Coincident alcohol dependence and depression increases risk of suicidal ideation among Army National Guard soldiers

PurposeSuicide rates among military service members have risen dramatically, while drivers remain poorly understood. We examined the relationship between coincident alcohol dependence and depression in shaping risk of suicidal ideation among National Guard forces.MethodsWe performed a longitudinal analysis using a randomly selected, population-based sample of Ohio Army National Guard soldiers. Telephone-based surveys of 1582 soldiers who participated in both wave 1 (2008–2009) and wave 2 (2009–2010) were analyzed.ResultsOdds ratios (ORs) for suicidal ideation among those with versus without alcohol dependence were similar among nondepressed (OR = 3.85 [95% confidence intervals (CIs) = 1.18–12.52]) and depressed individuals (OR = 3.13 [95% CI = 0.88–11.14]); multiplicative interaction was not observed. In contrast, the risk differences (RDs) among those with versus without alcohol dependence diverged for those without depression (RD = 0.04 [95% CI = 0.02–0.07]) compared with those with depression (RD = 0.11 [95% CI = 0.06–0.18]); strong evidence of additive interaction was observed.ConclusionsWe found that alcohol dependence and depression interact statistically in shaping risk for incident suicidal ideation among Army National Guard service members. A high-risk prevention approach including population-based screening for suicidality among patients with alcohol dependence, depression, and particularly those with both conditions is warranted in military populations.     

Cross-sectional associations between 24-h movement guideline adherence and suicidal thoughts among Canadian post-secondary students

Suicide is one of the leading causes of death among post-secondary students. It is, therefore, imperative that we identify behavioral risk factors that can have protective effects in preventing against suicide. This study examined whether different combinations of adherence to the Canadian 24-Hour Movement Guidelines for Adults (i.e., physical activity, sedentary behavior, sleep) were associated with reduced odds of suicidal ideation and planning among emerging adults attending post-secondary education. This cross-sectional observational study used data from the first cycle of the Canadian Campus Wellbeing Survey, which included a total of 17,633 students (Mean age = 21.7 ± 2.92 years; 67.1% female, 31.5% male, 1.4% other) enrolled in 20 Canadian post-secondary institutions. Logistic regression models with covariate balanced propensity score weighting were computed. Suicidal ideation and suicidal planning were reported by 14.4% and 4.9% of students, respectively. Adherence to the sleep (OR = 0.71; 95% CI: 0.58–0.86), physical activity and sleep (OR = 0.74; 95% CI: 0.62–0.88), sedentary behavior and sleep guidelines (OR = 0.64; 95% CI: 0.45–0.90) as well as concurrent adherence to all three guidelines (OR = 0.58; 95% CI: 0.44–0.75) were associated with significantly reduced odds of suicidal ideation. Among students who reported suicidal ideation, only adherence to the physical activity and sleep guidelines (OR = 0.67; 95% CI: 0.48–0.96) was associated with suicidal planning. Collectively, findings suggest the promotion of healthy movement behavior patterns may be a promising avenue for broad suicide and mental health prevention efforts on campus, although the potency of these effects may not extend to more severe suicidal thoughts.     

Association between Sexual Behaviors,Bullying Victimization and Suicidal Ideation in a National Sample of High School Students: Implications of a Sexual Double Standard

PurposeThe sexual double standard is the notion that women are more harshly judged for their sexual behaviors than men. The purpose of this study was to investigate if the sexual double standard could explain gender differences in bullying victimization among adolescents and the extent to which that relationship correlated with depression and suicidal ideation.MethodsAnalyses were conducted using a sample of high school students (n = 13,065) from the 2011 Youth Risk Behavior Survey, a cross-sectional and national school-based survey conducted by the Centers for Disease Control and Prevention. Data were assessed using multiple logistic regression, gender-stratified analyses, and interaction terms.FindingsStudents who engaged in sexual intercourse (sexually active) had higher odds of being bullied. When this association was stratified by gender, odds of being bullying increased for girls (odds ratio [OR], 1.83; 95% CI, 1.58–2.13) and decreased for boys (OR, 0.94; 95% CI, 0.77–1.16). Sexually active students who were bullied also displayed more than five times (OR, 5.65; 95% CI, 4.71–6.78) the adjusted odds of depression and three times (adjusted OR, 3.38; 95% CI, 2.65–4.32) the adjusted odds of suicidal ideation compared with students who reported neither of those behavioral characteristics. When stratified by gender, girls had slightly higher odds of depression and suicidal ideation but overall, the odds remained strong for both genders.ConclusionsResults provide some evidence that a sexual double standard exists and may play a prominent role in bullying victimization among girls. Therefore, addressing the sexual double may be important to consider when tailoring school bullying intervention programs.     

