Deaths from Self-Injury Increase 65% Over 15 Year Period

MedicalResearch.com Interview with:

Ian Rockett, PhD, MPH, FACE Professor, Department of Epidemiology School of Public Health West Virginia University Morgantown, WV

Dr. Ian Rockett

Ian Rockett, PhD, MPH, FACE
Professor, Department of Epidemiology
School of Public Health
West Virginia University
Morgantown, WV

MedicalResearch.com: What is the background for this study?

Response: Self-injury deaths in the United States are seriously underestimated because they are officially limited to registered suicides, and exclude non-suicide deaths from drug self-intoxication. Suicides themselves are undercounted due primarily to under-resourcing of medical examiner and coroner offices and associated challenges in detecting drug suicides. Although most drug-intoxication deaths involve deliberate behaviors that markedly elevate risk of premature death, they are formally classified, but mischaracterized, as “accidents” on death certificates. Representing self-injury mortality (SIM) as a combination of registered suicides and estimated deaths from drug self-intoxication (DDSI), this study compared its national trends and patterns with those of 3 proximally ranked top 10 causes of death.

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Reducing Access to Guns Key to Reducing Successful Suicide Attempts

MedicalResearch.com Interview with:

J. John Mann MD Paul Janssen Professor of Translational Neuroscience Director, Molecular Imaging and Neuropathology Division Department of Psychiatry Columbia University/New York State Psychiatric Institut

Dr. Mann

J. John Mann MD
Paul Janssen Professor of Translational Neuroscience
Director, Molecular Imaging and Neuropathology Division
Department of Psychiatry
Columbia University/New York State Psychiatric Institute

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In 2014 there were 21,000 firearm suicides in the USA. Overseas, programs that have resulted in major reductions in firearm availability have reduced firearm suicide rates which have also been shown in the USA to be closely correlated with risk of firearm suicide. Reducing access to firearms to those at risk for suicide would help reduce firearm suicide rates in the USA. Most such suicides involve a firearm purchased many years earlier. We recommend methods for reducing such access including improved gun safety and smart gun technology.

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Youth Suicide Can Be Decreased With Comprehensive Prevention Program

Christine Walrath, PhD Public Health Division, ICF International New York, New York

Dr. Christine Walrath

MedicalResearch.com Interview with:
Christine Walrath, PhD
Public Health Division
ICF International
New York, New York

Medical Research: What is the background for this study? What are the main findings?

Dr. Walrath: The study is part of a legislatively mandated evaluation of programs funded by the Garrett Lee Smith Memorial Act, signed into law in 2004 in recognition of the major public health problem of suicide and suicidal behavior in the US. The legislation set aside funding for campuses, states, tribes and US territories to develop, evaluate, and improve early intervention and suicide prevention programs. This is the most widely implemented group of suicide prevention programs in the United States, and allowed a unique opportunity, as reflected in the findings of this study and the study in the American Journal of Public Health in the spring (Walrath, C., Godoy Garraza, L., Reid, H., Goldston, D. B., & McKeon, R. (2015) to demonstrate that comprehensive community based suicide prevention programs appear to be effective in reducing suicide and suicide attempts.

As mentioned, this is the second article on the impact of GLS suicide prevention program on youth suicide behavior. The previous one, published in APHA earlier this year, focused on suicide deaths, while this one focuses on suicide attempts. They use different sources for the outcome measures: vital records in one case and a large national survey in the other. In both cases, the county is the unit of analysis. They both take advantage of the availability of a large amount of information for relatively small areas to select counties that are essentially comparable. Making sure that the counties being compared are similar except for the GLS implementation is very important when randomized trials to assess impact of the prevention program are not feasible.

The study found a reduction in the rate of suicide attempts among youth 16 to 23 following the implementation of the GLS program in counties exposed to these prevention activities when compared with similar counties that were not exposed to such intervention. The difference is significant and substantial: 4.9 less attempts per thousand youths. There is no evidence of a simultaneous change in the suicide attempt rate among adults, a group that was not targeted by GLS. The findings are consistent with those from the previous study, which found a substantial reduction in suicide mortality among youths 10-24 following GLS implementation: 1.3 fewer deaths per one hundred thousand youths.

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Suicide Risk Increases After Bariatric Surgery

Dr. Junaid A. Bhatti MBBS PhD Sunnybrook Health Sciences Centre Toronto, ONMedicalResearch.com Interview with:
Dr. Junaid A. Bhatti MBBS PhD
Sunnybrook Health Sciences Centre
Toronto, ON

Medical Research: What is the background for this study? What are the main findings?

