Prevalence Of Suicide Attempts Research Articles

Incidence rates of suicide attempts and self-harm in Europe. What can we learn? A systematic review and meta-analysis

IntroductionDefinitions used for suicide attempts and self-harm have been discussed for many years and is used differently in European countries, sometimes even interchangeably. Therefore, it is difficult to compare relevant rates across nations.ObjectivesThis study aims at estimating the rate of suicide attempts and self-harm in chosen European countries in the more recent years when distinguishing between applied definitions.MethodsA systematic search for relevant articles published between 2010-2020 will be performed in databases such as PubMed, Embase, PsycINFO, and Web of Science. Only articles in English or Danish will be included. Data will be collected for all age groups above 15 years of age. The prevalence of suicide attempts and self-harm will be calculated by a random effect model. Subgroup analyses will be performed to compare the rates according to age.Resultsfrom the performed systematic review and meta-study will be presented at the conference.ConclusionsThe conclusion will be presented when results have been analysed.DisclosureNo significant relationships.

Epidemiological and clinical profile of suicide attempts in Tunisian adolescents

IntroductionSuicidal behavior remains an important clinical problem and a major cause of death in youth.ObjectivesThe purpose of this study was to describe the epidemiological and clinical profile of adolescents with suicide attempts.MethodsThis is a retrospective descriptive study that focused on a population of Tunisian adolescents aged between 10 and 19 years old and who were hospitalized after a suicide attempt between between January, 1st 2010 and November,15th 2018, in Razi Hospital.We used a pre-established questionnaire that explored the sociodemographic and clinical data of patients.ResultsSixty adolescents were included in this study. The average age of the respondents was 14.3±2 years. The sex-ratio (m/f ) was 0, 36. The suicidal adolescent was a female (73%), single (98%), enrolled in school (66%) with school failure history (52%). Family history of suicide was reported in 8%. Fifty adolescents (83%) lived with their parents and the relationship with them was described as disturbed in 60% of them. A history of physical and sexual abuse was reported in 25% during first adolescence and 15% during second adolescence. The most frequent diagnoses were adjustment disorder with depressed mood (45%) and depression (28%). Drug ingestion was the most common mean of suicide (63%), in an impulsive way in 82% of cases.ConclusionsDevelopment of repeated epidemiological surveys makes it possible to better understand the prevalence of suicide attempts in adolescents and to implement suicide prevention programs.DisclosureNo significant relationships.

Eating disorder and suicide attempt

IntroductionThe quantification of suicidal risk in specific populations is important for the adoption of prevention and risk reduction measures. This risk remains very high in patients with eating disorders compared to the general population.ObjectivesThe present study evaluates the prevalence of suicide among patients with eating disorders all seeking different suicidal risk factors in these patients.MethodsA retrospective study of medical records of all patients with eating disorders, diagnosed according to DSM 5 criteria, at Arrazi hospital of Salé for the past 14 years, by assessing the prevalence of suicide attempts and care.ResultsIn our work, all patients are female, 17 years old on average, 18 patients out of 20 have anorexia nervosa, 4 of them have had bouts of bulimia, and only one patient was admitted for management of bulimia nervosa alone. The mean age of onset was 15 years with addictive comorbidity in 5 patients. Thirteen patients had comorbid depressive disorder, one patient was schizophrenic and six patients had borderline personality disorder.12 patients have made suicide attempts, planned especially in a depressive environment.ConclusionsPreventive management of suicidal risk must be taken in order to improve the prognosis in this category of patients.DisclosureNo significant relationships.

The relationship between sexual and gender stigma and suicide attempt and ideation among LGBTQI + populations in Thailand: findings from a national survey

PurposeThailand has one of the highest suicide rates in Southeast Asia; yet, little is known about suicidality among lesbian, gay, bisexual, trans, queer, intersex, and other gender and sexually diverse (LGBTQI +) people living in the region, who may experience elevated risk for suicide. We sought to identify the prevalence of lifetime suicidal attempts and ideation among a nationally recruited sample of LGBTQI + people in Thailand. We further examined the relationship between levels of sexual/gender stigma and suicidal attempt and ideation.MethodsData were derived from a national online survey of Thai LGBTQI + individuals between January and March 2018. Multivariable logistic regression was used to examine the relationship between sexual/gender stigma scales, adapting a previously validated instrument, and suicide attempt and ideation.ResultsAmong 1,290 LGBTQI + participants, the median age was 27 years. The prevalence of suicide attempt and ideation was 16.8% and 50.7%, respectively. In multivariable analyses, after adjusting for potential confounders, experiences of perceived and enacted sexual/gender stigma were independently and positively associated with suicide attempt (adjusted odds ratio [AOR] = 1.25; 95% confidence interval CI:1.10–1.41 and AOR = 1.31; 95% CI:1.11–1.55, respectively) and ideation (AOR = 1.30; 95% CI:1.17–1.43 and AOR = 1.34; 95% CI:1.14–1.58, respectively).ConclusionOne-sixth of the sample reported a suicide attempt, while a half reported ever contemplating suicide. Both experiences of perceived and enacted sexual/gender stigma were associated with lifetime suicide attempt and ideation. Multi-level interventions are needed to decrease stigma and in turn suicide among LGBTQ + people in Thailand, including anti-discrimination policies and support for mental health and well-being.

