Prevalence of the ADHD phenotype in 7- to 9-year-old children: effects of informant,gender and non-participation

Purpose  

To estimate the prevalence of the ADHD phenotype based on parent and teacher reports in a general population sample of 7- to 9-year-old Norwegian children and evaluate the effect of parent attrition, gender and informant on the prevalence estimate.     

Psychological distress in children with developmental coordination disorder and attention-deficit hyperactivity disorder

This study explored whether or not a population-based sample of children with developmental coordination disorder (DCD), with and without comorbid attention deficit/hyperactivity disorder (ADHD), experienced higher levels of psychological distress than their peers. A two-stage procedure was used to identify 244 children: 68 with DCD only, 54 with ADHD only, 31 with comorbid DCD and ADHD, and 91 randomly selected typically developing (TD) children. Symptoms of depression and anxiety were measured by child and parent report. Child sex and caregiver ethnicity differed across groups, with a higher ratio of boys to girls in the ADHD only group and a slightly higher proportion of non-Caucasian caregivers in the TD group. After controlling for age, sex, and caregiver ethnicity, there was significant variation across groups in both anxiety (by parent report, F(3,235) = 8.9, p < 0.001; by child report, F(3,236) = 5.6, p = 0.001) and depression (parent report, F(3,236) = 23.7, p < 0.001; child report, F(3,238) = 9.9, p < 0.001). In general, children in all three disorder groups had significantly higher levels of symptoms than TD children, but most pairwise differences among those three groups were not significant. The one exception was the higher level of depressive symptoms noted by parent report in the ADHD/DCD group. In conclusion, children identified on the basis of motor coordination problems through a population-based screen showed significantly more symptoms of depression and anxiety than typically developing children. Children who have both DCD and ADHD are particularly at heightened risk of psychological distress.     

Evaluation of the implementation of the Meeting Centres Support Program in Italy,Poland, and the UK; exploration of the effects on people with dementia

Objectives

MEETINGDEM investigated whether the Dutch Meeting Centres Support Programme (MCSP) could be implemented in Italy, Poland, and the UK with comparable benefits. This paper reports on the impact on people living with dementia attending pilot Meeting Centres in the 3 countries.

Methods

Nine pilot Meeting Centres (MCs) participated (Italy—5, Poland—2, UK—2). Effectiveness of MCSP was compared with Usual Care (UC) on outcomes measuring behavioural and psychological symptoms (NPI), depression (CSDD), and quality of life (DQoL, QOL‐AD), analysed by ANCOVAs in a 6‐month pre‐test/post‐test controlled trial.

Results

Pre/post data were collected for 85 people with dementia and 93 carers (MCSP) and 74 people with dementia /carer dyads' receiving UC. MCSP showed significant positive effects for DQoL [Self‐esteem (F = 4.8, P = 0.03); Positive Affect (F = 14.93, P < 0.00); Feelings of Belonging (F = 7.77, P = 0.01)] with medium and large effect sizes. Higher attendance levels correlated with greater neuropsychiatric symptom reduction (rho = 0.24, P = 0.03) and a greater increase in feelings of support (rho = 0.36, P = 0.001).

Conclusions

MCSPs showed significant wellbeing and health benefits compared with UC, building on the evidence of effectiveness from the Netherlands. In addition to the previously reported successful implementation of MCSP in Italy, Poland, and the UK, these findings suggest that further international dissemination of MCSP is recommended.     

Gender differences in psychiatric comorbidity: a population‐based study of 40 000 adults with attention deficit hyperactivity disorder

Objective

We aimed at determining whether gender modified associations between ADHD and psychiatric comorbidities in adults.

Method

We identified adults with ADHD by linking Norwegian national registries and compared them with the remaining adult population (born 1967–1997, ADHD and bipolar during 2004–2015, other psychiatric disorders 2008–2015). Prevalence differences (PDs) and prevalence ratios (PRs) of psychiatric disorders were determined by Poisson regression. Interaction by gender was evaluated on additive (PDs) and multiplicative (PRs) scales. Proportions of psychiatric disorders attributable to ADHD were calculated.

