Greater Odds Of Suicidal Ideation Research Articles

Suicidal ideation among non-physician hospital system staff: Prevalence and workplace correlates

BackgroundResearch suggests that healthcare workers are at greater risk for suicide than other occupations, but most published studies focus on physicians. This study examines the prevalence of suicidal ideation (SI) and associated occupational factors among a broad group of non-physician healthcare staff. MethodsAn anonymous online survey was sent to a random sample of 30 % of non-physician healthcare staff at a large urban healthcare system between September and November 2022. Weighted multivariable binary logistic regressions were conducted to determine the workplace and mental health factors associated with SI. ResultsThe 1084 respondents included nurses, administrative staff, research staff, medical assistants, nurse practitioners, physician assistants, and other roles. Of the sample, 8.6 % endorsed having SI over the prior two weeks. Results of the regression indicated that, after adjusting for demographic factors, greater odds of SI were associated with physical violence experienced from a patient or visitor (odds ratio [OR] = 2.15, 95 % confidence interval [CI] = 1.06–4.37), lower perceived leadership support (OR = 0.95, 95 % CI = 0.92–0.98), and positive screening for depression (OR = 4.66, 95 % CI = 2.45–8.86). Exploratory analysis suggests that depression may be a mediating factor between workplace stressors and SI. LimitationsLimitations include the moderate response rate, the use of a single item to assess SI, and the cross-sectional design. ConclusionFindings suggest that workplace violence and leadership support are important occupational factors associated with SI among healthcare workers. Reducing and mitigating workplace violence, enhancing leadership support, and improving access to mental health care should be considered targets for interventions to decrease suicide risk in this population.

Clustering of lifestyle risk factors in relation to suicidal thoughts and behaviors in young adolescents: a cross-national study of 45 low- and middle-income countries

BackgroundPrior research has reaffirmed lifestyle risk behaviors to cluster among adolescents. However, the lifestyle cluster effect on suicidal thoughts and behaviors (STBs) was unclear among adolescents in low- and middle-income countries (LMICs). No comparison of such associations was conducted across nations.MethodsData from 45 LMICs were obtained from the Global School-based Student Health Survey (GSHS) between 2009 and 2019. Lifestyle behavior factors were collected through a structured questionnaire. Suicidal ideation, plan, and attempt were ascertained by three single-item questions. Lifestyle risk scores were calculated via a sufficient dimension reduction technique, and lifestyle risk clusters were constructed using a latent class analysis. Generalized linear mixed models with odds ratio (OR) and 95% confidence interval (CI) were used to estimate the lifestyle-STB associations.ResultsA total of 229,041 adolescents were included in the final analysis. The weighted prevalence of suicidal ideation, plan, and attempt was 7.37%, 5.81%, and 4.59%, respectively. Compared with the favorable lifestyle group, the unfavorable group had 1.48-, 1.53-, and 3.11-fold greater odds of suicidal ideation (OR = 1.48, 95%CI: 1.30–1.69), plan (OR = 1.53, 95%CI 1.34–1.75), and attempt (OR = 3.11, 95%CI 2.64–3.65). Four clusters of lifestyle risk behaviors were identified, namely healthy lifestyles (H–L), insufficient intake of vegetables and fruit (V-F), frequent consumption of soft drinks and fast food (D-F), and tobacco smoking and alcohol drinking (S-A) clusters. Compared with H–L cluster, V-F cluster was associated with 43% and 42% higher odds of suicidal ideation and plan, followed by S-A cluster (26% for ideation and 20% for plan), but not significant in D-F cluster (P > 0.05). D-F cluster was associated with 2.85-fold increased odds of suicidal attempt, followed by V-F cluster (2.43-fold) and S-A cluster (1.18-fold).ConclusionsClustering of lifestyle risk behaviors is informative for risk stratification of STBs in resource-poor settings. Lifestyle-oriented suicide prevention efforts should be initiated among school-attending adolescents in LMICs.

Helping the Helpers: Mental Health Challenges of Psychosocial Support Workers During the Russian-Ukrainian War.