Suicidal risk factors and completed suicide: meta-analyses based on psychological autopsy studies

The purpose of the present review is to evaluate the effects of common risk factors for suicide by meta-analyses using data extracted from studies based on the psychological autopsy method. We focused on five common risk factors of suicide: substance-related disorders, mood disorders, adverse marital status, adverse employment status, and self-harm behaviors. A total of 24 articles were identified from MEDLINE in which the crude odds ratio (OR) could be calculated for the above five risk factors through 30 April 2007, using such search keywords as “suicide,” “psychological autopsy,” and “case-control study.” Overall, both substance-related disorders [OR = 5.24; 95% confidence interval (CI) = 3.30–8.31] and mood disorders [OR = 13.42; 95% CI = 8.05–22.37] were strongly associated with suicidal risk. Suicidal attempt and deliberate self-harm, which can directly lead to completed suicide, have been shown to be very strongly associated with suicidal risk [OR = 16.33; 95% CI = 7.51–35.52]. Effects of social factors such as adverse marital and employment status were relatively small. As substance-related disorders and mood disorders were strongly associated with an increased risk of completed suicide, the comorbidity of these two disorders should be paid a maximum attention. The effective prevention of suicide depends on whether we can successfully incorporate these personal factors as well as social factors into an adequate multi-factorial model. Members of the Stress Research Group of the Japanese Society for Hygiene are listed in the Appendix.     

Precarious employment and the risk of suicidal ideation and suicide attempts

ObjectiveAlthough the effect of occupation or employment status on suicide risk is notable, there are few studies on the effect of precarious employment on suicide. We compared suicidal ideation and suicide attempts in precarious workers and their non-precarious counterparts using a representative sample from South Korea.MethodThe 2008 Korean Community Health Survey data were used for this study. Information was obtained on 52,161 participants (41,063 employees with non-precarious work and 11,098 employees with precarious work). The outcome of the logistic regression model was the presence of suicidal thoughts and attempts, and the independent variables were the demographics, socioeconomic status, and health status.ResultsEmployees with precarious work were more likely to exhibit suicidal ideation (OR = 1.41; 95% CI, 1.28–1.55) and suicide attempts (OR = 1.52; 95% CI, 1.02–2.27) than employees with non-precarious work. After controlling for income and education (Model 2) depressive feelings (Model 6), compared with unadjusted model, remained significant but the odds ratio was largely attenuated, indicating a strong association between suicidal risk and socioeconomic and feelings of depression.ConclusionPrecarious workers had a higher risk of suicidal ideation and suicide attempts than non-precarious workers. Our study suggests that precarious employment is an important risk for suicide.     

童年期虐待的不同形式与中学生自杀行为关联性研究

目的 探讨不同形式的童年期虐待与中学生自杀行为的关系。方法 采用分层整群抽样的方法,以广州、新乡、沈阳和重庆4个地区14221名中学生为研究对象,使用问卷调查了解一般人口统计学指标、心理问题症状、童年期虐待经历及自杀行为等信息,建立多因素logistic回归模型,分析不同形式的童年期虐待对自杀行为发生的影响。结果 中学生童年期总体虐待、躯体虐待、情感虐待、性虐待、自杀意念、自杀计划和自杀未遂的检出人数(率)分别为7246(51.0%)、5824(41.0%)、5409(38.0%)、1039(7.3%)、2042(14.4%)、1174(8.3%)和548(3.9%)。男生躯体虐待的检出率高于女生,女生情感虐待和自杀意念的检出率高于男生,组间差异有统计学意义(P<0.01);童年期性虐待、自杀计划和自杀未遂的检出率在不同性别间的差异无统计学意义(P>0.01)。控制相关混杂因素的作用后,童年期虐待经历会增加男生自杀意念(OR=2.03,95%CI:1.72~2.40)和自杀计划(OR=1.93,95%CI:1.57~2.37)的发生风险,增加女生自杀意念(OR=2.45,95%CI:2.12~2.82)、自杀计划(OR=2.46,95%CI:2.02~3.00)和自杀未遂(OR=2.12,95%CI:1.61~2.78)的发生风险。除童年期躯体虐待与男生自杀未遂外,不同类型的童年期虐待均是男女中学生自杀行为发生的危险因素(P<0.01)。随着童年期虐待种类数的增加,男女生自杀行为的发生风险亦呈增高趋势(P<0.01)。持续受虐以及施虐人为父母/其他的中学生,自杀行为的发生风险显著增加。结论 童年期虐待经历是中学生自杀行为发生的重要危险因素。     

