Suicidal expressions among young people in Nicaragua

BACKGROUND: Suicidal behaviour is a major public health problem among adolescents. In Nicaragua as well as in most other countries, young people aged 15-24 have the highest rate of attempted suicide according to hospital records. The aims of this study were to investigate self-reported life-weariness, death wishes, suicidal ideation, suicidal plans and suicide attempts (i.e. suicidal expressions) among young men and women in the community and to identify factors associated with suicidal expressions. METHODS: The sample was derived from an established study base in the city of León, Nicaragua. From 352 randomly selected subjects aged 15-24 years, 278 individuals (145 males and 133 females) were interviewed using the Attitudes Towards Suicide (ATTS) questionnaire, including questions on suicidal expressions. RESULTS: The overall 1-year prevalence of any suicidal expression was 44.8% among males and 47.4% among females. A suicide attempt in the past year was reported by 2.1% of males and 1.5% of females. There was no significant gender difference in reporting of the separate types of suicidal expressions, except for death wishes, where females reported higher prevalence (33.8% vs. 20.7%). Exposure to suicidal expressions among significant others was significantly associated with own serious suicidal expressions. The study failed to identify any association between suicidal expressions and sociodemographic factors such as poverty or educational level. CONCLUSIONS: The present study highlights that suicidal behaviour is a significant public health problem among young people in Nicaragua. The finding that suicidal behaviour among significant others appears to have a contagious effect on adolescents, needs to be addressed in the prevention of suicidal behaviour.     

Suicidality and its relationships with individual,family, peer,and psychopathology factors among adolescents with attention-deficit/hyperactivity disorder

The aim of this study was to examine the prevalence rates of suicidal intent and its correlates among adolescents diagnosed with ADHD in Taiwan. A total of 287 adolescents aged 11–18 years and diagnosed with ADHD participated in this study. Their suicidal ideation and suicide attempts were assessed. Logistic regression analysis was used to examine the associations of suicide with individual, family, peer, ADHD, and psychopathology factors. A total of 12.2% of the participants reported suicidal ideation or a suicide attempt. A logistic regression analysis model showed that adolescents who were older, were bullying perpetrators, and reported high depression level were more likely to have suicidal intent. These three factors were also significantly correlated with suicidal ideation; however, only having high depression level was significantly correlated with suicidal attempts. The results of this study showed that a high proportion of adolescents with ADHD reported suicidal ideation or a suicide attempt. Multiple factors were significantly associated with suicidal intent among adolescents with ADHD. Clinicians, educational professionals, and parents of adolescents with ADHD should monitor the possibility of suicide in adolescents with ADHD who exhibit the correlates of suicidal intent identified in this study.     

The associations between health risk behaviours and suicidal ideation and attempts in a nationally representative sample of young adolescents.

OBJECTIVE: To examine associations between health risk behaviours and suicidal ideation and attempts in Canadian adolescents aged 12 to 13 years. Young adolescents think about and attempt suicide. However, most existing research on suicide has been conducted on individuals aged 15 years and older. METHOD: The present study examined a nationally representative Canadian sample of adolescents aged 12 to 13 years (n=2090). Health risk behaviours included disruptive (shoplifting, physical fighting, damaging property, fighting with a weapon, carrying a knife, and gambling), sexual (petting below the waist and sexual intercourse), and substance use behaviours (smoking cigarettes, consuming alcohol, marijuana or hash, and glue or solvents). Unadjusted and adjusted (for all significant health risk behaviour and psychiatric symptoms) models were tested. RESULTS: All health risk behaviours were common among male and female adolescents. In unadjusted models, almost all health risk behaviours were associated with suicidal ideation and attempts among adolescent boys. In adjusted models, only damaging property, sexual intercourse, and smoking cigarettes remained statistically associated with suicidal ideation, while smoking cigarettes and using marijuana or hash remained statistically associated with suicide attempts among adolescent boys. All health risk behaviours were statistically associated with suicidal ideation and attempts among female adolescents in unadjusted models. In adjusted models, only carrying a knife remained statistically associated with suicidal ideation, while shoplifting and gambling remained statistically associated with suicide attempts among adolescent girls. CONCLUSIONS: Health risk behaviours among young adolescents are associated with suicidal ideation and attempts among young adolescents. Recognizing health risk behaviours among young adolescents may be one means of understanding who among them is at increased risk of suicidality.     

