Delayed reward discounting and increased risk for suicide attempts among U.S. adults with probable PTSD

Background: Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. Aims: This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Methods: Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Results: Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. Conclusions: The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.

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756 The Moderating Influence of Depression on Insomnia and Suicidal Ideation in a Military Sample

SLEEP ◽

10.1093/sleep/zsab072.753 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A294-A295

Author(s):

Emma Palermo ◽

Jennifer Goldschmied ◽

Elaine Boland ◽

Elizabeth A Klingaman ◽

Philip Gehrman ◽

...

Keyword(s):

Depressive Symptoms ◽

Suicidal Ideation ◽

Research University ◽

Negative Binomial ◽

Suicide Attempts ◽

Risk And Resilience ◽

Depression Severity ◽

Significant Interaction Effect ◽

Increased Risk ◽

The Impact

Abstract Introduction Military personnel are at an increased risk for suicide compared to the general population, making it important to develop a deeper understanding of which factors contribute to this elevated risk. Given that suicidal ideation (SI) is one of the strongest predictors of suicide attempts, understanding factors that underlie SI may improve prevention efforts. Insomnia and depression both serve as independent risk factors for SI, and therefore the aim of this study was to examine the extent to which depressive symptoms moderate the association between insomnia and SI. Methods Data were obtained from the All Army Study of the Army Study to Assess Risk and Resilience in Servicemembers (STARRS). Soldiers (n=21,450) completed questions related to suicidal ideation (5 items), depressive symptoms (9 items), and insomnia (5 items) based on symptom presence in the past 30 days. Items in each domain were summed to create a total severity score. GEE models using a negative binomial linking function were conducted to examine the impact of depression, insomnia, and their interaction on SI. Results Both depression (χ2 =117.56, p<0.001) and insomnia (χ2=11.79, p=0.0006) were found to have significant main effects on SI, and there was a significant interaction effect (χ2=4.52, p=0.0335). Follow up simple effects revealed that insomnia was no longer significantly associated with SI when depression severity was low, but was associated with SI in the presence of greater depression severity (χ2=2.91, p=0.0882). Conclusion In a large sample of Army soldiers, depression significantly moderated the association between SI and insomnia, such that insomnia seems to amplify the effects of depression on SI. These findings highlight the importance of addressing insomnia severity as a mean of reducing SI in those with depression, potentially allowing for intervention prior to a suicide attempt. Support (if any) Perlis: K24AG055602 & R01AG041783. This publication is based on public use data from Army STARRS (Inter-university Consortium for Political and Social Research, University of Michigan- http://doi.org/10.3886/ICPSR35197-v1), funded by U.S. NIMH-U01MH087981.

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Chinese Sexual Minority Male Adolescents’ Suicidality and Body Mass Index

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15112558 ◽

2018 ◽

Vol 15 (11) ◽

pp. 2558 ◽

Cited By ~ 2

Author(s):

Yeen Huang ◽

Pengsheng Li ◽

Zhisheng Lai ◽

Xiaofei Jia ◽

Di Xiao ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Sexual Minority ◽

Weight Status ◽

Suicide Attempts ◽

Male Students ◽

Minority Status ◽

Minority Males ◽

Male Adolescents ◽

Increased Risk

Excess weight status may increase the risk of suicidality among sexual minority females, but few studies have examined this suicidality disparity in sexual minority males. This study examined the association between sexual minority status and suicide attempts in Chinese male adolescents and tested whether body mass index (BMI) had a moderating effect on that association. Data were collected from 7th to 12th graders from seven randomly selected provinces of China in the 2015 School-Based Chinese Adolescents Health Survey. In total, 72,409 male students completed the questionnaires regarding sexual attraction, self-reported weight and height, and suicide attempts. After adjustment for covariates, sexual minority status was associated with suicide attempts among male students (AOR = 1.74, 95% CI = 1.57–1.93). Stratification analyses showed that BMI category moderated this association; compared with the results before stratification analyses, sexual minority males who were obese had increased risk of suicide attempts (AOR = 2.15, 95% CI = 1.09–4.24), sexual minority males who were overweight had reduced odds of suicide attempts (AOR = 1.40, 95% CI = 1.01–1.92), and no significant association change was found in sexual minority males who were underweight (AOR = 1.82, 95% CI = 1.43–2.33). Our study indicated that BMI moderated the risk of suicide attempts in sexual minority males. Suicide prevention targeting sexual minority males should be focused on weight status disparity and the creation of a positive climate to reduce minority stressors due to body image.

