Mental disorders and suicidal behavior in refugees and Swedish-born individuals: is the association affected by work disability?

Abstract Background Among potential pathways to suicidal behavior in individuals with mental disorders (MD), work disability (WD) may play an important role. We examined the role of WD in the relationship between MD and suicidal behavior in Swedish-born individuals and refugees. Methods The study cohort consisted of 4,195,058 individuals aged 16–64, residing in Sweden in 2004–2005, whereof 163,160 refugees were followed during 2006–2013 with respect to suicidal behavior. Risk estimates were calculated as hazard ratios (HR) with 95% confidence intervals (CI). The reference groups comprised individuals with neither MD nor WD. WD factors (sickness absence (SA) and disability pension (DP)) were explored as potential modifiers and mediators. Results In both Swedish-born and refugees, SA and DP were associated with an elevated risk of suicide attempt regardless of MD. In refugees, HRs for suicide attempt in long-term SA ranged from 2.96 (95% CI: 2.14–4.09) (no MD) to 6.23 (95% CI: 3.21–12.08) (MD). Similar associations were observed in Swedish-born. Elevated suicide attempt risks were also observed in DP. In Swedish-born individuals, there was a synergy effect between MD, and SA and DP regarding suicidal behavior. Both SA and DP were found to mediate the studied associations in Swedish-born, but not in refugees. Conclusion There is an effect modification and a mediating effect between mental disorders and WD for subsequent suicidal behavior in Swedish-born individuals. Also for refugees without MD, WD is a risk factor for subsequent suicidal behavior. Particularly for Swedish-born individuals with MD, information on WD is vital in a clinical suicide risk assessment.

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Depression as a mediator between bullying and suicidal behavior in children and adolescents

Behavioral Psychology/Psicología Conductual ◽

10.51668/bp.8321203n ◽

2021 ◽

Vol 29 (2) ◽

pp. 259-281

Author(s):

Anyerson Gómez-Tabares

Keyword(s):

Suicide Attempt ◽

Children And Adolescents ◽

Suicidal Behavior ◽

Structural Equation ◽

Suicide Risk ◽

Structural Equation Models ◽

School Bullying ◽

Mediating Effect ◽

Post Traumatic Stress ◽

The Relationship

Few studies have explored the mediating effect of depression on the relationship between school bullying and suicidal behavior. This study analyzed the mediating effect of depression on the association between school bullying and suicide risk and attempt in a sample of 221 children and adolescents between 11 and 17 years old (M= 13.52, SD= 1.74). Regression analysis showed that depression (OR= 1.2) and school bullying (OR= 1.4) explain between 34% and 54% of the variance in suicide risk. Depression (OR= 1.1) and the symptomatology of anxiety, depression, post-traumatic stress, and effects on self-esteem (OR= 1.3) explain between 25% and 41% of the variance in suicide attempt. Two structural equation models were constructed to demonstrate that depression mediates the relationship between school bullying, risk and suicide attempt. These findings will guide intervention strategies to prevent school bullying and suicide risk in school and community settings.

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Mental disorders, suicide attempt and suicide: differences in the association in refugees compared with Swedish-born individuals

The British Journal of Psychiatry ◽

10.1192/bjp.2019.215 ◽

2019 ◽

Vol 217 (6) ◽

pp. 679-685 ◽

Cited By ~ 3

Author(s):

Emma Björkenstam ◽

Magnus Helgesson ◽

Ridwanul Amin ◽

Ellenor Mittendorfer-Rutz

Keyword(s):