Attitudes of parents towards influenza vaccine in the Eastern Mediterranean Region: A multilevel analysis

BackgroundSeasonal influenza vaccines (SIVs) can protect against influenza and substantially reduce the risk of influenza-related hospitalizations and fatalities in children. This study aimed to assess parental attitudes towards SIVs in the Eastern Mediterranean region (EMR).MethodsThrough an anonymous online survey conducted in 19 countries in the EMR, parents or caregivers over 18 years who had at least one child above 6 months filled out the Parent Attitudes about Childhood Vaccines questionnaire. As data had two levels; country and individual factors, we utilized multilevel binary logistic regression models.ResultsIn total, 6992 respondents filled out the questionnaire. Of them, 47.4 % were residents of middle-income countries, 72.4 % of the mothers were between 26 and 45 years old, 56.5 % had at least a university degree, and approximately 51.6 % were unemployed. Nearly 50.8 % of the respondents were hesitant to vaccinate their children against seasonal influenza. Parental attitudes towards seasonal influenza vaccination differed significantly between countries, p < 0.001. The main predictors of parental seasonal influenza vaccine hesitancy (VH) were parents vaccination (odds ratio (OR) = 0.42, 95 % CI = 0.32–0.55, p < 0.001)), the mother's education if mother educated vs. who did not receive any education (OR ranged from 0.48 to 0.64, p < 0.05), living in low-income countries (OR = 0.52, 95 % CI = 0.35–0.77, p < 0.01), mountain residence (0.69, 95 % CI = 0.49–0.99, p < 0.05), health workers as a source of information (OR = 0.70, 95 % CI = 0.58–0.85, p < 0.001), children vaccination against COVID-19 (OR = 0.52, 95 % CI = 0.41–0.65, p < 0.001), not receiving routine vaccinations (OR = 1.93, 95 % CI = 1.09–3.44, p = 0.025), and if parents respondents could not remember whether their child had suffered from seasonal influenza in the previous year (OR = 1.57, 95 % CI = 1.33–1.84, p < 0.001).ConclusionA high seasonal influenza VH rate was found in the EMR. Health authorities should implement different interventions targeting the identified modifiable risk factor to increase vaccine uptake among children, especially those at risk of complication from seasonal influenza infection.     

Suicide and friendships among American adolescents

OBJECTIVES: We investigated the relationship between friendships and suicidality among male and female adolescents. METHODS: We analyzed friendship data on 13,465 adolescents from the National Longitudinal Survey of Adolescent Health to explore the relationship between friendship and suicidal ideation and suicide attempts. We controlled for known factors associated with suicidality. RESULTS: Having had a friend who committed suicide increased the likelihood of suicidal ideation and attempts for both boys and girls. Socially isolated females were more likely to have suicidal thoughts, as were females whose friends were not friends with each other. Among adolescents thinking about suicide, suicide attempts appear largely stochastic, with few consistent risk factors between boys and girls. CONCLUSIONS: The friendship environment affects suicidality for both boys and girls. Female adolescents' suicidal thoughts are significantly increased by social isolation and friendship patterns in which friends were not friends with each other.     

