Trends in suicidal ideation in England: the National Psychiatric Morbidity Surveys of 2000 and 2007

BackgroundRecent falls in suicide rates should be accompanied by a decline in the prevalence of suicidal ideation.MethodWe used a pseudo-cohort analytic strategy to examine trends in suicidal ideation measured identically in 2000 and 2007, in nationally representative English probability samples of adults aged ⩾ 16 years. Suicidal ideation included tiredness of life, death wishes and thoughts of suicide. Logistic regression models were fitted to estimate trends in age-specific prevalence of suicidal ideation in the past year and past week between 2000 and 2007.ResultsThere were 6799 participants aged 16–71 years in 2000, and 6815 participants aged 16–78 years in 2007. There was little evidence of trends in prevalence of suicidal ideation, with the exception of women aged 44–50 years in 2007, whose prevalence was unusually high. Prevalence of suicidal ideation in the past year followed a W-shaped profile with age, with peaks at the transition to adulthood, in the forties, and in the oldest participants.ConclusionsDespite falling suicide rates, suicidal ideation did not decline overall between 2000 and 2007. This may indicate the success of the National Suicide Prevention Strategy. Women aged 44–50 years in 2007 were, however, particularly prone to suicidal ideation. As they also have the highest age-adjusted prevalence of common mental disorders and the highest female suicide rate, there are clear implications for treatment access, availability and delivery in primary care.

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Association between sensory impairment and suicidal ideation and attempt: a cross-sectional analysis of nationally representative English household data

BMJ Open ◽

10.1136/bmjopen-2020-043179 ◽

2021 ◽

Vol 11 (2) ◽

pp. e043179

Author(s):

Maitri Khurana ◽

Natalie Shoham ◽

Claudia Cooper ◽

Alexandra Laura Pitman

Keyword(s):

Suicidal Ideation ◽

Suicide Attempt ◽

Psychiatric Morbidity ◽

Population Sample ◽

Cross Sectional Study ◽

Sensory Impairment ◽

Cross Sectional ◽

The Past ◽

Sensory Impairments ◽

Nationally Representative

ObjectivesSensory impairments are associated with worse mental health and poorer quality of life, but few studies have investigated whether sensory impairment is associated with suicidal behaviour in a population sample. We investigated whether visual and hearing impairments were associated with suicidal ideation and attempt.DesignNational cross-sectional study.SettingHouseholds in England.ParticipantsWe analysed data for 7546 household residents in England, aged 16 and over from the 2014 Adult Psychiatric Morbidity Survey.ExposuresSensory impairment (either visual or hearing), Dual sensory impairment (visual and hearing), visual impairment, hearing impairment.Primary outcomeSuicidal ideation and suicide attempt in the past year.ResultsPeople with visual or hearing sensory impairments had twice the odds of past-year suicidal ideation (OR 2.06; 95% CI 1.17 to 2.73; p<0.001), and over three times the odds of reporting past-year suicide attempt (OR 3.12; 95% CI 1.57 to 6.20; p=0.001) compared with people without these impairments. Similar results were found for hearing and visual impairments separately and co-occurring.ConclusionsWe found evidence that individuals with sensory impairments are more likely to have thought about or attempted suicide in the past year than individuals without.

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Paid employment and common mental disorders in 50–64-year olds: analysis of three cross-sectional nationally representative survey samples in 1993, 2000 and 2007

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796017000403 ◽

2017 ◽

Vol 28 (1) ◽

pp. 88-99

Author(s):

G. Perera ◽

G. Di Gessa ◽

L. M. Corna ◽

K. Glaser ◽

R. Stewart

Keyword(s):

Mental Health ◽

Employment Status ◽

Common Mental Disorders ◽

Common Mental Disorder ◽

Psychiatric Morbidity ◽

Housing Tenure ◽

Cross Sectional ◽

Paid Employment ◽

Nationally Representative ◽

Over Time

Aims.Associations between employment status and mental health are well recognised, but evidence is sparse on the relationship between paid employment and mental health in the years running up to statutory retirement ages using robust mental health measures. In addition, there has been no investigation into the stability over time in this relationship: an important consideration if survey findings are used to inform future policy. The aim of this study is to investigate the association between employment status and common mental disorder (CMD) in 50–64-year old residents in England and its stability over time, taking advantage of three national mental health surveys carried out over a 14-year period.Methods.Data were analysed from the British National Surveys of Psychiatric Morbidity of 1993, 2000 and 2007. Paid employment status was the primary exposure of interest and CMD the primary outcome – both ascertained identically in all three surveys (CMD from the revised Clinical Interview Schedule). Multivariable logistic regression models were used.Results.The prevalence of CMD was higher in people not in paid employment across all survey years; however, this association was only present for non-employment related to poor health as an outcome and was not apparent in those citing other reasons for non-employment. Odds ratios for the association between non-employment due to ill health and CMD were 3.05 in 1993, 3.56 in 2000, and 2.80 in 2007, after adjustment for age, gender, marital status, education, social class, housing tenure, financial difficulties, smoking status, recent physical health consultation and activities of daily living impairment.Conclusions.The prevalence of CMD was higher in people not in paid employment for health reasons, but was not associated with non-employment for other reasons. Associations had been relatively stable in strength from 1993 to 2007 in those three cross-sectional nationally representative samples.