Prevalence of suicidal ideation and suicide attempts among refugees: a meta-analysis

BackgroundSuicidal ideation and attempts are one of the most serious mental health problems affecting refugees. Risk factors such as mental disorders, low socio-economic status, and stressful life events all contribute to making refugees a high-risk group. For this reason, this meta-analysis aims to investigate the prevalence of suicidal ideation and attempts among refugees in non-clinical populations.MethodWe searched PubMed, Web of Science, PubPsych, and PsycInfo for articles reporting (period) prevalence rates of suicidal ideation and attempts. Inclusion criteria were the population of refugees or asylum seekers (aged 16 years and older), assessment of the prevalence of suicidal ideation and attempts in empirical studies in cross-sectional or longitudinal settings, written in English, and published by August 2020. Exclusion criteria were defined as a population of immigrants who have lived in the host country for a long time, studies that examined children and adolescents younger than 16 years, and research in clinical samples. Overall prevalence rates were calculated using Rstudio.ResultsOf 294 matches, 11 publications met the inclusion criteria. The overall period prevalence of suicidal ideation was 20.5% (CI: 0.11–0.32, I2 = 98%, n = 8), 22.3% (CI: 0.10–0.38, I2 = 97%, n = 5) for women, and 27.7% for men (CI: 0.14–0.45, I2 = 93%, n = 3). Suicide attempts had an overall prevalence of 0.57% (CI: 0.00–0.02, I2 = 81%, n = 4).ConclusionThere is a great lack of epidemiological studies on suicidal ideation and attempts among refugees. The high prevalence of suicidal ideation indicates the existence of heavy psychological burden among this population. The prevalence of suicide attempts is similar to that in non-refugee populations. Because of the large heterogeneity between studies, the pooled prevalence estimates must be interpreted with caution. The results underline the need for systematic and standardized assessment and treatment of suicidal ideation and attempts.

Prevalence of suicidality in clinically stable patients with major depressive disorder during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic is associated with an increased risk of mental health problems including suicide in many subpopulations, but its influence on stable patients with major depressive disorder (MDD) has been studied fleetingly. This study examined the one-year prevalence of suicidality including suicidal ideation (SI), suicide plans (SP), and suicide attempts (SA) as well as their correlates in clinically stable MDD patients during the COVID-19 pandemic. MethodsA cross-sectional, observational study was conducted between October 1, 2020, and October 15, 2021, in six tertiary psychiatric hospitals. Socio-demographic information, clinical data and one-year prevalence of suicidality were recorded. ResultsAltogether, 1718 participants who met the eligibility criteria were included. The overall one-year prevalence of suicidality during the COVID-19 pandemic was 68.04% (95% confidence intervals (CI) =65.84–70.25%), with one-year SI prevalence of 66.4% (95%CI = 64.18–68.65%), SP prevalence of 36.26% (95%CI = 33.99–38.54%), and SA prevalence of 39.35% (95%CI = 37.04–41.66%). Binary logistic regression analyses revealed male gender, married marital status, college education level and above and age were negatively associated with risk of suicidality. Urban residence, unemployed work status, experiences of cyberbullying, a history of suicide among family members or friends, and more severe fatigue, physical pain, and residual depressive symptoms were positively associated with risk of suicidality. ConclusionsSuicidality is common among clinically stable MDD patients during the COVID-19 pandemic. Regular suicide screening and preventive measures should be provided to clinically stable MDD patients during the pandemic.

