Prevalence and risk factors for suicidal ideation in a multiple sclerosis population

Objective

To estimate the prevalence, incidence and determinants of suicidal ideation in the multiple sclerosis (MS) population.

Methods

A sample of 188 subjects were randomly selected from a community-based MS clinic registry and participated in as many as 13 interviews over 6 months. Thoughts of “being better off dead” or of “harming oneself” were assessed using item 9 on the Patient Health Questionnaire, Brief (PHQ-9).

Results

At baseline, the 2-week period prevalence of suicidal ideation was 8.3%. Over the course of 6 months, 22.1% of respondents reported having such thoughts at least once. Survival analysis incorporating baseline PHQ-8 scores as a covariate confirmed that being age 65 and over (HR = 4.3, 95% CI 1.7–11.3) and having lower quartile self-efficacy ratings (HR = 3.5, 95% CI 1.5–8.2) predicted suicidal ideation. Lower levels of task-oriented coping (treated as a continuous variable) also predicted suicidal ideation after adjustment for depressive symptoms (p = 0.015), as did self-reported bladder or bowel symptoms (HR = 2.6, 95% CI 1.1–6.0) and difficulties with speaking and swallowing (HR = 2.9, 95% CI 1.3–6.8). Associations with MS symptoms were not confounded by depressive symptoms.

Conclusion

This study identified several potentially modifiable factors that may be useful for preventing suicide in people with MS.     

Trauma exposure,posttraumatic stress disorder and risk for alcohol,nicotine, and marijuana dependence in Israel

Background

Substance dependence is more common among trauma-exposed individuals; however, most studies suggest that Posttraumatic Stress Disorder (PTSD) accounts for the link between trauma exposure (TE) and substance dependence.

Objectives

This study examined associations between TE and substance dependence (alcohol, nicotine, and marijuana), and whether PTSD accounted for this association.

Method

1317 Jewish Israeli household residents completed in-person structured interviews assessing TE, PTSD, and substance (alcohol, nicotine, marijuana) dependence between 2007 and 2009. Regression analyses examined associations among TE, PTSD, and substance dependence.

Results

In the full sample, mean number of traumatic events was 2.7 (sd = 2.2), with 83.7% experiencing at least one event. In the full sample, mean number of PTSD symptoms was 2.5 (sd = 3.4), with 13.5% meeting PTSD diagnostic criteria. Prevalence of alcohol dependence was 13.4%; nicotine dependence 52.8%; and marijuana dependence 12.1%. Number of traumatic events was associated with increased odds of alcohol (OR = 1.3; 95% CI = 1.2–1.4) and nicotine (OR = 1.2; 95% CI = 1.1–1.3) dependence. Similarly, any traumatic event exposure was associated with increased odds of alcohol (OR = 3.1; 95% CI = 1.6–6.0) and nicotine (OR = 1.9; 95% CI = 1.2–2.9) dependence. PTSD symptoms were associated with increased odds of alcohol (OR = 1.2; 95% CI = 1.1–1.3), nicotine (OR = 1.1; 95% CI = 1.1–1.2), and marijuana (OR = 1.1; 95% CI = 1.04–1.2) dependence; similarly, a PTSD diagnosis was associated with increased odds of alcohol (OR = 3.4; 95% CI = 2.1–5.5), nicotine (OR = 2.2; 95% CI = 1.4–3.4), and marijuana (OR = 2.6; 95% CI = 1.2–5.9) dependence. PTSD symptoms accounted for a sizeable proportion of the TE effect on alcohol (46%) and nicotine dependence (31%).

Conclusion

Individuals with more traumatic events had heightened risk for alcohol and nicotine dependence, and PTSD symptoms partially accounted for this risk. However, marijuana dependence was only significantly related to PTSD symptoms. Clinicians and researchers should separately assess different types of dependence among trauma-exposed individuals both with and without PTSD symptoms.     

