 816 fatal incidents involving 880 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately. Of the 70,688 deaths, the majority (58.2%) were suicides, followed by homicides (31.5%), deaths of undetermined intent that might be due to violence (8.2%), legal intervention deaths (1.3%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm injury deaths (<1.0%). The term "legal intervention" is a classification incorporated into the International Classification of Diseases, Tenth Revision, and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.Demographic patterns and circumstances varied by manner of death. The suicide rate was higher for males than for females. Across all age groups, the suicide rate was highest among adults aged ≥85 years. In addition, non-Hispanic American Indian or Alaska Native (AI/AN) persons had the highest suicide rates among all racial and ethnic groups. Among both males and females, the most common method of injury for suicide was a firearm. Among all suicide victims, when circumstances were known (84.4%), suicide was most often preceded by a mental health, intimate partner, or physical health problem or by a recent or impending crisis during the previous or upcoming 2 weeks. The homicide rate was higher for males than for females. Among all homicide victims, the homicide rate was highest among persons aged 20-24 years compared with other age groups. Non-Hispanic Black or African American (Black) males experienced the highest homicide rate of any racial or ethnic group. Among all homicide victims, the most common method of injury was a firearm. When the relationship between a homicide victim and a suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. Homicide most often was precipitated by an argument or conflict, occurred in conjunction with another crime, or, for female victims, was related to intimate partner violence. Nearly all victims of legal intervention deaths were male, and the legal intervention death rate was highest among men aged 30-34 years. The legal intervention death rate was highest among AI/AN males, followed by Black males. A firearm was used in the majority of legal intervention deaths. When circumstances were known, the most frequent circumstances reported for legal intervention deaths were as follows: the victim used a weapon in the incident and the victim had a substance use problem (other than alcohol use). Other causes of death included unintentional firearm injury deaths and deaths of undetermined intent. Unintentional firearm injury deaths were most frequently experienced by males, non-Hispanic White (White) persons, and persons aged 15-24 years. These deaths most frequently occurred while the shooter was playing with a firearm and were precipitated by a person unintentionally pulling the trigger. The rate of deaths of undetermined intent was highest among males, particularly among AI/AN and Black males, and among adults aged 30-54 years. Poisoning was the most common method of injury in deaths of undetermined intent, and opioids were detected in nearly 80% of decedents tested for those substances. Interpretation This report provides a detailed summary of data from NVDRS on violent deaths that occurred in 2021. The suicide rate was highest among AI/AN and White males, whereas the homicide rate was highest among Black males. Intimate partner violence precipitated a large proportion of homicides for females. Mental health problems, intimate partner problems, interpersonal conflicts, and acute life stressors were primary precipitating circumstances for multiple types of deaths examined. Public Health Action Violence is preventable, and data can guide public health action. NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in developing, implementing, and evaluating programs, policies, and practices to reduce and prevent violent deaths. NVDRS data can be used to enhance prevention efforts into actionable strategies. States or jurisdictions have used their Violent Death Reporting System (VDRS) data to guide suicide prevention efforts and highlight where additional focus is needed. For example, North Carolina VDRS program data have played a significant role in expanding activities related to firearm safety and injury prevention. The program served as a primary data source for partners, which led to the creation of the Office of Violence Prevention in the state, focusing on combatting firearm-related deaths. In Maine, the VDRS provided data on law enforcement officer suicides that were used to help support a bill mandating mental health resiliency and awareness training in the state's law enforcement training academy, along with plans for similar training addressing mental health, substance use, and alcohol problems among corrections officers. In addition, states and jurisdictions have also used their VDRS data to examine factors related to homicide in their state or jurisdiction. For example, Georgia VDRS collaborated with the City of Atlanta Mayor's Office of Violence Reduction to develop two public dashboards that not only offer comprehensive data on violent deaths but also present data on the geographic distribution of populations disproportionately affected by violence to help inform violence prevention interventions.
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Affiliation(s)
- Brenda L. Nguyen
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC
| | - Bridget H. Lyons
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC
| | - Kaitlin Forsberg
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC
| | - Rebecca F. Wilson
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC
| | - Grace S. Liu
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC
| | - Carter J. Betz
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC
| | - Janet M. Blair
- Division of Violence Prevention, National Center for Injury Prevention and Control, CDC
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Singh K, Kaur R, Behera C, Balhara YPS, Kaushik R. Suicide deaths in south and south-east districts of Delhi during pre- and post-COVID-19 period - A comparative analysis. Ind Psychiatry J 2024; 33:390-395. [PMID: 39898070 PMCID: PMC11784671 DOI: 10.4103/ipj.ipj_304_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/06/2024] [Accepted: 08/16/2024] [Indexed: 02/04/2025] Open
Abstract
Background Suicides are among the leading causes of death in the world and pose a major public health challenge. Mental health issues intensified during the COVID-19 pandemic, causing an increase in the number of suicides globally. Contributory factors included social isolation, loneliness, unemployment, grief due to loss of family, fear of death, and financial stress. Aim To assess the pattern of suicide deaths following the COVID-19 pandemic as compared to pre-COVID-19 in the South and South-east districts of Delhi. Materials and Methods Pre-COVID-19 suicide data were reviewed from April 2017 to March 2020. We collected data from police inquest papers, medical records, and the evaluation of autopsy reports. Post-COVID-19 data for suicide deaths were collected from April 2020 and March 2023. The close relatives of the deceased were interviewed using a standardized proforma. Data were analyzed using STATA version 16. Results A total of 1435 and 1462 suicide deaths were reported in the pre- and post-COVID-19 pandemic period, respectively. Suicide deaths among males were significantly higher in the post-COVID-19 period (P = 0.001). The place of suicide was non-residence in a significantly higher number of suicide deaths during the post-COVID-19 period (P = 0.001), while there was no significant difference in terms of alcohol use (P = 0.249), and physical illness (P = 0.28) during pre- and post-COVID-19 period. The most common cause of death was hanging both in the pre-COVID-19 (93.91%) and post-COVID-19 (95.5%) period. Conclusion There was no significant difference in the number of suicide deaths pre- and post-COVID pandemic. A significantly higher rate among males, non-residence as the place of suicide, and history of psychiatric illness was found in the post-COVID-19 period.
