Differences In Suicidal Behavior Research Articles

Cognitive function and suicide risk in Han Chinese inpatients with schizophrenia

The lifetime risk of suicide in patients with schizophrenia is estimated to be 4.9–13%. While there are many known risk factors for suicide in schizophrenia, the relationship between cognitive function and suicide risk is unclear, particularly in non-Caucasian populations. In our cross-sectional study, we administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to 316 Han Chinese chronic inpatients with schizophrenia and compared the performance of those who had attempted suicide (n=25) to non-attempters (n=291). The lifetime suicide attempt data were collected from medical records and interviews with patients and their family members. We found a lifetime suicide attempt rate of 7.9%. Suicide attempters were more likely to be single, but showed no significant differences in other demographic factors such as age, gender, or living arrangements. Contrary to our hypothesis, there was no significant relationship between performance on the RBANS test and lifetime risk of suicide attempts in Han Chinese inpatients with schizophrenia. The literature remains mixed on this topic. Culturally influenced differences in suicidal behavior may have affected the outcome of this study and further investigation of this topic is necessary.

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

ObjectiveSuicide in adolescents is a major problem worldwide. The purpose of this study was to identify differences in suicidal behaviors with respect to parental marital status. MethodsThe data used in this study were obtained from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) of middle and high school students in 2010. Using a national representative sample, this study analyzed data from 73,238 subjects. With respect to gender, the odds ratios of suicidal behavior were calculated based on the parental marital status, living situation, and family affluence scale (FAS). ResultsAfter adjusting for age, achievement, sadness, and substance use, the prevalence of suicidal ideation in adolescents with a remarried parent significantly increased among boys to 1.364 [95% confidence interval (CI)=1.027–1.813] and among girls to 1.511 (95% CI=1.215–1.879). The odds ratio of suicide attempts increased to 1.808 (95% CI=1.119–2.923) for adolescent boys and to 1.947 (95% CI=1.609–2.356) for adolescent girls. However, having a single parent did not affect the prevalence of suicidal ideation in either gender. In girls, as family affluence decreased, the odds ratio of suicidal ideation notably increased. For girls whose families were in a low tier of the FAS, the odds ratio of both suicidal ideation and suicide attempts increased. ConclusionsBoth boys and girls were more likely to report suicidal ideation and attempts after a parent’s remarriage, whereas family affluence was inversely related to suicidal ideation and attempts in girls.

Buried Above Ground: A University-Based Study of Risk/Protective Factors for Suicidality Among Sexual Minority Youth in Canada

This study examined differences in suicidal behavior between lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) and non-LGBTQ university students as well as investigated the importance of risk and protective factors in the prediction of suicidality between these two groups. A total of 1,205 university students participated in the survey. Findings show, compared to non-LGBTQ respondents, sexual minority youth are at a greater risk for serious suicidal ideation (8.9% versus 23%, respectively) and suicide attempt (3.5% versus 26.2%). Among LGBTQ respondents, significant risk covariates for suicidality were depressive symptoms, socioeconomic status, being bullied, age, and childhood trauma. The only significant protective factor was self-esteem.

Gender differences in suicidal behaviour in patients with first‐episode psychosis

Prior research shows contradictory gender patterns in suicidal behaviour among patients with first-episode psychosis. The aim of this study was to investigate gender differences in the prevalence of suicidal behaviour (suicidal ideation, suicide plans and suicide attempts) and to delineate risk factors for suicidal behaviour among consecutively included male and female patients with first-episode psychosis in the TIPS II early detection study. Patients with first-episode psychosis (n = 246) from a hospital catchment area with a system for early detection were assessed and compared on baseline sociodemographical and clinical variables according to gender. Current (past 1 month) and lifetime prevalence of suicidal behaviour were assessed. Current and lifetime rates of suicidal behaviour were high (50.8% and 65.9%, respectively) and higher among females (lifetime: 78.3 %, past month: 64.2 %) versus males (lifetime: 56.4 %, past month: 40.7 %). Depressive symptoms and female gender were associated with both lifetime and current risk for suicidal behaviour. Lifetime prevalence was also associated with a longer duration of untreated psychosis and young age after controlling for other risk factors. Suicidal behaviour was frequent among patients with first-episode psychosis, with a higher prevalence of suicidal behaviour in females. Depressive symptoms and female gender were significantly associated with suicidal behaviour.

