Is cigarette smoking associated with suicidal ideation among young people?

OBJECTIVE: The authors examined the association between suicidal ideation in early adulthood and daily tobacco smoking in a community sample of adolescents. METHOD: Participants were enrolled in a longitudinal study of health and development. The factors of disadvantage, impulsiveness, stress, depressed mood, tobacco smoking, other substance use, and parental attachment were included in multivariate modelling of suicidal ideation. RESULTS: Data on tobacco use were available for 764 participants. Early tobacco smoking was significantly predictive of later suicidal ideation, but there was no longer a significant relationship when high levels of stress and depression and low levels of parental attachment in adolescence were included in the multivariate model. CONCLUSIONS: Tobacco smoking in adolescence does not appear to elevate the risk of later suicidal ideation.     

Social support and suicidal ideation in Japan: are home visits by commissioned welfare volunteers associated with a lower risk of suicidal ideation among elderly people in the community?

Aims

Social support has consistently been reported to be effective in reducing suicidal ideation. This cross-sectional study was performed to determine whether home visits by commissioned welfare volunteers (i.e., organizations of community residents appointed by national or prefectural governments) are associated with a lower risk of suicidal ideation among the elderly.

Methods

In August 2010, questionnaires were sent to all residents aged ≥65 years in three municipalities (n = 21,232) in Okayama prefecture, Japan, and 13,929 returned the questionnaire (response rate: 65.6 %). We finally analyzed 11,218 subjects. Both home visits by commissioned welfare volunteers and suicidal ideation within the last 30 days were assessed in the questionnaire. Odds ratios (ORs) and 95 % confidence intervals (CIs) for suicidal ideation were calculated adjusting for age, sex, educational attainment, and marital status. We then additionally adjusted for instrumental and emotional support, separately.

Results

The prevalence of suicidal ideation was 10.0 % and higher in women than in men (11.4 % vs. 8.0 %). Home visits were significantly associated with a lower risk of suicidal ideation after adjusting for instrumental and emotional support, respectively (OR: 0.60, 95 % CI: 0.53–0.69; OR: 0.67, 95 % CI: 0.59–0.78). In sex-stratified analysis, the association was clearer for women than for men: the corresponding ORs among women were 0.55 (95 % CI: 0.46–0.65) and 0.61 (95 % CI: 0.52–0.73), whereas they were 0.71 (95 % CI: 0.56–0.90) and 0.78 (95 % CI: 0.61–0.99) among men.

Conclusion

Our findings suggest that home visits by commissioned welfare volunteers are significantly associated with lower suicidal ideation among the elderly, particularly in women.     

Are patients with Parkinson's disease suicidal?

Using the National Center of Health Statistics' mortality statistics databases for 1991 through 1996 (12,430,473 deaths), we isolated 144,364 individuals 40 years of age or older with a primary diagnosis of Parkinson's disease (PD). Of these, 122 died by suicide. The rate of suicide in the general population was about 10 times higher than in patients with PD (0.8% compared with only 0.08%, respectively). These different rates of suicide cannot be attributed to differences in age, gender, race, education, or marital status. Compared with patients with suicidal PD, patients with PD who died from other causes manifested significantly lower rates of affective disorders. The referent population exhibited a higher rate of malignancy and a lower rate of depression. The findings suggest that marital status, mood disorder, and somatic comorbidity provide only a limited understanding of completed suicide.     

Are structural brain abnormalities associated with suicidal behavior in patients with psychotic disorders?

Suicide represents a major health problem world-wide. Nevertheless, the understanding of the neurobiological underpinnings of suicidal behavior remains far from complete. We compared suicide attempters to non-attempters, and high vs. low lethality attempters, to identify brain regions associated with suicidal behavior in patients with psychotic disorders. 489 individuals with schizophrenia, schizoaffective disorder, or psychotic bipolar disorder I and 262 healthy controls enrolled in the B-SNIP study were studied. Groups were compared by attempt history and the highest medical lethality of previous suicide attempts. 97 patients had a history of a high lethality attempt, 51 of a low lethality attempt and 341 had no attempt history. Gray matter volumes were obtained from 3T structural MRI scans using FreeSurfer. ANCOVAs were used to examine differences between groups, followed by Hochberg multiple comparison correction. Compared to non-attempters, attempters had significantly less gray matter volume in bilateral inferior temporal and superior temporal cortices, left superior parietal, thalamus and supramarginal regions, right insula, superior frontal and rostral middle frontal regions. Among attempters, a history of high lethality attempts was associated with significantly smaller volumes in the left lingual gyrus and right cuneus. Compared to non-attempters, low lethality attempters had significant decreases in the left supramarginal gyrus, thalamus and the right insula. Structural brain abnormalities may distinguish suicide attempters from non-attempters and high from low lethality attempters among individuals with psychotic disorders. Regions in which differences were observed are part of neural circuitries that mediate inhibition, impulsivity and emotion, visceral, visual and auditory perception.     