Suicide attempts among Greenlandic forensic psychiatric patients – prevalence and determinants

ABSTRACT This nationwide cross-sectional study of the lifetime prevalence and determinants of suicide attempts includes 90% of Greenlandic forensic psychiatric patients. Retrospective data were collected from electronic patient files, court documents, and forensic psychiatric assessments using a coding form from a similar study. We used unpaired t-tests and chi2 or Fisher’s exact test. The lifetime prevalence of suicide attempts was 36% (n = 32), and no difference in prevalence was found between male and female patients (p = 0.95). Patients having attempted suicide had a higher rate of physical abuse in childhood (p = 0.04), family history of substance misuse (p = 0.007), and criminal convictions among family members (p = 0.03) than patients who had never attempted suicide. Women primarily used self-poisoning in their latest suicide attempts (67%), whereas men more often used sharp objects or a firearm (42%). Over a third of Greenlandic forensic patients have attempted suicide at some point in their life, and patients with traumatic childhood experiences are at higher risk of suicidal behaviour. It is not possible to conclude whether the lifetime prevalence of suicide attempts among Greenlandic forensic patients is comparable to that of other high-risk groups in other Arctic regions due to methodological differences among the very few other comparable studies.

Prevalence and correlates of suicide attempts in high-risk populations: a cross-sectional study among patients receiving opioid agonist therapy in Norway

BackgroundDeath by suicide in patients enrolled in opioid agonist therapy (OAT) is a major clinical concern. However, little knowledge exists regarding suicide attempts in this patient group. This study presents the lifetime prevalence of suicide attempts and the associations between suicide attempts and clinical and sociodemographic variables such as education, sex, early onset of substance use (< 13 years of age), substance use patterns, and injecting substance use among patients receiving OAT.MethodsWe used data from a cohort of OAT patients in Norway obtained from a health assessment of self-reported suicide attempts and sociodemographic and clinical factors. A total of 595 patients receiving OAT were assessed from 2016 to 2020. A binary logistic regression analysis was performed and reported with an unadjusted odds ratio and 95% confidence intervals (OR). The purpose of this assessment was to analyze associations between suicide attempts and substance use patterns as well as the injection of substances during the 30 days leading up to the health assessment. A negative binomial regression analysis with an incidence rate ratio and 95% confidence intervals (IRR) was performed to investigate sex, education, early onset of substance use, and the number of suicide attempts.ResultsForty-one percent of the OAT patients had attempted to die by suicide at least once during their lifetime. An early onset of substance use was strongly associated with the suicide attempts (IRR: 1.7, 1.3–2.2). No significant association was found between suicide attempts and sex (IRR: 1.2, 0.9–1.6) or education (IRR: 0.6, 0.2–2.1). Likewise, no association was identified between suicide attempts and injecting substance use (OR: 0.9, 0.6–1.3), nor using alcohol (OR: 0.9, 0.7–1.3), amphetamines (OR: 1.0, 0.7–1.3), benzodiazepines (OR: 1.0, 0.7–1.4), cannabis (OR: 1.2, 0.9–1.7), cocaine (OR: 1.3, 0.6–3.0), or opioids (OR: 1.4, 0.9–2.0).ConclusionThe lifetime prevalence of suicide attempts was alarmingly high in the OAT population. An early onset of substance use seemed to be an important risk factor for suicide attempts. There was a non-significant association to more current use of opioids among OAT patients with previous suicide attempts.

48. Hospitalization for Suicide Attempt and Self-Harm Among Youth Diagnosed With Gender Dysphoria

Transgender and gender non-conforming (TGNC) youth experience severe discrimination which has been linked to adverse mental health outcomes, including an increased prevalence of suicidality and self-harm. Few epidemiological studies have examined this relationship; thus, we studied the relationship between hospitalization for suicidality, self-harm and gender dysphoria in a large, nationally representative database. We used the 2016 Kids’ Inpatient Database to identify a subset of TGNC youth < 21 years of age captured by the database (using ICD-10 gender dysphoria-related codes). We identified suicidal ideation or suicide attempt using either explicit “suicidality” codes, or one of 355 distinct self-harm codes. Using descriptive statistics, prevalence of suicidality and self-harm was compared between youth with and without gender dysphoria. A multivariable logistic regression model adjusting for individual, admission and hospital-level variables was constructed looking for association between gender dysphoria and suicidality. The cohort included 3,115,589 subjects, of whom 1,980 (64 per 100,000 admissions) had gender dysphoria. Analysis of demographic variables revealed the gender dysphoria diagnosis group was comprised of a disproportionately lower proportion of non-white, publicly insured, and low median income young adults compared to the entire cohort. Prevalence of suicidal ideation and suicide attempt in the entire cohort was 2%, compared to 35.3% in young people with gender dysphoria. Using the expanded definition of self-harm and attempted suicide, prevalence increased to 44.1%. After adjusting for individual, admission and hospital-level variables, subjects with gender dysphoria had 7.89 increased odds of attempted suicide or suicidal ideation (95%CI: 7.09-8.79). Using a large and representative database, we found significantly higher prevalence of suicide attempt and self-harm in hospitalized youth with a gender dysphoria-related diagnosis. For youth hospitalized after suicide attempt or self-harm, gender-affirming care and inclusive language is essential to reduce psychological stress secondary to physician-mediated interpersonal discrimination. Importantly, this study only captured TGNC youth with a formal gender dysphoria diagnosis, and not all youth who identify as TGNC have a diagnosis or disclose their identity; thus, the results should not be generalized to the entire population of TGNC youth. Furthermore, there were fewer non-white, publicly insured, and low median income youth with a gender dysphoria diagnosis compared to the entire cohort, which suggests inequities in accessing gender-affirming care among racial minority and economically disadvantaged youth. The results of this study highlight the need for structural interventions and policies to reduce discrimination and improve access to gender-affirming care in order to prevent these adverse outcomes.