Racial and ethnic differences in risk factors associated with suicidal behavior among young adults in the USA

Objective. The objectives of this study are to examine racial and ethnic differences in suicidal behaviour, its main risk factors, and the effect of the risk factors on suicidal behaviour in young adults in the United States.Design. Using nationally representative data (n = 10,585) from Add Health, we calculate the prevalence of suicidal behavior and associated risk factors for non-Hispanic White, non-Hispanic Black, and Hispanic youth (aged 18–26) using logistic regression models of suicidal ideation stratified by race.Results. Non-Hispanic White and Hispanic young adults have higher rates of suicidal ideation than their non-Hispanic Black counterparts, but racial/ethnic differences in attempts are not statistically significant. Non-Hispanic Whites and Hispanic young adults are more likely to possess key risk factors for suicide. With the exception of substance use variables (i.e. alcohol and marijuana use) which appear to be more conducive to suicidal ideation in non-Hispanic Black than in non-Hispanic White young adults, the effects of risk factors appear to be similar across race/ethnicity.Conclusion. The higher prevalence of suicidal ideation in non-Hispanic White and Hispanic young adults may be driven by their greater exposure to risk factors, as opposed to differences in the effects of these risk factors. More research is needed to uncover why non-Hispanic White and Hispanic young adults have higher rates of suicidal ideation than their non-Hispanic Black counterparts; yet, rates of suicide attempts are comparable and non-Hispanic White young adults have the highest rate of completed suicides.

S09 * GENDER DIFFERENCES IN ALCOHOLISM I

S09 * GENDER DIFFERENCES IN ALCOHOLISM I

'Plue plun' male, 'kath klei' female: gender differences in suicidal behavior as expressed by young people in Cambodia.

Few studies from low- and middle-income countries use qualitative methodology to explore suicidal behavior among young people. In Cambodia, young people face the challenge of rapidly changing times and are vulnerable for suicidal behavior as revealed by research in transitional economies. This study seeks to gain a deeper understanding of the suicidal phenomena from a gender, psychosocial and cultural perspective. Six focus-group discussions were conducted among boys and girls, aged 15–19 years, in two secondary schools in a suburban area close to Phnom Penh, the capital city. The data was analyzed using thematic analysis approach. The participants highlighted the gender difference in suicidal behavior by describing the suicide-prone, acting-out male as ‘plue plun’, while suicide-prone females were described as caught in constricted, tunneled-thinking behavior, expressed as ‘kath klei’. Parental attitude and family environment were also pointed out as the chief causes of discontent and there was a strong wish on the part of young people to find space for modern values within the traditional family. The young people's awareness of their challenges in everyday life suggests that school-based programs to prevent suicidal behavior ought to be gender-sensitive and peer-focused.

Pesticides availability and medically serious suicide attempts in China.

Pesticides availability and medically serious suicide attempts in China.

School performance and gender differences in suicidal behaviour – a 30-year follow-up of a Stockholm cohort born in 1953

Astonishingly little is known about the relationship between high educational achievements and suicidal behaviour among women. This is remarkable given that a woman breaking into traditionally male-dominant spheres is a well established example of social-role marginality. The current study combines fatal and non-fatal suicidal behaviour and analyses, by means of logistic regression, the degree to which high school performance during pre-adolescence in the mid-1960s, in Sweden, had a detrimental effect on suicidal behaviour for women, as opposed to men, in adolescence and young adulthood. The Stockholm birth cohort study was used for this purpose. The results show that girls with both above and below average marks had an elevated risk of engaging in suicidal behaviour. However, this relation only held for girls who had grown up with supportive parental ambitions in terms of educational commitment. For boys, only low school performance was shown to be suicidogenic, irrespective of parental ambitions.

Life cycle and suicidal behavior among women.

It is nowadays accepted that, independently of methodological issues, women commit fewer suicides than men but make more frequent attempts. Yet, female suicidal risk varies greatly along the lifetime and is linked to the most significant moments in it. A wide analysis of the existing literature was performed to provide a narrative description on the evolution of female suicidal rates from childhood to old age, considering the milestones in their life history. A detailed analysis of gender differences in suicidal behavior is key to establish preventive measures and priorities. More specific studies are needed to adapt future interventions on female suicide.