Results

We identified 40 103 adults with ADHD (44% women) and 1 661 103 adults (49% women) in the remaining population. PDs associated with ADHD were significantly larger in women than in men for anxiety, depression, bipolar and personality disorders, for example depression in women: 24.4 (95% CI, 23.8–24.9) vs. in men: 13.1 (12.8–13.4). PDs were significantly larger in men for schizophrenia and substance use disorder (SUD), for example SUD in men: 23.0 (22.5–23.5) vs. in women: 13.7 (13.3–14.0). Between 5.6 and 16.5% of psychiatric disorders in the population were attributable to ADHD.

Conclusion

The association between ADHD and psychiatric comorbidities differed significantly among men and women. Clinicians treating adults with ADHD should be aware of these frequent and gender‐specific comorbidities, such that early treatment can be offered.     

Development of a short form of the Attitudes to Ageing Questionnaire (AAQ)

Objectives

The original 24‐item Attitudes to Aging Questionnaire (AAQ) is well established as a measure of attitudes to aging, comprising domains of psychosocial loss (PL), physical change (PC), and psychological growth (PG). This paper presents a new 12‐item short form Attitudes to Aging Questionnaire (AAQ‐SF).

Methods

The original field trial data used to develop the 24‐item AAQ (AAQ‐24) were used to compare 6‐item, 9‐item, and 12‐item versions of AAQ‐SF (sample 1, n = 2487) and to test the discriminative validity of the selected 12‐item AAQ‐SF (sample 2, n = 2488). Data from a separate study reporting on the AAQ‐24 (sample 3, n = 792) verified the analyses.

Results

The 12‐item AAQ‐SF reported adequate internal consistency in both sample 1 (PL α = .72, PC α = .72, and PG α = .62) and sample 3 (PL α = .68, PC α = .73, and PG α = .61). The AAQ‐SF functioned consistently with the profile of the AAQ‐24 in that subscales in both formats of this measure discriminate between respondents on key parameters such as depression, subjective health status, and overall quality of life in sample 2. Sample 3 also demonstrated the AAQ‐SF can detect the differences in attitudes toward aging between individuals experiencing anxiety and depression and those without psychological symptoms. Confirmatory factor analysis confirmed that the structure of the AAQ‐SF mirrors that of the original 24‐item AAQ.

Conclusions

The AAQ‐SF is a robust measure of attitudes toward aging, which can reduce respondent burden when used within longer questionnaire batteries or longitudinal research. Copyright © 2017 John Wiley & Sons, Ltd.     

Impact of attention-deficit/hyperactivity disorder on the patient and family: results from a European survey

Background

Children with attention-deficit/hyperactivity disorder (ADHD) often experience problems with education, interaction with others and emotional disturbances. Families of ADHD children also suffer a significant burden, in terms of strain on relationships and reduced work productivity. This parent survey assessed daily life for children with ADHD and their families.

Method

This pan-European survey involved the completion of an on-line questionnaire by parents of children (6–18 years) with ADHD (ADHD sample) and without ADHD (normative population sample). Parents were questioned about the impact of their child's ADHD on everyday activities, general behaviour and family relationships.

Results

The ADHD sample comprised 910 parents and the normative population sample 995 parents. 62% of ADHD children were not currently receiving medication; 15% were receiving 6–8 hour stimulant medication and 23% 12-hour stimulant medication. Compared with the normative population sample, parents reported that ADHD children consistently displayed more demanding, noisy, disruptive, disorganised and impulsive behaviour. Significantly more parents reported that ADHD children experienced challenges throughout the day, from morning until bedtime, compared with the normative population sample. Parents reported that children with ADHD receiving 12-hour stimulant medication experienced fewer challenges during early afternoon and late afternoon/early evening than children receiving 6–8 hour stimulant medication; by late evening and bedtime however, this difference was not apparent. ADHD was reported to impact most significantly on activities such as homework, family routines and playing with other children. All relationships between ADHD children and others were also negatively affected, especially those between parent and child (72% of respondents). Parents reported that more children with ADHD experienced a personal injury in the preceding 12 months, including those requiring the attention of healthcare professionals. Although 68% of parents were satisfied with their child's current treatment, 35–40% stated that their child's ADHD symptoms needed to be more effectively treated during the afternoon and evening.