The ongoing Russian-Ukrainian war has been linked to mental health problems in the Ukrainian general population. To date, however, scarce research has examined the mental health of psychosocial support workers (PSWs) in Ukraine who have a burdensome workload in the context of ongoing conflict. This study aimed to examine the prevalence and correlates of burnout, posttraumatic stress disorder (PTSD), and suicidal ideation (SI) in PSWs in Ukraine during the Russian-Ukrainian war. One hundred seventy-eight PSWs in Ukraine completed a survey assessing war exposure, mental health, and psychosocial characteristics. A total 59.6% of PSWs screened positive for burnout, 38.2% for PTSD, and 10.7% for current SI. Lower optimism was associated with greater odds of burnout. Greater distress from witnessing war-related destruction, lower optimism, lower presence of meaning in life, and lower levels of close social relationships were associated with greater odds of burnout. Lower presence of meaning in life was associated with greater odds of SI. Results of this study highlight the mental health challenges faced by PSWs in Ukraine during the ongoing Russian-Ukrainian war. They further suggest that interventions to foster meaning in life and promote social connectedness may "help the helpers" during this ongoing conflict.

An Exploration of Racial Differences of Psychosocial Stressors and Their Association With Mental Health Between Asian and White Sexual Minority Men: The P18 Cohort Study.

There is growing concern that Asian sexual minority men (SMM), including gay, bisexual, and other men who have sex with men, may be at elevated risk of psychological distress and suicidal ideation, yet limited attention has focused on how psychosocial stressors may affect them. This study seeks to (a) explore differences in psychosocial stressors, anxiety, depression, and suicidal ideation between Asian and White SMM and (b) evaluate the potential moderation of associations between psychosocial stressors and mental health by race. Data were obtained from the P18 Cohort Study. We restricted the sample to only those who identified as non-Hispanic Asian or White and used regression analysis to assess the associations of psychosocial stressors and mental health outcomes in the overall sample by race. Of the 217 participants in our analytic sample, 23% self-identified as Asian. Compared with White SMM, Asian SMM had a higher prevalence of loneliness, internalized homophobia, and public gay-related stigma. In regression analyses, most psychosocial stressors were significantly associated with anxiety, depression, and suicidal ideation in the overall sample. Associations between each stressor and mental health outcome primarily did not differ between Asian and White SMM. However, White SMM experiencing higher levels of public gay-related stigma had greater odds of suicidal ideation, although this was not observed for Asian SMM. Overall, Asian SMM may be experiencing similar effects of psychosocial stressors on mental health to White SMM. Health professionals may want to consider how these stressors impact the mental health and well-being of their Asian SMM clients.

Relationships between Weight Perceptions and Suicidal Behaviors in Chinese Adolescents: Results from an Ongoing School-Based Survey in Zhejiang Province.

Weight perception has been implicated in suicidal behaviors among children and adolescents, yet little is known about the relationships in China. We examined the associations of self-perceived weight status and weight misperception with suicidal behaviors among Chinese adolescents. Data used in this analysis were from the 2017 Zhejiang Youth Risk Behavior Survey, which included 17,359 middle and high school students aged 9 to 18 years. Information on perceived weight status, as well as the actual height, weight and other related traits, was extracted by a self-reported questionnaire. Multivariate logistic regression models were used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for suicidal behaviors associated with perceived weight status and weight misperception. Overall, the mean (SD) age was 15.7 (1.6) years among the study participants. Students who perceived themselves as overweight were more likely to have increased suicidal ideation and attempts reports, with ORs of 1.22 (95% CI: 1.09-1.37) and 1.32 (1.06-1.34), compared to those who perceive themselves as having about the right weight. Overestimated weight was significantly associated with greater odds of suicidal ideation (OR: 1.15, 95% CI: 1.03-1.27) and attempts (1.35, 1.10-1.65) relative to accurate weight perception. Controlling for potential confounders, we found that both self-perception of overweight and overestimated perception were significantly associated with suicidal ideation and attempts among Chinese adolescents.

Exploring the relation between psychosis-like experiences and suicidal ideation, plans, and attempts among college students in the United States.