Association Between Parental Marital Status and Types of Suicidal Behavior Among Korean Adolescents: A Cross-sectional Study

ObjectivesAdolescent suicide is a global problem. This study aimed to identify associations between parental marital status and suicidal behavior.MethodsThis study analyzed 118 715 middle and high school students from the 13th and 14th Korea Youth Risk Behavior Web-based Survey. The odds ratios (ORs) of suicidal ideation, planning, and attempts were calculated based on parental marital status, living situation, and socioeconomic factors. The data were analyzed using multiple logistic regression.ResultsWhen compared to those living with 2 married biological parents, the ORs of suicidal ideation among adolescents living with either remarried or no parents were 1.34 (95% confidence interval [CI], 1.17 to 1.53) and 1.36 (95% CI, 1.11 to 1.66), respectively. For suicidal planning, the OR of those living with 1 remarried biological parent was 1.24 (95% CI, 1.01 to 1.52), and that of those living without parents was 1.28 (95% CI, 0.95 to 1.73), when compared to adolescents living with 2 married biological parents. For suicide attempts, when compared to adolescents with 2 married biological parents, the OR of those living with 1 remarried biological parent was 1.48 (95% CI, 1.17 to 1.87) and that of those living without parents was 2.02 (95% CI, 1.44 to 2.83). For adolescents living with 1 remarried biological parent, suicidal behavior was strongly associated with having no siblings and were weakly associated with not living with grandparents.ConclusionsSuicidal behavior among adolescents was associated with the remarriage and loss of parents. Therefore, special attention and interventions are needed for adolescents in those situations.     

Prevalence and Risk Factors for Female Sexual Dysfunction Among Turkish Women Attending a Maternity and Gynecology Outpatient Clinic

Female sexual dysfunction is a common health problem for many women all over the world. This study was constructed to determine risk factors and prevalence of female sexual dysfunction among Turkish women, in Ordu province of Turkey between May 2008 and December 2008. Four hundred and twenty-five married women, between 18 and 56 years of age, who consented to participate, were included in the study. Data was collected by using a questionnaire form and the Female Sexual Function Index. The prevalence of female sexual dysfunction was 52.2%. The risk factors for female sexual dysfunction were, low education level of the woman (odds ratio [OR] = 1.830, 95% confidence interval [CI] = 1.088–3.078), low education level of the husband (OR = 1.734, 95% CI = 1.094–2.750), being brought up by parents with restrictive attitudes (OR = 1.558, 95% CI = 1.001–2.424), and having genital infections or symptoms (OR = 1.925, 95% CI = 1.213–3.055).     

Immigrant Density, Sense of Community Belonging, and Suicidal Ideation Among Racial Minority and White Immigrants in Canada

Immigrants represent a substantial proportion of suicides in Canada. This study assesses the hypothesis that high immigrant density fosters personal sense of community belonging among immigrants, and in turn, protects against suicide risk. This multilevel cross-sectional study is based on individual-level data from the 2007 Canadian Community Health Survey (n = 12,951 participants) merged with area-level data from the 2006 Canadian census (n = 57 health regions). Prevalence of suicidal ideation was 1.3 %. Among rural racial minority immigrants, each 10 % increase in immigrant density associated with 67 % lower odds of suicidal ideation (adjusted odds ratio (AOR) = 0.33, 95 % CI: 0.14–0.77); sense of community belonging did not mediate this association, but was independently associated with suicidal ideation (AOR = 0.44, 95 % CI: 0.28–0.69). Immigrant density was not associated with suicidal ideation among white immigrants or urban settings. Immigrant density and sense of community belonging may correlate with suicidal ideation through distinct mechanisms of association.     

Suicidal Ideation and its Correlates among Juvenile Delinquents in South Korea

Objectives

This study investigated suicidal ideation and its correlates among juvenile delinquents in South Korea.

Methods

Suicidal ideation, psychological health status, and health-related behaviors were assessed using a self-administered questionnaire in 1682 juvenile offenders aged between 15 and 18 years in 2012.

Results

The prevalence of suicidal ideation in juvenile delinquents was 15.2%. Girls were more likely to report suicidal thoughts than boys (30.3% vs. 12.7%). Suicidal ideation was more common among adolescents who were not living with their family prior to entering detention centers (22.6% vs. 13.2%) than their counterparts. The likelihood of suicidal ideation was significantly associated with problem drinking [odds ratio (OR) = 1.84], psychedelic drug use (OR = 2.04), feeling unhappy (OR = 3.05), feeling sad or depressed (OR = 13.37) after controlling for sociodemographic factors, other health behaviors and perceptions.

