新入伍士兵自杀意念与自杀行为影响因素调查

目的调查分析影响新入伍士兵自杀意念与自杀行为的主要因素,为自杀预防干预提供依据。方法采取随机整群抽样的方式对5345名官兵使用SCL-90问卷筛查,对筛查阳性者再实施半结构式访谈定性,确认自杀意念形成的主要相关因素。结果存在不同程度自杀意念者共171人,占调查人数的3.1%,其中13人有过对有关实施方式的计划。自杀意念和行为形成的因素中,家庭因素影响较多,主要是家庭关系、家族史、家庭经济等。结论新入伍士兵自杀意念和自杀行为形成过程中,家庭是重要的因素,进行预防性自杀干预时,应对其家庭因素给予充分的关注。     

大学生自杀意念及行为因素的相关分析

目的 分析在校大学生自杀意念的发生状况,探讨自杀意念及自杀行为的影响因素.方法 采用自制的调查表,以随机整群抽样的方法对520名在校大学生进行调查,并进行单因素和多因素Logistic回归分析.结果 大学生自杀意念的发生率为21.5%,进行过自杀的有15.8%.多因素的Logistic回归模型分析显示:自杀意念发生有关的主要危险因素是:家庭成员的支持、家庭和睦程度、与他人的关系等.结论 自杀意念及自杀行为与其影响因素联系密切,应根据其影响因素予以积极干预,从而减少自杀行为的发生.     

Study on suicide attempts among drug addicts--prevalence of suicide attempts and investigation of related risk factors]

While the relationship between substance use disorder and suicidal behavior is well known, few studies have been conducted on this issue in Japan to date. The present study aimed to investigate the profiles of drug-dependent individuals with a history of suicide attempts not including completed suicides. A survey was conducted on 101 drug-dependent patients in 8 drug rehabilitation institutions. The survey included a questionnaire that assessed various items regarding personal profiles, such as history of suicide attempts and drug abuse, physical and mental problems. In addition, the survey included the Parental Bonding Instrument (PBI) and the Center for Epidemiological Studies Depression Scale (CES-D). The results indicated that 50 patients (49.5%) had attempted suicide, and that subjects with a history of suicide attempts were significantly younger than those without suicide attempts. It was also revealed that subjects with a history of suicide attempts had started abusing drugs at an earlier age, had more psychiatric problems, and scored higher on the CES-D and lower on both the parental and maternal care scores of the PBI. These findings suggest that early-age drug abuse, psychiatric problems, depressive symptoms, and parental rearing behaviors perceived as cold and rejecting may predispose drug-dependent individuals to suicidal behavior.     

Serotonin transporter gene expression predicts the worsening of suicidal ideation and suicide attempts along a long-term follow-up of a Major Depressive Episode

The quest for biomarkers in suicidal behaviors has been elusive so far, despite their potential utility in clinical practice. One of the most robust biological findings in suicidal behaviors is the alteration of the serotonin transporter function in suicidal individuals. Our main objective was to investigate the predictive value of the serotonin transporter gene expression (SLC6A4) for suicidal ideation and as secondary, for suicide attempts in individuals with a major depressive episode (MDE). A 30-week prospective study was conducted on 148 patients with a MDE and 100 healthy controls including 4 evaluation times (0, 2, 8 and 30 weeks). Blood samples and clinical data were collected and SLC6A4 mRNA levels were measured from peripheral blood mononuclear cells using RT-qPCR. We first demonstrated the stability and reproducibility of SLC6A4 mRNA expression measures over time in healthy controls (F=0.658; p=0.579; η²=0.008; ICC=0.91, 95% CI [0.87–0.94]). Baseline SLC6A4 expression level (OR=0.563 [0.340–0.932], p=0.026) as well as early changes in SLC6A4 expression between baseline and the 2^nd week (β=0.200, p=0.042) predicted the worsening of suicidal ideation (WSI) in the following 8 weeks. Moreover, changes in SLC6A4 expression between the 2^nd and 8^th weeks predicted the occurrence of a suicide attempt within 30 weeks (OR=10.976 [1.438–83.768], p=0.021). Altogether, the baseline level and the changes in SLC6A4 mRNA expression during a MDE might predict the WSI and the occurrence of suicidal attempts and could be a useful biomarker in clinical practice.     

认知疗法对自杀意念和行为的干预效果

目的探讨认知疗法对自杀意念和自杀未遂者的干预效果。方法对门诊和住院有严重自杀意念158人和20名自杀未遂者进行贝克的识别自动化思维,识别错误认知和真实性检验技术和梅肯鲍姆的技能获得和复述技术进行心理干预。结果动摇自杀意念效果明显,歪曲认知有所改变,SCL-90平均减分率大于25%,心理状况好转。结论认知疗法是早期消除自杀观念,稳定情绪最有效的方法。     

The impact of active and passive peer influence on young adult smoking: an experimental study

Background

Peers influence adolescent and young adult smoking, but little is known about the underlying mechanisms. It is necessary to understand whether the current assumption of peer pressure is valid, or whether an alternative explanation as imitation is more appropriate. We examined whether passive (imitation) and/or active (pressure) peer influence affects young adult smoking.

