Suicidal ideation and suicide attempts among adult Danes

This study describes the prevalence of suicidal ideation and attempted suicide in a representative survey among adults in Denmark and gives the proportion of people reporting a suicide attempt that results in contact with the health care system. The data for the 1994 Danish national health interview survey were collected by personal interview and a self-administered questionnaire. A subsample of 1362 individuals participated in the part of the survey that addressed suicidal behaviour (64% of the random sample). The results show that 6.9% reported having had suicidal thoughts within the past year. Averaging across all age groups the overall prevalence of people reporting ever having made a suicide attempt was 3.4% and the one-year prevalence was 0.5%. Suicidal ideation was more prevalent among young people than among older people, whereas ever-attempted suicide showed no age gradient. Both suicidal ideation and ever-attempted suicide were more prevalent among economically inactive people (e.g. unemployed) and among unmarried or divorced people. We estimate that 50-60% of suicide attempts reported in a representative, national survey become known to the healthcare system.     

Peer relationships and suicide ideation and attempts among Chinese adolescents

Background Suicide is a global health concern. Therefore, studying suicide behaviour and identifying the early roots of suicide are critical. To address these issues, the present study examined (i) the association between peer relationships and suicide ideation and attempts among Chinese adolescents; and (ii) whether such associations were moderated or mediated by feeling of loneliness. We hypothesized that problems in peer relationships were positively associated with suicide ideation and attempts, and that feeling of loneliness would moderate and mediate such associations. Methods The sample included 8778 Chinese adolescents from a large survey. Measures of peer relationships, suicide ideation and attempts, and feeling of loneliness were obtained through adolescents' self‐reports. Results Results from multivariate logistic regressions suggested that specific problems in peer relationships, such as lack of peer association and being victimized by bullying, were significantly related to suicide ideation and attempts. In addition, the moderating effects of feeling of loneliness on the association between peer relationships and suicide ideation and attempts were found. Finally, some gender effects were also found. Conclusions The present study provided strong evidence that suicide ideation and attempts were serious problems among adolescents in China, to which peer relationships played an important role. Further, feeling of loneliness acted as a moderator affecting the association between peer relationships and suicide ideation and attempts. Finally, there were some gender differences that have important implications.     

Precarious employment and the risk of suicidal ideation and suicide attempts

ObjectiveAlthough the effect of occupation or employment status on suicide risk is notable, there are few studies on the effect of precarious employment on suicide. We compared suicidal ideation and suicide attempts in precarious workers and their non-precarious counterparts using a representative sample from South Korea.MethodThe 2008 Korean Community Health Survey data were used for this study. Information was obtained on 52,161 participants (41,063 employees with non-precarious work and 11,098 employees with precarious work). The outcome of the logistic regression model was the presence of suicidal thoughts and attempts, and the independent variables were the demographics, socioeconomic status, and health status.ResultsEmployees with precarious work were more likely to exhibit suicidal ideation (OR = 1.41; 95% CI, 1.28–1.55) and suicide attempts (OR = 1.52; 95% CI, 1.02–2.27) than employees with non-precarious work. After controlling for income and education (Model 2) depressive feelings (Model 6), compared with unadjusted model, remained significant but the odds ratio was largely attenuated, indicating a strong association between suicidal risk and socioeconomic and feelings of depression.ConclusionPrecarious workers had a higher risk of suicidal ideation and suicide attempts than non-precarious workers. Our study suggests that precarious employment is an important risk for suicide.     