Delirium is a risk factor for institutionalization and functional decline in older hip fracture patients

Objectives

The risk of institutionalization and functional decline is substantial after a hip fracture. However, previous research has not established the extent to which delirium plays a contributory role.

Methods

Using a prospective design, we studied 207 hip fracture patients aged 65 and older, home-dwelling before the fracture. Patients were screened daily for delirium using the Confusion Assessment Method. Proxy information on pre-fracture cognitive function and function in activities of daily living (ADL) was obtained using the Informant Questionnaire on Cognitive Decline in the Elderly, 16-item version, and the Barthel ADL Index. After 6 months, the patients' functions in ADL measured by the Barthel ADL Index and place of living were registered.

Results

Delirium was present in 80 patients (39%) during the hospital stay. After 6 months, 33 (16%) were institutionalized. Delirium and lower Barthel ADL Index score were the main risk factors for institutionalization with an adjusted odds ratio (AOR) of 5.50 (95% CI = 1.77–17.11) and 0.54 (95% CI = 0.40–0.74) respectively. In patients able to return to their private home, the independent risk factors for functional decline were higher age (B = 0.053, 95% CI = 0.003–0.102) and delirium (B = 0.768, 95% CI = 0.039–1.497).

Conclusions

At 6 month follow-up, delirium constitutes an independent risk factor for institutionalization and functional decline in hip fracture patients living at home prior to the fracture.     

Suicidal tendency in a sample of adolescent outpatients with Adjustment Disorder: Gender differences

Background

Although Adjustment Disorder (AD) is a prevalent diagnosis in adolescent mental health services and linked to suicidal tendency in adolescence, little research exists examining prevalence and gender differences of suicidal symptoms among AD patients using standardized instruments.

Aims

The present study aims to assess the presence of suicidal tendency in a clinical sample of Spanish adolescents with AD analyzing gender differences.

Method

Ninety-seven adolescents with AD were recruited at a public mental health center and included in the AD sample; they were administered the Inventario de Riesgo Suicida para Adolescentes (Suicide Risk Inventory for Adolescents-IRIS) and the Millon Adolescent Clinical Inventory (MACI). Ninety-nine community adolescents were recruited and administered the IRIS inventory. The community sample works as a contrast group.

Results

Girls with AD show higher levels of suicidal symptoms than boys on both the IRIS Suicidal Ideation and Intention scale (t = 8.15, p < .001) and the MACI Suicidal Tendency scale (t = 6.6, p < .001). Girls with AD scored significantly higher than girls from the community contrast group sample in the IRIS Suicidal Ideation and Intention scale, but boys with AD presented no differences with regard to boys form the community contrast group sample. Compared with normative clinical samples of the MACI, no differences in the Suicidal Tendency scale scores were found between AD and normative girls, but AD boys showed significantly lower mean scores than normative boys. Suicidal symptoms were presented by 27% of girls and 18% of boys, although only 6% of the girls and none of the boys presented clear suicidal tendencies.

Conclusions

Considering suicidal tendencies in adolescents with Adjustment Disorder is important—especially in girls, who present high suicidal tendencies in relation both to boys and to community peers and the normative clinical population.     

Perceived weight in youths and risk of overweight or obesity six years later

Objective

To examine the association between perceived overweight in adolescents and the development of overweight or obesity later in life.

Methods

This paper uses data from a prospective, two-wave cohort study. Participants are 2445 adolescents 11–17 years of age who reported perceived weight at baseline and also had height and weight measured at baseline and at follow-up six years later sampled from managed care groups in a large metropolitan area.

Results

Youths who perceived themselves as overweight at baseline were approximately 2.5 times as likely to be overweight or obese six years later compared to youths who perceived themselves as average weight (OR = 2.45, 95% CI = 1.77–3.39), after adjusting for weight status at baseline, demographic characteristics, major depression, physical activity and dieting behaviors. Those who perceived themselves as skinny were less likely to be overweight or obese later (OR = 0.36, 95% CI = 0.27–0.49).