Conclusion

The present study provides evidence for an association between suicidal ideation and psychological health and health risk behaviors among juvenile delinquents. It also highlights the importance of mental health and behavioral interventions for this population to prevent suicidality.     

Expressed and unexpressed social needs in low-income adults in the U.S

Many healthcare organisations are now routinely screening patients for social needs such as food and housing. It is largely unknown whether the needs they identify would have been expressed by the patient in the absence of screening. To better understand expressed and unexpressed social needs, we administered a social needs screener to 1,397 low-income adults who called a 2-1-1 helpline in Missouri seeking assistance with social needs between June 2017 and October 2019. Merging data from the screener and 2-1-1, we found that the screener identified all of the social needs expressed to 2-1-1 for about half the participants, and on average identified at least one social need not expressed to 2-1-1 (i.e., unexpressed needs). Certain social needs (utility payment assistance, housing) were much more likely to be expressed than unexpressed, while others (childcare, employment, personal safety) were almost universally unexpressed. In regression analyses, having certain expressed needs significantly increased the odds of having certain unexpressed needs. For example, those seeking transportation assistance from 2-1-1 had greater odds of unexpressed needs for food (OR = 3.19; 95% CI = 1.45–7.02) and healthcare (OR = 2.18; 95% CI = 1.06–4.48) than those not expressing transportation needs. Those seeking employment assistance from 2-1-1 had greater odds of unexpressed needs for personal safety (OR = 3.04; 95% CI = 1.20–7.68) and healthcare (OR = 2.58; 95% CI = 1.15–5.77) than those not expressing employment needs. Implications for healthcare (screening detects expressed and unexpressed needs) and social service organisations (certain requests may be markers for other needs) are discussed.     

Socioeconomic and Clinical Characteristics Associated With Repeat Suicide Attempts Among Young People

PurposeRepeat suicidal behaviors in young people are a critical public health concern. The study investigates individual socioeconomic and episode-dependent clinical factors predicting repeat suicide attempts among youth by gender.MethodsUsing a retrospective cohort study, we identified a total of 4,094 male and 3,219 female youths who had the index suicide episode at the ages of 15–24 years from the 1996–2007 National Health Insurance Research Database in Taiwan. The recurrence of suicide attempt was assessed within 1 year after the index suicide. Information pertaining to suicide management and postsuicide treatment was obtained from healthcare records. Repeated event survival analyses were used to estimate episode-dependent risk of suicide attempt.ResultsThe occurrence of repeat suicide attempts was more common in males, yet the phenomenon of risk aggravation appears more prominent in females. The estimate for peak hazard of the second repeat attempt was 2-fold higher than that of the first repeat event in males, and approximately 6-fold in females. Socioeconomic (e.g., labor market participation: adjusted Hazard Ratio [aHR] = 1.14, 95% CI = 1.01–1.28) and index suicide management characteristics (e.g., receiving treatment at clinic, aHR = 1.54, 95% CI = 1.19–1.99) were found to play important roles for repeat suicide attempts in males. For females, postsuicide treatment of mental disorders appears more influential.ConclusionsThe relationships between socioeconomic and clinical factors with repeat suicide attempts in young people vary by gender. School/workplace-based post suicide attempt consultation and clinical management for youth may be planned and delivered on a gender-appropriate basis.     

Immigration and Selected Indicators of Health Status and Healthcare Utilization among the Chinese

We examined indicators of health status and healthcare utilization according to immigration status to assess the ‘healthy immigrant effect’ for Chinese adults. Data for Chinese in Taiwan (n = 15,549) were from the 2001 Taiwan National Health Interview Survey (NHIS). Data for U.S.-born Chinese (n = 964) and Chinese Immigrants in the U.S. (n = 253) were from the 1998–2004 U.S. NHIS. We used multivariate logistic regression to estimate the adjusted odds of perceived poor health, having ever smoked, and past year emergency room visits according to immigration status. For Chinese immigrants, more years in the U.S. were associated with lower odds of reporting poor health (OR = 0.4; 95% CI = 0.2–0.8) and past-year emergency room use (OR = 0.5; 95% CI = 0.3–0.9). Compared with recent Chinese immigrants (<5 years in U.S.), Chinese in Taiwan had higher odds of reporting poor health (OR = 6.2; 95% CI = 3.2–12.1) and having ever smoked (OR = 1.6; 95% CI = 1.1–2.5). Our results suggest that those who migrate have better health profiles than those who do not migrate. However, recent Chinese immigrants were not significantly different than U.S.-born Chinese.     