Conclusion

This parent survey highlights the breadth of problems experienced by ADHD children and the impact throughout the day on both activities and relationships. Therefore, there is a need for treatment approaches that take into account the 24-hour impact of the disorder and include all-day coverage with effective medication.     

Validation of the Mood and Feelings Questionnaire (MFQ) and Short Mood and Feelings Questionnaire (SMFQ) in New Zealand help‐seeking adolescents

Objective

This study examines the reliability and validity of the Mood and Feelings Questionnaire (MFQ) and Short Mood and Feelings Questionnaire (SMFQ) for measuring depression in New Zealand help‐seeking adolescents.

Method

A sample of 183 adolescents completed the 33‐item MFQ, which includes all 13 items on the SMFQ, at three time points during a trial of a computerized intervention for depression.

Results

Both the MFQ and SMFQ demonstrated good to excellent Cronbach's alphas, moderate to strong item‐total score correlations, moderate to strong correlations with quality of life and anxiety measures, and strong correlations with the clinician‐rated Children's Depression Rating Scale—Revised and the Reynolds Adolescent Depression Scale 2 at all time points, indicating good reliability and content, convergent, and concurrent validities, respectively. Favoring sensitivity over specificity, the optimal cut‐off value for differentiating depressed from nondepressed cases for the MFQ was ≥28 and for the SMFQ was ≥12. Both instruments demonstrated satisfactory diagnostic accuracy and sensitivity to change.

Conclusion

The MFQ and SMFQ are free and simple instruments that can be used to identify depression and measure symptom change in New Zealand help‐seeking adolescents.

     

The behavioural profile of children with attention-deficit/hyperactivity disorder and of their siblings

The behavioural profiles in N = 69 index children with attention-deficit/hyperactivity disorder (ADHD), N = 32 siblings with ADHD, N = 35 siblings without ADHD, and N = 36 normal controls were compared by the use of standardized parent and teacher rating scales. The four groups were matched by age and IQ. The behavioural profiles of the two ADHD groups were very similar not only in the behavioural domains of ADHD, but also in scales measuring emotional and conduct problems. Siblings without ADHD shared more similarities with normal controls except for more emotional problems. These general trends were stronger in the parent compared to the teacher ratings. These findings indicate that not only ADHD-related but also other behaviours show a strong family aggregation. The informant differences may reflect context dependent differences in child behaviour and contrast effects particularly in parental ratings.     

Impact of falls on depressive symptoms among the oldest old: Results from the AgeQualiDe study

Objective

The purpose of this study was to examine the impact of falls on depressive symptoms among the oldest old in Germany longitudinally.

Methods

Data were used from 2 waves of the multicenter prospective cohort “Study on needs, health service use, costs and health‐related quality of life in a large sample of oldest‐old primary care patients (85+)” (AgeQualiDe). This study covers primary care patients ≥85 years (at baseline: n = 547, average age of 88.9 ± 3.0 years; ranging from 85 to 100 years). General practitioner‐diagnosed falls were used as explanatory variable. The Geriatric Depression Scale was used as outcome measure.

Results

Linear fixed effects regressions showed that the occurrence of falls is associated with an increase in depressive symptoms (β = .60, P = .02), whereas changes in marital status, ageing, social support, functional decline (instrumental activity of daily living), cognitive impairment, and an increase in chronic diseases did not affect depressive symptoms. In sensitivity analysis, an increase in depressive symptoms was associated with functional impairment (basic activities of daily living; Barthel index; β = ?.04, P = .005).