北京市某社区医院门诊患者及家属自杀意念及自杀未遂的影响因素分析

目的 了解北京市海淀区某社区医院门诊就诊患者及家属的自杀意念和自杀未遂检出率及其危险因素.方法 2008年6月至9月,采用现况研究及偶遇抽样方法,对在北京市海淀区某社区卫生服务站,使用一般情况调查表、Beck抑郁量表、Beck焦虑量表和Beck无望量表,对前来该社区卫生服务站就诊的患者及家属进行问卷调查,在SPSS 13.0软件的支持下对自杀意念和自杀未遂的影响因素进行单因素Х^2检验和多因素Logistic回归分析.结果 发放问卷3100份,收回有效问卷2791份,问卷有效率为90.0％.调查对象的平均年龄（36.8±13.1）岁,其中男性1074例,女性1717例.近1年内自杀意念和自杀未遂的检出率分别为2.8％（77/2791）和1.1％（30/2791）.不同职业、有无负性生活事件、有无自杀家族史、有无精神疾病家族史、无望程度、抑郁程度和焦虑程度的调查对象在1年内自杀意念检出率方面,差异有统计学意义（Х^2=12.512、53.287、103.922、20.640、77.337、135.918、70.303,P＜0.05）.不同职业、有无精神疾病家族史、无望程度、抑郁程度和焦虑程度的调查对象在1年内自杀未遂检出率方面,差异有统计学意义（Х^2=7.954、6.257、29.838、21.352、10.014,P＜0.05）.多因素分析显示：抑郁（轻度、中度和重度抑郁的OR值分别为2.38、5.55和16.21;95％CI分别为1.07～5.31、2.31～13.37和6.93～37.92）、有自杀家族史（OR=11.68,95％CI：5.03～27.10）、无望（轻度、中度和重度无望的OR值分别为3.65、4.25和5.02;95％CI分别为1.55～8.56、1.70～10.65和1.46～17.26）以及近期有负性生活事件（0R=2.25,95％CI为1.35～4.45）是自杀意念的危险因素.无望（轻度、中度和重度无望的OR值分别为1.09、5.58和7.62;95％CI分别为0.36～3.34、2.03～15.30和1.50～38.72）、抑郁（轻度、中度和重度抑郁的OR值分别为1.08、0.27和3.02;95％CI分别为0.43～2.75、0.03～2.29和1.05～8.75）以及有精神病家族史（OR=3.00,95％CI为1.07～8.46）是自杀未遂的危险因素.结论 无望及抑郁情绪增加自杀的危险;应加强社区人群心理健康管理工作,培养社区医生识别、评估和处理心理危机的技能.     

大学生童年期负性生活事件人格特征与自杀意念关系

目的了解大学生童年期负性生活事件与人格特征自杀意念的关系,为预防大学生心理危机提供参考依据。方法整群随机抽取吉林和浙江6所高校的1 244名学生,采用Beck自杀意念量表中文版、童年期负性事件问卷和艾森克人格问卷简式量表中国版进行问卷调查。结果大学生自杀意念发生率为16.64%,自杀意念得分女生(8.47±2.20)高于男生(5.92±1.25),农村学生(7.90±0.92)高于城市学生(5.68±1.16)。有84.57%的大学生至少经历过1种童年期负性生活事件。大学生自杀意念与童年期负性生活事件、精神质、神经质呈正相关,与内外向呈负相关(r值分别为0.14,0.42,0.65,-0.58,P值均<0.01)。精神质、神经质在童年期负性生活事件影响和大学自杀意念之间具有完全中介效应,路径系数分别为0.43,0.54,效应量分别为13.19%,39.33%。结论大学生自杀意念与童年期负性生活事件及人格特征密切相关,人格特征在童年期负性生活事件与大学自杀意念的关系中起中介作用。     

安徽省625名女性强制戒毒人员自杀意念、自杀未遂及影响因素

目的 了解女性强制戒毒人员自杀意念和自杀未遂及其影响因素。方法 采用症状自评量表、结构式自杀调查问卷以及一般情况调查表对安徽省625名女性强制戒毒人员进行调查。结果 女性强制戒毒人员心理问题、自杀意念和自杀未遂的检出率分别为65.92%、21.28%及13.92%;心理健康组和心理问题组的自杀意念检出率（13.6%,25.2%）和自杀未遂检出率（6.1%、18.0%）比较差异均具有统计学意义（均有P<0.05）;多因素非条件Logistic回归分析显示,SCL-90总均分高（OR=1.854,95%CI：1.377~2.496,P<0.001）对自杀意念的影响差异具有统计学意义;毒品类型：与冰毒比较,单纯海洛因型和混合型以及SCL-90总均分高对自杀未遂的影响,差异均具有统计学意义（均有P<0.05）。结论 安徽省女性强制戒毒人员心理问题、自杀意念、自杀未遂的检出率高;自杀意念受心理问题严重程度的影响;自杀未遂受毒品类型、心理问题严重程度的影响。     