Prevalence and correlates of suicidal behaviour among adolescents in southwest Nigeria

BACKGROUND: Despite being recognized by the World Health Organization as a significant social and health concern, information on suicidal behaviours in Nigerian adolescents is unknown. AIMS: To establish the prevalence and associated psychosocial correlates of suicidal ideation and attempts in Nigerian youth. METHODS: Stratified sampling was used to identify youth aged 10-17 years who completed the Nigeria version of the Global School Health Questionnaire (GSHQ) and the Diagnostic Predictive Scale (DPS) for youths (suicidal behaviour questions) in a classroom setting. RESULTS: A total of 1429 youth completed the instruments. Over 20% reported suicidal ideation and approximately 12% reported that they had attempted suicide in the last year. Adolescents living in urban areas, from polygamous or disrupted families, had higher rates of suicidal behaviour. Multiple psychosocial factors such as sexual abuse, physical attack and involvement in physical fights were significant predictors of suicidal behaviour. CONCLUSION: Factors associated with suicidal ideation and behaviours are similar to those found in other studies but the rates of both suicidal ideation and attempts are towards the upper limit of rates for youth. This study suggests that there is an urgent need for Nigerian policymakers and health providers to review and address this issue.     

Suicidal ideation, deliberate self-harm behaviour and suicide attempts among adolescent outpatients with depressive mood disorders and comorbid axis I disorders

OBJECTIVE: We aimed to analyse and compare prevalence and associated clinical features of suicidal ideation, self-harm behaviour with no suicidal intent and suicide attempts among adolescent outpatients with depressive mood disorders with or without comorbidity. METHOD: A sample of 218 consecutive adolescent outpatients aged 13-19 years with depressive mood disorders was interviewed using K-SADS-PL for DSM-IV Axis I diagnoses. They filled out self-report questionnaires assessing depressive and anxiety symptoms. Suicidal behaviour was assessed by K-SADS-PL suicidality items. RESULTS: Half of the subjects reported suicidal ideation or behaviour. There was no difference in prevalence of suicidal behaviour between non-comorbid and comorbid mood disorder groups. Multivariate logistic regression analyses produced the following associations: (1) suicidal ideation with self-reported depressive symptoms and poor psychosocial functioning, (2) deliberate self-harm behaviour with younger age and poor psychosocial functioning, and (3) suicide attempts with self-reported depressive symptoms and poor psychosocial functioning. CONCLUSIONS: Depressed mood disorders, whether comorbid or not, are associated with suicidal ideation and suicide attempts. Diagnostic assessment should be supplemented by self-report methods when assessing suicidal behaviour in depressed adolescents.     

Suicide attempts among indigenous Sami adolescents and majority peers in Arctic Norway: prevalence and associated risk factors

The prevalence of suicide attempts and associated risk factors such as sociodemographic conditions, emotional/behavioural problems and parent-child relationships were examined among 591 indigenous Sami and 2100 majority adolescents in Arctic Norway. There were no significant ethnic differences in prevalence of suicide attempts. In both ethnic groups, suicidal ideation, anxious/depressed problems and eating behaviour problems were associated with suicide attempts. Cross-cultural differences in risk factors associated with suicide attempts existed. For Sami adolescents, factors diverging from the traditional cultural norms were associated with suicide attempts, such as alcohol intoxication, single-parent home and paternal overprotection (p相似文献   

12-Month and Lifetime Prevalence of Suicide Attempts Among Black Adolescents in the National Survey of American Life