The suicide rate among college students is particularly high, with evidence that psychosis-like experiences (PLEs) put these individuals at greater risk. The current study explored whether there are differential relations between four subtypes of PLEs and three suicide outcomes. We analysed a large sample of college students from the Fall semester cohort of the 2020 Healthy Minds Study (HMS) (weighted N=36727). PLEs and suicide outcomes were assessed using binary variables from the World Health Organization Composite International Diagnostic Interview. Findings revealed that reporting any of the subtypes of PLEs was associated with greater odds of suicidal ideation (SI), a suicide plan (SP) and a suicide attempt (SA) (signficant a ORs ranging from 1.30 to 3.30). For college students who endorsed SI or a SP in the past year, experiencing delusional mood (aOR [95% CI]=1.30 [1.02-1.65]), suspiciousness (aOR [95% CI]=1.31 [1.00-1.71]) and hallucinatory experiences (aOR [95% CI]=2.76 [2.05-3.71]) in their lifetime increased their odds of reporting a SA in the past year. There was also evidence of a dose-dependent relation between the number of PLEs endorsed and all three suicide outcomes. Certain subtypes of PLEs including delusional mood, suspiciousness and hallucinatory experiences may contribute to an elevated risk of suicide outcomes in college students. Moreover, the odds of reporting suicide outcomes were greater for individuals who endorsed a greater number of PLEs. It may be helpful to assess for indicated subtypes when determining suicide risk among college students and to be particularly mindful of those who report three or more PLEs.

Barriers to Possessing Gender-Concordant Identity Documents are Associated with Transgender and Nonbinary People's Mental Health in Aotearoa/New Zealand.

Purpose: This study sought to expand on previous scholarship focused on gender-concordant identity documents (IDs) as a social determinant of health. We examined the association between barriers to legal gender recognition and the mental health of transgender and nonbinary people in Aotearoa/New Zealand. Methods: We used data from a 2018 nationwide community-based survey of trans and nonbinary people in Aotearoa (N = 818). Variables of investigation included: gender-concordant IDs, mental health (past-month psychological distress, past-year nonsuicidal self-injury, past-year suicidality) and barriers to changing gender markers on a birth certificate or passport. Associations between gender-concordant IDs and mental health were determined using generalized linear regression models. Results: In total, 34.8% reported the correct name on all of their IDs. The proportion with the correct gender marker on both birth certificates and passports was 16.0%. Participants with gender-concordant IDs were more likely to be older, have higher levels of income and education, and have had genital reconstruction. In addition, 68.7% of participants reported experiencing at least one barrier to changing gender markers on their IDs, and these participants had significantly higher average points of psychological distress scores (b = 2.39) and greater odds of suicidal ideation (odds ratio = 2.02) than those with gender-concordant IDs, after adjusting for sociodemographic variables. Conclusion: We present novel findings on higher levels of mental health problems among trans and nonbinary people who faced barriers in trying to obtain gender-concordant IDs compared with those with gender-concordant IDs. Removing barriers to legal gender recognition may be an effective way to improve mental health.

Prevalence and correlates of suicidal ideation and suicide attempts in preadolescent children: A US population-based study

The present study evaluated sociodemographic and diagnostic predictors of suicidal ideation and attempts in a nationally representative sample of preadolescent youth enrolled in the Adolescent Brain Cognitive Development Study. Rates and predictors of psychiatric treatment utilization among suicidal youth also were examined. Eleven thousand eight hundred and seventy-five 9- and 10-year-old children residing in the United States were assessed. Children and their parents/guardians provided reports of children’s lifetime history of suicidal ideation, suicide attempts, and psychiatric disorders. Parents also reported on sociodemographic characteristics and mental health service utilization. Multivariate logistic regression analyses were employed to evaluate sociodemographic and diagnostic correlates of suicidal ideation, suicide attempts among youth with suicidal ideation, and treatment utilization among youth with suicidal ideation and suicide attempts. Lifetime prevalence rates were 14.33% for suicidal ideation and 1.26% for suicide attempts. Youth who identified as male, a sexual minority, or multiracial had greater odds of suicidal ideation, and sexual minority youth and youth with a low family income had greater odds of suicide attempts. Comorbid psychopathology was associated with higher odds of both suicidal ideation and suicide attempts. In youth, 34.59% who have suicidal ideation and 54.82% who had attempted suicide received psychiatric treatment. Treatment utilization among suicidal youth was lower among those who identified as female, Black, and Hispanic. Suicidal ideation and attempts among preadolescent children are concerningly high and targeted assessment and preventative efforts are needed, especially for males, racial, ethnic, and sexual minority youth, and those youth experiencing comorbidity.