Are neurocognitive factors associated with repetition of self-harm? A systematic review

BackgroundPrediction of self-harm is limited clinically. Early identification of individuals likely to repeat self-harm could improve outcomes and reduce suicide risk. Various neurocognitive deficits have been found in people who self-harm, but the ability of these to predict repetition has yet to be establishedAimsIdentify neurocognitive factors that may predict repetition of self-harm.MethodsSystematic narrative review of English language publications assessing neurocognitive functioning and self-harm repetition, searching multiple databases from inception to March 2015. Quality of studies was appraised. A narrative synthesis was performed.Results7026 unique records were identified, and 169 full-texts assessed. 15 unique studies provided data. No imaging studies could be included. Most studies assessed cognitive control or problem solving, but neither factor was consistently associated with repetition. However, specific tasks may show promise. Two studies in adolescents suggest that value-based decision-making impairments could be predictive of repetition. There were too few results for memory to draw specific conclusions.ConclusionsSelected studies suggest promise for particular neurocognitive factors and specific cognitive tasks in terms of repetition of self-harm.     

Is a history of school bullying victimization associated with adult suicidal ideation?: a South Australian population-based observational study

The objective of this research was to determine whether a history of school bullying victimization is associated with suicidal ideation in adult life. A random and representative sample of 2907 South Australian adults was surveyed in Autumn, 2008. Respondents were asked "When you were at school, did you experience traumatic bullying by peers that was particularly severe, for example, being frequently targeted or routinely harassed in any way by 'bullies'?" Depression was determined by the mood module of the PRIME-MD which includes a suicidal ideation question; "In the last 2 weeks, have you had thoughts that you would be better off dead or hurting yourself in some way?" The overall prevalence of suicidal ideation in postschool age respondents was 3.4% (95% confidence interval: 2.8%-4.2%) in 2008. Bullying by peers was recalled by 18.7% (17.2%-20.3%). Respondents with a history of being bullied were approximately 3 times (odds ratio: 3.2) more likely to report suicidal ideation compared with those who did not. The association between being bullied and suicidal ideation remained after controlling for both depression and sociodemographic variables (odds ratio: 2.1). The results from the present research suggest that there is a strong association between a history of childhood bullying victimization and current suicidal ideation that persists across all ages. Bullying prevention programs in schools could hold the potential for longer lasting benefits in this important area of public health.     

Suicidal ideation in prisoners: risk factors and relevance to suicidal behaviour. A prospective case–control study

Objective

To investigate risk factors for suicidal ideation (SI) in prisoners, as well as the prediction of suicidal behaviour by SI.

Method

Participants were recruited from the all–male,adults', high security prison of Patras, Greece. Sixty–seven prisoners who expressed SI were evaluated using a structured interview, Hamilton's Rating Scale for Anxiety (HAMA) and the MontgomeryÅsberg Rating Scale for Depression (MADRS). Sixtyseven control prisoners without SI, matched for age, nationality and penal status were evaluated using the same structured interview and rating scales. All participants were followed–up prospectively for 12 months after their initial assessment and any acts of self–destructive behaviour were recorded.

Results

Independent significant risk factors for SI in prisoners were the family history of suicidal behaviour (OR = 56.34, 95% CI = 4.23–750.1, p < 0.002), history of psychiatric hospitalisation (OR = 7.18, 95% CI = 1.83–28.16, p < 0.005), and higher scores in the MADRS (p < 0.03) and HAMA (p < 0.03) scales. During the follow–up period, suicidal behaviour (suicide attempt or self–mutilation) was observed in 12 (17.9%) inmates with SI, as opposed to none of the controls (p < 0.0001).

Conclusion

A family history of suicidal behaviour, history of psychiatric hospitalisation and symptoms of anxiety or depression were independent risk factors for SI in prisoners. Inmates with SI had a higher risk for self–destructive acts at follow–up. Inmates with SI are a high–risk group for future self–destructive acts, so special precautions designed to reduce this risk are warranted.     

Is antiepileptic drug use related to depression and suicidal ideation among patients with epilepsy?

