Suicidal Ideation Odds Ratio Research Articles

Association between mental health and meal patterns among elderly Koreans.

The present cross-sectional study analyzed the differences in mental health among community-dwelling elderly Koreans based on type of meal skipping and family meal frequency. We carried out a secondary data analysis using data from 4742 older adults aged ≥65 years from the Korea National Health and Nutrition Examination Survey V (2010-2012), a nationally representative sample. In the final model, after adjusting for covariates, we found differences in stress, depression and suicidal ideation based on the type of meal skipping. Specifically, breakfast skippers showed a greater odds ratio for depression and suicidal ideation than breakfast eaters; dinner skippers showed a greater odds ratio for suicidal ideation than dinner eaters. We also found differences in stress, depression and suicidal ideation per family meal frequency. It is necessary to consider the type of meal skipping and family meal frequency while providing limited social resources to improve the mental health of older adults. Geriatr Gerontol Int 2018; 18: 161-168.

A Systematic Review and Meta-Analysis of Migraine and Suicidal Ideation.

Previous studies have demonstrated an association between migraine and major depressive disorder. However, relatively little is known about the relationship between suicidal ideation, with or without concurrent depression, and migraine. We conducted a systematic literature review to synthesize the available research focused on investigating the association of migraine with suicidal ideation. Relevant research papers were identified through searches of major electronic databases including PubMed, Embase (Elsevier), Web of Science (Thomson Reuters), PsycINFO (EBSCO), and Google Scholar. We performed a meta-analysis to estimate the pooled unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between migraine and suicidal ideation extracted from each study. A total of 148,977 participants in 6 studies were included in this analysis. Overall, findings from available studies documented elevated odds of suicidal ideation among individuals with migraines. In unadjusted models, the odds of suicidal ideation was 2.49-fold higher among individuals with migraine (OR, 2.49; 95% CI, 2.34-2.65) compared with those without migraine. In multivariate-adjusted models, the pooled adjusted OR of suicidal ideation was 1.31 (OR, 1.31; 95% CI, 1.10-1.55). A meta-analysis of available studies suggests a modest positive association between migraine and suicidal ideation. Further studies allowing for a more comprehensive investigation of the association between migraine and the full range of suicidal behaviors are warranted. A larger and more robust evidence-base may be useful to inform the clinical screening and diagnoses of comorbid conditions in migraineurs.

Long and short sleep duration are both associated with suicidal ideation in Korean employees

The aim of this study was to investigate the association between self-reported sleep duration and suicidal ideation in Korean employees. We studied 204,629 employees who attended health screenings in 2014. Total sleep duration was assessed with a self-reported question and categorized in one of 7 subcategories: ≤4, 5, 6, 7, 8, 9, and ≥10 h per day. Suicidal ideation was assessed with a self-reported question. Depression and anxiety symptoms were assessed with the Korean version of the Center for Epidemiologic Studies Depression scale and the Beck Anxiety Inventory, respectively. Occupational stress was assessed with the Korean Occupational Stress Scale, Short Form, a self-report questionnaire. We used multiple logistic regressions to calculate odds ratio of suicidal ideation according to self-reported sleep duration category, after adjusting for sex, age, occupational stress and either depression or anxiety. The prevalence rate of suicidal ideation was higher at both extremes of sleep duration and lowest at 7 h per day, showing a U-shaped curve. The odds ratio for suicidal ideation increased in groups of less than or equal to 6 h and greater than or equal to 10 h of sleep. Long and short sleep duration are both associated with suicidal ideation in Korean employees. The results of this study suggest that self-reported sleep duration might be used as a behavioral indicator for screening possible suicidal ideation in employees.

Characteristics of Telephone Crisis Hotline Callers with Suicidal Ideation in Japan

Hotline callers do not always have suicidal ideation and previous studies have noted that the rate of such callers is limited. Crisis hotline counselors must be able to identify high-risk callers in order to provide appropriate support. This study investigated the characteristics of Japanese crisis hotline callers in 2012 (N=541,694) and is the first to analyze crisis hotline data for all parts of Japan over 1year. About 14% of the callers had suicidal ideation and 6% had a history of attempted suicide. The odds ratio for suicidal ideation among those with a history of attempted suicide was 15.5. The suicidal ideation rate was much smaller compared to previous studies in other countries. There is a psychological barrier that must be broken for high-risk people to use support hotlines. In addition, attempted suicide is a strong exclusive predisposing factor for death due to suicide; therefore, counselors should pay careful attention to callers with a history of attempted suicide. The characteristics of Japanese crisis hotline callers and the features of suicidal ideation revealed in the present study are expected to be useful in developing telephone crisis hotline strategies.