Association between commensality with depression and suicidal ideation of Korean adults: the sixth and seventh Korean National Health and Nutrition Examination Survey, 2013, 2015, 2017

ObjectivesThis study investigated whether commensality (eating a meal with others) is associated with mental health (depression, suicidal ideation) in Korean adults over 19 years old.MethodsOur study employed data from the sixth and seventh Korea National Health and Nutritional Examination Surveys (KNHANES) for 2013, 2015, and 2017. The study population consisted of 14,125 Korean adults (5854 men and 8271 women). In this cross-sectional study, data were analyzed with the Rao-Scott chi-square test and multiple logistic regression to evaluate the association between commensality(0[includes skipping meals] to 3 times eating meals together) and both depression and suicidal ideation using select questions from the Mental Health Survey. By setting socioeconomic factors, health conditions, and behavioral factors as confounders, we conducted a subgroup analysis to reveal the effect on depression and suicidal ideation commensality.ResultsCommensality was significantly associated with depression and suicidal ideation (p < 0.05). In both sexes, people who ate fewer meals together had poorer mental health. In a subgroup analysis, we revealed greater odds of developing depression in men when living in rural areas and belonging to low-income groups. In contrast, greater odds of suicidal ideation in men who ate alone when living in the city and belonging to high-income groups. On the other hand, Women in every region had greater odds of being depressed if they ate alone. And greater odds of suicidal ideation in women who ate alone when living in the city and belonging to medium-high income groups.ConclusionsOur analysis confirmed that Korean adults with lower chance of commensality had greater risk of developing depression and suicidal ideation. And it could be affected by individuals’ various backgrounds including socioeconomic status. As a result, to help people with depression and prevent a suicidal attempt, this study will be baseline research for social workers, educators and also policy developers to be aware of the importance of eating together.

Nonmedical use of prescription opioids, psychological distress, and suicidality among adolescents.

The present study examined associations between nonmedical use of prescription opioids and serious psychological distress, suicidal ideation, and suicide attempts, and tested whether age and sex moderate these relationships. Data on 5582 adolescents were obtained from a representative province-wide survey of students in grades 7 through 12 (mean age: 15.3years) across Ontario, Canada. Nonmedical use of prescribed opioids in the last 12months was categorized in "no use", "infrequent use (1-2 times)", and "regular use (3 times or more)". Logistic regression analysis was adjusted for age, sex, ethnicity, subjective socioeconomic status, and other substance use (i.e., tobacco cigarette, alcohol, cannabis). Overall, regular nonmedical use of prescription opioids was strongly associated with greater odds of serious psychological distress (OR: 3.47; 95% CI 1.42-8.45), suicidal ideation (OR: 2.73; 95% CI 1.84-4.05), and suicide attempts (OR: 3.21; 95% CI 1.40-7.37). However, infrequent nonmedical use of prescription opioids was associated with greater odds of serious psychological distress (OR: 1.79; 95% CI 1.08-2.98) and suicidal ideation (OR: 1.63; 95% CI 1.20-2.21), but not suicide attempts (OR: 1.84; 95% CI 0.76-4.45). Age-stratified analyses showed that both infrequent (OR: 1.61; 95% CI 1.01-2.58) and regular (OR: 3.40; 95% CI 2.11-5.46) nonmedical use of prescription opioids was strongly associated with greater odds of suicidal ideation among 15- to 20-year-olds, but not 11- to 14-year-olds. These findings suggest that nonmedical use of prescription opioids is strongly associated with mental health problems among adolescents. Future research using a longitudinal design is needed to confirm age differences and temporality.

Intimate Partner Violence and Mental Health: Sex-Disaggregated Associations Among Adolescents and Young Adults in Uganda.

Experiences of intimate partner violence (IPV) victimization have well-established associations with poor mental health. There is also burgeoning evidence regarding the association between IPV perpetration and mental health in a small number of countries. However, there is a paucity of data about the gendered differences for these IPV experiences within sub-Saharan African. This study examines the association between IPV victimization, perpetration, and mental health outcomes for male and female adolescents and young adults in Uganda. Data on IPV perpetration were available for a nationally representative sample of 1,373 males and 2,022 females in Uganda. Observations were weighted to be representative of 13- to 24-year-olds in Uganda. Study procedures used multivariate logistic regression models to examine associations between ever-perpetration of IPV and four self-reported mental health variables: severe sadness, feelings of worthlessness, suicide ideation, and alcohol abuse. Models controlled for age, marital status, schooling, and past exposure to violence. Models were sex-disaggregated to examine sex-specific associations. Standard errors were adjusted for sampling stratification and clustering. Data analysis showed that males were more than twice as likely as females to perpetrate IPV (14% vs. 6%, respectively; p < .001), while odds of perpetration for both sexes were higher for those ever experiencing IPV (adjusted odds ratio [aOR] = 12.12 for males; aOR=4.73 for females). Male perpetrators had 2.93 greater odds of experiencing suicidal ideation (95% confidence interval [CI]: [1.78, 4.82], p < .001) and increased drinking behaviors (2.21, 95% CI: [1.39, 3.50], p < .001) when compared with non-perpetrating males. In addition, female perpetrators had 2.59 times greater odds of suicidal ideation (95% CI: [1.34,4.99], p < .01), as compared with non-perpetrating females. Our findings among youth and adolescents demonstrated associated but different experiences for males and females. Findings indicate the importance of understanding the relationship between IPV victimization and perpetration, and addressing these correlates with a gender-sensitive perspective to inform policy and programming.

