The relationship between parental marital status and suicidal ideation and attempts by gender in adolescents: Results from a nationally representative Korean sample

Objective

Suicide in adolescents is a major problem worldwide. The purpose of this study was to identify differences in suicidal behaviors with respect to parental marital status.

Methods

The data used in this study were obtained from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) of middle and high school students in 2010. Using a national representative sample, this study analyzed data from 73,238 subjects. With respect to gender, the odds ratios of suicidal behavior were calculated based on the parental marital status, living situation, and family affluence scale (FAS).

Results

After adjusting for age, achievement, sadness, and substance use, the prevalence of suicidal ideation in adolescents with a remarried parent significantly increased among boys to 1.364 [95% confidence interval (CI) = 1.027–1.813] and among girls to 1.511 (95% CI = 1.215–1.879). The odds ratio of suicide attempts increased to 1.808 (95% CI = 1.119–2.923) for adolescent boys and to 1.947 (95% CI = 1.609–2.356) for adolescent girls. However, having a single parent did not affect the prevalence of suicidal ideation in either gender. In girls, as family affluence decreased, the odds ratio of suicidal ideation notably increased. For girls whose families were in a low tier of the FAS, the odds ratio of both suicidal ideation and suicide attempts increased.

Conclusions

Both boys and girls were more likely to report suicidal ideation and attempts after a parent’s remarriage, whereas family affluence was inversely related to suicidal ideation and attempts in girls.     

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.     

Lifetime prevalence of suicidal ideation among men who have sex with men: a meta-analysis

Background

Suicide is a leading cause of death among men who have sex with men (MSM) and suicidal ideation may put individuals at higher risk of suicide. A great disparity of lifetime prevalence of suicidal ideation among MSM was observed across studies, indicating the importance of a reliable estimation of the pooled lifetime prevalence. However, the only one published meta-analysis estimating the pooled lifetime prevalence of suicidal ideation among MSM was conducted in 2008 with only 2 eligible studies. Subsequently, there was a rapid increase of publications about lifetime suicidal ideation among MSM, suggesting that an update on the pooled lifetime prevalence of suicidal ideation among MSM was necessary. Therefore, this study aimed to update the estimation of the pooled lifetime prevalence of suicidal ideation among MSM.

Methods

Electronic databases of PubMed, CINAHL, Scopus (social science), Embase and PsycInfo were searched until September 2017 to identify relevant studies. Cross-sectional studies exploring the lifetime prevalence of suicidal ideation among MSM were enrolled. Heterogeneity was evaluated using the Cochran Q test and quantified using the I ² statistic. The possibility of publication bias was assessed using both Begg’s rank test and Egger’s linear test, and an Egger’s funnel plot for asymmetry was presented. Subgroup analyses were performed according to the geographic area, sample source and HIV status.

Results

Nineteen studies with a total of 26,667 MSM were included, of which 9374 were identified with suicidal ideation. A high degree of heterogeneity (P?≤?0.001, I ² =99.2%) was observed among the eligible studies, with the reported prevalence ranging from 13.18 to 55.80%. The pooled lifetime prevalence of suicidal ideation among MSM by a random effects model was 34.97% (95% confidence interval: 28.35%–41.90%). Both the Begg’s rank test and Egger’s linear test indicated low possibility of publication bias. Subgroup analyses showed that the lifetime prevalence of suicidal ideation among MSM differed significantly by geographic area, sample source and HIV status (P?<?0.05).

Conclusions

The high pooled lifetime prevalence of suicidal ideation among MSM found in this meta-analysis significantly underscores the importance of early assessment of suicidal ideation among MSM, as well as the need for strengthening the psychological interventions.

     

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.     

Point prevalence and correlates of depression in a national community sample with multiple sclerosis

Objective

The prevalence of depression in multiple sclerosis (MS) is known to be elevated, but nearly all available studies have estimated period prevalence. The objective of this study was to estimate the point prevalence of depression in a representative community sample using the Patient Health Questionnaire, Brief (PHQ-9).

Methods

The data source for this study was the Survey of Living with Neurological Conditions in Canada, which was derived from a representative sample of household residents.

Results

The sample included 630 respondents with MS. With application of the standard PHQ-9 cut point (10 +), the prevalence of depression was 26.0% (95% confidence interval 18.9%–33.0%). Depressed subjects had lower quality of life; an increased frequency of suicidal ideation; and more often reported a negative disease course, high stress, low social support and stigmatization.