Conclusions

Perceived overweight was associated with overweight or obesity later in life. This relationship was not fully explained by extreme weight control behaviors or major depression. Further research is needed to explore the mechanism involved.     

Association between Problematic Cellular Phone Use and Suicide: The Moderating Effect of Family Function and Depression

Background

Suicidal ideation and attempt among adolescents are risk factors for eventual completed suicide. Cellular phone use (CPU) has markedly changed the everyday lives of adolescents. Issues about how cellular phone use relates to adolescent mental health, such as suicidal ideation and attempts, are important because of the high rate of cellular phone usage among children in that age group. This study explored the association between problematic CPU and suicidal ideation and attempts among adolescents and investigated how family function and depression influence the association between problematic CPU and suicidal ideation and attempts.

Methods

A total of 5051 (2872 girls and 2179 boys) adolescents who owned at least one cellular phone completed the research questionnaires. We collected data on participants’ CPU and suicidal behavior (ideation and attempts) during the past month as well as information on family function and history of depression.

Results

Five hundred thirty-two adolescents (10.54%) had problematic CPU. The rates of suicidal ideation were 23.50% and 11.76% in adolescents with problematic CPU and without problematic CPU, respectively. The rates of suicidal attempts in both groups were 13.70% and 5.45%, respectively. Family function, but not depression, had a moderating effect on the association between problematic CPU and suicidal ideation and attempt.

Conclusion

This study highlights the association between problematic CPU and suicidal ideation as well as attempts and indicates that good family function may have a more significant role on reducing the risks of suicidal ideation and attempts in adolescents with problematic CPU than in those without problematic CPU.     

Emotion suppression and mortality risk over a 12-year follow-up

Objective

Suppression of emotion has long been suspected to have a role in health, but empirical work has yielded mixed findings. We examined the association between emotion suppression and all-cause, cardiovascular, and cancer mortality over 12 years of follow-up in a nationally representative US sample.

Methods

We used the 2008 General Social Survey–National Death Index (GSS–NDI) cohort, which included an emotion suppression scale administered to 729 people in 1996. Prospective mortality follow up between 1996 and 2008 of 111 deaths (37 by cardiovascular disease, 34 by cancer) was evaluated using Cox proportional hazards models adjusted for age, gender, education, and minority race/ethnicity.

Results

The 75th vs. 25th percentile on the emotional suppression score was associated with hazard ratio (HR) of 1.35 (95% Confidence Interval [95% CI] = 1.00, 1.82; P = .049) for all-cause mortality. For cancer and cardiovascular disease mortality, the HRs were 1.70 (95% CI = 1.01, 2.88, P = .049) and 1.47 (95% CI = .87, 2.47, P = .148) respectively.

Conclusions

Emotion suppression may convey risk for earlier death, including death from cancer. Further work is needed to better understand the biopsychosocial mechanisms for this risk, as well as the nature of associations between suppression and different forms of mortality.     

Risk of suicidal ideation in diabetes varies by diabetes regimen,diabetes duration,and HbA1c level

Objective

To investigate patient subgroups based on the clinical characteristics of diabetes to evaluate risk factors for suicidal ideation using a large population-based sample in South Korea.

Methods

Data from the Fifth Korea National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey, were analyzed. The participants were 9159 subjects aged ≥ 40 years. We defined patients with diabetes based on self-reported physician-diagnosed diabetes. We evaluated clinical risk factors for suicidal ideation according to diabetes regimen, diabetes duration, and glycated hemoglobin (HbA1c) level compared with no diabetes. Given the complex sample design and unequal weights, we analyzed weighted percentages and used survey logistic regression.

Results

Diabetes per se was not associated with suicidal ideation. However, suicidal ideation was significantly more prevalent among patients who had injected insulin, had a duration of diabetes ≥ 5 years and had HbA1c levels ≥ 6.5 compared with those without diabetes. Depressive symptoms were the most prominent predictor of suicidal ideation.