Mental Disorders ◽

Suicide Attempt ◽

Substance Misuse ◽

Psychiatric Care ◽

Reference Group ◽

Related Disorder ◽

Hazard Ratios ◽

History Of ◽

Specific Disorders ◽

The Relationship

BackgroundMental disorders are associated with an elevated risk for suicide attempt and suicide. Whether the strength of the associations also holds for refugees is unclear.AimsTo examine the relationship between specific mental disorders and suicide attempt and suicide in refugees and Swedish-born individuals.MethodThis longitudinal cohort study included 5 083 447 individuals aged 16–64 years, residing in Sweden in 2004, where 196 757 were refugees. Mental disorders were defined as having a diagnosis in psychiatric care during 2000–2004. Estimates of risk of suicide attempt and suicide were calculated as hazard ratios with 95% confidence intervals. Adjustments were made for important confounding factors, including history of attempt. The reference group comprised Swedish-born individuals without mental disorders.ResultsRates for suicide attempt in individuals with a mental disorder were lower in refugees compared with Swedish-born individuals (480 v. 850 per 100 000 person-years, respectively). This pattern was true for most specific disorders: compared with the reference group, among refugees, multivariable-adjusted hazard ratios for suicide attempt ranged from 3.0 (anxiety) to 7.4 (substance misuse), and among Swedish-born individuals, from 4.9 (stress-related disorder) to 9.3 (substance misuse). For schizophrenia, bipolar disorder and personality disorder, estimates for suicide attempt were comparable between refugees and Swedish-born individuals. Similar patterns were seen for suicide.ConclusionsFor most mental disorders, refugees were less likely to be admitted to hospital for suicide attempt or die by suicide compared with Swedish-born individuals. Further research on risk and protective factors for suicide attempt and suicide among refugees with mental disorders is warranted.Declaration of interestNone.

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Depression after Stroke and Risk of Mortality: A Systematic Review and Meta-Analysis

Stroke Research and Treatment ◽

10.1155/2013/862978 ◽

2013 ◽

Vol 2013 ◽

pp. 1-11 ◽

Cited By ~ 51

Author(s):

Francesco Bartoli ◽

Nicoletta Lillia ◽

Annamaria Lax ◽

Cristina Crocamo ◽

Vittorio Mantero ◽

...

Keyword(s):

Meta Analysis ◽

Long Term Outcomes ◽

Random Effects Models ◽

Risk Of Death ◽

Hazard Ratios ◽

Risk Of Mortality ◽

The Relationship ◽

Great Burden

Background.Depression after stroke may have great burden on the likelihood of functional recovery and long-term outcomes.Objective. To estimate the association between depression after stroke and subsequent mortality.Methods. A systematic search of articles using PubMed and Web of Science databases was performed. Odds ratios (ORs) and hazard ratios (HRs) were used as association measures for pooled analyses, based on random-effects models.Results. Thirteen studies, involving 59,598 subjects suffering from stroke (6,052 with and 53,546 without depression), had data suitable for meta-analysis. The pooled OR for mortality at followup in people suffering from depression after stroke was 1.22 (1.02–1.47). Subgroups analyses highlighted that only studies with medium-term followup (2–5 years) showed a statistically significant association between depression and risk of death. Four studies had data suitable for further analysis of pooled HR. The meta-analysis revealed a HR for mortality of 1.52 (1.02–2.26) among people with depression after stroke.Conclusions. Despite some limitations, this paper confirms the potential role of depression on post stroke mortality. The relationship between depression and mortality after stroke seems to be related to the followup duration. Further research is needed to clarify the nature of the association between depression after stroke and mortality.

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Interactive Effects of Acute Suicidal Affective Disturbance and Pain Persistence on Suicide Attempt Frequency and Lethality

Crisis ◽

10.1027/0227-5910/a000588 ◽

2019 ◽

Vol 40 (6) ◽

pp. 413-421 ◽

Cited By ~ 2

Author(s):

Megan L. Rogers ◽

Thomas E. Joiner

Keyword(s):