Conclusions

Based on a large, population‐based longitudinal study, this study underlined the impact of falls on depressive symptoms and consequently extended previous knowledge about an association between falls and depressive symptoms in the oldest old. Developing strategies to prevent falls might also help to prevent depressive symptoms.     

Evaluation of maternal inflammation as a marker of future offspring ADHD symptoms: A prospective investigation

Early life predictors of attention-deficit/hyperactivity disorder (ADHD) are critically needed; they could inform etiological theory and may help identify new prevention targets. The current study examined prospectively whether maternal cytokine levels during pregnancy predict offspring ADHD symptoms at age 4–6 years. Secondarily, we evaluated maternal cytokine levels as a possible common pathway through which prenatal risks exert influence on child ADHD. Data came from a sample of women recruited during the 2nd trimester of pregnancy (N = 62) and followed postnatally until children were 4–6 years old. Maternal inflammation was assessed using 3rd trimester plasma concentrations of three indicators of nuclear factor kappa B signaling: interleukin-6, tumor necrosis factor-alpha, and monocyte chemoattractant protein-1 which were combined into a latent variable. Mothers and teachers reported on child ADHD symptoms, negative affect, and externalizing behaviors at 48–72 months of age. Maternal inflammation in the 3rd trimester predicted ADHD symptoms when children were 4–6 years old (β = 0.53, 95% CI = 0.154, 0.905, p = 0.006). Further, maternal inflammation mediated the effect of prenatal distress on child ADHD (β = 0.21, 95% CI = 0.007, 0.419, p = 0.04). The inflammation effect on ADHD was not explained by concurrent child negative affect, externalizing behavior, or familial ADHD status. This is the first human study to prospectively link maternal pregnancy cytokine levels and offspring ADHD symptoms, suggesting that cytokine levels are a possible marker of ADHD risk. Results also provide new evidence that maternal prenatal inflammation may be one common pathway by which prenatal risk factors influence offspring mental health outcomes.     

The generation gap in numbers: parent-child disagreement on youth’s emotional and behavioral problems

Objective  

To evaluate discrepancies between parent and child reports on youth’s emotional and behavioral problems in a representative, community based sample of Greek 18-year-olds, and to identify associated factors.     

Externalizing psychopathology and persistence of offending in childhood first-time arrestees

This study aims to investigate the predictive validity of externalizing psychopathology for persistence in delinquent behavior when controlling for socio-demographic and first arrest characteristics in childhood first-time arrestees. A sample of first-time arrestees aged under 12 (n = 192) was assessed using the Diagnostic Interview Schedule for Children (DISC-IV) parent-version on attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD). Based on child and parent reports of offending as obtained at arrest and at 2-year follow-up, three groups of offenders were differentiated: (1) persistent high (n = 48), (2) occasional (n = 62), and (3) persistent low offenders (n = 82). Over one-third of the sample (33.9%) was diagnosed with an externalizing disorder, and 13.5% with both ADHD and ODD or CD. Higher levels of externalizing psychopathology distinguished persistent high offenders from occasional (comorbid ADHD and ODD/CD: OR 8.2, CI 2.6–25.5) and persistent low offenders (comorbid ADHD and ODD/CD: OR 18.2, CI 4.6–72.3; ADHD: OR 4.1, CI 1.3–13.0), over and above socio-demographic and first offense characteristics. Living with both biological parents distinguished the persistent low offenders from the occasional offenders (OR 2.5, CI 1.2–5.0). Since the prevalence of externalizing disorders was high and predicted re-offending, mental health screening and intervention initiatives, aiming at these conditions, should be investigated for this high-risk sample.     