Conclusions

This study adds to the existing literature by providing point prevalence data: in any 2-week period, about one quarter of community residents with MS experience substantial levels of depressive symptoms.     

Effects of mindfulness-based cognitive therapy on self-reported suicidal ideation: results from a randomised controlled trial in patients with residual depressive symptoms

Introduction

The aim of the present study was to investigate the effects of mindfulness-based cognitive therapy (MBCT) on suicidal ideation in an open-label randomised controlled trial of patients with residual depressive symptoms. Furthermore, this study aimed at examining whether an effect of MBCT on suicidal ideation was dependent on a reduction in depression severity, worry and rumination, or an increase in mindfulness.

Methods

One hundred and thirty participants were randomised to a treatment arm (treatment as usual plus MBCT) or a wait list arm. Change in depression, change in worry, change in rumination and change in mindfulness were entered as covariates in a repeated measures ANOVA in order to assess to what degree MBCT-induced changes in suicidal ideation were independent from changes in these parameters.

Results

There was a significant group × time (pre vs. post) interaction on suicidal ideation indicating a significant reduction of suicidal ideation in the MBCT group, but not in the control group. The interaction remained significant after addition of the above covariates. Change in worry was the only covariate associated with change in suicidal ideation, causing a moderate reduction in the interaction effect size.

Conclusions

The results suggest that MBCT may affect suicidal ideation in patients with residual depressive symptoms and that this effect may be mediated, in part, by participants’ enhanced capacity to distance themselves from worrying thoughts.     

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.     

Depression,aggression, and suicidal ideation in first graders: a school-based cross-sectional study

Objective

This study explored the clinical characteristics and risk factors of suicidal ideation in a sample of first graders from South Korea. Children's depression and aggression and maternal depression were examined as possible risk factors.

Methods

This study is a school-based, cross-sectional study of 5 elementary schools in Gunpo City, South Korea. Participants were 707 first graders (mean age, 6.54 years) and their mothers. We assessed children's depressive and aggressive symptoms using the Behavior Assessment System for Children-2 (BASC-2) and maternal depression using the Beck Depression Inventory (BDI). Two items from BASC-2 and 1 item from BDI identified children's and maternal suicidal ideation.

Results

Twenty-seven (3.8%) children evidenced suicidal ideation. Children with suicidal ideation had higher mean scores of depression domain (10.11 ± 5.34 vs 4.57 ± 3.44, P < .0001) and aggression domain (7.78 ± 3.84 vs 3.80 ± 2.85, P < .0001) on BASC-2 and maternal depression (9.78 ± 6.45 vs 7.28 ± 5.38, P = .02) on BDI. In regression analysis, children's depression (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.07-1.32; P = .001) and aggression (OR, 1.24; 95% CI, 1.08-1.41; P = .002) contributed significantly to children's suicidal ideation, whereas maternal depression was not significantly related to children's suicidal ideation (OR, 0.99; 95% CI, 0.92-1.06; P = .75).

Conclusions

This study demonstrated that even first graders had a considerable prevalence of suicidal ideation and that depression and aggression were associated with suicidal ideation in young children.     

Anxiety,depression and suicidal ideation in patients with rheumatoid arthritis in use of methotrexate,hydroxychloroquine, leflunomide and biological drugs

Objective

This paper aims to investigate the prevalence of anxiety, depression and suicidal ideation in patients with rheumatoid arthritis taking different drugs to control the disease.

Methods

The study included 105 patients with rheumatoid arthritis who were treated with methotrexate, leflunomide, hydroxychloroquine and biological drugs. All patients were assessed using the Mini International Neuropsychiatric Interview, the Beck Scale for Suicide Ideation and the Hospital Anxiety and Depression Scale.

Results

Difference was statistically significant (p < 0.001) for both depression and anxiety as to suicidal ideation among groups of patients according to the medication used. Furthermore, the value reached by those patients taking biological drugs was alarming with higher scores for all measures, including suicide ideation. The patients using methotrexate and leflunomide reported lower scores on suicidal ideation than those using hydroxychloroquine and biological drugs. Patients using leflunomide showed less mental health impairment than other groups.