Dr. Bhatti:  Bariatric surgery remains an important option for morbidly obese patients where other obesity management options fail. It is a safe procedure with mortality risk not higher than any other major procedure of this type. Some studies report that some patients may experience psychological stress following surgery. Studies on the long-term outcomes noted that there was a higher suicide risk in bariatric patients as compared to the general population. It was not clear whether these risks increased following surgery.
In this study, we used the data of bariatric patients from Ontario who underwent surgery between 2006 and 2011. We assessed their emergency room visits three years before and three years following surgery. We looked into whether these patients had significantly more visits related to suicide attempts before compared to post surgery period. Overall, about 111 patients (1%) of the cohort had suicide attempts during follow-up. What we saw is that suicide risk increased by 50% following surgery than before surgery period. The risks were higher, but not significantly higher than others, if they were 35 years or older or from low-income or rural settings. The emergency services utilization of suicide attempts following surgery was more intense for the visits before surgery.

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Male Sex, Age and Occupation Linked To Workplace Suicide

Dr. Hope M. Tiesman MSPH, PhD CDC, AtlantaMedicalResearch.com Interview with:
Dr. Hope M. Tiesman MSPH, PhD

CDC, Atlanta

Medical Research: What is the background for this study? What are the main findings?

Dr. Tiesman: The authors regularly monitor non-occupational injury trends, including the recent and significant increase in suicide rates. This finding led the authors to consider how these non-occupational trends impacted the workplace. We used data for two large national surveillance systems.  We obtained data on workplace suicides from the Bureau of Labor Statistics’ Census of Fatal Occupational Injury (CFOI) which compiles data on all fatal work-related injuries in the US.  We obtained data on non-workplace suicides from the CDC’s Web-Based Injury Statistics Query and Reporting System or WISQARS. WISQARS data are compiled using national death certificate data.  From here we calculated suicide rates and compared trends across workplace and non-workplace suicides as well as examined the socio-demographics and occupational characteristics of those who chose suicide in the workplace.

Several important findings to highlight.  Across the 8-yr timeframe, we found that workplace suicide rates remained relatively stable, even somewhat decreasing that it is until 2007 when a large and significant jump in rates was found.  This was in contrast with non-workplace suicide rates which increased over the entire study period.  Men had signifıcantly higher workplace suicide rates compared to women and generally, as age increased, so did workplace suicide rates.  Those aged between 65 and 74 years had the highest suicide rate of all workers which was also a bit different from non-workplace suicide rates.  Finally, we found that those in protective service occupations, such as police and firefighters, had the highest workplace suicide rates, followed closely by those in farming/fishing/and forestry occupations.  These occupations have been associated with higher overall suicide rates in prior studies.  A somewhat novel finding was that those in automotive maintenance and repair occupations also had significantly higher workplace suicide rates. Continue reading

Higher Suicide Rates Among Black Than White Children

Jeff Bridge, Ph.D Center for Innovation in Pediatric Practice Principal Investigator The Research Institute at Nationwide Children's HospitalMedicalResearch.com Interview with:
Jeff Bridge, Ph.D
Center for Innovation in Pediatric Practice
Principal Investigator
The Research Institute at Nationwide Children’s Hospital

Medical Research: What is the background for this study?

Dr. Bridge: Suicide is a leading cause of death among children younger than 12 years. Suicide rates in this age group have remained steady overall for the past 20 years, but this is the first national study to observe higher suicide rates among black children compared to white children. Little is known about the epidemiology of suicide in this age group, as prior research has typically excluded children younger than 10 years old and investigated trends only within specific older age groups.

Medical Research: What are the main findings?

Dr. Bridge: We found that suicide ranked 14th as a cause of death among 5- to 11-year old black children in 1993-97 but rose to 9th in 2008-12. For white children, suicide ranked 12th in 1993-97 and 11th in 2008-12. Rates have remained stable in Hispanic and non-Hispanic children. The findings in this study highlight an emerging racial disparity in the epidemiology of childhood suicide.

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Links Between Alcohol, Insomnia and Suicide Risk Explored

Michael Nadorff, PhD, Assistant professor Mississippi State University Starkville, Miss.MedicalResearch.com Interview with:
Michael Nadorff, PhD, Assistant professor
Mississippi State University
Starkville, Miss.

Medical Research: What is the background for this study? What are the main findings?

Dr. Nadorff: A growing literature has found that insomnia symptoms are associated with suicidal behavior, and several studies suggest that this relation may be independent of several different forms of psychopathology.  However, little research has examined the role sleep disorders, such as insomnia, play in explaining why known risk factors, such as alcohol use, are associated with suicidal behavior.  In our study, we examined whether insomnia symptoms explained a significant portion of the relation between alcohol symptoms and suicide risk.  We found that for both men and women insomnia symptoms explained a significant amount of the variance in the relation between alcohol use and suicide risk.
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Genetic Blood Test May Predict Suicidal Behaviors

dr_zachary_kaminskyMedicalResearch.com Interview with:
Zachary A. Kaminsky, Ph.D.
Assistant Professor
Johns Hopkins University School of Medicine
Department of Psychiatry
Baltimore, MD, 21205


Medical Research: What are the main findings of the study?