Association of sleep characteristics with suicidal ideation and suicide attempt among adults aged 50 and older with depressive symptoms in low- and middle-income countries

ObjectivesInvestigate the association of sleep characteristics with suicidal ideation and suicide attempt among middle-aged and older adults with depressive symptoms in five low- and middle-income countries (LMICs). DesignCross-sectional. SettingChina, Ghana, India, Russia, and South Africa. ParticipantsAdults aged ≥50 years with depressive symptoms from the World Health Organization (WHO) Study on Global AGEing and Adult Health (n=2,040). MeasurementsPredictors were self-reported average sleep duration for the past 2 nights (<7 hours (shorter), 7 to <9 hours (reference), ≥9 hours (longer)), sleep quality for the past 2 nights (moderate/good/very good [both nights], poor/very poor [≥1 night]), past-month insomnia symptoms (none/mild, moderate, severe/extreme), and past-day daytime sleepiness. Outcomes were past-year suicidal ideation and suicide attempt. Analyses were adjusted for age, sex, household wealth, marital status, self-rated health, cognitive performance, number of depressive symptoms, and country of residence. ResultsParticipants with poor/very poor sleep quality ≥1 night had greater odds of suicidal ideation (vs. moderate/good/very good sleep quality both nights). Participants with moderate and severe/extreme insomnia symptoms had greater odds of suicidal ideation and suicide attempt (vs. none/mild insomnia symptoms). In moderation analyses, greater insomnia symptoms were associated with higher odds of suicidal ideation among women only and those aged 60-60 years and ≥80 years only. ConclusionsAmong middle-aged and older adults with depressive symptoms in LMICs, sleep characteristics are markers of—and potential contributors to—suicidal ideation and suicide attempt, and there was evidence of moderation by age and sex. Interventions aimed at preventing suicide-related outcomes in these populations should consider the role of sleep.

PIH6 PREVALENCE OF ADVERSE EVENTS AMONG CHILDREN TAKING MULTIPLE VERSUS SINGLE ANTIPSYCHOTICS

To compare the prevalence of adverse events (AEs) among children and adolescents taking single and multiple antipsychotics (APs). A retrospective observational cohort study was conducted using 2016-2018 Mississippi Medicaid administrative claims data. Inclusion criteria were prescription fills for APs during study period, age 18 years or less, continuous enrollment 6 months pre- and 12 months post-AP start date. Multiple AP users were defined as those who had at least 45 days of continuous use of 2 or more APs. Beneficiaries were excluded if they had AP use in the 6 month baseline period. Logistic regression and generalized linear models were used to assess the relationships among type of AP use (multiple or single) and AEs. The study cohort included 124 multiple AP users and 821 single AP users. During the 12-month post-period, 13.6% of the single AP users had an AE compared to 19.3% of the multiple AP users. The most common AE was suicidal ideation (9.0% for single AP users and 16.1% for multiple AP users). Controlling for age, gender, race, and pharmacy plan, multiple AP users had 2.16 times the odds [95% CI: (1.19-3.90)] of suicidal ideation as single AP users. Multiple AP users had higher rates for tachycardia (2.1% for single AP users and 4.0% for multiple AP users [OR = 1.73, 95% CI: 0.58 – 5.92] and any AE [Odds Ratio (OR) = 1.51, 95% CI: 0.89 – 2.57], but these were not statistically significant. Children and adolescents taking multiple APs have significantly greater odds of suicidal ideation compared to those taking a single AP. Even though the analysis was limited by low sample size, the results highlight the safety concerns associated with multiple AP use. Further research needs to be conducted in a larger sample to confirm these findings.

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

ABSTRACTIn 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.