Stoicism and sensation seeking: Male vulnerabilities for the acquired capability for suicide

Our aim was to investigate two personality traits (i.e., stoicism and sensation seeking) that may account for well-established gender differences in suicide, within the framework of the interpersonal theory of suicide. This theory proposes that acquired capability for suicide, a construct comprised of pain insensitivity and fearlessness about death, explains gender differences in suicide. Across two samples of undergraduates (N=185 and N=363), men demonstrated significantly greater levels of both facets of acquired capability than women. Further, we found that stoicism accounted for the relationship between gender and pain insensitivity, and sensation seeking accounted for the relationship between gender and fearlessness about death. Thus, personality may be one psychological mechanism accounting for gender differences in suicidal behavior.

Additional Effect Size Measures Helpful in Understanding Lithium and Valproate Trial Results

Back to table of contents Previous article Next article Communications and UpdatesFull AccessAdditional Effect Size Measures Helpful in Understanding Lithium and Valproate Trial ResultsEric G. Smith, M.D., M.P.H.Eric G. SmithWorcester, Mass.Search for more papers by this author, M.D., M.P.H.Published Online:1 Jan 2012https://doi.org/10.1176/appi.ajp.2011.11081263AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: The article by Oquendo et al. (1) in the October 2011 issue of the Journal deserves commendation for tackling one of the preeminent questions in psychiatry: whether certain psychiatric medications help to reduce suicidal behaviors. Oquendo and colleagues' randomized controlled trial was foresightedly conceived and initiated more than a decade ago, and I applaud the efforts of both the research staff and the patients (some of whom agreed to receive double-blind medication for more than 2 years!) involved in this important study.However, an unfortunate limitation of the published report from Oquendo et al. is the lack of hazard ratios or other measures of effect size. Such information would be valuable, despite the lack of statistical power, because even underpowered findings are important to incorporate in later meta-analyses. In addition, the Oquendo et al. study is the first trial comparing lithium and valproate with a primary outcome of suicidal behavior, and even an underpowered finding would help inform future research. While it is also true that assumptions concerning proportional hazards may not be met for this study, given the intersection of survival curves in Figure 2, this can sometimes be addressed by breaking the curves into shorter time frames. We would like to request that the authors provide, if possible, hazard ratios or another measure of effect size for their reported outcomes, especially the time to first suicide attempt (since examining suicidal behavior alone, rather than outcomes including prophylactic hospitalizations, has previously been a more sensitive measure for detecting differences in suicidal behavior among medications [2]).In addition, the authors powered their study for a 1:5 difference in suicidality and argue that even a 1:2 difference might be clinically important. However, I would argue that even a 20% difference in suicide or suicidal behavior risks between psychiatric agents—if reliably demonstrated—may prove clinically significant. A 20% difference was the target for the International Suicide Prevention Trial study (2), and it remains relevant today. While Oquendo et al. are right to address concerns of overdose toxicity, thus far the Baldessarini et al. (3) meta-analysis points to decreases in suicide deaths as well as suicidal behavior in lithium recipients and a decreasing ratio of suicides to suicide attempts. These patterns seem the opposite of what we would expect if overdose toxicity clearly outweighed the possible clinical and behavioral benefits of lithium.Clearly the important field of psychiatric medication and suicide risk warrants continued investigation; further detail about the results (e.g., hazard ratios) from Oquendo and colleagues' valuable trial would be an important step.Worcester, Mass.Dr. Smith has received a career development award with research funding and salary support from Veterans Health Administration and has received grant funding from Forest Research Institute, an affiliate of Forest Pharmaceuticals.Accepted for publication in October 2011.

Suicidality, ethnicity and immigration in the USA

Suicide is the 11th leading cause of death in the USA. Suicide rates vary across ethnic groups. Whether suicide behavior differs by ethnic groups in the USA in the same way as observed for suicide death is a matter of current discussion. The aim of this report was to compare the lifetime prevalence of suicide ideation and attempt among four main ethnic groups (Asians, Blacks, Hispanics, and Whites) in the USA. Suicide ideation and attempts were assessed using the World Mental Health version of the Composite International Diagnostic Interview (WMH-CIDI). Discrete time survival analysis was used to examine risk for lifetime suicidality by ethnicity and immigration among 15 180 participants in the Collaborative Psychiatric Epidemiological Surveys (CPES), a group of cross-sectional surveys. Suicide ideation was most common among Non-Hispanic Whites (16.10%), least common among Asians (9.02%) and intermediate among Hispanics (11.35%) and Non-Hispanic Blacks (11.82%). Suicide attempts were equally common among Non-Hispanic Whites (4.69%), Hispanics (5.11%) and Non-Hispanic Blacks (4.15%) and less common among Asians (2.55%). These differences in the crude prevalence rates of suicide ideation decreased but persisted after control for psychiatric disorders, but disappeared for suicide attempt. Within ethnic groups, risk for suicidality was low among immigrants prior to migration compared to the US born, but equalized over time after migration. Ethnic differences in suicidal behaviors are explained partly by differences in psychiatric disorders and low risk prior to arrival in the USA. These differences are likely to decrease as the US-born proportion of Hispanics and Asians increases.