儿童期受虐待经历与大学生自杀意念的关联

目的研究儿童期受虐待经历与大学生自杀意念之间的关联,为保障大学生的身心健康提供依据。方法2018年5—7月,运用多阶段随机整群抽样的方法,选取山西省6所大学的大学生(儿童期虐待有效调查人数3 854名,自杀意念有效调查3 882名),进行儿童期虐待问卷中文版和自杀意念自评量表调查。结果儿童期至少有过1种虐待经历的占42.4%,近1周内有过自杀意念的占3.9%。经χ²检验,儿童期遭受过躯体虐待、情感虐待、性虐待、躯体忽视、情感忽视大学生自杀意念检出率均高于未遭受相应虐待大学生(χ²值分别为13.78,12.97,17.10,56.56,66.58,P值均<0.01);Spearman相关性分析结果显示,儿童期各型受虐待经历均和大学生自杀意念存在正相关(r值分别为0.06,0.06,0.07,0.12,0.13,P值均<0.01);多因素Logistic回归模型发现,在控制其他影响因素后,儿童期遭受躯体忽视以及情感忽视与大学生自杀意念发生呈正相关(OR值分别为2.18,2.07,P值均<0.05)。结论儿童期遭受躯体忽视和情感忽...     

Suicidal ideation and suicide attempts in a nationwide sample of operational Norwegian ambulance personnel

This is the first paper on suicidal ideation and attempts among ambulance personnel. This study aimed to investigate levels of suicidal ideation and suicide attempts among ambulance personnel, and to identify important correlates and the factors to which ambulance personnel attribute their serious suicidal ideation. A comprehensive nationwide questionnaire survey of 1,180 operational ambulance personnel was conducted. Measurements included: Paykel's Suicidal Feelings in the General Population questionnaire, the Hospital Anxiety and Depression scale, the Subjective Health Complaints Questionnaire, the Maslach Burnout Inventory, the Job Satisfaction Scale, the Basic Character Inventory, and the Rosenberg Self-Esteem Scale. Lifetime prevalence ranged from 28% for feelings that life was not worth living to 10.4% for seriously considered suicide and 3.1% for a suicide attempt. Serious suicidal ideation was independently associated with job-related emotional exhaustion (feelings of being overextended and depleted of resources) (OR 1.5, 95% CI 1.1-2.0) and bullying at work (OR 1.7, 95% CI 1.02-2.7), younger age, not married/cohabitant, depression symptoms, low self-esteem and the personality trait reality weakness. In general, suicidal thoughts were hardly attributable to working conditions, since only 1.8% of ambulance personnel attributed suicidal ideation to work problems alone. In conclusion, ambulance personnel reported a moderate level of suicidal ideation and suicide attempts. Although serious suicidal ideation was rarely attributed to working conditions in general, this study suggests that job-related factors like emotional exhaustion and bullying may be of importance.     

Population attributable fractions of adenocarcinoma of the esophagus and gastroesophageal junction

Obesity, gastroesophageal reflux, and smoking have repeatedly been shown to be important and independent risk factors for adenocarcinoma of the esophagus (EAC) and of the gastroesophageal junction (GEJAC). There have been few attempts, however, to quantify the proportion of disease associated with these potentially modifiable factors. The authors have estimated the population attributable fraction of EAC and GEJAC attributable to obesity, symptoms of gastroesophageal reflux, and smoking using data from a population-based case-control study conducted in Australia between 2002 and 2005. Cases were patients with EAC (n = 364) or GEJAC (n = 425). Controls (n = 1,580) were randomly sampled from a population register. Combinations of smoking, body mass index (weight in kilograms divided by height in meters squared), and gastroesophageal reflux together accounted for 76% (95% confidence interval: 66, 84) of EAC cases and 69% (95% confidence interval: 58, 78) of GEJAC cases. Individually, high body mass index (≥30) and frequent acid reflux (≥1 time/week) accounted for the greatest proportions of EAC (23% and 36%, respectively), and smoking and frequent symptoms of acid reflux accounted for the greatest proportions of GEJAC (43% and 28%, respectively). The present study suggests that these cancers may be largely prevented by maintaining healthy body mass index, avoiding smoking, and controlling symptomatic gastroesophageal reflux.     

北京50家综合医院门诊患者自杀意念及自杀未遂调查

目的 了解北京市综合医院门诊患者的自杀意念和自杀未遂出现率及其危险因素.方法 采用自制量表对随机抽取的北京市50家各级综合医院2877例门诊患者进行调查,通过logistic分析筛选出其危险因素.结果 自杀意念和自杀未遂终生发生率分别为6.08%和1.18%;多因素分析显示两者的共同危险因素为近一年有绝望感、年纪轻、熟人有过自杀行为、女性.结论 北京市综合医院门诊就诊患者经常有自杀危险、抑郁等心理问题;应培养普通门诊医务人员识别、评估和处理这类问题的技能.     