Adolescent Nonmedical Use of Prescription Pain Relievers, Stimulants, and Depressants, and Suicide Risk

Background: Although the link between drug abuse and suicide risk is established, few studies have examined the relationship between the nonmedical use of prescription drugs (NMUPD) and suicide risk, particularly among adolescents. Objectives: To explore the relationship between NMUPD and suicide risk among 4,148 adolescents in grades 9–12 enrolled in five public high schools. Methods: Logistic regression models were constructed for the nonmedical use of prescription pain relievers, depressants, stimulants, and a composite measure for any NMUPD. Models were estimated before and after controlling for key covariates. Results: About 21% of respondents reported lifetime NMUPD. After covariate adjustment, students who had reported any NMUPD were between 1.7 and 2.3 times more likely to report suicidal ideation, but not a suicide attempt (p < .0001). When stratified by sex and drug, nonmedical use of pain relievers, stimulants, and depressants were significantly associated with greater odds of suicidal ideation and behavior for both males and females (p < .05). However, NMUPD of pain relievers were not associated with greater odds of suicide attempts for males or females or among males who reported nonmedical use of stimulants. Nonmedical use of depressants was associated with greater odds of suicide attempts for both males and females (OR = 1.61 and 2.25, respectively) and among females who reported nonmedical use of stimulants (OR = 2.06, p < .01). Conclusions/Importance: Results suggest that some adolescents may be inappropriately self-medicating psychological distress with prescription medications or NMUPD may promote suicide risk, especially for males and females who use depressants and females who use stimulants.

Residential Transience, Major Depressive Episodes, and the Risk of Suicidal Thoughts, Plans, and Attempts.

The association between past-year residential transience (frequent moving) and suicidal ideation among a nationally representative sample of over 190,000 U.S. adults was evaluated. Suicidal thoughts, plans, and attempts were more prevalent among transient adults. Among adults without major depressive episodes (MDE), transience was associated with 70% to 90% greater odds of suicidal ideation compared to nontransient adults. Among adults with MDE, transience was associated with a 60% to 80% increased odds of suicidal ideation compared to nontransient adults. Residential transience may be an indicator for increased suicide risk even in the absence of depression.

Adolescent suicidal behavior across the excess weight status spectrum.

The present study examined relative suicidal behavioral risks (ideation, attempts) for overweight, obese, and extremely obese adolescents (vs. healthy weight) and who did/did not accurately perceive themselves as overweight utilizing cross-sectional data from the publicly available Youth Risk Behavior Survey (YRBS). A new variable (weight status/accuracy) was computed that combined actual weight status (based on BMI) with weight perception accuracy. To evaluate the effect of weight status/accuracy on each suicidal risk behavior, logistic regression was performed to calculate odds-ratios and 95% confidence intervals (CI). Potential model covariates included gender, age, race, survey year, and whether they had felt sad/hopeless. Weight perception accuracy increased as the degree of excess weight increased. Relative to healthy weight, being obese or extremely obese (but not overweight) was associated with significantly greater risk for adolescent engagement in suicidal ideation, but was unrelated to suicide attempts. Adolescents in all excess weight categories who were accurate in their weight perception were at significantly greater odds of suicidal ideation, whereas those who were inaccurate of no greater odds of suicidal ideation than healthy weight youth who accurately perceived their weight. Findings regarding suicide attempts varied based on actual weight/weight perception accuracy and race/ethnicity. The present findings are both important and clinically relevant. While widely accepted that there are multiple pathways to suicide, our understanding of adolescent suicidal behavior risks and accordingly, prevention efforts, will be informed by comprehensive prospective studies that should also, from here forward, consider categorization of the entire weight spectrum (e.g., extreme obesity).

1739 THE ASSOCIATION OF SUICIDAL IDEATION, DEPRESSION AND LOWER URINARY TRACT SYMPTOMS, DATA FROM THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES), 2005-2006 AND 2007-2008