ObjectiveProvide nationally representative data on the prevalence and psychiatric correlates of suicidal ideation and attempts among African American and Caribbean black adolescents in the United States.MethodData on nonfatal suicidal behavior among 1,170 African American and Caribbean black adolescents aged 13 to 17 years are from the National Survey of American Life-Adolescent, a nationally representative household survey of adults with an attached adolescent sample conducted between February 2001 and June 2003.ResultsNationwide black adolescents reported having a lifetime prevalence of 7.5% for suicidal ideation and 2.7% for attempts. The 12-month prevalence of suicidal ideation and attempt was 3.2% and 1.4%, respectively. Among all respondents, 4% of black American adolescents and 7% of female subjects were projected to attempt suicide by age 17 years. African American adolescents were approximately five times more likely than Caribbean black adolescents to attempt suicide. Almost half of the National Survey of American Life-Adolescent respondents who reported a suicide attempt had never met criteria for any of the DSM-IV disorders by the time of their attempts.ConclusionsClinicians should be trained to screen for suicidal behavior, even among those without DSM-IV disorders, when treating black adolescents, particularly female subjects. In addition, preventive efforts should consider ethnic differences in suicide risk and targeting nonclinical settings.     

Suicidal ideation in inpatients with acute schizophrenia.

OBJECTIVE: Schizophrenia has been associated with a high rate of suicide. This study investigates the prevalence of suicidal ideation in a population of inpatients with acute schizophrenia, together with the clinical parameters associated with suicidal thoughts. METHOD: We assessed 93 schizophrenia patients. We matched subjects for age and sex and compared subjects with and without suicidal thoughts. We performed stepwise multiple regression analysis to assess the association between specific clinical symptoms and suicidal ideation. RESULTS: Of the patients, 20.4% reported suicidal thoughts during the last 15 days. Severity of depressive symptoms, motor retardation, guilt feelings, pathological guilt, and self-depreciation predicted the patients' suicidal ideation. CONCLUSIONS: Suicidal thoughts are frequent among inpatients with acute schizophrenia. Prevention of suicidal behaviour should include helping patients improve their self-esteem and reducing depression and guilt feelings.     

Bullying perpetration and victimization associations to suicide behavior: a longitudinal study

Previous studies have reported a longitudinal association between cybervictimization and suicidal thoughts and behavior. However, the relationship between cyber-perpetration and prospective suicide risk remains unclear. The sample was composed of 2150 at-risk adolescents (mean age 15.42), enrolled in Vocational Education and Training high schools in Israel. Cyberbullying, traditional bullying, depression, hostility, serious suicidal ideations, and suicide attempts were assessed through self-report questionnaires at the beginning of the school year and one year later. All types of victimization and preparation were cross-sectionally associated with suicide ideation and attempts. Longitudinal associations were found between cyber-perpetration and suicidal ideation/attempts. Cyber-perpetrators were found to be over twice more likely to report serious suicidal ideation (OR = 2.04) or attempt suicide (OR = 2.64) in the subsequent year compared to noninvolved adolescents. These associations were significant even after adjusting for baseline depression, hostility, and traditional bullying. Traditional bullying perpetration was prospectively associated with suicide attempts. Traditional victimization was cross-sectionally associated with suicide ideation and attempts but not prospectively. Cybervictimization was prospectively associated with suicide ideation but not to suicide attempts. The findings demonstrate the prospective risk of involvement in bullying in regard to suicide ideation and behavior. Cyberbullying was found to be a somewhat differentiated phenomena from traditional bullying.

     

Suicide Ideation and Behaviour in People with Pathological Gambling Attending a Treatment Service

This study aimed to describe the 12-month period prevalence and risk factors for suicidal ideation and behaviour in a cohort of patients with pathological gambling attending a treatment service. Seventy-nine people with a diagnosis of pathological gambling received a mail out survey that included questions on postulated risk factors for suicidal ideation and behaviour, the modified Suicide Ideation Scale (SIS), the South Oaks Gambling Screen (SOGS), the Beck Depression Inventory (BDI) and the CAGE. A total of 54.4% of the surveys were returned completed. There were 81.4% who showed some suicidal ideation and 30.2% reported one or more suicide attempts in the preceding 12 months. Suicidal ideation and behaviours were positively correlated with the gambling severity (SOGS scores), the presence of debt attributed to gambling, alcohol dependence and depression (BDI). Suicidal ideation/behaviour was not significantly associated with gender and living arrangements, nor a history of receiving treatment for depression during the preceding 12 months. People with pathological gambling attending a treatment service had higher levels of suicidal ideation and behaviour than previous studies. Pathological gambling should be seen as a chronic condition with a similar risk for suicidal ideation and behaviour as other mental illnesses. Counselling services, general practitioners and mental health services should screen for gambling problems when assessing risk after suicide attempts and for suicide risk in patients presenting with gambling problems and co-morbid depression, alcohol abuse and a previous suicide attempt.The authors have no conflict of interest to declare.The intensive treatment service at Flinders Medical Centre is funded by a grant from the South Australian Department of Human Services.     