Suicide rates and suicidal behaviour in displaced people: A systematic review.

BackgroundRefugees, and other forcibly displaced people, face mental distress and may be disproportionately affected by risk factors for suicide. Little is known about suicidal behaviour in these highly mobile populations because collecting timely, relevant, and reliable data is challenging.Methods and findingsA systematic review was performed to identify studies of any design reporting on suicide, suicide attempts, or suicidal ideation among populations of displaced people. A sensitive electronic database search was performed in August 2020, and all retrieved studies were screened for relevance by two authors. Studies were categorised by the population being evaluated: refugees granted asylum, refugees living in temporary camps, asylum seekers, or internally displaced people. We distinguished between whether the sampling procedure in the studies was likely to be representative, or the sample examined a specific non-representative subgroup of displaced people (such as those already diagnosed with mental illness). Data on the rates of suicide or the prevalence of suicide attempts or suicidal ideation were extracted by one reviewer and verified by a second reviewer from each study and converted to common metrics. After screening 4347 articles, 87 reports of 77 unique studies were included. Of these, 53 were studies in representative samples, and 24 were based on samples of specific target populations. Most studies were conducted in high-income countries, and the most studied population subgroup was refugees granted asylum. There was substantial heterogeneity across data sources and measurement instruments utilised. Sample sizes of displaced people ranged from 33 to 196,941 in studies using general samples. Suicide rates varied considerably, from 4 to 290 per 100,000 person-years across studies. Only 8 studies were identified that compared suicide rates with the host population. The prevalence of suicide attempts ranged from 0.14% to 15.1% across all studies and varied according to the prevalence period evaluated. Suicidal ideation prevalence varied from 0.17% to 70.6% across studies. Among refugees granted asylum, there was evidence of a lower risk of suicide compared with the host population in 4 of 5 studies. In contrast, in asylum seekers there was evidence of a higher suicide risk in 2 of 3 studies, and of a higher risk of suicidal ideation among refugees living in camps in 2 of 3 studies compared to host populations.ConclusionWhile multiple studies overall have been published in the literature on this topic, the evidence base is still sparse for refugees in camps, asylum seekers, and internally displaced people. Less than half of the included studies reported on suicide or suicide attempt outcomes, with most reporting on suicidal ideation. International research networks could usefully define criteria, definitions, and study designs to help standardise and facilitate more research in this important area.RegistrationPROSPERO CRD42019137242.

Understanding suicide risk for youth who are both Black and Native American: The role of intersectionality and multiple marginalization.

Native American and multiracial youth experience elevated risk for suicide ideation (SI) and suicide attempts (SA); however, intersectional identities are often unexamined in suicide research. We examined the prevalence of SI and SA, and the impact of intersectional identities (sex, sexual minority identity, and economic insecurity) on these rates, in 496 biracial Black-Native American, 2,804 Native American, 14,220 Black, 5,569 biracial Native American-White, 4,076 biracial Black-White, and 118,816 White youth who participated in the Minnesota Student Survey. Black-Native American youth reports of SI and SA resembled other Native American youth and were significantly higher than those reported by Black, White, and Black-White (SA only) youth. While sexual minority youth reported higher rates of SI and SA than heterosexual youth, this difference between sexual minority and heterosexual Black-Native American youth was smaller as compared to their peers. Though they largely resemble their mono/biracial Native American peers, Black-Native American youth show some distinct patterns of SA when accounting for their intersectional identities. Despite presumed similarities in systemic risk factors, Black and Black-Native American youth differ considerably in reported suicidality. The experiences of Black-Native American teens warrant further examination.