Autism spectrum disorder symptoms in children with ADHD: A community-based study

This study examined the prevalence of autism spectrum disorder (ASD) symptoms in a community-based sample of children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls. We also examined the relationship between ASD symptoms and ADHD subtype, ADHD symptom severity and child gender. Participants were 6–10-year-old children (164 ADHD; 198 non-ADHD control) attending 43 schools in Melbourne, Australia, who were participating in the Children's Attention Project. ADHD was assessed in two stages using the parent and teacher Conners’ 3 ADHD index and the Diagnostic Interview Schedule for Children IV (DISC-IV). ASD symptoms were identified using the Social Communication Questionnaire (SCQ). Unadjusted and adjusted linear and logistic regression examined continuous and categorical outcomes, respectively. Children with ADHD had more ASD symptoms than non-ADHD controls (adjusted mean difference = 4.0, 95% confidence interval (CI) 2.8; 5.3, p < 0.001, effect size = 0.7). Boys with ADHD had greater ASD symptom severity than girls with ADHD (adjusted mean difference = 2.9, 95% CI 0.8; 5.2, p = 0.01, effect size = 0.4). Greater ADHD symptom severity was associated with greater ASD symptom severity (regression co-efficient = 1.6, 95% CI 1.2; 2.0, p < 0.001). No differences were observed by ADHD subtype. Greater hyperactive/impulsive symptoms were associated with greater ASD symptoms (regression coefficient = 1.0; 95% CI 0.0; 2.0, p = 0.04) however, this finding attenuated in adjusted analyses (p = 0.45). ASD symptoms are common in children with ADHD. It is important for clinicians to assess for ASD symptoms to ensure appropriate intervention.     

Objective Sleep Measurement in Typically and Atypically Developing Preschool Children with ADHD-Like Profiles

Objective This study investigated the association between preschool children’s sleep patterns measured by actigraphy and parent-reported hyperactivity symptoms. Many previous studies have reported sleep problems in children with attention deficit hyperactivity disorder (ADHD)-like symptoms. Methods This study examined a cross-sectional sample of 186 preschoolers age 2–5 years in three groups: children with autism, children with developmental delay without autism, and typically developing children recruited from the general population. One week of actigraphic sleep data plus a parent report of the presence or absence of a current sleep problem were collected. Parents completed the child behavior checklist; a subset of children in preschool had teachers who completed the caregiver-teacher report form. Sleep behavior was compared for those children with and without clinical levels of attention-deficit/hyperactivity symptoms (T scores ≥65). Results The prevalence of a parent-defined sleep problem across the entire sample was 36.1%. Thirty-four percent of the sample had a parent-reported ADHD composite in the clinical range. Those children with a clinical ADHD profile were more likely to be described by parents as having a sleep problem. However, no significant differences in actigraphic sleep patterns or night-to-night sleep-wake variability were found for children with an ADHD profile in the clinical range. Conclusions In this non-clinical sample of preschool age children, parental reports of clinical ADHD profiles were significantly associated with parental reports of sleep problems but not with actigraphically recorded sleep-wake data.     

Change in depression across adolescence: The role of early anger socialization and child anger

The purpose of this longitudinal study was to examine the relations of early socialization of anger with change in adolescent depression, and moderation by child anger. Using a sample of low-income, ethnic minority children at familial risk for psychopathology in the United States (n = 92; ages 3–5; 53% female; 65% African American; 27% Latina/o), early anger socialization (i.e., parent response to child anger) was tested as a predictor of change in depression from preadolescence to adolescence [i.e., age 8 (n = 63), 11 (n = 58), and 13 (n = 44)]. A videotaped parent-child interaction was coded for parental socialization of preschooler anger, and psychiatric interviews of depression were conducted three times across preadolescence and adolescence. Major depression diagnoses increased from preadolescence to adolescence. Latent growth modeling indicated parent discouragement of child anger was a significant predictor of an increase in the child's later depression from preadolescence to adolescence, and child anger intensity was a significant moderator.     