Risk Factors for Suicidal Ideation Among Telephone Crisis Hotline Callers in Japan.

Telephone hotlines are a widely used type of suicide prevention program. The aim of this study was to clarify the risk factors for suicidal ideation by investigating its association with a number of characteristics among telephone hotline callers. Data were collected over a 10-year period from a total of 246,595 calls to Inochi No Denwa, a telephone crisis hotline in Ibaraki, Japan, and subsequently analyzed. Odds ratios for suicidal compared with nonsuicidal ideation were also calculated. About 6% of the calls to the hotline were suicide related, and about 2% of the callers had attempted suicide in the past. Odds ratios for suicidal ideation increased during winter, but no daily tendencies were evident. Those whose problems were related to their way of life were at the highest risk of suicidal ideation, followed by those with health-related concerns. We were able to identify risk factors for suicidal ideation based on an analysis of enormous amounts of data from a telephone crisis hotline in Japan. Knowledge of these risk factors is expected to lead to improvements in suicide prevention programs.

Relationships between suicidal ideation and psychosocial factors among residents living in Nagano Prefecture of Japan

Feeling ashamed for seeking help when distressed is known to be a critical factor promoting suicidal behaviors. The objective of this study was to examine the relationship between suicidal ideation and psychosocial factors, including worries or anxieties, having a person to confide in, feeling ashamed for seeking help when distressed, and K6 score. Fourteen out of 77 municipalities from Nagano Prefecture participated in this questionnaire survey. Participants of both sexes over 20 years of age were randomly selected according to age distribution in each municipality. Association between suicidal ideation and sociodemographic and psychosocial factors, including "feeling ashamed for seeking help", were determined by multiple logistic regression analysis. Among a total of 11,100 participants, 7394 (66.6%) returned the questionnaire. 2147 participants responded properly to essential study parameters and were submitted to the final analyses. The adjusted odds ratio of suicidal ideation was 2.09 (95% CI 1.49-2.94) among participants feeling ashamed for seeking help, compared to those not feeling ashamed. Although the rate of "no person to confide in" was 4.4%, participants who responded with "no person to confide in" had significantly increased odds ratio of suicidal ideation compared with those who responded with "having a person to confide in" (OR 1.97, 95% CI 1.12-3.47). Our findings suggest a need for tailored intervention targeting individuals at risk by gatekeepers to encourage individuals at risk to overcome feeling ashamed for seeking help and to cultivate an appropriate person to confide in.

Suicidal ideation and suicide attempts in chronic obstructive pulmonary disease: the Korea National Health and Nutrition Examination Survey (KNHANES IV, V) from 2007-2012.

Background:There is good evidence for an association between chronic obstructive pulmonary disease (COPD) and depression, but there are few studies on the relationship between COPD and suicidal ideation/suicidal attempts.Aims:To evaluate the mental health of patients with COPD in Korea and to compare it with that of the general population.Methods:We analysed data of 15,718 subjects (age ⩾40 years) who participated in the 2007–2012 Korea National Health and Nutrition Examination Survey. COPD was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria for people aged ⩾40 years. We compared the mental health outcomes of 2,506 patients with COPD (2,355 GOLD stages I and II; 151 GOLD stages III and IV) with those of 13,212 controls.Results:Suicidal thoughts were reported by 16.0% of patients in stages I and II, by 23.8% of those in stages III and IV and by 15.7% of controls (P=0.023). Suicidal attempts were reported by 0.6% of patients in stages I and II, by 2.6% of those in stages III and IV and by 1.0% of controls (P=0.019). The crude odds ratio (OR) for suicidal ideation in those in stages III and IV was 1.68 (95% confidence interval (CI), 1.16–2.46), and the OR for suicidal attempts in stages III and IV was 2.83 (95% CI, 1.03–7.75). In multivariate analysis, the OR for suicidal ideation in stages III and IV was 1.67 (95% CI, 1.12–2.49) and that for suicidal attempts was 2.94 (95% CI, 1.03–8.31).Conclusions:GOLD stages III and IV COPD were associated with a marked increase in suicidal behaviour.