Conclusions

Insulin therapy, diabetes of long duration, and unsatisfactory glycemic control were identified as risk factors for suicidal ideation; thus, patients with these characteristics warrant special attention. Our findings suggest the need to integrate efforts to manage emotional distress into diabetes care.     

Sleep problems and suicidality in the National Comorbidity Survey Replication

Objective

Links between sleep problems and suicidality have been frequently described in clinical samples; however, this issue has not been well-studied in the general population. Using data from a nationally representative survey, we examined the association between self-reported sleep difficulties and suicidality in the United States.

Methods

The WHO Composite International Diagnostic Interview was used to assess sleep problems and suicidality in the National Comorbidity Survey Replication (NCS-R). Relationships between three measures of sleep (difficulty initiating sleep, maintaining sleep, early morning awaking), and suicidal thoughts, plans, and attempts were assessed in logistic regression analyses, while controlling for demographic characteristics, 12-month diagnoses of mood, anxiety and substance use disorders, and chronic health conditions.

Results

In multivariate models, the presence of any of these sleep problems was significantly related to each measure of suicidality, including suicidal ideation (OR = 2.1), planning (OR = 2.6), and suicide attempt (OR = 2.5). Early morning awakening was associated with suicidal ideation (OR = 2.0), suicide planning (OR = 2.1), and suicide attempt (OR = 2.7). Difficulty initiating sleep was a significant predictor of suicidal ideation and planning (ORs: 1.9 for ideation; 2.2 for planning), while difficulty maintaining sleep during the night was a significant predictor of suicidal ideation and suicide attempts (ORs: 2.0 for ideation; 3.0 for attempt).

Conclusions

Among community residents, chronic sleep problems are consistently associated with greater risk for suicidality. Efforts to develop comprehensive models of suicidality should consider sleep problems as potentially independent indicators of risk.     

Sex differences and eating disorder risk among psychiatric conditions,compulsive behaviors and substance use in a screened Canadian national sample

Objective

This study examined sex differences and eating disorder risk among psychiatric conditions, compulsive behaviors (i.e., gambling, suicide thoughts and attempts) and substance use in a nationally representative sample.

Method

Data from participants of the Canadian Community Health Survey Cycle 1.2 who completed the Eating Attitudes Test (n= 5116) were analyzed. Sex differences were compared among psychiatric comorbidities according to eating disorder risk, binging, vomiting and dieting behavior. Poisson regression analysis provided prevalence ratios (PRs) of disordered eating adjusting for age, marital status, income, body mass index and recent distress.

Results

Pronounced sex differences were associated with eating disorder risk (PRs 4.89–11.04; all P values < .0001). Findings of particular interest included significantly higher PRs for eating disorder risk in males associated with gambling (PR 5.07, P< .0001) and for females associated with steroid and inhalant use as well as suicide thoughts and attempts (PRs 5.40–5.48, all P values < .0001).

Discussion

The findings from this detailed exploration of sex differences and eating disorder risk among psychiatric conditions, compulsive behaviors and substance use suggest that problem gambling, the use of inhalants and steroids and suicidal ideation in relationship to eating disorder risk warrant further investigation.     

Potentially traumatic events and serious life stressors are prospectively associated with frequency of doctor visits and overnight hospital visits

Objective

Cumulative lifetime exposure to potentially traumatic events and serious life stressors has been linked with both mental and physical health problems; however, less is known about the association between exposure to potentially traumatic events and serious life stressors with health care use. We investigated whether a higher number of potentially traumatic events and serious life stressors were prospectively associated with an increased number of doctor visits and nights spent in the hospital.

Methods

Participants were drawn from the Health and Retirement Study, a prospective and nationally representative study of adults aged 50 + in the United States (n = 7168). We analyzed the data using a generalized linear model with a gamma distribution and log link.

Results

A higher number of potentially traumatic events and serious life stressors were associated with an increased number of doctor visits and nights spent in the hospital. On a 10-point scale, each additional potentially traumatic event or serious life stressor was associated with an 8% increase in doctor visits after controlling for sociodemographic factors (RR = 1.08, 95% CI = 1.06–1.11; p < .001). Each additional potentially traumatic event or serious life stressor was also associated with an 18% increase in the number of nights spent in the hospital after controlling for sociodemographic factors (RR = 1.18, 95% CI = 1.10–1.27; p < .001).