Physical and Psycho-Social Predictors of Adolescents’ Suicide Behaviors

The current study examined the relationship between suicidal behaviors and physical and psycho-social predictors including body image, weight control behaviors, and risky sexual behaviors among Asian, African American, Caucasian, and Hispanic adolescents. This study used the 2007 Youth Risk Behavior Survey (YRBS). The target populations were 11,134 adolescents (5,636 female and 5,498 male) in 9th–12th grade who completed the survey. A linear regression was conducted to examine the correlation between predictors and suicidal behaviors. The results showed that gender, grade, depression, substance use, body image, weight control behaviors, and risky sexual behaviors were significant predictors of adolescents’ suicidal behaviors, while race/ethnicity was not a good predictor. Also, there were significant gender and grade differences in suicidal behaviors. Based on the results, practice implications for suicide prevention were discussed.

Deliberate self-harm in rural and urban regions: A comparative study of prevalence and patient characteristics

In countries like the UK, people living in urban regions are more likely to suffer poor physical and mental health than rural populations, and to have increased rates of psychiatric disorder. Urban/rural differences in suicidal behaviour have most frequently focussed on variations in the occurrence of suicide. We have investigated rates of deliberate self-harm (DSH) in urban and rural districts of Oxfordshire, England, and compared characteristics of DSH patients resident in these two areas. Information was collected on 6833 DSH episodes by 4054 persons aged 15 years and over presenting to the local general hospital between 2001 and 2005. We found that urban DSH rates were substantially higher than rural rates amongst both males and females aged between 15 and 64 years. This relationship was sustained even when socio-economic deprivation and social fragmentation were taken into account. There was little difference between urban and rural rates for patients aged 65 years and over. Urban DSH patients were more likely to be younger, non-white in ethnic origin, unemployed, living alone, to have a criminal record, to have previously engaged in DSH, and to report problems with housing. Rural DSH patients were more likely to suffer from physical illness, and to have higher suicide intent scores. Results of studies such as this can help identify where resources for preventive initiatives should be primarily directed and also what types of individuals may be at most risk in different areas. However, since variation by area will in part be due to differences at the individual level, further research utilising multi-level modelling techniques would be useful.

A systematic review of suicidal behaviour in old age: a gender perspective

This article presents the findings of a systematic review of the literature on suicidal behaviour in old age, specifically examining gender differences. Background. Numerous studies have reported that older people are at a higher risk for suicide than other age groups in most countries. Rarely do they examine whether there are differences in suicidal behaviour among older males and females. Systematic review. Electronic databases were systematically searched to identify English language reports of research about suicide and suicide attempts in old age. Studies were assessed for inclusion based on inclusion criteria. Key results concerning suicide in old age were extracted and synthesised. Twenty-two gender-specific studies on suicidal behaviour in old age were identified. All studies were of the quantitative type. Five factors affecting suicide by gender in old age were identified from the selected papers. Most findings concluded that older males had a higher risk of suicide than older females. Some findings nevertheless revealed that the risk factors for one socio-demographic group may be less relevant to others and that people operate differently in different social contexts. Further in-depth exploration on the gender-specific characteristics in old-age suicide is recommended. Health professionals are encouraged to increase their knowledge of the risk factors leading to suicide in old age in their local contexts and to be able to identify potential victims and render timely and appropriate intervention. They should also be ready to open up their service boundaries and develop collaborative partnerships with local agencies and the general public.