Methods

An experiment was conducted among 68 daily-smoking students aged 16–24. The actual study aim was masked. Participants had to do a 30-min music task with a confederate. The experiment consisted of a 2 (smoking condition: confederate smokes or not) by 2 (pressure condition: confederate offers the participant a cigarette or not) factorial design, resulting in four conditions: (1) no smoking and no pressure (N = 15); (2) smoking but no pressure (N = 16); (3) pressure but no smoking (N = 20); and (4) smoking and pressure (N = 17). The primary outcome tested was the total number of cigarettes smoked during this music assignment.

Results

Peer smoking significantly predicted the total number of cigarettes smoked by young adults while peer pressure did not. The interaction effect of peer pressure and peer smoking was not significant.

Conclusions

Peer pressure did not have a significant additional contribution, over and above smoking of the peer. Passive (imitation) peer influence affected young adult smoking rather than active (pressure) peer influence. Thus, smoking cessation efforts should aim at preventing interaction with smoking peers and raising awareness about its impact.     

MCMI‐III scores on substance abusers with and without histories of suicide attempts

Sixty‐eight patients with a history of suicide attempt were compared to 340 patients without a history of suicide attempt using the MCMI‐III, a frequently used test for measuring personality disorders. Patients with a suicide attempt history scored higher on Schizoid, Avoidant, Depression, Dependent, Passive‐Aggressive (Negativistic), Self‐Defeating, and Paranoid and significantly lower on Histrionic and Compulsive and scored higher on all clinical syndrome scales except for Drug Dependence and Delusional Disorder. Logistic regression correctly predicted the no‐suicide‐history group with 97% accuracy, but only accurately predicted 16% of the patients with a suicide attempt history. A discriminant function analysis correctly predicted 90% of the patients with a suicidal attempt history and 63% of the patients with no history of suicide attempt. Results suggest that MCMI‐III scores may be able to detect patients with a history of suicide attempt, using multivariate statistics.     

The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and meta-analysis of randomized controlled trials

Aims

To undertake a systematic review and meta-analysis of randomized controlled trials concerned with the impact of community pharmacist-led interventions on blood pressure control in patients with hypertension.

Methods

Eight electronic databases were searched up to 30 November 2013, with no start date (Web of Science, Embase, The Cochrane Library, Medline Ovid, Biomed Central, Biosis Citation Index, CINAHL, PsycINFO). All studies included were randomized controlled trials involving patients with hypertension, with or without cardiovascular-related co-morbidities, with difference in blood pressure as an outcome. Data collected included the study design, baseline characteristics of study populations, types of interventions and outcomes. The Cochrane tool was used to assess risk of bias.

Results

From 340 articles identified on initial searching, 16 randomized controlled trials (3032 patients) were included. Pharmacist-led interventions were patient education on hypertension, management of prescribing and safety problems associated with medication, and advice on lifestyle. These interventions were associated with significant reductions in systolic [11 studies (2240 patients); −6.1 mmHg (95% confidence interval, −3.8 to −8.4 mmHg); P < 0.00001] and diastolic blood pressure [11 studies (2246 patients); −2.5 mmHg (95% confidence interval, −1.5 to −3.4 mmHg); P < 0.00001].

Conclusions

Community pharmacist-led interventions can significantly reduce systolic and diastolic blood pressure. These interventions could be useful for improving clinical management of hypertension.     

The associations between early alcohol use and suicide attempts among adolescents with a history of major depression

Objective

Previous studies have identified significant associations between alcohol initiation before the age of 13 years and risk for suicide attempts. However, these associations have not been extensively tested using data obtained from populations with clinically significant psychopathology. The current study seeks to extend knowledge of the associations between early alcohol initiation and risk for suicide by identifying the associations between age of first alcohol use and suicide attempts among a sample of youth age 13 to 15 years with a history of major depression.

Methodology

Data were obtained from the National Study of Drug Use and Health (NSDUH), a household-based survey of U.S. adolescents and adults age 12 years and older.

Results

Results from these analyses confirm previous reports of significant associations between age of first alcohol use and suicide attempts and extend previous understanding of risk by using data obtained from a household-based survey and from adolescents with clinically relevant psychopathology.

Conclusions

These findings provide further support for the implementation, enforcement, and continued support of both targeted and universal prevention strategies designed to reduce underage drinking.     

Depressed mood and the effect of two universal first grade preventive interventions on survival to the first tobacco cigarette smoked among urban youth

Introduction

As part of an evaluation of two first-grade, universal preventive interventions whose proximal targets were early learning and behavior, we investigated the influence of depressed mood, the interventions, and their interaction on survival to the first tobacco cigarette smoked through age 19. One intervention focused on improving teacher behavior management and instructional skills (Classroom-Centered, CC) as a means of improving student behavior and learning and the other on the family–school partnership (FSP). Variation in the relationship between depressed mood and first cigarette smoked by gender and grade was also examined.