Canadian military personnel's population attributable fractions of mental disorders and mental health service use associated with combat and peacekeeping operations

Objectives. We investigated mental disorders, suicidal ideation, self-perceived need for treatment, and mental health service utilization attributable to exposure to peacekeeping and combat operations among Canadian military personnel.Methods. With data from the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement, a cross-sectional population-based survey of active Canadian military personnel (N = 8441), we estimated population attributable fractions (PAFs) of adverse mental health outcomes.Results. Exposure to either combat or peacekeeping operations was associated with posttraumatic stress disorder (men: PAF = 46.6%; 95% confidence interval [CI] = 27.3, 62.7; women: PAF = 23.6%; 95% CI = 9.2, 40.1), 1 or more mental disorder assessed in the survey (men: PAF = 9.3%; 95% CI = 0.4, 18.1; women: PAF = 6.1%; 95% CI = 0.0, 13.4), and a perceived need for information (men: PAF = 12.3%; 95% CI = 4.1, 20.6; women: PAF = 7.9%; 95% CI = 1.3, 15.5).Conclusions. A substantial proportion, but not the majority, of mental health–related outcomes were attributable to combat or peacekeeping deployment. Future studies should assess traumatic events and their association with physical injury during deployment, premilitary factors, and postdeployment psychosocial factors that may influence soldiers’ mental health.The current military occupations in Iraq and Afghanistan have created a substantial resurgence of international interest in the mental health consequences of combat.^1,2–7 Epidemiological studies of soldiers during postdeployment of combat and peacekeeping missions have demonstrated a high prevalence of mental disorders, mental health service use, and somatic complaints.^2–4,8–17 However, it is important to note that several studies have not found an association between peacekeeping or combat operations and mental disorders⁵ or suicide.^18,19To the best of our knowledge, there is only 1 study that has examined the population attributable fractions (PAFs) associated with combat, and it was conducted in a nationally representative civilian sample.²⁰ This study found that 28% of past-year posttraumatic stress disorder (PTSD) and approximately 10% of past-year major depression and substance use problems were attributable to lifetime combat exposure in men.²⁰ Because none of the women in the study²⁰ reported exposure to combat, the study was limited to men.To date, there has been no empirical evaluation of PAFs for mental disorders in relation to combat in a representative sample of active military personnel. Also, no data are available on the PAFs for mental disorders associated with peacekeeping operations. There are many studies suggesting that soldiers involved in peacekeeping operations experience stressors different from those of soldiers involved in combat.^21,22 Finally, there is no empirical evaluation of PAFs among female soldiers.We studied data from a large population-based survey of active military personnel, the Canadian Community Health Survey Cycle 1.2 Canadian Forces Supplement.¹⁴ This survey is unique because it uses a multistage sampling design in active military personnel and includes the use of standardized state-of-the-art variable assessment of mental disorders,²³ the self-perceived need for treatment,^24,25 and mental health service use.²³ Our main objective was to estimate the PAFs for mental disorders, suicidal ideation, and treatment need and use parameters (i.e., self-perceived need for treatment and mental health service utilization) associated with combat or peacekeeping operations.     

Sexual orientation and risk factors for suicidal ideation and suicide attempts among adolescents and young adults

Same-gender sexual orientation has been repeatedly shown to exert an independent influence on suicidal ideation and suicide attempts, suggesting that risk factors and markers may differ in relative importance between lesbian, gay, and bisexual individuals and others. Analyses of recent data from the National Longitudinal Study of Adolescent Health revealed that lesbian, gay, and bisexual respondents reported higher rates of suicidal ideation and suicide attempts than did heterosexual respondents and that drug use and depression were associated with adverse outcomes among heterosexual respondents but not among lesbian, gay, and bisexual respondents.     

Early substance use initiation and suicide ideation and attempts among students in France and the United States

Objective  

In response to recent research documenting a link between early substance use and suicidal behaviors among youth, the current study sought to examine the associations between ages of substance use initiation and suicidal behavior among students in France and the USA.     