Conclusion

Exposure to potentially traumatic events and serious life stressors is associated with increased doctor visits and nights spent in the hospital, which may have important implications for the current standard of care.     

Cilostazol for Primary Prevention of Stroke in Peripheral Artery Disease: A Population-based Longitudinal Study in Taiwan

Background

Clopidogrel, cilostazol, and aspirin were compared in terms of efficacy and safety for primary prevention of stroke in peripheral artery disease (PAD) patients.

Methods

This retrospective cohort study analyzed data contained in the Taiwan National Health Insurance Bureau database for patients treated for PAD but not for stroke during 2002–2008. Patients were stratified according to treatment with aspirin, clopidogrel, cilostazol, or combined therapy. The primary efficacy and safety endpoints were stroke and hemorrhage.

Results

Of the 931 patients enrolled in this study, 479 had received aspirin, 39 had received clopidogrel, 294 had received cilostazol alone, and 33 had received a cilostazol-based combined therapy. Compared to patients treated with aspirin, the patients treated with cilostazol had significantly lower all-stroke risk not only in the overall group (HR = 0.66, 95% CI = 0.48-0.90, p = 0.0086), but also in the subgroup of patients with diabetes (HR = 0.64, 95% CI = 0.42-0.98, p = 0.0394) and in the subgroup of patients with high cardiovascular risk (HR = 0.66, 95% CI = 0.46-0.95, p = 0.0254). Additionally, compared to patients treated with aspirin, those treated with cilostazol did not have significantly more hemorrhagic events in the overall group, in the diabetes subgroup, or in the high cardiovascular risk subgroup. Clopidogrel, cilostazol-based combined therapy and aspirin did not significantly differ in terms of efficacy and hemorrhagic events.

Conclusion

Although this database study indicated that cilostazol therapy is an effective alternative treatment for primary prevention of stroke in PAD, further confirmation is needed in large, prospective, and randomized trials.     

Suicide attempts and mortality in eating disorders: a follow-up study of eating disorder patients

Objective

The aim of this study is to explore the prevalence of hospital-treated suicide attempts in a large clinical population of eating disorder patients.

Method

Follow-up study of adults (N= 2462, 95% women, age 18–62 years) admitted to the Eating Disorder Clinic of Helsinki University Central Hospital in the period 1995–2010. For each patient, four controls were selected and matched for age, sex and place of residence. The end point events were modeled using Cox’s proportional hazard model, taking matching into account.

Results

We identified 156 patients with eating disorder (6.3%) and 139 controls (1.4%) who had required hospital treatment for attempted suicide. Of them, 66 (42.3%) and 37 (26.6%) had more than one attempt. The rate ratio (RR) for suicide attempt in patients with eating disorder was 4.70 [95% confidence interval (CI) 1.41–15.74]. In anorexia nervosa, RR was 8.01 (95% CI 5.40–11.87), and in bulimia nervosa, it was 5.08 (95% CI 3.46–7.42). In eating disorder patients with a history of suicide attempt, the risk of death from any cause was 12.8%, suicide being the main cause in 45% of the deaths.

Conclusion

Suicide attempts and repeated attempts are common among patients with eating disorders. Suicidal ideation should be routinely assessed from patients with eating disorders.     

Botulinum toxin type A versus amitriptyline for the treatment of chronic daily migraine

Objective

To compare the effects of botulinum toxin type A with those of amitriptyline on the treatment of chronic daily migraines.

Methods

Chronic migraine sufferers were randomized into two groups and treated with 25 or 50 mg/day of amitriptyline or 250 U of botulinum toxin type A. A reduction of at least 50% in the number of pain episodes, in the intensity of pain, and in the number of drug doses for pain and reports of improvement by the patient or by the examiner were the main endpoints.