Methods

Self-reports of smoking behavior and depressed mood were collected on an annual basis from grade 6 through age 19. The present analyses were restricted to the 563 youth who had never smoked by grade 6, or 83% of the original sample of first grade participants. Discrete-time survival analysis was used to examine the effects of depressed mood and the interventions on survival to the first tobacco cigarette smoked.

Results

Depressed mood was associated with reduced survival time to the first cigarette smoked (adjusted hazard ratio, aHR: 1.4; 95% CI: 1.1–1.9), whereas the CC intervention prolonged survival time (aHR: 0.8; 95% CI: 0.7–0.9). No significant variation in the effect of depressed mood on survival was found by gender or grade, nor was the effect of the CC intervention moderated by depressed mood.

Conclusions

Strategies to prevent tobacco cigarette smoking should include both a focus on depressed mood in adolescence as well as on early success in elementary school.     

The curvilinear effects of sexual orientation on young adult substance use

Alcohol, tobacco, and marijuana are commonly used by adolescents and linked with harmful health-related outcomes (e.g. injury, dependence). Moreover, heavy episodic (binge) drinking predicts more severe consequences. When examined by sexual orientation, highest rates of substance use have been found among bisexual individuals, with lower use at either end of the spectrum. When examined also by sex, this curvilinear trend is maintained among women but not men. These substance use patterns were identified using group differences (i.e. heterosexual vs. bisexual vs. homosexual). However, evidence suggests that sexual orientation is a continuous, not categorical, variable. This study examined the hypotheses that sexual orientation and commonly used substances (heavy episodic drinking, tobacco, marijuana) would have a quadratic relation among women, but not among men. Six negative binomial regressions tested study hypotheses using data from 7372 participants. Results indicated that sexual orientation had a quadratic relation with heavy episodic drinking, tobacco use, and marijuana use among women, as hypothesized. Additionally, a quadratic relation was found between marijuana use and sexual orientation among men. These findings indicate that women identifying as having mixed sexual orientation are at higher risk than women at either end of the sexual orientation continuum for substance use and related negative outcomes. For men, this is only true for marijuana use and resultant negative consequences. This observed increased use may relate to coping with increased stressors, which has been linked to more problematic use. By better understanding LBG identities and behaviors, clinicians and researchers will be more adept at identifying risk factors and better understanding the nuances across the sexual orientation spectrum.     

The impact of sleep and psychiatric symptoms on alcohol consequences among young adults

ObjectiveIndependent lines of research have documented links between psychiatric symptoms and poor sleep quality, psychiatric symptoms and alcohol use, and alcohol use and poor sleep quality. The current study examined the synergistic effect of poor sleep quality and psychiatric symptoms on alcohol-related consequences in heavy-drinking young adults.MethodMatriculating college students reporting at least one heavy drinking episode over the first nine weeks of the semester (N = 385, 52% female) were categorized as experiencing ‘good’ (n = 280) versus ‘poor’ sleep quality (n = 105) and screening ‘positive’ (n = 203) or ‘negative’ (n = 182) for a psychiatric disorder. Sleep quality was assessed using the Pittsburgh Sleep Quality Index; psychiatric diagnosis was assessed using the Psychiatric Diagnostic Screening Questionnaire; and alcohol-related consequences were assessed using the Brief Young Adult Alcohol Consequences Questionnaire. General linear models were used to examine the main effects and interaction between sleep quality and psychiatric symptoms on alcohol-related consequences.ResultsSleep quality moderated the association between psychiatric screen and alcohol-related consequences among heavy-drinking college students, such that psychiatric symptoms were associated with more alcohol-related consequences in the context of poor sleep quality.ConclusionsThe combination of poor sleep quality and psychiatric symptoms is associated with increased alcohol-related consequences among heavy-drinking college students. Given the significant interaction between these symptoms, healthcare providers are encouraged to screen for the presence of sleep and psychiatric disorders among heavy-drinking young adults and to provide empirically-supported treatments as appropriate.     

The toxicity of some dithiocarbamate compounds in young and adult domestic fowl

Sodium diethyldithiocarbamate, sodium dimethyldithiocarbamate, ferric dimethyldithiocarbamate, zinc dimethyldithiocarbamate, and tetramethylthiuram disulphide were given po to young and adult domestic fowl. All these compounds had an adverse effect on body weight, retarded testicular development, and produced degeneration in the seminiferous epithelium of mature birds. Nerve fiber degeneration was produced in the medulla and spinal cord of chicks by sodium diethyldithiocarbamate and of cocks by sodium dimethyldithiocarbamate. This is the first record of nerve fiber degeneration being produced by sodium dimethyldithiocarbamate. Chicks given thiram became lame, and their long bones developed greatly swollen epiphyses. This was due to abnormal endochondral ossification, giving rise to a thickened cartilaginous epiphyseal plate. Ziram was the most toxic of the compounds, and sodium diethyldithiocarbamate and tetramethylthiuram disulphide appeared to be more toxic to adult fowl than sodium or ferric dimethyldithiocarbamate.