Telephone‐based management of chronic pain in older adults in an integrated care program

Objective

Few studies have explored behavioral strategies for managing chronic pain in older adults. Pain Care Management (PCM) is a telephone‐based behavioral intervention for chronic pain. The present study examined chronic pain characteristics among older adults and tested the delivery of PCM as an adjunct to depression and anxiety care management.

Methods

Participants were drawn from a state‐sponsored program offering care management services to community members aged 65 and older who were prescribed a psychotropic medication by a primary care provider. Chronic pain information was collected for all participants in the state program (N = 250) and treatment outcome data were collected for a subset with significant chronic pain. Eighty participants with high chronic pain interference were offered PCM and compared to 80 participants with chronic pain who received monitoring only on depression, anxiety, and pain interference outcomes.

Results

Chronic pain was identified in 14% of older adults newly prescribed a psychotropic medication. Compared to monitoring only, PCM participants had higher odds of seeing a reduction of 2 or more points in pain interference at 6 months. Pain care management participants' anxiety scores significantly decreased over the study period.

Conclusions

Older adults treated with psychotropic medications often also experience chronic pain that interferes with daily activities. A telephone‐based care management intervention is acceptable and feasible with an older community‐based population and can lead to improvements in anxiety symptoms and interference from chronic pain. Further research will help to refine interventions that may help improve symptoms and increase functioning with this population.     

Mitochondrial DNA m.13514G>A heteroplasmy is associated with depressive symptoms in the elderly

Objectives

Mitochondrial DNA (mtDNA) heteroplasmy is a mixture of normal and mutated mtDNA molecules in a cell. High levels of heteroplasmy at several mtDNA sites in complex I lead to inherited neurological neurologic diseases and brain magnetic resonance imaging (MRI) abnormalities. Here, we test the hypothesis that mtDNA heteroplasmy at these complex I sites is associated with depressive symptoms in the elderly.

Methods

We examined platelet mtDNA heteroplasmy for associations with depressive symptoms among 137 participants over age 70 from the community‐based Health, Aging and Body Composition Study. Depressive symptoms were assessed using the 10‐point version of the Center for Epidemiologic Studies Depression Scale (CES‐D 10). Complete mtDNA sequencing was performed and heteroplasmy derived for 5 mtDNA sites associated with neurologic mitochondrial diseases and tested for associations with depressive symptoms.

Results

Of 5 candidate complex I mtDNA mutations examined for effects on depressive symptoms, increased heteroplasmy at m.13514A>G, ND5, was significantly associated with higher CES‐D score (P = .01). A statistically significant interaction between m.13514A > G heteroplasmy and sex was detected (P = .04); in sex‐stratified analyses, the impact of m.13514A>G heteroplasmy was stronger in male (P = .003) than in female (P = .98) participants. Men in highest tertile of mtDNA heteroplasmy exhibited significantly higher (P = .0001) mean ± SE CES‐D 10 scores, 5.37 ± 0.58, when compared with those in the middle, 2.13 ± 0.52, and lowest tertiles, 2.47 ± 0.58. No associations between the 4 other candidate sites and depressive symptoms were observed.

Conclusions

Increased mtDNA heteroplasmy at m.13514A>G is associated with depressive symptoms in older men. Heteroplasmy may represent a novel biological risk factor for depression.     

The occurrence and persistence of thoughts of suicide,self‐harm and death in family caregivers of people with dementia: a longitudinal data analysis over 2 years

Objective

Family caregivers of people with dementia often report high levels of stress and depression, but little is known about those who contemplate suicide or self‐harm. This study explores thoughts of suicide, self‐harm and death in dementia caregivers and investigates the characteristics that distinguish them from those without such thoughts.

Methods

Data were collected every 3 months, for 24 months, from 192 family caregivers of people with dementia living in the Netherlands. Caregivers did not have a clinical depression or anxiety disorder at baseline. Suicide‐related thoughts were measured with an item from the Mini International Neuropsychiatric Interview, a diagnostic instrument for DSM‐IV mental disorders. Fisher exact, analysis of variance or Kruskal–Wallis tests compared the characteristics of caregivers who had contemplated suicide with two comparison groups.