Dr. Kaminsky: A DNA methylation increase at the SKA2 gene was identified and observed across three post mortem brain tissue cohorts and was associated with suicide. The DNA methylation at the SKA2 gene was associated with lower gene expression of the gene. The same association was found in blood allowing us to attempt to predict suicidal behaviors in living individuals.
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Is There An Association Between Economic Crisis, Unemployment and Suicide?

Grégoire Rey Directeur du CépiDc CépiDc-Inserm Hopitâl Bicêtre FranceMedicalResearch.com Interview with:
Grégoire Rey
Directeur du CépiDc
CépiDc-Inserm
Hopitâl Bicêtre France

MedicalResearch: What are the main findings of the study?

Dr. Rey: We found that, between 2000 and 2010, unemployment and suicide rates were globally associatedin eight Western European countries (Austria, Finland, France, Germany, the Netherlands, Spain, Sweden, and the UK). However, this ecological association was weak (0.3% increase in suicide rate for a 10% increase in unemployment rate). Across countries, it was inconsistently confounded by the effect of other concomitant features of the economic crisis.

MedicalResearch: Were any of the findings unexpected?
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Primary Care and Suicide Screening: US Task Force Statement

MedicalResearch.com Interview with:

Albert L. Siu, MD, MSPH Co-Vice Chair Mount Sinai School of Medicine, New YorkMedicalResearch.com Interview with:
Albert L. Siu, MD, MSPH
Co-Vice Chair
Mount Sinai School of Medicine, New York

MedicalResearch: What are the main findings of the study?

Dr. Siu:  The Task Force looked to see if primary care clinicians could identify people who are at risk of suicide among those without a diagnosed mental health disorder or symptoms of mental illness, and if there were treatments that would help prevent suicide attempts. While there has been some promising early research, at this time, it is not clear how primary care clinicians can effectively identify and help people at risk of suicide.

MedicalResearch: Were any of the findings unexpected?

Dr. Siu:  To make this draft recommendation and update its 2004 recommendation, the Task Force reviewed evidence on screening adolescents, adults, and older adults for suicide risk in primary care. The evidence continues to be insufficient to determine the balance of benefits and harms of screening for suicide risk in the primary care setting, so the recommendation did not change.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Siu:  The lives of too many people, both young and old, including those who have served our country in the military, have been lost to suicide. It is critical to find the best ways to identify those at risk and support them with effective treatment. Primary care clinicians who have patients who are suicidal should get them immediate help. Since depression is strongly associated with suicide risk, primary care clinicians should screen both adolescents and adults for depression.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Siu:   The Task Force is calling for more research to better understand current screening tests, including evidence on screening tests that may better identify people without symptoms who are at risk for suicide as well as evidence on effective treatment programs for those who are identified as high risk.

Citation:

LeFevre ML, on behalf of the U.S. Preventive Services Task Force. Screening for Suicide Risk in Adolescents, Adults, and Older Adults in Primary Care: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2014;160:719-726.

Suicide A Risk Factor for Mental Health Issues, Suicide in Bereaved

Dr Alexandra Pitman MBBS MRC Psych MRC Clinical Research Fellow, UCL Division of Psychiatry, UCL (University College LondonMedicalResearch.com interview with:
Dr Alexandra Pitman MBBS MRC Psych
MRC Clinical Research Fellow,
UCL Division of Psychiatry, UCL (University College London


MedicalResearch: What are the main findings of the study?

Answer: We conducted a systematic review of all published research comparing the experience of suicide bereavement with bereavement due to other causes, in which we considered the evidence from 57 studies evaluating the effect of bereavement on death, mental health, and social functioning of family members, friends, and other close contacts of the deceased. These studies showed that parents and children bereaved by suicide were at higher risk of mental health problems after the loss than parents and children bereaved by other causes, and that spouses and mothers bereaved by suicide were at higher risk of suicide than spouses and mothers bereaved by other causes. We also found some evidence that people from a range of kinship groups bereaved by suicide report more rejection and shame than people bereaved by other violent deaths, and that feeling stigmatised by the death is commonly experienced after any violent bereavement. It seemed that people bereaved by violent deaths, for example due to accidental death, homicide, drug-related death, motor vehicle crash, undetermined death or suicide, shared a sense of feeling blamed for the death or tainted by their association with the deceased. Continue reading

Suicide and Self-Harm: Genetic and Environmental Influences Overlap

MedicalResearch.com Interview Invitation
Karin J. H. Verweij, PhD
Department of Developmental Psychology and EMGO Institute for Health and Care Research,  VU University
Amsterdam, the Netherlands

MedicalResearch.com: What are the main findings of the study?