Results

Seventy-two subjects were enrolled in the study. A reduction of at least 50% in the number of days of pain was recorded in 67.8% of the patients in the BTX-A group and 72% (n = 23) of the patients in the AM group (p = 0.78; RR = 0.94; CI = 0.11–8). The reduction in the intensity of pain, as assessed using the visual analogical scale, was 50% in the BXT-A group and 55.6% in the AM group (p = 0.79; RR = 1.11; CI = 0.32–3.8). The reduction in the number of pain drug doses was 77% for the toxin group and 71% for the amitriptyline group (p = 0.76; RR = 0.92; CI = 0.45–1.88).

Conclusions

Botulinum toxin type A was as effective as amitriptyline for the prophylactic treatment of chronic daily migraines.     

The association between suicidality and Internet addiction and activities in Taiwanese adolescents

Objective

The aims of this cross-sectional study were to examine the associations of suicidal ideation and attempt with Internet addiction and Internet activities in a large representative Taiwanese adolescent population.

Methods

9510 adolescent students aged 12–18 years were selected using a stratified random sampling strategy in southern Taiwan and completed the questionnaires. The five questions from the Kiddie Schedule for Affective Disorders and Schizophrenia were used to inquire as to the participants’ suicidal ideation and attempt in the past one month. The Chen Internet Addiction Scale was used to assess participants’ Internet addiction. The kinds of Internet activities that the adolescents participated in were also recorded. The associations of suicidal ideation and attempt with Internet addiction and Internet activities were examined using logistic regression analysis to control for the effects of demographic characteristics, depression, family support and self-esteem.

Results

After controlling for the effects of demographic characteristics, depression, family support and self-esteem, Internet addiction was significantly associated with suicidal ideation and suicidal attempt. Online gaming, MSN, online searching for information, and online studying were associated with an increased risk of suicidal ideation. While online gaming, chatting, watching movies, shopping, and gambling were associated with an increased risk of suicidal attempt, watching online news was associated with a reduced risk of suicidal attempt.

Conclusions

The results of this study indicated that adolescents with Internet addiction have higher risks of suicidal ideation and attempt than those without. Meanwhile, different kinds of Internet activities have various associations with the risks of suicidal ideation and attempt.     

Optimism measured pre-operatively is associated with reduced pain intensity and physical symptom reporting after coronary artery bypass graft surgery

Objective

Optimism is thought to be associated with long-term favourable outcomes for patients undergoing coronary artery bypass graft (CABG) surgery. Our objective was to examine the association between optimism and post-operative pain and physical symptoms in CABG patients.

Methods

We assessed optimism pre-operatively in 197 adults undergoing CABG surgery, and then followed them up 6–8 weeks after the procedure to measure affective pain, pain intensity, and physical symptom reporting directly pertaining to CABG surgery.

Results

Greater optimism measured pre-operatively was significantly associated with lower pain intensity (β = − 0.150, CI = − 0.196 to − 0.004, p = .042) and fewer physical symptoms following surgery (β = − 0.287, CI = − 0.537 to − 0.036, p = .025), but not with affective pain, after controlling for demographic, clinical and behavioural covariates, including negative affectivity.

Conclusions

Optimism is a modest, yet significant, predictor of pain intensity and physical symptom reporting after CABG surgery. Having positive expectations may promote better recovery.     

Carnitine palmitoyltransferase 2 gene polymorphism is a genetic risk factor for sudden unexpected death in infancy

Rationale

Carnitine palmitoyltransferase (CPT) II is one of a pivotal enzyme in mitochondrial fatty acid oxidation, which is essential for energy production during simultaneous glucose sparing and a requirement for major energy supply, such as prolonged fasting or exercise. When infants require more energy than provided by the glycolytic system, they rely on the mitochondrial fatty acid oxidation pathway. Mutations of the CPT2 gene have been reported to cause sudden unexpected death in infancy (SUDI). A thermolabile phenotype of a CPT2 polymorphism (F352C) has been recently reported to reduce CPT II enzyme activity. The F352C variant results in energy crisis at high temperature and is suspected as a risk factor for acute encephalopathy. However, a relationship between CPT2 gene polymorphism and SUDI has not been described.