Results

Within 24 months, 76 caregivers reported symptoms of a potential depression and were further assessed for suicidal thoughts. Nine carers (11.8%, 4.7% of the total sample) reported suicidal thoughts with three of those at multiple points. Caregivers with suicidal thoughts had more severe depressive and anxious symptoms, had a lower sense of competence and mastery, felt less happy and experienced more health problems, less family support and more feelings of loneliness than caregivers who had not.

Conclusion

Suicidal thoughts are present in dementia caregivers and can persist across the care trajectory. Various psychological and social characteristics significantly distinguish caregivers with suicidal thoughts from those without. More research is needed to enable the identification of high‐risk caregivers and provide an evidence base for the development of preventive strategies and interventions. © 2017 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.     

The Impact of Depressive Symptoms in Adults with ADHD Symptoms on Family Function and ADHD Symptoms of Their Children

Objective

People with attention-deficit/hyperactivity disorder (ADHD) exhibit considerable impairment in social, academic, or occupational functioning. The present study aimed to examine the patterns of associations between ADHD symptoms, depression, and family functioning.

Methods

The sample consisted of 1,022 adults randomly selected from a district in Seoul, South Korea. Several self-assessment scales were utilized to rate ADHD symptoms (both past and current), current symptoms of depression, and level of family functioning. ADHD symptoms in the children of these participants were also assessed. Pearson''s correlation and multiple linear regression analyses were performed; structural equation modeling (SEM) was conducted to determine the best fitting model.

Results

Adult ADHD symptoms were positively associated with depressive symptoms. Depressive symptoms, in turn, mediated the relationship between adult ADHD symptoms and cohesion among family members. In addition, depressive symptoms mediated the relationship between adult ADHD symptoms and their children''s ADHD symptoms.

Conclusion

The relationship between adult ADHD symptoms and family dysfunction may be influenced by depressive symptoms. When treating ADHD in adults, clinicians should pay attention to the presence or absence of depression.     

Association of recent gay‐related stressful events and emotional distress with suicidal behaviors over 12 months in Chinese men who have sex with men

Introduction

The study was designed to assess the association of gay‐related stressful events (GRSEs) and emotional distress with suicidal behaviors over a 12‐month period in Chinese men who have sex with men (MSM).

Methods

A total of 807 MSM were recruited using a respondent‐driven sampling method from 4 cities in northeastern China. The GRSEs were measured using the Gay‐related Stressful Life Events Scale, depression using the Self‐rating Depression Scale, and anxiety using the Self‐rating Anxiety Scale.

Results

A total of 26.0% of study participants experienced GRSEs during the 3 months, and their average Self‐rating Depression Scale and Self‐rating Anxiety Scale scores were significantly lower than the national norms. Over a 12‐month period, the prevalence of suicidal ideation, plan, and attempt was 9.7%, 4.0%, and 3.0%, respectively, each of which is at least 3 to 4 times greater than that of male adults in the general population of China. Multiple logistic regression analysis showed that GRSEs significantly increased the risk of suicidal ideation (odds ratio [OR] = 2.3, 95% confidence interval [CI], 1.4‐3.7) and plan (OR = 2.8, 95% CI, 1.3‐6.0). Depressive symptoms significantly increased the risk of suicidal ideation (OR = 3.5, 95% CI, 2.1‐5.8), plan (OR = 4.4, 95% CI, 2.0‐9.6), and attempt (OR = 5.6, 95% CI, 21.94.8). Anxiety symptoms (OR = 3.4, 95% CI, 1.4‐8.4) and cohabitation with a same sex partner (OR = 3.0, 95% CI, 1.2‐7.9) significantly increased the risk of suicide attempt.

Discussion

More efforts to reduce GRSE are worth investigating as a strategy to reduce suicidal thoughts and behaviors in Chinese MSM.