The Relationship Between Age at Incarceration and Lifetime Suicide Attempt Among a Nationally Representative Sample of U.S. Adults.

To examine the association between age at incarceration and lifetime suicide attempt (SA), and whether it differs by gender. Lifetime prevalence of SA was compared between respondents with no incarceration, juvenile, and adult incarceration who completed the 2012-2013 National Survey of Alcohol and Related Conditions-III (N = 36,107). We compared the odds of SA, adjusting for sociodemographic characteristics, psychiatric disorders, and childhood adverse experiences, and stratified the results by gender. Adjusted odds ratio (AOR) of SA relative to no incarceration history was 1.66 (95% Confidence Interval [CI] 1.32-2.07) for adult incarceration and 2.00 (95% CI 1.49-2.70) for juvenile incarceration. AOR of SA relative to no incarceration history was 2.14 (95% CI 1.56-2.93) for adult and 2.15 (95% CI 1.38-3.35) for juvenile incarceration in women; it was 1.73 (95% CI 1.14-2.60) in juvenile incarceration relative to no incarceration history in men. A history of incarceration may increase SA, particularly among juvenile and women offenders.

Suicide Attempts among School-Attending Adolescents in Mongolia: Associated Factors and Gender Differences

Attempting suicide is an important risk factor that can lead to suicide death. The aim of the current study was to examine the prevalence of suicide attempts and to identify the gender-specific predictors of suicide among adolescents in Mongolia. We analyzed data from the 2019 Mongolian Global School-Based Health Survey (GSHS) conducted nationwide among 13–18-year-old students. Univariable and multivariable analyses were performed to assess the correlates of suicide attempts. Overall, 32.1% of the adolescents reported to have had suicide attempts. Multivariable analysis showed a significant association in the total sample of suicide attempts with lack of close friends, anxiety, injury and violence, smoking and alcohol drinking, and sexual intercourse. Male suicide attempters were less likely to have close friends and more likely to have injuries, been physically attacked, been bullied, smoke, drink alcohol, and have had sexual intercourse. Within the female subgroup, anxiety, injury and violence, smoking and alcohol drinking significantly increased the odds of reporting suicide attempts. Increase of the student’s age by one year decreased the odds ratio of suicide attempts. Nearly one in three students had had a suicide attempt. Several factors, including mental distress, violence, and risky behaviors were found to be associated with suicide attempts. These can aid in designing intervention strategies for preventing suicidal behaviors among adolescents.

Association of Suicide Attempt with Stimulant Abuse in California Emergency Departments in 2011: A Study of 10 Million ED Visits.

IntroductionOur goal in this study was to identify stimulant abuser patients who are at specifically high risk of suicide attempt (SAT), in order to prioritize them in preventive and risk mitigation programs.MethodsWe used the California State Emergency Department Database (SEDD) to obtain discharge information for 2011. The SEDD contains discharge information on all outpatient ED encounters, including uninsured patients and those covered by Medicare, Medicaid, and private insurance. We identified SAT and stimulant abuse by using the relevant International Classification of Diseases, Ninth Revision, codes.ResultsThe study included 10,124,598 outpatient ED visits. Stimulant abuse was observed in 0.97% of ED visits. Stimulant abuse was more common among young and middle-aged males and people with low median household income. Moreover, it was more common among Native American (1.8%) and Black (1.8%), followed by non-Hispanic White (1.1%) patients. The prevalence of SAT was 2.0% (N = 2000) for ED visits by patients with a history of stimulant abuse, and 0.3% (N = 28,606) for ED visits without a history of stimulant abuse (odds ratio 7.29, 95% confidence interval, 6.97–7.64). The SATs were directly associated with stimulant abuse, younger age (age groups >10), and non-Hispanic White and Native American race. Association of SAT with stimulant abuse was stronger in female patients.ConclusionStimulant abuse was the only modifiable risk factor for suicide attempt in our study. Reaching out to populations with higher prevalence of stimulant abuse (young and middle-aged individuals who are Native American or Black, with lower household income) to control the stimulant abuse problem, may reduce the risk of SAT. In this regard, people who are at higher risk of SAT due to non-modifiable risk factors (younger age, and Native American or White race) should be prioritized. Moreover, controlling stimulant abuse among women may be specifically effective in SAT prevention.