Suicide attempts among Inuit youth: a community survey of prevalence and risk factors

The prevalence of and risk factors for attempted suicide and suicidal ideation were examined with a survey of 99 Inuit, aged 14–25 years, residing in a community in Northern Québec. A total of 34% of survey respondents reported a previous suicide attempt, and 20% had attempted suicide more than once. A suicide attempt had resulted in injury in about 11 % of those surveyed. The prevalence of suicidal ideation was also very high: 43% of subjects reported past thoughts of suicide, and 26% had had suicidal thoughts during the month before the survey. Risk factors for suicide attempts included male gender, having a friend who had attempted or committed suicide, a history of being physically abused, a history of solvent abuse, and having a parent with an alcohol or drug problem. Protective factors included a family history of having received treatment for a psychiatric problem, more frequent church attendance, and a high level of academic achievement. While individuals in the community who are at high risk for suicide can be targeted for preventive measures, the high prevalence and effect of family problems on likelihood of suicide attempts indicate the need for family- and community-based approaches.     

Suicidal ideation and suicide attempts among immigrant adolescents from the former Soviet Union to Israel

OBJECTIVE: A community survey was conducted to examine suicidal ideation and suicide attempts, behavior problems, psychological distress, social support, and adjustment difficulties in a sample of adolescents. METHOD: Four hundred six Russian-born Jewish immigrants to Israel, aged 11 to 18 years, were selected to match the age and sex distribution of the total immigrant adolescent population. Two indigenous samples of Jewish adolescents in Russia (n = 203) and in Israel (n = 104) were matched with immigrants for comparison. Parameters of interest were measured with self-administered questionnaires. RESULTS: The 6-month prevalence rate of suicidal ideation in the immigrant sample (10.9%) was significantly higher than that for Russian controls (3.5%) but not for Israeli natives (8.7%). There were few gender differences in suicidal ideation and suicide attempts. Older adolescents reported suicidal ideation 2 times more frequently than their younger counterparts. Suicide ideators scored significantly higher than nonideators on all scales of psychological distress and behavior problems. They rated higher sources of immigration difficulties concerning language, physical health, personality characteristics, and family problems but had less socioeconomic and intercultural problems of migration and lower social support from the family but not from other sources. CONCLUSIONS: Results clearly support the migration-convergence hypothesis of suicide risk among adolescents.     

Suicidal ideation and suicide attempts in a sample of homeless people with mental illness

This study utilized data from the national ACCESS program (N = 7224) to investigate the prevalence of suicidal ideation and suicide attempts in a sample of homeless people with mental illness. The prevalence of suicidal ideation in this sample was high (66.2% lifetime prevalence). In addition, 51.3% of the sample reported that they had ever attempted suicide, 26.9% reported an attempt that resulted in a nonpsychiatric hospitalization, and 8% reported an attempt in the previous 30 days. Youth, substance abuse, and psychiatric symptoms were all significantly associated with suicide attempts. Those who reported a recent attempt also reported higher rates of mental health care utilization, particularly inpatient care. The authors conclude that homeless people with mental illness are at particularly high risk for suicidal behavior, however, only in part because of the high prevalence of traditional risk factors.     