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Natural History/Evaluation & Markers1 Apr 20131739 THE ASSOCIATION OF SUICIDAL IDEATION, DEPRESSION AND LOWER URINARY TRACT SYMPTOMS, DATA FROM THE NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES), 2005-2006 AND 2007-2008 Benjamin Breyer, Stacey Kenfield, and Bradley Erickson Benjamin BreyerBenjamin Breyer San Francisco, CA More articles by this author , Stacey KenfieldStacey Kenfield San Francisco, CA More articles by this author , and Bradley EricksonBradley Erickson Iowa City, IA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2909AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To examine the association between self-reported lower urinary tract symptoms (LUTS) and suicidal ideation or depression in a large cross-sectional population-based study. METHODS The study included 2890 men participating in the 2005-2006 or 2007-2008 cycles of the National Health and Nutrition Examination Survey (NHANES), who were ≥ 40 years old and without a history of prostate cancer. Men were considered to have LUTS if they reported nocturia, urinary hesitancy and/or incomplete bladder emptying and were examined by number of LUTS symptoms. Men reported frequency of suicidal ideation in the prior two weeks (frequency categories) and depression status was determined using the 9 item depression scale of the Patient Health Questionnaire (PHQ-9). Logistic regression was used to measure association. Multivariate models were adjusted for demographic factors (age, race, education), lifestyle factors (smoking, physical activity, alcohol use, BMI), comorbidities, health care utilization, and other factors associated with depression including depression medications. Suicidal ideation adjusted models also included emotional/financial support and number of close friends. RESULTS The prevalence of LUTS was 43.3% and 5.6% for men reporting 1 symptom and ≥ 2 symptoms, respectively. Moderate to severe depression and suicidal ideation were reported by 181 (6.3%) and 109 (3.8%), respectively. Men with depression were more likely to be younger, have less than a college degree, were more likely to smoke, and were less likely to exercise and consume alcohol on a weekly basis. Men with ≥ 2 LUTS symptoms were more likely to report moderate to severe depression (adjusted odds ratio (AOR) 3.1, 95% Confidence Interval (95%CI) 1.2-8.1 and a trend was observed across higher (worse) depression scores (p=0.02). Men with ≥ 2 LUTS symptoms had a 1.8-fold greater odds of suicidal ideation (95% CI, 0.9-3.7), with a significant trend observed with greater LUTS symptoms (Ptrend=0.01). CONCLUSIONS Having LUTS increases risk for reporting major depression and may increase risk of suicidal ideation. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e714-e715 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Breyer San Francisco, CA More articles by this author Stacey Kenfield San Francisco, CA More articles by this author Bradley Erickson Iowa City, IA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Suicidal Ideation and Suicide Attempt Across Stages of Nonmedical Prescription Opioid Use and Presence of Prescription Opioid Disorders Among U.S. Adults

This study compares the likelihood of suicidal ideation and suicide attempt across stages of nonmedical prescription opioid use and by presence of prescription opioid disorders (dependence and/or abuse) among adult respondents. In the 2009 National Survey on Drug Use and Health, 37,933 adult respondents were asked if they had thought about suicide or had attempted suicide in the past year. The likelihood of ideation and attempt were compared across the following four categories: (a) those who never used prescription opioids, (b) former users, (c) persistent users, and (d) recent-onset users. Weighted multinomial logistic regressions were used to examine if these stages and presence of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for prescription opioid disorders were associated with suicidal ideation and suicide attempt. Five percent of respondents (n = 2,021) reported suicidal ideation; of these, 15% (n = 310) reported attempt. Former and persistent nonmedical prescription opioid users had greater odds of suicidal ideation than those who never used these medications nonmedically. The stages of prescription opioid use were not associated with suicide attempt. Presence of prescription opioid disorders among past-year prescription opioid users was associated with suicidal ideation but not suicide attempt. The risk for suicidal ideation was greater in those who no longer used prescription opioids, in persistent users, and among nonmedical users who had a prescription opioid disorder compared with users without the disorder. The results suggest a need to continue monitoring for suicide risk even among those who have stopped using prescription opioids.

Differential experiences during the holocaust and suicidal ideation in older adults in treatment for depression

Data were used on 275 Jewish individuals aged 50 and older in outpatient treatment for depression in this retrospective cross-sectional study. Holocaust survivors who were in work camps, in ghettos, or in hiding (HS-WGH) and holocaust survivors who were in concentration camps (HS-CC) were more likely to suffer posttraumatic stress disorder compared to other survivors (HS-OT) and controls. The HS-WGH and HS-CC groups had at least a threefold greater odds of suicidal ideation compared to controls. Suicidal ideation rates did not differ significantly between HS-OT group and controls. Among survivors, HS-WGH had a threefold greater odds of suicidal ideation compared to HS-OT. The results are applicable to survivors of similar atrocities and show that differing types and severities of traumatic experiences have important implications for treatment planning.