A trend analysis of the prevalence of opioid misuse, social support, and suicide attempt among American Indian/Alaska native high school students in New Mexico: 2009\u20132019 Youth Risk Resiliency Survey (YRRS)

BackgroundAmerican Indian and Alaska Native (AI/AN) youth face stark inequities in opioid misuse, social support, and suicide attempt. This study examined trends in these behavioral measures among AI/AN students in New Mexico (NM).MethodsUsing the NM oversampled Youth Resiliency and Risk Survey (NM-YRRS, 2009 – 2019: odd years), prevalence estimates of opioid misuse, social support (SS), and suicide attempt for AI/AN high school students were generated. Trends over time were assessed via linear regression of weighted proportions according to Peter Armitage. Stratified trends by demographics were also employed.ResultsWhile the prevalence of suicide attempt did not change significantly over time, it was consistently higher among females (2011–2019), those who misused opioids, received low social support, had a mother with less than high school education, had a C, D, or F for academic performance, and non-straight students relative to their counterparts. In particular, the prevalence of suicide attempt among AI/AN students who reported opioid misuse in 2009 was significantly higher by 25.4% than their counterparts who did not report opioid misuse (35.8% vs. 10.4%.) A significant decreasing trend over time (2009–2017) was observed for opioid misuse (16.1%↓8.8%, p-value = 0.0033), including when stratifying by sex (males: 15.9%↓9%, p-value = 0.002; females: 16.2%↓8.6%, p-value = 0.012). Youth with high maternal education exhibited significant decline in opioid misuse (13.5%↓6.7%, p-value = 0.019; 2011–2017.) Opioid misuse increased significantly from 2017 to 2019 (8.8%↑12.9%, p-value < 0.0001.) For instance, in 2019 among AI/AN students who reported low social support, opioid misuse was roughly doubled (18.9% vs. 8.5%, p < 0.0001), and suicide attempt was tripled (21.3% vs. 7.0%, p < 0.0001) compared to students with high social support.ConclusionNo significant trend was observed for suicide attempt. We observed a significant decreasing trend in opioid misuse between 2009 through 2017 but a significant increase from 2017 to 2019. A higher level of maternal education (college or above), and an A or B school grade performance were protective against both opioid misuse and suicide attempt.

Suicide Attempts Among Adult Eritrean Refugees in Tigray, Ethiopia: Prevalence and Associated Factors.

PurposeThe present study assessed the prevalence of and factors associated with suicide attempts among adult Eritrean refugees in Tigray, Ethiopia.MethodsA community-based cross-sectional study was carried out among adult refugees from February 2020 to April 2020. The exposure variables included socio-demographic, clinically related, and psychosocial characteristics, and substance use-related factors. We included 400 participants and recruited them via a systematic random sampling technique. The study participants were between 18 and 60 years old. Data were collected using a structured interviewer-administered questionnaire. We applied bivariable and multivariable logistic regression to determine predictors for suicide attempts. Multicollinearity was checked to test correlations among predictor variables, and the Hosmer and Lemeshow test (p>0.2) was conducted to check the fitness of the model. Odds ratios and p-values were determined to check the associations between variables, and a p-value <0.05 was considered as a cut-off for statistical significance.ResultsThe prevalence of suicide attempts was 7.3% (95% CI: 4.8%, 9.8%). Having current symptoms of trauma (AOR=5.6, 95% CI: 2.1, 14.9), a family history of mental disorder (AOR=3.02, 95% CI: 1.01, 9.07), a history of post-traumatic stress disorder (PTSD) (AOR=2.7, 95% CI: 1.01, 7.4), and severe hopelessness (AOR=3.9, 95% CI: 1.3, 12.7) were significantly associated with suicide attempts.ConclusionThis study showed that during the stay in the refugee camp, there was a high prevalence of suicide attempts compared to the prevalence of suicide attempts among the general populations of Ethiopia, Europe, and China, and the lifetime pooled prevalence across 17 countries. Current symptoms of trauma, PTSD, a family history of mental illness, and hopelessness were the factors statistically associated with the suicide attempt. Early screening, detection, and management of suicidal behavior, as well as appropriate mental healthcare, are warranted in refugee camps to reduce the number of suicide attempts.