Conclusion

Greater scores for depression, as a comorbidity of rheumatoid arthritis, increase the rate of suicidal ideation and depression also can worsen general pain, hardships, treatment denial, and prognosis, as well as cause a faster reduction in quality of life. Patients taking biologic DMARDs (drugs known as disease-modifying drugs) had the highest rates of depression, anxiety and suicidal ideation among all patients studied. The current analysis showed that psychiatric aspects such as depression, anxiety and even suicide ideation, may differ between groups of patients with arthritis according to the drug used, serving as an alert to the importance of considering also this factors in therapeutic decisions.     

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.     

Suicide attempts before joining the military increase risk for suicide attempts and severity of suicidal ideation among military personnel and veterans

Objective

Past self-injurious thoughts and behaviors (SITB) are robust predictors of future suicide risk, but no studies have explored the prevalence of SITB occurring prior to military service among military personnel and veterans, or the association of premilitary SITB with suicidal ideation and suicide attempts during or after military service. The current study explores these issues in two separate samples.

Method

Self-report data were collected from 374 college student veterans via anonymous only survey (Study 1) and from 151 military personnel receiving outpatient mental health treatment (Study 2).

Results

Across both studies, premilitary suicide attempts were among the most prominent predictor of subsequent suicide attempts that occurred after joining the military, even when controlling for demographics and more recent emotional distress. Among military personnel who made a suicide attempt during or after military service, approximately 50% across both samples experienced suicidal ideation and up to 25% made a suicide attempt prior to joining the military. Military personnel and veterans who made suicide attempts prior to joining the military were over six times more likely to make a later suicide attempt after joining the military. In Study 2, significantly more severe current suicidal ideation was reported by participants with histories of premilitary suicide risk, even when controlling for SITB occurring while in the military.

Conclusions

Military personnel and veterans who experienced SITB, especially suicide attempts, prior to joining the military are more likely to attempt suicide while in the military and/or as a veteran, and experience more severe suicidal crises.     

Suicidal behavior in adolescents and adults with bulimia nervosa

Background

Recent evidence suggests increased risk for mortality in bulimia nervosa (BN). However, little is yet known about suicidal behavior in BN.

Aims

To examine frequency and correlates of suicidal ideation and attempts in adolescents and adults with BN in two population-based samples.

Method

A total of 10,123 adolescents and 2980 adults in two nationally representative surveys of mental disorder were queried regarding eating disorder symptoms and suicidal ideation and attempts.

Results

Less than 1 percent (0.9%) of adolescents and 1.0% of adults met the criteria for BN. Suicidal ideation was more common among adolescents with BN (53.0%) compared with those with binge eating disorder (BED) (34.4%), other psychopathology (21.3%) or no psychopathology (3.8%). Similar trends emerged for the association between BN and self-reported suicidal plans or attempts. Among adults, suicidality was more common in BN than in the no psychopathology group, but not significantly different from the anorexia nervosa (AN), BED, or other psychopathology subgroups.

Conclusion

There is a high risk of suicidal ideation and behavior among those with BN. These results underscore the importance of addressing suicide risk in adolescents and adults with eating disorder symptoms.     

Animal category-preferential gamma-band responses in the lower- and higher-order visual areas: Intracranial recording in children

Objective

We determined where and when category-preferential augmentation of gamma activity took place during naming of animal or non-animal pictures.

Methods

We studied 41 patients with focal epilepsy who underwent measurement of naming-related gamma-augmentation at 50–120 Hz during extraoperative electrocorticography. The assigned task consisted of naming of a visually-presented object classified as either ‘animal’ or ‘non-animal’.

Results

Within 80 ms following the onset of picture presentation, regardless of stimulus type, gamma-activity in bilateral occipital regions began to be augmented compared to the resting period. Initially in the occipital poles (at 140 ms and after) and subsequently in the lateral, inferior and medial occipital regions (at 320 ms and after), the degree of gamma-augmentation elicited by ‘animal naming’ became larger (by up to 52%) than that by ‘non-animal naming’. Immediately prior to the overt response, left inferior frontal gamma-augmentation became modestly larger during ‘animal naming’ compared to ‘non-animal naming’.

Conclusions

Animal category-preferential gamma-augmentation sequentially involved the lower- and higher-order visual areas. Relatively larger occipital gamma-augmentation during ‘animal naming’ can be attributed to the more attentive analysis of animal stimuli including the face. Animal-preferential gamma-augmentation in the left inferior frontal region could be attributed to a need for selective semantic retrieval during ‘animal naming’.