Chronotype Differences in Suicidal Behavior and Impulsivity Among Suicide Attempters

Morning- and evening-type individuals differ on a number of psychological and biological variables. There has been increasing interest in the relationship between chronotype and personality traits. The aim of this study was to investigate the relationship between impulsivity and chronotype in suicide attempters. Eighty-nine suicide attempters were included in the study, and systematic information on suicide attempts was recorded. The Morningness-Eveningness Questionnaire was applied to determine chronotype, and attempter impulsivity was measured by the total score of the Barratt Impulsiveness Scale. Significant differences between chronotype and impulsivity scores were found. Evening-type subjects reported significantly higher impulsivity scores than both neither- and morning-types. A significant association between chronotype and type of suicide attempt was detected. The largest proportion of violent suicide attempters were evening-type subjects. Violent suicide attempters also reported significantly higher impulsivity scores than nonviolent attempters. Previous studies have pointed out possible relations between eveningness and impulsivity. Current findings suggest that eveningness may be a risk factor for violent suicide attempts by increasing impulsivity. (Author correspondence: dryavuzselvi@yahoo.com)

Suicidal behavior and ethnicity of young females in Rotterdam, the Netherlands: rates and risk factors

Objective. Although Western Europe is becoming increasingly multicultural, ethnic minorities are scarcely included in studies of suicidology. We investigated the prevalence of non-fatal suicidal behavior and examined risk factors in non-western female immigrant adolescents compared to majority female adolescents in the city of Rotterdam, the Netherlands. Design. We conducted logistic regression on a dataset that consisted of self-reported health and well-being questionnaires filled out by 4527 adolescents of Dutch, South Asian-Surinamese, Moroccan, and Turkish origin. We examined whether young females of specific ethnic groups had elevated risk for attempted suicide. Well-known risk factors in suicidology of social economic class, level of education, life events, abuse, and family context were investigated to verify whether these factors are beneficial to explaining ethnic differences in suicidal behavior. Results. We found that rates of attempted suicide among Turkish and South Asian-Surinamese young women were higher than of Dutch females, while Moroccan females had lower rates than Dutch female adolescents. Physical and sexual abuse, and an impaired family environment, as well as parental psychopathology or parental substance abuse contributed to non-fatal suicidal behavior of females across ethnicities. However, these risk factors, as well as low social economic class and of level of education, did not fully explain the vulnerability of Turkish and South Asian-Surinamese females. Conclusion. Our findings underscored the need for developing suicide prevention for specific minority females in multicultural cities in Western Europe. Screening programs, which aim at preventing suicide attempts by young immigrant women should include risk factors in the family environment and relationship with the parents as well as physical and sexual abuse. However, the study also showed that the disproportionate risk of Turkish and South Asian-Surinamese females could not be understood by risk factors alone and transpired that the origins of ethnic disparities in suicidal behavior deserve further examination.

P.3.a.028 Gender differences in suicidal behaviour of patients with depressive disorders

P.3.a.028 Gender differences in suicidal behaviour of patients with depressive disorders

Socio-economic inequalities in suicide attempts and suicide mortality in Québec, Canada, 1990–2005

Little research has evaluated changes in the association between area deprivation and suicidal behaviour over time. This study investigated patterns in suicide attempts and suicide mortality according to material deprivation in the province of Québec, Canada between 1990 and 2005. Ecological analysis. Data on suicide attempts were extracted from the hospital discharge summary database (n=47,516) and data on suicides were extracted from the Québec death file (n=20,851). Gender- and age-specific (10-24, 25-44, 45-64 and > or = 65 years) suicide attempt and mortality rates were calculated for four time periods (1990-1993, 1994-1997, 1998-2001 and 2002-2005) for the entire Québec population aged 10 years and older residing in 162 communities ranked by decile of material deprivation. Absolute and relative measures of inequality were calculated to summarize differences between the most and least materially deprived areas. Commonly used methods of suicidal behaviour were examined. Differentials in suicide attempt hospitalization between the most and least deprived areas were present for all age groups, and these decreased slightly among males and increased among females over time. Inequalities in suicide attempts were greatest among young adults (age 25-44 years) for both genders, and were smallest among the elderly (> or = 65 years). For suicide mortality, differentials increased among females but not males; these differentials were greatest among males and 25-44 year olds, and smallest among the elderly. Differentials in commonly used methods were evident for poisoning hospitalizations in both genders and for hanging deaths among males. In Québec, differences in suicide attempts and mortality between the most and least materially deprived areas persisted or even increased over time. Inequalities were more pronounced for suicide attempts than for suicide mortality, and were greatest among adults of working age. Strategies to reduce socio-economic differences in suicidal behaviour may be important.