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Affiliation(s)
- Kumkum Singh
- Center for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ravneet Kaur
- Center for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chittaranjan Behera
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
| | - Yatan P. S. Balhara
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Ruchika Kaushik
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences, New Delhi, India
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Alothman D, Lewis S, Fogarty AW, Card T, Tyrrell E. Primary care consultation patterns before suicide: a nationally representative case-control study. Br J Gen Pract 2024; 74:e426-e433. [PMID: 38331442 PMCID: PMC11157587 DOI: 10.3399/bjgp.2023.0509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/01/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Consultation with primary healthcare professionals may provide an opportunity to identify patients at higher suicide risk. AIM To explore primary care consultation patterns in the 5 years before suicide to identify suicide high-risk groups and common reasons for consulting. DESIGN AND SETTING This was a case-control study using electronic health records from England, 2001 to 2019. METHOD An analysis was undertaken of 14 515 patients aged ≥15 years who died by suicide and up to 40 matched live controls per person who died by suicide (n = 580 159), (N = 594 674). RESULTS Frequent consultations (>1 per month in the final year) were associated with increased suicide risk (age- and sex -adjusted odds ratio [OR] 5.88, 95% confidence interval [CI] = 5.47 to 6.32). The associated rise in suicide risk was seen across all sociodemographic groups as well as in those with and without psychiatric comorbidities. However, specific groups were more influenced by the effect of high-frequency consultation (>1 per month in the final year) demonstrating higher suicide risk compared with their counterparts who consulted once: females (adjusted OR 9.50, 95% CI = 7.82 to 11.54), patients aged 15-<45 years (adjusted OR 8.08, 95% CI = 7.29 to 8.96), patients experiencing less socioeconomic deprivation (adjusted OR 6.56, 95% CI = 5.77 to 7.46), and those with psychiatric conditions (adjusted OR 4.57, 95% CI = 4.12 to 5.06). Medication review, depression, and pain were the most common reasons for which patients who died by suicide consulted in the year before death. CONCLUSION Escalating or more than monthly consultations are associated with increased suicide risk regardless of patients' sociodemographic characteristics and regardless of the presence (or absence) of known psychiatric illnesses.
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Affiliation(s)
- Danah Alothman
- School of Medicine, University of Nottingham, Nottingham
| | - Sarah Lewis
- School of Medicine, University of Nottingham, Nottingham
| | | | - Timothy Card
- School of Medicine, University of Nottingham, Nottingham
| | - Edward Tyrrell
- School of Medicine, University of Nottingham, Nottingham
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Nguyen TTL, Nguyen VC. Factors Associated with Depression among Working-Age Household Heads in Korea: A Cross-Sectional Household Study. Korean J Fam Med 2024; 45:207-214. [PMID: 38351745 PMCID: PMC11273164 DOI: 10.4082/kjfm.23.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/20/2023] [Accepted: 11/03/2023] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Depression is a mental disorder common worldwide. This study determined the relationships between demographics, health status, household parameters, and depression rates among working-age household heads. METHODS We analyzed data from the Korea Welfare Panel Study Survey conducted in 2020. The 11-item version of the Center for Epidemiologic Studies Depression Scale was used to assess depression. Bivariate analyses and a multiple logistic regression model were used to evaluate the influence of these factors on depression among household heads. RESULTS The overall prevalence of depression among working-age household heads was 11.69% (19.83% of females and 9.58% of males). The relative risk of depression was 1.71 times higher among the unemployed than among wage earners and 2.18 times higher among those with low income than among those with general income. The relative risk of depression was 3.23 times higher in those with poor health status than in those with good health, and 2.45 times more in those with severe disabilities than in those without disabilities. The rate of depression decreased with education level, number of family members, and presence of children but increased with the presence of the disabled or elderly. CONCLUSION This study provides a comprehensive overview of depression among working-age household heads and identifies factors strongly associated with depression. These findings may have implications for policymakers to reduce the burden on and improve the quality of life of household heads.
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