Dr. Verweij: We performed a twin study using over 10,000 adult Australian twins to determine the relative importance of genetic and environmental influences on individual differences in non-suicidal self-injury (NSSI) and suicidal ideation and their covariation.

We found that individuals that report self-harm are approximately eight times more likely to also report suicidal ideation. Results from the bivariate genetic model indicated that the substantial correlation between non-suicidal self-injury and suicidal ideation (r=0.49 for males and 0.61 for females) is largely explained by overlapping genetic factors: 62% and 76% for males and females, respectively. Overlapping residual influences, including nonshared environmental influences and measurement error, also explain part of the covariance between the two traits. These findings suggest that the two behaviors share similar biological underpinnings.
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Suicide in Children and Adolescents: Relationship Between Peer Victimization, Cyberbullying

Mitch van Geel, PhD Institute of Education and Child Studies, Leiden University Leiden, the NetherlandsMedicalResearch.com Interview with:
Mitch van Geel, PhD
Institute of Education and Child Studies, Leiden University
Leiden, the Netherlands


MedicalResearch.com: What are the main findings of the study?

Dr.van Geel: We performed a meta-analysis, which is a way to statistically summarize effect sizes from earlier studies. Individual studies often provide varying effect sizes, which makes it difficult to judge whether and how strong variables are related. Furthermore, study characteristics (sampling methods, response rates, controlling for certain confounders) might influence study results. By using a meta-analysis it can be analyzed to what extent study characteristics are related to results; if a particular result only tends to be established in studies with certain designs (for example a convenience sample), we might wonder whether such an effect really exists; but if we find that a particular outcome is unrelated to study characteristics or found in studies with relatively stronger designs, we might feel more certain in concluding that a relation between variables (bullying-suicide thoughts or attempts) exists.

By using a meta-analysis we established a significant relation between bullying and thoughts about suicide, and bullying and suicide attempts, and we found that these results were unrelated to study characteristics.
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Suicide: Bereavement Course in Close Relatives and Spouses

Marieke de Groot, PhD Senior Researcher University of Groningen/University Medical Center Groningen VU University Amsterdam, department of Clinical Psychology The EMGO Institute for Health and Care Research (EMGO+)MedicalResearch.com Interview with:
Marieke de Groot, PhD
Senior Researcher
University of Groningen/University Medical Center Groningen
VU University Amsterdam, department of Clinical Psychology
The EMGO Institute for Health and Care Research (EMGO+)

MedicalResearch.com: What are the main findings of the study?

Answer: We investigated the long term course of bereavement through suicide in a community-based sample of 153 first-degree relatives and spouses of 74 suicide cases. Outcome measures were complicated grief, depression and suicide ideation. We found that outcomes are mutually strongly associated over the 8-10 years course. A history of attempted suicide predicts a increased risk of suicide ideation during the bereavement course. Depression is more likely predicted by factors generally associated with a increased risk of depression such as female gender and low mastery, whereas complicated grief is more likely predicted by the trauma of losing a child due to suicide. No significant associations were found between outcomes and the use of help resources except for mutual (or peer) support, which is associated with a increased risk of complicated grief. Time is the only factor (included in this study) predicting decrease of the risk of depression and complicated grief.
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Suicide: Impact of 2008 Global Economic Crisis

Shu-Sen Chang, MD, MSc, PhD Research Assistant Professor HKJC Centre for Suicide Research and Prevention The University of Hong Kong 2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road Pokfulam, Hong KongMedicalResearch.com Interview with:
Shu-Sen Chang, MD, MSc, PhD
Research Assistant Professor
HKJC Centre for Suicide Research and Prevention
The University of Hong Kong
2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road Pokfulam, Hong Kong

MedicalResearch.com: What are the main findings of the study?

Dr. Chang: The study shows a marked increase in suicide in 2009 following the 2008 global economic crisis, particularly in men in the 27 European and 18 American countries included in the study. There were estimated approximately 5000 excess suicides across all 54 study countries in 2009. The largest increase in Europe was seen in 15-24 year old men and in 45-64 year old men in America.
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Sleep Duration as a Predictor of Moderate/High (vs Low) Suicide Risk in Insomnia

MedicalResearch.com eInterview with:

Linden Oliver, MA, Clinical Research Coordinator
University of Pennsylvania Behavioral Sleep Medicine Research Program Philadelphia, Pa

MedicalResearch.com: What are the main findings of the study?

Answer: We found that less sleep is associated with greater suicide risk in those with insomnia. Specifically, we looked at suicide risk in people with insomnia, and also asked how much sleep they got in the past month. In those with some suicide risk, the likelihood of being high risk (versus low risk) decreased by 72% for every hour of sleep that person reported getting at night.

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