Methods

Single nucleotide polymorphisms of the CPT2 gene were investigated among 54 SUDI cases and 200 healthy volunteers.

Results

The frequency of the C allele was significantly higher in the SUDI group than in the control group [25.0% vs 16.0%, odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.05–2.92, p = 0.030). The frequency of the F352C homozygote was significantly higher in the SUDI group than in control group (11.1% vs 3.5%, OR = 3.45, 95% CI = 1.11–10.73, p = 0.036).

Conclusion

The F352C CPT2 variant might be a genetic risk factor for SUDI.     

TPH2 is not a susceptibility gene for suicide in Japanese population

Background

Serotonergic systems mediate a control of aggression and/or impulsivity in human and are suggested to be involved in suicidal behavior. The newly identified neuronal tryptophan hydroxylase isoform 2 (TPH2), the rate-limiting enzyme in serotonin synthesis, represents a prime candidate in numerous genetic association analyses of suicidal behavior; however, the results are still inconclusive. The discrepancy may result from the heterogeneity of pathogenesis of suicidal behavior and/or methodological mismatches. We, therefore, attempted to replicate the association of TPH2 gene with suicide using a case-control study of 234 completed suicides and 260 control subjects in Japanese population.

Methods

We genotyped 15 tagging-single nucleotide polymorphisms (SNPs) including 4 SNPs, which were previously reported to be associated with suicidal behavior, using the TaqMan probe assays and the polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) method.

Results

We found no significant differences in genotypic distributions (uncorrected p = 0.06–0.98) or allelic frequencies (uncorrected p = 0.09–0.95) of the fifteen SNPs between the completed suicides and control groups. Haplotypes constructed with these SNPs were also not associated with suicide (uncorrected p = 0.03–0.96 and corrected p = 0.20–1.00). Even when we took sex and suicidal methods (violent or non-violent) into account for the analyses, no significant differences in genotypic distributions, allelic/haplotypic frequencies were found in the two groups.

Conclusion

Our results suggest that the common SNPs and haplotypes of the TPH2 gene are unlikely to contribute to the genetic susceptibility to suicidal behavior in Japanese population.     

The prevalence of suicidal ideation among the elderly in China: A meta-analysis of 11 cross-sectional studies

Objective

This study aimed to estimate the pooled prevalence of suicidal ideation among Chinese elderly aged ≥60 years.

Methods

Two reviewers independently searched the potentially relevant studies through electronic database (PubMed-Medline, Embase, Wanfang Data, Chinese National Knowledge Infrastructure and Chongqing VIP) using key terms ‘suicid*’, ‘suicidal ideation’ combined with ‘aged’, ‘elderly’ and ‘old people’. All selected studies should meet the eligibility criteria in this study. Chi-square based Q test and I² statistic assessed the heterogeneity. Forest plots were used to display results graphically. Potential publication bias was assessed by the funnel plot and Begg’s test. Prevalence rate was meta-analysed.

Results

In total, 11 studies were included with 11,526 subjects. The prevalence of suicidal ideation among Chinese elderly ranged from 2.2% to 21.5%. The pooled prevalence of all 11 studies was 11.5% (95% CI: 8.3%–14.8%). Subgroup analyses showed the prevalence for males was 11.0%, and for the females was 15.6%. In three subgroups for age, 60–69, 70–79 and ≥80, the prevalence was 9.1%, 12.1% and 18.9% respectively. A slightly higher prevalence in rural areas was calculated than in urban (14.7% vs. 11.8%). In mainland China, the prevalence was 12.6%. And in Taiwan and Hongkong, the pooled prevalence was 9.2%.

Conclusions

The prevalence of suicidal ideation was relatively high among elderly in China, and it should attract enough attention.