Suicidality among South Brazilian tobacco growers

ObjectiveTo assess prevalence of suicidal ideation and suicide attempt among South Brazilian tobacco growers and to analyze the associated factors related to the suicidal ideation.MethodsA cross-sectional study was conducted in 2011 with a random sample of 2469 tobacco growers in São Lourenço do Sul/RS. Suicidal ideation was characterized by the question “Has the thought of ending your life been on your mind?”. Suicide attempt was assessed by the question “Have you ever tried to kill yourself?”. Investigation of factors associated with suicidal ideation was done by means of Poisson regression.ResultsPrevalence of suicidal ideation and suicide attempt was 2.5 % and 1.2 % respectively. In the adjusted analysis, suicidal ideation was associated with being female, older age, moderate participation in religious activities and difficulty in paying debts. Those who worked in activities that required inadequate postures (hunched over or other forced positions), as well as farmers who performed 6–9 pesticide-related tasks demonstrated greater risk of suicidal ideation. Regarding health conditions, medical diagnosis of asthma, chronic low back pain, number of lifetime green tobacco sickness episodes and lifetime pesticide poisoning were positively associated with suicidal ideation.ConclusionSuicidal thoughts and attempts are relevant mental health problems among tobacco growers. Reducing pesticide use, as well as exposure to nicotine and improving socio-economic conditions, can reduce suicidal ideation and improve the mental health of exposed workers.     

Suicidality in eating disorders: clinical and psychological correlates

Although many authors have described eating disorders as often being associated with suicidal feelings and behaviour, few studies to date have evaluated the prevalence and characteristics of suicidal behaviour in eating disordered patients. In the present study, in which a consecutive series of 495 out-patients was studied, 13% of the patients reported at least one suicide attempt and 29% reported current suicidal ideation; 26% of attempters reported multiple attempts. A history of suicide attempt was more prevalent among binge-eating/purging anorexics and among purging bulimics than in the other subgroups. In cases with anorexia nervosa, suicide attempters were older, had a longer illness duration, weighed less, had more often used drugs and/or alcohol and tended to be more obsessive than non-attempters. In cases with bulimia nervosa, attempters presented with more psychiatric symptoms and had more frequently been sexually abused.     

Self-harm, suicidal ideation and suicide attempts among college students

Self-harm, suicidal ideation, and suicide attempts are well represented behaviours in the general population of both developed and developing countries. These behaviours are indicative of underlying risk factors that show a strong interdependent correlation. In this study we attempted to define correlates for and prevalence of self-harm, suicidal ideation, and suicide attempts among Turkish college students. This 2006 study included 636 students from two Turkish state universities. Our results showed that the lifetime prevalence of self-harm was 15.4%, the prevalence of suicidal ideation was 11.4%, and the prevalence of suicide attempts was 7.1%. We uncovered correlates for self-harm, including low income, unsatisfying familial relationships, smoking, and alcohol, inhalant, and tranquilizer abuse. Tranquilizer abuse shared a dual role as a correlate for suicide ideation and as a means to attempt suicide. Additionally, we found that drug abusers and adolescents who practise self-harm presented the highest suicide risk.     

Suicidal ideation and suicide attempts among patients with panic disorder: a survey of two outpatient clinics.

OBJECTIVE: Recent epidemiologic studies found that 20% of subjects with the diagnosis of panic disorder had attempted suicide. This study sought to determine the prevalence of suicidal ideation and suicide attempts among patients with panic disorder and whether the presence of comorbid borderline personality disorder influenced the prevalence of suicidal thoughts and behavior. METHOD: At two outpatient clinics, experienced clinicians conducted retrospective reviews of data from the intake interviews and charts of 59 patients with panic disorder and comorbid borderline personality disorder and 234 patients with panic disorder with or without axis II disorders other than borderline personality disorder. RESULTS: Suicide attempts were reported by 2% of the patients with panic disorder, compared to 25% of the patients with both panic disorder and borderline personality disorder. In addition, 2% of the patients with panic disorder, compared to 27% of the patients with panic disorder and borderline personality disorder, reported suicidal ideation that was judged to be of clinical significance. CONCLUSIONS: The rate of suicidal ideation and suicide attempts for psychiatric outpatients with panic disorder was discrepant with the findings of the earlier studies. The increased suicide risk in this group of patients was associated with borderline personality disorder, increased substance abuse, and affective instability. While 61% of the panic disorder patients and 78% of the patients with both panic disorder and borderline personality disorder reported thinking about death, this must be distinguished from actual suicidal ideation and clinical risk of suicide.     