Suicidal ideation and suicide attempts among diabetes mellitus: The Korea National Health and Nutrition Examination Survey (KNHANES IV, V) from 2007 to 2012

ObjectiveThe present study evaluated the mental health of patients with diabetes mellitus (DM) in Korea and compared it with mental health in the general Korean population. MethodsAll data included in the final analyses were collected from 34,065 subjects (20years of age or older) who participated in the 2007–2012 Korea National Health and Nutrition Examination Survey (KNHANES). The mental health of 3846 DM patients were compared with that of 30,219 controls. ResultsA depressed mood for 2 or more continuous weeks was reported by 13.6% of subjects with normal glucose tolerance (NGT), 14.3% of those with impaired glucose intolerance (IFG), and 17.6% of DM patients. Suicidal thoughts were reported by 15.3% of individuals with NGT, 15.6% of participants with IFG, and 17.6% of DM patients. Suicidal attempts were reported by 0.8% of people with NGT, 1.0% of those with IFG, and 1.3% of DM patients. In DM patients, the crude odds ratio (OR) for depressive mood was 1.376 (95% confidence interval [CI]: 1.258–1.504), the OR for suicidal ideation was 1.481 (95% CI: 1.361–1.611) and the OR for suicidal attempts was 1.413 (95% CI: 1.021–1.956). A multivariate analysis revealed that the ORs for depression, suicidal ideation, and suicidal attempts in DM patients were 1.178 (95% CI: 1.070–1.297), 1.152 (95% CI: 1.050–1.263), and 1.413 (95% CI: 1.021–1.956), respectively. ConclusionsThe present study found that DM was associated with a marked increase in suicidal behaviors.

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.

기혼여성의 자녀특성과 자살생각의 관련성

Background: There are some data to support the theory of a protective effect of parenthood against suicide, as proposed by Durkheim in 1897. We conducted this study to examine the relationship between children characteristics and suicidal ideation among Korean married women. Methods: The data were obtained from the Korean National Health and Nutrition Examination Surveys IV, conducted in 2007-2009, respectively (3,202 married women aged 20-49 years). The children characteristics are the age of the youngest child and the number of children living with subject. Data were analyzed by using logistic regression with SAS 9.2. Results: The risk for suicidal ideation was higher among married women having a young child (aged <7 years). It had strong effect on suicidal ideation in non-employee subjects. The odds ratio for suicidal ideation of women having a youngest child aged 2-3 years compared with reference groups was 1.673 with statistical significance. But the association of suicidal ideation with number of children shows insignificant. Conslusion: The findings suggest a different result with the theory, the protective effect of being a parent of young child on suicide risk for women, first suggested by Durkheim and supported by previous studies and the need for further prospective investigation that lead to policies according children characteristics aimed at improving married women's life.

The Impact of Health-Related Quality of Life on Suicidal Ideation and Suicide Attempts among Korean Older Adults

The purpose of this study was to examine the risk factors for suicidal ideation and suicide attempts among Korean older adults and to provide evidence for nursing intervention with respect to health-related quality of life (HRQoL). Data from adults 60 and older obtained through the Fourth Korean National Health and Nutrition Examination Survey (2007-2009) were used. Self-report questionnaires assessed suicidal ideation, suicide attempts, and EuroQoL 5D (EQ-5D) scores. Survey logistic regression was used to reflect the complex survey design. Among the sample of 4,506 individuals, 27.3% had thought about and 1.7% had attempted suicide. Older adults with EQ-5D index scores <0.7 had a 9.1-fold greater odds ratio for suicidal ideation than those with scores of 1 (denotes completely healthy status) (95% confidence interval [CI] [5.3, 15.8]). For suicide attempts, older adults with EQ-5D index scores <0.7 had a 3.4-fold greater odds ratio (95% CI [1.3, 8.9]) than those with index scores of 0.8 to 1. Decreased HRQoL strongly affected suicidal ideation, regardless of disease status. Due to its comprehensiveness and simplicity, the EQ-5D may be useful for identifying older individuals in nursing homes at risk of attempting suicide.

Suicidality and divalproex sodium: analysis of controlled studies in multiple indications.

BackgroundRecent analyses of antiepileptic drugs have indicated an increase in the risk of suicidality. The objective of this report was to provide clinical information and an independent meta-analysis of divalproex sodium and suicidality events by analyzing data from 13 placebo-controlled studies and 1 low-dose controlled study.MethodsAdverse events considered to be possibly suicide related were identified using the Columbia Classification Algorithm of Suicide Assessment (C-CASA) methodology. Indications included epilepsy, bipolar disorder, migraine prophylaxis, impulsive aggression, and dementia. Narratives were produced for every event, and suicidality event ratings were performed by a third party blinded to treatment assignment. Statistical analyses were conducted using methodology similar to that reported by the US Food and Drug Administration (FDA).ResultsSuicidality events were identified in 5 of the 13 placebo-controlled studies. Of the 1,327 (0.83%) subjects taking divalproex sodium, 11 had suicidality events: 2 suicide attempts and 9 suicidal ideation. Of 992 (0.91%) subjects taking placebo, 9 had suicidality events: 1 preparatory act toward suicide, 2 suicide attempts, and 6 suicidal ideation. Across placebo-controlled studies, the overall estimated odds ratio (OR) of suicidal behavior or ideation was 0.72 (95% CI 0.29 to 1.84). The OR for suicidal behavior was 0.37 (95% CI 0.04 to 2.58), and the OR for suicidal ideation was 0.90 (95% CI 0.31 to 2.79).ConclusionsIn this meta-analysis, divalproex sodium does not appear to increase the risk of suicide-related adverse events relative to placebo in the populations studied. Clinicians should nonetheless remain vigilant in assessing suicidality, not only in patients treated for mental disorders with inherently high suicide risk, but also in patients taking antiepileptic medications.