Street scars: Suicide ideation and suicide attempt among street-involved adolescents and youth in southern Brazil

ObjectiveTo measure the prevalence of suicidal ideation and attempts as well as suicide attempts' associated factors among street-involved youth in southern Brazil. Participants and settingCross-sectional study was conducted with street-involved adolescents and children from Porto Alegre and Rio Grande, Brazil. MethodsA respondent-driven sampling strategy was used to access this hard-to-reach population quickly and efficiently. Descriptive, bivariate, and multivariate analyses were conducted, with the latter being binary logistic regression. ResultsThe prevalence of suicide attempts was 16.3%, while the frequency of suicidal ideation was 30.9%. Most participants were male, aged between 16 and 18 years, with no ties to school and family. Almost half of the sample had been in a street situation for five years or more, and two-thirds reported spending more than seven hours a day on the streets. Variables independently associated with suicide attempts were aged 19–21 years old, with reduced ties with school and family, having had an experience of sexual abuse, and lifetime use of crack. ConclusionsPublic policies targeting the strengthening ties of street-involved children, adolescents, and youth with school and family might reduce their vulnerability to threats, such as sexual abuse and use of crack, and hence focus on decreasing suicide attempts.

Subthreshold lifetime depression and anxiety are associated with increased lifetime suicide attempts: A Korean nationwide study

BackgroundSubthreshold depression and anxiety are highly prevalent and known to be associated with functional limitations and future onset of major depression or anxiety disorders. However, studies regarding suicidality at subthreshold levels of depression and anxiety are limited. MethodsA total of 17,639 Koreans aged from 18 to 64 responded to the Korean version of the WHO-composite international diagnostic interview (K-CIDI) version 2.1 between 2006 and 2016. Prevalence of subthreshold depression and anxiety, and information on lifetime suicide attempt (SA) were assessed. Multivariable logistic regression was performed to calculate the risk of SA by the level of depression or anxiety. ResultsThe risk of lifetime SA increased incrementally according to the level of depression and anxiety. In the subthreshold depression group, individuals with subthreshold anxiety increased the odds about threefold (OR = 3.15, 95% CI 3.12–3.18) and the threshold anxiety disorder group increased the odds about fivefold (OR = 5.33, 95% CI 5.27–5.38) for SA, compared to the group without any level of anxiety. In threshold depressive disorder, the subthreshold anxiety group showed about 1.8-fold higher odds (OR = 1.76, 95% CI 1.75–1.77) and the threshold anxiety disorder group showed threefold higher odds (OR = 2.93, 95% CI 2.92–2.95) for SA compared to the group without any level of anxiety. ConclusionsSubthreshold levels of depression and anxiety were prevalent among Koreans and were associated with an increased prevalence of lifetime SA. A detailed assessment of depression and anxiety symptoms according to their level should be performed on a diagnostic continuum to prevent suicide.

Suicidal Thoughts and Behaviors Among Adults Aged ≥18 Years - United States, 2015-2019.

Problem/ConditionSuicidal thoughts and behaviors are important public health concerns in the United States. In 2019, suicide was the 10th leading cause of death among persons aged ≥18 years (adults); in that year, 45,861 adults died as a result of suicide, and an estimated 381,295 adults visited hospital emergency departments for nonfatal, self-inflicted injuries. Regional- and state-level data on self-inflicted injuries are needed to help localities establish priorities and evaluate the effectiveness of suicide prevention strategies.Period Covered2015–2019.Description of SystemThe National Survey on Drug Use and Health (NSDUH) is an annual survey of a representative sample of the civilian, noninstitutionalized U.S. population aged ≥12 years. NSDUH collects data on the use of illicit drugs, alcohol, and tobacco; initiation of substance use; substance use disorders and treatment; health care; and mental health. This report summarizes data on responses to questions concerning suicidal thoughts and behaviors contained in the mental health section among sampled persons aged ≥18 years in all 50 states and the District of Columbia. This report summarizes 2015–2019 NSDUH data collected from 254,767 respondents regarding national-, regional-, and state-level prevalence of suicidal thoughts, planning, and attempts by age group, sex, race and ethnicity, region, state, education, marital status, poverty level, and health insurance status.ResultsPrevalence estimates of suicidal thoughts and behaviors varied by sociodemographic factors, region, and state. During 2015–2019, an estimated 10.6 million (annual average) adults in the United States (4.3% of the adult population) reported having had suicidal thoughts during the preceding year. The prevalence of having had suicidal thoughts ranged from 4.0% in the Northeast and South to 4.8% in the West and from 3.3% in New Jersey to 6.9% in Utah. An estimated 3.1 million adults (1.3% of the adult population) had made a suicide plan in the past year. The prevalence of having made suicide plans ranged from 1.0% in the Northeast to 1.4% in the Midwest and West and from 0.8% in Connecticut and New Jersey to 2.4% in Alaska. An estimated 1.4 million adults (0.6% of the adult population) had made a suicide attempt in the past year. The prevalence of suicide attempts ranged from 0.5% in the Northeast to 0.6% in the Midwest, South, and West and from 0.3% in Connecticut to 0.9% in West Virginia. Past-year prevalence of suicidal thoughts, suicide planning, and suicide attempts was higher among females than among males, higher among adults aged 18–39 years than among those aged ≥40 years, higher among noncollege graduates than college graduates, and higher among adults who had never been married than among those who were married, separated, divorced, or widowed. Prevalence was also higher among those living in poverty than among those with a family income at or above the federal poverty threshold and higher among those covered by Medicaid or the Children’s Health Insurance Program than among those with other types of health insurance or no health insurance coverage.InterpretationThe findings in this report highlight differences in the adult prevalence of suicidal thoughts, plans to attempt suicide, and attempted suicide during the 12 months preceding the survey at the national, regional, and state levels during 2015–2019. Geographic differences in suicidal thoughts and behavior varied by sociodemographic characteristics and might be attributable to sociodemographic composition of the population, selective migration, or the local cultural milieu. These findings underscore the importance of ongoing surveillance to collect locally relevant data on which to base prevention and intervention strategies.Public Health ActionUnderstanding the patterns of and risk factors for suicide is essential for designing, implementing, and evaluating public health programs for suicide prevention and policies that reduce morbidity and mortality related to suicidal thoughts and behaviors. State health departments and federal agencies can use the results from this report to assess progress toward achieving national and state health objectives in suicide prevention. Strategies might include identifying and supporting persons at risk, promoting connectedness, and creating protective environments.