儿童期不良经历与青少年饮酒的关联

目的 探究儿童期不良经历(adverse childhood experiences,ACEs)与青少年饮酒的关联,为青少年饮酒行为的防控提供指导.方法 采用分层整群抽样的方法选取上海市某区3所公立初中六至八年级的1 550名学生,于2017年和2018年11-12月开展2次匿名电子问卷调查.采用潜类别分析(laten...     

童年期不良经历与青春期发育的前瞻性研究

探讨童年期不良经历对青春期发育的影响,为针对性开展早期干预提供参考.方法 于2017年10月在安徽省马鞍山市3所小学,采用整群抽样的方法以班级为单位抽取1 057名三至四年级学生为调查对象,自我报告童年期不良经历(adverse childhood experiences,ACEs),包括躯体、情感与性虐待和躯体、情感忽视.客观评估男生睾丸容积和女生乳房Tanner发育分期.1年后随访再次评价ACEs与青春期发育.根据儿童基线与随访暴露情况,将ACEs分为无暴露组、短暂暴露组和持续暴露组.采用多元线性回归模型分析各组ACEs与随访1年后青春期发育的关联.结果 持续情感虐待与女生乳房Tanner分期和男生睾丸容积均呈正相关(β值分别为0.36,1.07,95%CI值分别为0.09~0.63,0.47~ 1.66,P值均<0.01);持续躯体虐待与男生睾丸容积呈负相关(β=-0.83,95%CI=-1.58~-0.08,P<0.05);性虐待与女生乳房Tanner分期呈负相关(持续β=-1.43,95%CI=-2.86~-0.02;短暂β=--0.45,95%CI=-0.73-0.19,P值均<0.05);持续情感忽视与女生乳房Tanner分期呈正相关(β=0.33,95% CI=0.06~0.61,P<0.05),与男生睾丸容积呈负相关(β=-0.19,95%CI=-1.38~-0.09,P<0.01).结论 青春期发育与童年期不良经历相关.不同ACEs青春期发育效应差异的具体机制和相同ACEs青春期发育效应的性别差异仍需进一步探讨.     

Relationships between obesity and DSM-IV major depressive disorder, suicide ideation, and suicide attempts: results from a general population study

OBJECTIVES: This study sought to test the relationships between relative body weight and clinical depression, suicide ideation, and suicide attempts in an adult US general population sample. METHODS: Respondents were 40,086 African American and White participants interviewed in a national survey. Outcome measures were past-year major depression, suicide ideation, and suicide attempts diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The primary predictor was relative body weight, treated both continuously (i.e., body mass index [BMI]) and categorically in logistic regression analyses. Covariates included age, income and education, disease status, and drug and alcohol use. RESULTS: Relative body weight was associated with major depression, suicide attempts, and suicide ideation, although relationships were different for men and women. Among women, increased BMI was associated with both major depression and suicide ideation. Among men, lower BMI was associated with major depression, suicide attempts, and suicide ideation. There were no racial differences. CONCLUSIONS: Differences in BMI, or weight status, were associated with the probability of past-year major depression, suicide attempts, and suicide ideation. Longitudinal studies are needed to differentiate the causal pathways and mechanisms linking physical and psychiatric conditions.     

Asthma, suicidal ideation, and suicide attempts: findings from the Baltimore epidemiologic catchment area follow-up

OBJECTIVES: We examined cross-sectional and longitudinal associations between asthma, suicidal ideation, and suicide attempt among adults in the community. METHODS: Data were drawn from 3 waves (1981,1982,1993-1996) of the Baltimore follow-up of the Epidemiologic Catchment Area study. Multiple logistic regression analyses were used to examine associations between asthma, asthma treatment, suicidal ideation, suicide attempt, and suicide completion. RESULTS: Asthma at wave 1 was associated with a significantly increased odds of suicidal ideation (odds ratio [OR] = 2.33; confidence interval [CI] = 1.03, 5.25) and suicide attempt (OR=3.54; CI=1.4, 8.99), which persisted independent of lifetime National Institute of Mental Health Diagnostic Interview Schedule/Diagnostic and Statistical Manual of Mental Disorders, Third Edition major depression and treatment for asthma at wave 2. CONCLUSIONS: These findings provide preliminary evidence suggestive of an association between asthma and an increased likelihood of suicidal ideation and suicide attempt among adults in the community. Neither lifetime major depression nor treatment for asthma explained this relation. These results provide important directions for future research, and if replicated these data may have clinical and public health implications.