Using Data Linkage to Investigate Inconsistent Reporting of Self-Harm and Questionnaire Non-Response

The objective of this study was to identify factors that may account for the disproportionately high prevalence of suicidal behaviors among Hispanic/Latina youth by examining whether associations of health risk behaviors with suicidal ideation and suicide attempts vary by race/ethnicity among female students. Data from the school-based 2007 national Youth Risk Behavior Survey were analyzed. Analyses were conducted among female students in grades 9 through 12 and included 21 risk behaviors related to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted infections, including human immunodeficiency virus; physical activity; obesity and weight control; and perceived health status. With the exception of physical activity behaviors and obesity, all risk behaviors examined were associated with suicidal ideation and suicide attempts. Associations of risk behaviors with suicidal ideation varied by race/ethnicity for 5 of 21 behaviors, and for 0 of 21 behaviors for suicide attempts. Stratified analyses provided little insight into factors that may account for the higher prevalence of suicidal behaviors among Hispanic/Latina female students. These results suggest that the increased risk of suicidal behaviors among Hispanic/Latina female students cannot be accounted for by differential associations with these selected risk behaviors. Other factors, such as family characteristics, acculturation, and the socio-cultural environment, should be examined in future research.     

Predicting future suicide attempts among depressed suicide ideators: a 10-year longitudinal study

Suicidal ideation and attempts are a major public health problem. Research has identified many risk factors for suicidality; however, most fail to identify which suicide ideators are at greatest risk of progressing to a suicide attempt. Thus, the present study identified predictors of future suicide attempts in a sample of psychiatric patients reporting suicidal ideation. The sample comprised 49 individuals who met full DSM-IV criteria for major depressive disorder and/or dysthymic disorder and reported suicidal ideation at baseline. Participants were followed for 10 years. Demographic, psychological, personality, and psychosocial risk factors were assessed using validated questionnaires and structured interviews. Phi coefficients and point-biserial correlations were used to identify prospective predictors of attempts, and logistic regressions were used to identify which variables predicted future attempts over and above past suicide attempts. Six significant predictors of future suicide attempts were identified - cluster A personality disorder, cluster B personality disorder, lifetime substance abuse, baseline anxiety disorder, poor maternal relationship, and poor social adjustment. Finally, exploratory logistic regressions were used to examine the unique contribution of each significant predictor controlling for the others. Comorbid cluster B personality disorder emerged as the only robust, unique predictor of future suicide attempts among depressed suicide ideators. Future research should continue to identify variables that predict transition from suicidal thoughts to suicide attempts, as such work will enhance clinical assessment of suicide risk as well as theoretical models of suicide.     

Prevalence of suicide ideation among adolescents and young adults in rural Bangladesh

Suicide is a leading cause of death world-wide. However, adolescent suicidal behavior is a neglected public health issue, especially in low-income countries such as Bangladesh. The study was conducted to estimate the prevalence of suicidal ideation among adolescents in a rural community and to examine factors associated with suicidal ideation. A cross-sectional survey was carried out in 2013 among 2,476 adolescents aged 14–19 years, selected randomly from a rural community of Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district. A two stage screening was performed to identify the suicidal ideation cases. It was found that the life-time prevalence for suicidal ideation was 5 percent among adolescents. The majority of the adolescents with suicidal ideation were females 66 (52.8%), unmarried 103 (82.4%), and students 92 (73%). Suicidal ideation was statistically significantly associated with age, education, occupation, living with parents or others, and house ownership. Respondents who were aged 18–19 years, had secondary school certificate (SSC) and secondary school certificate (HSC) or higher education, were day laborers, had own house, and do not lived with parents had odds ratios of 2.31 (CI 1.46–3.65), 2.38 (CI 1.51–3.77), 4.15 (CI 2.41–7.14), 0.28 (CI 0.13–0.60), 0.14(CI 0.05–0.35), and 1.80 (CI 1.07–3.03), respectively. Among adolescents, the prevalence of life-time suicidal ideation was moderately high. Age, education, occupation, house ownership, and living with parents were statistically significantly associated with suicidal ideation. It is important to design and implement effective community based suicide prevention programs for adolescents in Bangladesh.