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Background:To study the variations of the effect of risk factors for suicidal ideation (SI) and suicide attempt (SA) by geographical regions among commercially insured youth and young adults in the US.Methods:A national level retrospective cohort study was conducted using health insurance claims data from four major insurance companies in the US. The cohort was defined as patients having a mental health (MH) or substance use disorder related outpatient encounter (index event). We used survival analysis to evaluate the geographical variation of the effect of risk factors on patients’ future SI and SA after the index event. Risk factors considered in the models consist of a mix of long-, mid-, and short-term prior comorbidities (i.e., depression, drug abuse) and/or prescriptions (i.e., Benzodiazepine, antidepressant) that are identified as important factors for predicting SA by Simon et al. 2018. Patients’ geographical regions were assigned to one of the nine divisions defined by the US Census Bureau: East North Central (Illinois, Indiana, Michigan, Ohio, and Wisconsin), East South Central (Alabama, Kentucky, Mississippi, and Tennessee), Mid-Atlantic (New Jersey, New York, and Pennsylvania), Mountain (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, and Wyoming), New England (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont), Pacific (Alaska, California, Hawaii, Oregon, and Washington), South Atlantic (Delaware, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, District of Columbia, and West Virginia), West North Central (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota), and West South Central (Arkansas, Louisiana, Oklahoma, and Texas). Patients were censored if they did not have an SI or SA diagnosis before 9/30/2015 (ICD-9 to ICD-10 switch date) or the last day of the insurance plan enrollment, whichever came first.Results:Between 2014-2015, we identified 317,383 commercially insured patients with mental health coverage of age <65 years old with an index encounter. The prevalence of SI was the highest in the Mountain region (6.98%; N=1657) and the lowest in the East South-Central region (3.56%; N=608). The prevalence of SA was the highest in the Mountain region (1.89%; N=448) and the lowest in the Mid-Atlantic region (0.87%; N=398). Results of Cox proportional hazards models showed significant geographic variations of the effect of risk factors on both SI and SA (p<0.001 for both SI and SA).For SI, there was regional variation of effects of rurality, alcohol use disorder diagnosis in the past 3 years, eating disorder diagnosis in the past 3 years, anxiety disorder diagnosis in the past 3 years, and MH inpatient stay in the past year. For individuals from the Mountain and West South-Central regions, living in rural areas was a protective factor of having SI (HRs=0.72 and 0.66, respectively). For individuals from the Mid-Atlantic and Mountain regions, having an eating disorder diagnosis in the past 3 years was a protective factor of having SI (HRs=0.70 and 0.74, respectively). Having anxiety disorder diagnosis in the past 3 years was positively associated with having SI, except for patients in East South Central and North West Central regions.For SA, there was regional variation of effects of age and having SA in the past year. In general, younger patients were more likely to have SA as compared to older patients. The effects of SA in the past year on future SA varied by geographical region, however none of them were statistically significant.Discussion:Among commercially insured patients in the US, residents of the Mountain region had the highest prevalence of both SI and SA. The effects of important risk factors on SI and SA varied by geographical region.