Suicide Attempt ◽

Suicidal Behavior ◽

Pain Perception ◽

Suicide Attempts ◽

Pain Tolerance ◽

Self Report ◽

Interactive Effects ◽

Physical Pain ◽

Affective Disturbance ◽

The Relationship

Abstract. Background: Acute suicidal affective disturbance (ASAD) has been proposed as a suicide-specific entity that confers risk for imminent suicidal behavior. Preliminary evidence suggests that ASAD is associated with suicidal behavior beyond a number of factors; however, no study to date has examined potential moderating variables. Aims: The present study tested the hypotheses that physical pain persistence would moderate the relationship between ASAD and (1) lifetime suicide attempts and (2) attempt lethality. Method: Students ( N = 167) with a history of suicidality completed self-report measures assessing the lifetime worst-point ASAD episode and the presence of a lifetime suicide attempt, a clinical interview about attempt lethality, and a physical pain tolerance task. Results: Physical pain persistence was a significant moderator of the association between ASAD and lifetime suicide attempts ( B = 0.00001, SE = 0.000004, p = .032), such that the relationship between ASAD and suicide attempts strengthened at increasing levels of pain persistence. The interaction between ASAD and pain persistence in relation to attempt lethality was nonsignificant ( B = 0.000004, SE = 0.00001, p = .765). Limitations: This study included a cross-sectional/retrospective analysis of worst-point ASAD symptoms, current physical pain perception, and lifetime suicide attempts. Conclusion: ASAD may confer risk for suicidal behavior most strongly at higher levels of pain persistence, whereas ASAD and pain perception do not influence attempt lethality.

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Cognitive Treatment for OCD

10.1093/oxfordhb/9780195376210.013.0076 ◽

2012 ◽

Author(s):

Maureen L. Whittal ◽

Melisa Robichaud

Keyword(s):

Term Treatment ◽

Future Directions ◽

Cognitive Treatment ◽

Long Term Treatment ◽

Inflated Responsibility ◽

And Control ◽

The Relationship ◽

Control Of Thoughts

The cornerstone of cognitive treatment (CT) for OCD is based upon the knowledge that unwanted intrusions are essentially a universal experience. As such, it is not the presence of the intrusion that is problematic but rather the associated meaning or interpretation. Treatment is flexible, depending upon the nature of the appraisals and beliefs, but can include strategies focused on inflated responsibility and overestimation of threat, importance and control of thoughts, and the need for perfectionism and certainty. The role of concealment and the relationship to personal values are important maintaining and etiological factors. The short-term and long-term treatment outcome is reviewed, along with predictors of treatment response and mechanisms of action, and the chapter concludes with future directions regarding CT for OCD.

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Blending in: A Case Study of Transitional Ambidexterity in the Financial Sector

Sustainability ◽

10.3390/su13041690 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1690

Author(s):

Beniamino Callegari ◽

Ranvir S. Rai

Keyword(s):

Financial Sector ◽

Economic Sustainability ◽

Organizational Ambidexterity ◽

Management Literature ◽

Innovative Capabilities ◽

Financial Firm ◽

The Relationship

Organizational ambidexterity is widely recognized as necessary for the economic sustainability of firms operating in the financial sector. While the management literature has recognized several forms of ambidexterity, the relationship between them and their relative merits remain unclear. By studying a process of implementation of ambidextrous capabilities within a large Scandinavian financial firm, we explore the role of top-down reforms and bottom-up reactions in determining the development of sector-specific innovative capabilities. We find that blended ambidexterity follows naturally from the attempt to correct the tensions arising from harmonic ambidextrous blueprints. The resulting blended practice appears to be closely related to the reciprocal model of ambidexterity, which appears to be a necessity rather than a choice, for large firms attempting to develop innovative capabilities. Consequently, we suggest to re-interpret current taxonomies of ambidexterity not as alternative blueprints, but rather as stages in a long-term process of transition.

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Relationship between Competency to Consent to Treatment and Psychological Well-Being: Mediating Effect of Empowerment and Emotion

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158170 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8170

Author(s):

Yeun-Joo Hur ◽

Joon-Ho Park ◽

MinKyu Rhee

Keyword(s):

Well Being ◽

Treatment Evaluation ◽

Mediating Effect ◽

Mediation Effect ◽

Psychiatric Outpatients ◽

Psychological Well Being ◽

Consent To Treatment ◽

Study Participants ◽

The Relationship

This study was conducted to evaluate the competency to consent to the treatment of psychiatric outpatients and to confirm the role of empowerment and emotional variables in the relationship between competency to consent to treatment and psychological well-being. The study participants consisted of 191 psychiatric outpatients who voluntarily consented to the study among psychiatric outpatients. As a result of competency to consent to treatment evaluation, the score of the psychiatric outpatient’s consent to treatment was higher than the cut-off point for both the overall and sub-factors, confirming that they were overall good. In addition, the effect of the ability of application on psychological well-being among competency to consent to treatment was verified using PROCESS Macro, and the double mediation effect using empowerment and emotional variables was verified to provide an expanded understanding of this. As a result of the analysis, empowerment completely mediated the relation between the ability of application and psychological well-being, and the relation between the ability of application and psychological well-being was sequentially mediated by empowerment and emotion-related variables. Based on these findings, the implications and limitations of this study were discussed.