Anxiety disorders and suicidal behaviours in adolescence and young adulthood: findings from a longitudinal study

The aim of this study was to estimate the extent to which anxiety disorders contribute to an increase in suicidal behaviour after controlling for both observed and non-observed sources of confounding. Data were collected from the Christchurch Health and Development Study (CHDS), a 25-year longitudinal study of over 1000 participants. Measures of anxiety disorders [phobia, generalized anxiety disorder (GAD), panic disorder], major depression (MD), substance use disorders, conduct/antisocial personality disorder, stressful life events, unemployment, and suicidal ideation/attempts for subjects aged 16-18, 18-21 and 21-25 years were used to fit random and fixed effects regression models of the associations between anxiety disorders and suicidal behaviours. Anxiety disorders were strongly associated with suicidal ideation/attempts. Any single anxiety disorder increased the odds of suicidal ideation by 7.96 times [95% confidence interval (CI) 5.69-11.13] and increased the rate of suicide attempts by 5.85 times (95% CI 3.66-9.32). Control for co-occurring mental disorders, non-observed fixed confounding factors and life stress reduced these associations [suicidal ideation odds ratio (OR) 2.80, 95% CI 1.71-4.58; suicide attempts incidence rate ratio (IRR) 1.90, 95% CI 1.07-3.39]. Rates of suicidal behaviour also increased with the number of anxiety disorders. Estimates of the population attributable risk suggested that anxiety disorders accounted for 7-10% of the suicidality in the cohort. Anxiety disorders may be a risk factor for suicidality, even after controlling for confounding, with risks increasing with multiple anxiety disorders. Management of anxiety disorders may be an important component in strategies to reduce population rates of suicide.

Anxiety Disorders and Risk for Suicidal Ideation and Suicide Attempts

Controversy exists whether anxiety disorders are independently associated (ie, after adjusting for comorbid mental disorders) with suicidal ideation and suicide attempts. To examine whether anxiety disorders are risk factors for suicidal ideation and suicide attempts in a large population-based longitudinal study. Data come from the Netherlands Mental Health Survey and Incidence Study, a prospective population-based survey with a baseline and 2 follow-up assessments over a 3-year period. The Composite International Diagnostic Interview was used to assess DSM-III-R mental disorders. Lifetime diagnoses of anxiety disorders (social phobia, simple phobia, generalized anxiety disorder, panic disorder, agoraphobia, obsessive-compulsive disorder) were assessed at baseline. Multiple logistic regression analyses were used to examine whether anxiety disorders were associated with suicidal ideation and attempts at baseline (n = 7076) and whether anxiety disorders were risk factors for subsequent onset of suicidal ideation and attempts (n = 4796). After adjusting for sociodemographic factors and all other mental disorders assessed in the survey, baseline presence of any anxiety disorder was significantly associated with suicidal ideation and suicide attempts in both the cross-sectional analysis (adjusted odds ratio for suicidal ideation, 2.29; 95% confidence interval, 1.85-2.82; adjusted odds ratio for suicidal attempts, 2.48; 95% confidence interval, 1.70-3.62) and longitudinal analysis (adjusted odds ratio for suicidal ideation, 2.32; 95% confidence interval, 1.31-4.11; adjusted odds ratio for suicide attempts, 3.64; 95% confidence interval, 1.70-7.83). Further analyses demonstrated that the presence of any anxiety disorder in combination with a mood disorder was associated with a higher likelihood of suicide attempts in comparison with a mood disorder alone. This is the first study to demonstrate that a preexisting anxiety disorder is an independent risk factor for subsequent onset of suicidal ideation and attempts. Moreover, the data clearly demonstrate that comorbid anxiety disorders amplify the risk of suicide attempts in persons with mood disorders. Clinicians and policymakers need to be aware of these findings, and further research is required to delineate whether treatment of anxiety disorders reduces the risk of subsequent suicidal behavior.