Significance

A specific program of cortical processing to distinguish an animal (or face) from other objects might be initiated in the lower-order visual cortex.     

Efficacy of psychotherapy on diurnal cortisol patterns and suicidal ideation in adjustment disorder with depressed mood

Aims

The aims were to examine the effects of psychotherapy on depressive and anxiety symptoms, the occurrence of suicidal ideations and diurnal cortisol patterns in patients with adjustment disorder (AD) with depressed mood.

Methods

Participants recruited from an outpatient department of psychiatry at a general hospital were randomly assigned to one of two groups: 34 in psychotherapy group and 37 in control group. The control group consisted of one-session psychoeducation. Psychotherapy included the eight-weekly body–mind–spirit (BMS) group psychotherapy. Measures included Beck Depression Inventory-II and State Trait Anxiety Inventory. Salivary cortisol samples were collected from the patients at their homes on awakening; 30 and 45min after awakening; and at 1200, 1700 and 2100 h. Measurements were taken at baseline and at months 2 (end of intervention), 5, 8 and 14.

Results

There was no differential change over time between the BMS and control groups in self-reported depression or anxiety symptoms. However, suicidal ideation appeared to be reduced in the psychotherapy group. Changes in diurnal cortisol patterns were also significantly different in group × time interactions, in favor of BMS group.

Conclusions

Psychotherapy likely provides improvements in psychobiological stress responses and decreases the occurrence of suicidal ideation in patients with AD.     

Sheehan Suicidality Tracking Scale (S-STS): Reliability,convergent and discriminative validity in young Italian adults

Background and purpose

The Sheehan Suicidality Tracking Scale (S-STS) is a patient self-report or clinician-administered rating scale that tracks spontaneous and treatment-emergent suicidal ideation and behaviors. This study set out to evaluate the reliability, convergent and divergent validity of the S-STS in a sample of college students, a population with a high risk of completed and attempted suicide.

Methods

Cross-sectional, survey design. Participants (303 undergraduate students; males: 42%) completed several measures assessing psychological distress (General Health Questionnaire; GHQ); self-esteem (Rosenberg Self Esteem Scale; RSES); social support (Modified Social Support Survey; MOSSS); and suicidal behavior, including ideation and attempts (S-STS).

Results

Both internal consistency and test–retest stability were excellent for the S-STS-global score. The S-STS subscale on suicide ideation also showed good reliability, while the subscale on suicidal behavior showed some inconsistency at retest. Convergent and divergent validity of S-STS was confirmed. All S-STS items loaded on a single factor, which had an excellent fit for the unidimensional model, thus justifying the use of the S-STS as a screening tool. In a mediation model, self-esteem and social support explained 45% of the effects of psychological distress on suicide ideation and behavior as measured by the S-STS-global score.

Conclusions

This study provided promising evidence on the convergent, divergent, internal consistency and test–retest stability of the Sheehan Suicidality Tracking Scale. The cross-sectional design and lack of measures of hopelessness and helplessness prevent any conclusion about the links of suicidal behavior with self-esteem and social support.     

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.     

Suicidal ideation in German primary care

Objective

To examine suicidal ideation in a sample of German primary care patients.

Methods

We conducted a cross-sectional study and included 1455 primary care patients who visited 1 of 41 general practitioners (GPs) working at 19 different sites. Suicidal ideation and psychopathology were assessed with the Patient Health Questionnaire (PHQ) in an anonymous screening together with health care utilization.

Results

One hundred seventy-one (11.8%) of 1455 patients endorsed the suicidal ideation item of the PHQ. These patients were significantly younger, more often female and unmarried, suffered more often from psychopathology and reported more health care utilization than patients without suicidal ideation. Patients with the highest frequency of suicidal ideation also talked more often routinely about psychosocial problems with their GP, used more often medication against their complaints and searched more often for a psychotherapist than other suicidal ideators. Yet, these patients were not more likely to be in psychotherapy at the time of the screening.

Conclusion

Our data suggest that suicidal ideation is a common phenomenon in primary care, which is independently associated with psychopathology in terms of depression, anxiety and somatoform complaints. Psychosocial support from GPs and medication seem to be easier available for primary care patients with suicidal ideation than psychotherapy, independent of the severity of the suicidal ideation.     