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Preditores de idealização suicida entre estudantes de medicina: uma revisão sistemática

International Journal of Health Education ◽

10.17267/2594-7907ijhe.v3i1.2413 ◽

2019 ◽

Vol 3 (1) ◽

pp. 78

Author(s):

Victor Meireles Campos ◽

Ieda Aleluia

Keyword(s):

Systematic Review ◽

Medical Students ◽

Suicidal Ideation ◽

Suicide Attempts ◽

Training Methods ◽

Increased Risk ◽

The World ◽

The Subject ◽

Health Objective ◽

De Medicina

BACKGROUND: Suicidal ideation is one of the main symptoms indicative of suicide attempts and suicide. According to the WHO, about 800,000 cases of suicide were reported around the world in 2014, which translates to an index of 1 suicide every 40 seconds. Medical students constitute a population at risk for the development of suicidal ideation. Several life factors may influence the risk of suicidal ideation, those being personality traits, social factors and mental health. OBJECTIVE: Identify the indicators of suicidal ideation among medical students during their academic training. METHODS: This is a systematic review carried out in the electronic databases Pubmed and BVS. Articles that addressed the subject of suicidal ideation among medical students in Portuguese, English and Spanish from 2008 to 2018 were included. RESULTS: We found 263 articles, of which 12 articles met the inclusion and exclusion criteria. After the application of the STROBE statement, 6 articles were selected for the creation of this systematic review. The prevalence of suicidal ideation varied from 3.7% to 35.6% around the world and several factors were linked to the increase of suicidal ideation risk. CONCLUSION: A suicidal ideation is a frequent and multifactorial phenomenon that involves several realms of a medical student's life. The risk factors identified in this review were linked to the increased risk of suicidal ideation development.

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Mortality in offspring of mothers with psychotic disorder

Psychological Medicine ◽

10.1017/s0033291707002383 ◽

2007 ◽

Vol 38 (8) ◽

pp. 1203-1210 ◽

Cited By ~ 9

Author(s):

J. Suvisaari ◽

L. Häkkinen ◽

J. Haukka ◽

J. Lönnqvist

Keyword(s):

High Risk ◽

General Population ◽

Psychotic Disorder ◽

Psychotic Disorders ◽

Suicide Attempts ◽

Risk Group ◽

High Risk Group ◽

Suicide Mortality ◽

Increased Risk ◽

Maternal Suicide

BackgroundPrevious studies suggest that offspring of mothers with psychotic disorders have an almost two-fold higher mortality risk from birth until early adulthood. We investigated predictors of mortality from late adolescence until middle age in offspring of mothers with psychotic disorders.MethodThe Helsinki High-Risk Study follows up offspring (n=337) of women treated for schizophrenia spectrum disorders in mental hospitals in Helsinki before 1975. Factors related to mortality up to 2005 among offspring of these mothers was investigated with a survival model. Hazard rate ratios (HRR) were calculated using sex, diagnosis of psychotic disorder, childhood socio-economic status, maternal diagnosis, and maternal suicide attempts and aggressive symptoms as explanatory variables. The effect of family was investigated by including a frailty term in the model. We also compared mortality between the high-risk group and the Finnish general population.ResultsWithin the high-risk group, females had lower all-cause mortality (HRR 0.43, p=0.05) and mortality from unnatural causes (HRR 0.24, p=0.03) than males. Having themselves been diagnosed with a psychotic disorder was associated with higher mortality from unnatural causes (HRR 4.76, p=0.01), while maternal suicide attempts were associated with higher suicide mortality (HRR 8.64, p=0.03). Mortality in the high-risk group was over two-fold higher (HRR 2.44, p<0.0001) than in the general population, and remained significantly higher when high-risk offspring who later developed psychotic disorders were excluded from the study sample (HRR 2.30, p<0.0001).ConclusionsOffspring of mothers with psychotic disorder are at increased risk of several adverse outcomes, including premature death.

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Supplemental Material for One-Year Predictions of Delayed Reward Discounting in the Adolescent Brain Cognitive Development Study

Experimental and Clinical Psychopharmacology ◽

10.1037/pha0000532.supp ◽

2021 ◽

Keyword(s):

Cognitive Development ◽

Development Study ◽

Delayed Reward ◽

Delayed Reward Discounting ◽

One Year

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A global perspective on suicides and suicide attempts

Oxford Textbook of Suicidology and Suicide Prevention ◽

10.1093/med/9780198834441.003.0013 ◽

2021 ◽

pp. 93-98

Author(s):

Elise Paul

Keyword(s):

Suicide Attempt ◽

Suicide Attempts ◽

Global Perspective ◽

World Health ◽

Populations At Risk ◽

Increased Risk ◽

World Mental Health Survey ◽

The World ◽

Health Organization ◽

Ongoing Monitoring

Specific populations at risk for suicide differ considerably according to region, country, sex, age, and the most common suicide methods used, highlighting the need for ongoing systematic surveillance to inform prevention efforts. The magnitude of the problem is not limited to suicide deaths. It is estimated that for every suicide, there are 20 more persons who have made an attempt. Individuals who have made a suicide attempt are at increased risk for dying by suicide. This chapter explores differences in the suicide and suicide attempt rates in the general population on different continents, by examining data from the World Health Organization (WHO) Global Health Estimates and the World Mental Health Survey Initiative. Differences across contexts in suicidal behaviours and the need for ongoing monitoring are emphasized.