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CO2 dynamics and heterogeneity in a cave atmosphere: role of ventilation patterns and airflow pathways

Theoretical and Applied Climatology ◽

10.1007/s00704-021-03722-w ◽

2021 ◽

Author(s):

Lovel Kukuljan ◽

Franci Gabrovšek ◽

Matthew D. Covington ◽

Vanessa E. Johnston

Keyword(s):

Temporal Variations ◽

Observation Point ◽

Spatially Distributed ◽

Combined Action ◽

Karst Systems ◽

The Relationship ◽

Co2 Dynamics ◽

Global Carbon

AbstractUnderstanding the dynamics and distribution of CO2 in the subsurface atmosphere of carbonate karst massifs provides important insights into dissolution and precipitation processes, the role of karst systems in the global carbon cycle, and the use of speleothems for paleoclimate reconstructions. We discuss long-term microclimatic observations in a passage of Postojna Cave, Slovenia, focusing on high spatial and temporal variations of pCO2. We show (1) that the airflow through the massif is determined by the combined action of the chimney effect and external winds and (2) that the relationship between the direction of the airflow, the geometry of the airflow pathways, and the position of the observation point explains the observed variations of pCO2. Namely, in the terminal chamber of the passage, the pCO2 is low and uniform during updraft, when outside air flows to the site through a system of large open galleries. When the airflow reverses direction to downdraft, the chamber is fed by inlets with diverse flow rates and pCO2, which enter via small conduits and fractures embedded in a CO2-rich vadose zone. If the spatial distribution of inlets and outlets produces minimal mixing between low and high pCO2 inflows, high and persistent gradients in pCO2 are formed. Such is the case in the chamber, where vertical gradients of up to 1000 ppm/m are observed during downdraft. The results presented in this work provide new insights into the dynamics and composition of the subsurface atmosphere and demonstrate the importance of long-term and spatially distributed observations.

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Sustainable Orientation of Management Capability and Innovative Performance: The Mediating Effect of Knowledge Management

Sustainability ◽

10.3390/su12041366 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1366

Author(s):

Julio C. Acosta-Prado ◽

Oscar H. López-Montoya ◽

Carlos Sanchís-Pedregosa ◽

Ulpiano J. Vázquez-Martínez

Keyword(s):

Knowledge Management ◽

Structural Equation ◽

Health Sector ◽

Mediating Effect ◽

Equation Modeling ◽

Innovative Performance ◽

Management Capability ◽

The Relationship ◽

Positive Effect

The literature suggests that innovation allows organizations to reach a desirable level of sustainability. There is evidence to support the role of knowledge management (KM) as well as management capability (MC) in producing a sustainable approach at organizations. Furthermore, organizations commonly achieve sustainable practices through corporate social responsibility (CSR). In particular, the health sector is increasingly implementing CSR strategies, although with a narrow understanding of the factors to success. Hence, trends lead to asymmetric growth between organizations. This study aims to examine the mediating role of KM in the relationship between MC and innovative performance (IP) in 331 Health Provider Institutions (HPIs). The research reflective model was assessed through Partial Least Squares Structural Equation Modeling (PLS-SEM). According to the results, MC has a positive effect on IP, MC has a positive effect on KM, and KM has a positive effect on IP. Likewise, KM significantly mediates the relationship between MC and IP. Our findings support the importance of KM in addressing MCs in HPIs as it enables innovative practices to address CSR goals to achieve a sustainable impact. Moreover, this study contributes by expanding KM to contexts that are not usually studied, such as health in a South American country.

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