Depression and suicide are increased in patients with epilepsy. The U.S. Food and Drug Administration warns that antiepileptic drugs (AEDs) are associated with increased risk of suicidality. This study examines the relationship among depression, suicidal ideation, and AEDs in a prospective cohort of 163 patients with epilepsy from a registry at the University of Florida (January 2006 to August 2008). The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was used to measure mood and suicidal ideation across two time points (median = 154 days). Groups included: (1) No AED Change, (2) New AED Added, (3) AED Dose Increased, (4) AED Reduced/Stopped, (5) Multiple AED Changes, and (6) Combined Any AED Change (groups 2-5 combined). No group had worsening mood or suicidal ideation. Significant improvements in proportions of depression and suicidal ideation were seen only for the No AED Change group, which differed only with the AED Dose Increased group with respect to suicidal ideation.     

Do the risk factors associated with conduct problems in adolescents vary according to gender?

The present paper examines whether there are gender differences in the associations between conduct problems and risk factors such as family conditions, peer influence, leisure activities, school-related variables and pubertal timing. We analysed self-reported data collected as part of a large general population study of Norwegian adolescents (N=9342). On the basis of earlier studies, conduct problems were decomposed into three dimensions, labelled theft and vandalism, school opposition and covert behaviour. The first dimension includes different kinds of theft and vandalism, whereas the second includes school-related conduct problems of an overt aggressive kind. The last dimension reflects avoidance of arenas under adult control. Whether or not gender differences were detected depended on the aspect of conduct problems considered. The associations between risk factors and "theft and vandalism" and "school opposition" were stronger for boys than for girls. No gender differences were detected in the associations between and risk factors and "covert behaviour". Even though there were gender differences in the strength of these associations, the same risk factors seem to be relevant in explaining conduct problems for both gender groups.     

Which risk factors are more associated with ischemic rather than hemorrhagic stroke in black Africans?

Objective

To comprehensively examine the relationship of vascular risk factors to stroke type in native black Africans.

Methods

We explored 34 candidate demographic, clinical, and laboratory variables in 282 consecutive adult stroke patients with brain imaging.

Results

Ischemic stroke (IS) was found in 61.7% (174). Gender, alcohol, cigarette, homocysteine, C-reactive peptide, anthropometry, and carotid parameters were not significantly associated with stroke type (p > 0.05). Patients with IS had relatively lower BP, were significantly older, and more frequently had diabetes mellitus, cardiac disease, or previous transient ischemic attack than patients with hemorrhagic stroke (HS). However, in multivariate regression model predicting 69% of stroke type correctly, age ≥ 62 years (OR: 4.0, 95% CI: 2.0–7.9), previous TIA (OR: 4.3, 95% CI: 1.2–15.7) and systolic BP ≥ 140 mmHg (OR: 0.4, 95% CI: 0.2–0.9) were the only independent significant predictors of IS.

Conclusions

With increasing proportion of the population over 61 years and better BP control, the proportion of IS is expected to rise in black African countries currently undergoing epidemiological transition (changing lifestyle/disease pattern). Therefore, relevant components of the stroke intervention quadrangle (stroke surveillance, acute care, preventive and rehabilitation services) should be tailored toward this need.     

Prevalence of and risk factors associated with carotid artery stenosis: the Troms? Study.

BACKGROUND AND PURPOSE: To assess prevalence, distribution, ultrasound characteristics and determinants of carotid artery stenosis in a large, population-based study of both women and men. METHODS: A total of 6,727 persons aged 25-84 years were screened for extracranial stenosis with Duplex ultrasound of the right carotid artery. Risk factors were compared in 225 persons with stenosis and 5,514 persons without. RESULTS: The prevalence of carotid stenosis was higher in men than in women, where 3.8% (95% CI, 3.2-4.6%) had carotid stenosis, compared to 2.7% (95% CI, 2.2-3.3%) in women (p = 0.001). The prevalence gradually increased by age in both genders. Cholesterol, HDL cholesterol, fibrinogen, systolic blood pressure levels and current smoking were independently associated with carotid artery stenosis in both women and men. The presence of carotid stenosis was significantly associated with a history of cerebrovascular disease, coronary heart disease and peripheral artery disease. For each 10% increase in the degree of carotid stenosis, the risk of having had a cerebrovascular event increased by 26%. CONCLUSIONS: The prevalence of carotid stenosis in the general population, as measured by ultrasound, is low. Age, male gender, smoking, total cholesterol, HDL cholesterol (inverse), fibrinogen and systolic blood pressure are all independent predictors of carotid artery stenosis.