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Risks of suicide attempts after prescription of zolpidem in people with depression: a nationwide population study in South Korea

SLEEP ◽

10.1093/sleep/zsz235 ◽

2019 ◽

Vol 43 (3) ◽

Author(s):

Hyewon Kim ◽

Yuwon Kim ◽

Woojae Myung ◽

Maurizio Fava ◽

David Mischoulon ◽

...

Keyword(s):

Suicide Attempt ◽

Medical Records ◽

Suicide Attempts ◽

Case Series ◽

Population Based ◽

Additional Increase ◽

Series Design ◽

Increased Risk ◽

Before And After ◽

Rate Ratios

Abstract Objectives To investigate the association between zolpidem prescription and suicide attempts in people with depression Methods A nationwide, population-based electronic medical records database from the Health Insurance Review & Assessment Service of South was used to investigate the incidence rate ratios (IRRs) of suicide attempts and probable suicide attempts in people with depression before and after zolpidem prescription using self-controlled case series design. Results In a total of 445 people who attempted suicide and 23 141 people who attempted probable suicide attempt, the IRRs of suicidal behavior during the risk periods before and after zolpidem prescription increased compared with those at the baseline. The IRRs gradually increased and peaked immediately before the prescription of zolpidem. The IRR was 70.06 (95% CI: 25.58–191.90) on day 2 before zolpidem prescription and 63.35 (95% CI: 22.99–174.59) on day 1 after zolpidem prescription in the suicide attempt group. The IRR was 24.07 (95% CI: 20.50–28.26) on the day before zolpidem prescription and 14.96 (95% CI: 12.21–18.34) on the day after zolpidem prescription in the probable suicide attempt group. The ratios declined eventually after zolpidem was prescribed. Conclusions Although zolpidem prescription was associated with an increased risk of suicide attempts in people with depression, the risk increased and peaked immediately before zolpidem prescription. The risk declined gradually thereafter. This result indicates that the risk of suicide attempts increases at the time of zolpidem prescription. However, zolpidem prescription does not contribute to additional increase in the risk of suicide attempts.

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DEATH ANXIETY AND FINANCIAL DECISION-MAKING IN AGING: A STUDY FROM THE HUMAN CONNECTOME PROJECT AGING (HCP-A)

Innovation in Aging ◽

10.1093/geroni/igz038.3311 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S907-S907

Author(s):

Timothy K Ly ◽

Mirella Diaz-Santos ◽

Liam Campbell ◽

Marcela Caldera ◽

Taylor Kuhn ◽

...

Keyword(s):

Older Adults ◽

Decision Making ◽

Death Anxiety ◽

Late Life ◽

Financial Decision Making ◽

Monetary Rewards ◽

Delayed Reward ◽

Human Connectome Project ◽

Financial Decision ◽

Delayed Reward Discounting

Abstract While research addressing late-life death anxiety (the fear of death or the dying process) has focused on end-of-life care decision-making, few have studied the effect of late-life death anxiety on financial decision-making. This is particularly relevant to financial decision-making as older adults are more vulnerable to fraud and deception. The aim of this study was to determine how age and death anxiety affect financial decision-making in a sample of older adults of 60-93 years of age (N = 102), who participated in the HCP-A project at UCLA. To study this relationship, we used a delayed reward discounting task to model financial decision-making, where higher rates of discounting indicate a greater preference for immediate, smaller monetary rewards and lower rates of discounting indicate more future-oriented planning. To account for age-related cognitive decline, cognitive functioning was assessed using the NIH Toolbox. We hypothesized that the presence of death anxiety will increase discounting of future rewards in older adults. Results from a univariate ANOVA showed an interaction between age, death anxiety, and delayed reward discounting. Specifically, older adults with self-reported death anxiety showed greater preference for immediate, smaller monetary rewards. By controlling for cognition, these findings suggest that death anxiety moderates decision-making in late-life adults and may add to our understanding of why older adults are more susceptible to financial abuse. These results suggest a need to consider death anxiety as a moderating variable when developing and implementing policies and services that are geared towards older adults.

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