Previous Breastfeeding Practices and Duration of Exclusive Breastfeeding in the United States

We examined the influence of duration of exclusive breastfeeding (DEBF) for a mother’s earlier children on the DEBF for her later children among multiparous women from the 2002 National Survey of Family Growth. DEBF was categorized as: never breastfed (NBF) (referent); not exclusively breastfed or exclusively breastfed for <4 months (EBF < 4); and exclusively breastfed for ≥4 months (EBF ≥ 4). We examined DEBF using weighted percentages and odds ratios (OR) with 95% confidence intervals (CI) from multinomial logistic regression models, adjusting for maternal factors. About 70% of multiparous women (n = 2,149) repeated the duration of exclusive breastfeeding of their first child for their second child; 14% of women repeated EBF ≥ 4. Among multiparous women, the adjusted odds ratio for EBF ≥ 4 for second children was 7.2 (95% CI = 4.0–12.9) when first children were EBF < 4 and 90.7 (95% CI = 45.4–181.4) when first children were EBF ≥ 4, relative to NBF first children. In analyses where DEBF of third children was the outcome, odds of EBF ≥ 4 were more strongly influenced by DEBF of second children while the impact of DEBF of first children was not as strong. Older maternal age and being married were related to an increased DEBF. Being married at second birth predicted a change from NBF for first children to EBF ≥ 4 for second children (OR = 6.2, 95% CI = 2.7–14.2). In conclusion, mothers generally repeated the DEBF of their previous child. For third children, DEBF of the second child was more likely to be repeated than that of the first child.     

Mental health and suicidal ideation among Chinese women who have sex with men who have sex with men (MSM)

ABSTRACT

In China, men who have sex with men (MSM) are the fastest growing population at risk for HIV. They face social stigma due to both MSM behavior and HIV. In addition, concern has been raised about the mental health of wives of MSM. In this cross-sectional study, the authors examine the mental health status of a sample of 135 of these women. Participants completed an Internet-administered questionnaire in Xi’an from April to June, 2012. Most were unaware at the time of marriage that their husbands were MSM. Physical abuse was frequently reported; depressive symptom and mental health (Symptom Checklist, SCL–90) scores were significantly higher than those of the general Chinese adult female population. A majority (59.8%) of women reported suicidal thoughts after discovering their husbands’ MSM behavior; about 10% had attempted suicide. Multiple logistic regression revealed that women’s experience with anal sex was associated with 7.8 times (95% CI: 1.3–65.9) greater odds of suicidal ideation. Also, women who demonstrated mental symptoms on the SCL–90 had 2.3 times (95% CI: 1.04–5.2) the odds of suicidal ideation. These results suggest that wives of MSM have a significant need for mental health care, suicide prevention, HIV education, and social support.     

家庭矛盾与青少年自杀行为关系的队列研究

目的 分析家庭矛盾与青少年自杀行为间的关系。方法 在山东省3个县（市）采用方便整群抽样的方法共选取8所中学作为调查学校，选取7、8和10年级的学生进行基线和随访调查，包括一般人口学、自杀行为、家庭矛盾和抑郁等信息，研究共纳入7 072名研究对象。采用多因素logistic回归模型分析家庭矛盾和自杀行为的关系。结果 7 072名研究对象的基线年龄为（14.58±1.45）岁，有任何自杀行为的有750人（10.6%），其中自杀意念、自杀计划和自杀未遂的人数（报告率）分别为707人（10.0%）、258人（3.6%）和190人（2.7%）。有自杀行为者的家庭矛盾得分高于没有自杀行为者。调整其他因素后，logistic回归结果显示，家庭矛盾与自杀行为（OR=1.05，95%CI：1.01~1.10）、自杀意念（OR=1.05，95%CI：1.00~1.09）、自杀计划（OR=1.08，95%CI：1.01~1.16）和自杀未遂（OR=1.10，95%CI：1.02~1.19）的风险增加有关。进一步对性别进行分层后，分析结果显示，女生的家庭矛盾和自杀行为无统计学关联；男生的家庭矛盾和自杀行为有统计学关联，尤其是自杀意念和自杀计划，且男生家庭矛盾对于自杀计划的预测作用大于自杀意念。敏感性分析显示该结果对于男生稳定。结论 家庭矛盾可能会增加青少年自杀行为的风险，尤其是男生。和谐的家庭环境、良好的家庭氛围对预防和控制青少年自杀行为的发生具有重要意义。     