Prevalence of suicide attempts in pathological gamblers in a nationwide Austrian treatment sample

Background

For pathological gambling (PG), a 12-month prevalence rate of up to 0.66% has been reported. Multiple financial, occupational and relationship problems and losses, humiliation of the person and the environment are possible side effects and may lead to hopelessness, suicidal ideation and suicidal behavior. Suicide attempt rates among pathological gamblers of between 4% and 40% and suicidal ideation of between 12% and 92% have been reported.

Aim

This study aims at assessing the prevalence of suicide attempts in PG and at elucidating differences between the patients with and without suicide attempt history (SAH) in a large nationwide Austrian sample.

Methods

Between 2002 and 2011, the Austrian Society for the Research of Non-Substance Related Addiction collected 862 questionnaires of pathological gamblers undergoing outpatient and inpatient treatment for PG in Austria.

Results

(a) Of all pathological gamblers, 9.7% had an SAH. (b) The SAH group suffered significantly more from a comorbid disorder and was more often in previous inpatient treatments. (c) The SAH patients had a longer time of an abstinence period in their PG career.

Discussion

One in 10 pathological gamblers has an SAH, demonstrating the relevance of suicidality in this population. Significant differences for several parameters were found for PG with and without SAH. However, a regression analysis only explained 15% of the variance. This suggests that suicidality must be considered in pathological gamblers in general.     

Suicide risk in type 1 diabetes mellitus: A systematic review

Background

Research has shown that suicide risk is often present in patients suffering from type 1 diabetes mellitus (DM-1).

Objectives

The aim of the present paper was to investigate whether there was a relationship between DM-1 and suicidal behavior and to determine whether or not people affected by DM-1 are at an increased risk of completed suicide, attempted suicide, and suicidal ideation.

Data sources

We performed a careful MedLine, ExcerptaMedica, PsycLit, PsycInfo and Index Medicus search to identify all papers on the topic for the period 1970 to 2013 written in English. The following search terms were used: (suicide OR suicide attempt OR ideation) AND (diabetes mellitus). Where a title or abstract seems to describe a study eligible for inclusion, the full article was examined.

Eligibility criteria

We included only original articles published in English peer-reviewed journals. We excluded meta-analyses and systematic reviews, studies that were not clear about follow-up times, the method of statistical analysis, diagnostic criteria or the number of patients included, and studies only on patients affected by type 2 diabetes mellitus (DM-2).

Results

The research reviewed indicated that patients with DM-1 are at an increased risk for suicide, although no clear consensus exists regarding the level of the increased risk.

Limitations

The studies used different measurement techniques and different outcomes, and they assessed patients at different time points.

Conclusions and implications

Our findings support the recommendation that a suicide risk assessment of patients with DM-1 should be part of the routine clinical assessment. The assessment of patients at risk should consist of the evaluation of current and previous suicidal behaviors (both suicidal ideation and attempted suicide).     

The prevalence of tinnitus and the relationship with neuroticism in a middle-aged UK population

Background

Previous research has suggested that a substantial proportion of the population are severely affected by tinnitus, however recent population data are lacking. Furthermore, there is growing evidence that the perception of severity is closely related to personality factors such as neuroticism.

Objective

In a subset (N = 172,621) of a large population sample of > 500,000 adults aged 40 to 69 years, (from the UK Biobank dataset) we calculated the prevalence of tinnitus and that which is perceived as bothersome, and examined the association between tinnitus and a putative predisposing personality factor, neuroticism.

Method

Participants were recruited through National Health Service registers and aimed to be inclusive and as representative of the UK population as possible. The assessment included subjective questions concerning hearing and tinnitus. Neuroticism was self-rated on 13 questions from the Eysenck Personality Inventory. Associations between neuroticism and tinnitus were tested with logistic regression analyses.

Results

Prevalence of tinnitus was significantly higher for males, and increased with age, doubling between the youngest and oldest age groups (males 13% and 26%; females 9% and 19% respectively). Of those with tinnitus, females were more likely to report bothersome tinnitus. Neuroticism was associated with current tinnitus and bothersome tinnitus, with the items: ‘loneliness’, ‘mood swings’, ‘worrier/anxious’ and ‘miserableness’, as the strongest associations of bothersome tinnitus.

Conclusions

Neuroticism was identified as a novel association with tinnitus. Individuals with tinnitus and higher levels of neuroticism are more likely to experience bothersome tinnitus, possibly as a reflection of greater sensitivity to intrusive experiences.