Drug and alcohol use disorders among adults with select disabilities: The national survey on drug use and health

BackgroundDeaths caused by drugs and alcohol have reached high levels in the US, and prior research shows a consistent association between disability status and substance misuse.ObjectiveUsing national data, this study quantifies the association between disability status and drug and alcohol use disorders among US adults.MethodsThe most recent pre-pandemic years (2018–2019) of the cross-sectional National Survey on Drug Use and Health (n = 83,439) were used to examine how the presence of any disability, and specific disabilities, were associated with past year drug and alcohol use disorders. Logistic regression was used to estimate adjusted odds ratios (aORs) controlling for potential sociodemographic confounders.ResultsAdults with any disability had increased odds of drug (aOR = 2.7; 95% CI = 2.5–3.0), and alcohol use disorder (aOR = 1.8; 95% CI = 1.6–2.0), compared to adults without disability. Examining specific types of disabilities, adults with cognitive limitations only had increased odds of drug (aOR = 3.1; 95% CI = 2.6–3.6), and alcohol use disorders (aOR = 2.2; 95% CI = 1.9–2.5), compared to adults without disability. Smaller associations were observed between vision and complex activity limitations and drug use disorder. Adults with two or more types of limitations had increased odds of drug (aOR = 3.7; 95% CI = 3.3–4.3), and alcohol use disorders (aOR = 2.3; 95% CI = 2.0–2.6).ConclusionsThe presence of disability, especially cognitive limitation only, or two or more types of limitations, is associated with elevated odds of drug and alcohol use disorder among US adults. Additional research should examine the temporal relationship between and mechanisms linking disability and substance misuse.     

Physical Activity is Associated With Fewer Subjective Cognitive Complaints in 47 Low- and Middle-Income Countries

ObjectivesTo determine the association between physical activity (PA) and subjective cognitive complaints (SCCs), and the influential factors in this association.DesignCross-sectional study.Setting and ParticipantsCommunity-based data of the World Health Survey, which included 248,504 individuals from 47 low- and middle-income countries (LMICs), were analyzed [mean age = 38.6 (standard deviation 16.1) years; 50.7% female].MethodsPA was assessed with the International Physical Activity Questionnaire. Participants were grouped into those who meet (high PA) the 150 minutes of moderate-to-vigorous intensity PA per week recommendation, and those who do not (low PA). Two questions on subjective memory and learning complaints in the past 30 days were used (scales ranged from 1 to 5, with higher scores representing more severe SCC). Multivariable ordinal logistic regression and mediation analyses were performed.ResultsOverall, after adjusting for sociodemographic and a wide range of behavioral, psychological, and physical factors, low PA was associated with a higher risk for having more severe subjective memory complaints [odds ratio (OR) = 1.10, 95% confidence interval (CI) = 1.04-1.23] and learning complaints (OR = 1.18, 95% CI = 1.12-1.26). Significant associations were only observed among the middle-aged (45-64 years; learning complaints OR = 1.19, 95% CI = 1.06-1.33) and older populations (≥65 years; memory complaints OR = 1.31, 95% CI = 1.15-1.49, and learning complaints OR = 1.41, 95% CI = 1.24-1.60). Chronic physical conditions, sleep problems, depression, and anxiety explained between 7.7% and 29.4% of the PA-SCC association among those aged ≥45 years.Conclusions and ImplicationsLow PA was associated with increased odds for more severe SCCs in middle-aged and older adults in LMICs. Given the particularly rapid increase in dementia in LMICs, more longitudinal research is warranted from this setting to understand the utility of PA promotion in the prevention of cognitive impairment.