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The contribution of work and non-work stressors to common mental disorders in the 2007 Adult Psychiatric Morbidity Survey

Psychological Medicine ◽

10.1017/s0033291711001759 ◽

2011 ◽

Vol 42 (4) ◽

pp. 829-842 ◽

Cited By ~ 47

Author(s):

C. Clark ◽

C. Pike ◽

S. McManus ◽

J. Harris ◽

P. Bebbington ◽

...

Keyword(s):

Social Support ◽

Mental Disorders ◽

Psychological Health ◽

Common Mental Disorders ◽

Psychiatric Morbidity ◽

Workplace Stress ◽

Housing Quality ◽

Work Stressors ◽

Compulsive Disorder ◽

The Past

BackgroundEvidence for an effect of work stressors on common mental disorders (CMD) has increased over the past decade. However, studies have not considered whether the effects of work stressors on CMD remain after taking co-occurring non-work stressors into account.MethodData were from the 2007 Adult Psychiatric Morbidity Survey, a national population survey of participants ⩾16 years living in private households in England. This paper analyses data from employed working age participants (N=3383: 1804 males; 1579 females). ICD-10 diagnoses for depressive episode, generalized anxiety disorder, obsessive compulsive disorder, agoraphobia, social phobia, panic or mixed anxiety and depression in the past week were derived using a structured diagnostic interview. Questionnaires assessed self-reported work stressors and non-work stressors.ResultsThe effects of work stressors on CMD were not explained by co-existing non-work stressors. We found independent effects of work and non-work stressors on CMD. Job stress, whether conceptualized as job strain or effort–reward imbalance, together with lower levels of social support at work, recent stressful life events, domestic violence, caring responsibilities, lower levels of non-work social support, debt and poor housing quality were all independently associated with CMD. Social support at home and debt did not influence the effect of work stressors on CMD.ConclusionsNon-work stressors do not appear to make people more susceptible to work stressors; both contribute to CMD. Tackling workplace stress is likely to benefit employee psychological health even if the employee's home life is stressful but interventions incorporating non-work stressors may also be effective.

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Pharmacovigilance of suspected or confirmed therapeutic ineffectiveness of artemisinin-based combination therapy: extent, associated factors, challenges and solutions to reporting

10.21203/rs.3.rs-36571/v2 ◽

2020 ◽

Author(s):

Ronald Kiguba ◽

Helen Byomire Ndagije ◽

Victoria Nambasa ◽

Leonard Manirakiza ◽

Elijah Kirabira ◽

...

Keyword(s):

Combination Therapy ◽

Associated Factors ◽

Sub Saharan Africa ◽

Pharmacovigilance Centre ◽

Public And Private ◽

Logistic Regression Models ◽

The Past ◽

National Pharmacovigilance Centre ◽

Nationally Representative ◽

Sub Saharan

Abstract Background Therapeutic ineffectiveness of artemisinin-based combination therapy (ACT) increases the risk of malaria-related morbidity and mortality, and raises healthcare costs. Yet, little has been done to promote the pharmacovigilance (PV) of ACT ineffectiveness in sub-Saharan Africa, particularly in Uganda. This study aimed to determine the extent and associated factors of the past 6 months reporting of suspected or confirmed ACT therapeutic ineffectiveness by healthcare professionals (HCPs), and difficulties and potential solutions to the PV of ACT therapeutic ineffectiveness.Methods Survey of 685 HCPs conducted using a self-administered questionnaire from June to July 2018 in a nationally representative sample of public and private health facilities in Uganda. HCPs disclosed if they had spontaneously reported ACT therapeutic ineffectiveness to appropriate authorities in the previous 6 months. Multivariable logistic regression models were used to identify determinants of past 6-months, HCP-reported ACT therapeutic ineffectiveness.Results One in five (20%, 137/685; 95% CI: 17-23%) HCPs reported ACT therapeutic ineffectiveness to an appropriate authority in the previous 6 months. HCPs commonly reported ACT therapeutic ineffectiveness to immediate supervisors (72%, 106/147), mostly verbally only (80%, 109/137); none had ever submitted a written report of ACT therapeutic ineffectiveness to Uganda’s National Pharmacovigilance Centre. Common difficulties of reporting ACT therapeutic ineffectiveness were: unavailability of reporting procedures (31%, 129/421), poor follow-up of treated patients (22%, 93/421) and absence of reporting tools (16%, 68/421). Factors associated with reporting ACT therapeutic ineffectiveness in the past 6 months were: hospital-status (vs other; OR = 2.4, 95% CI, 1.41-4.21), HCPs aged under 25 years (OR = 2.2, 95% CI, 1.29-3.76), suspicion of ACT therapeutic ineffectiveness in the past 4 weeks (OR = 2.3, 95% CI, 1.29-3.92), receipt of patient-complaint(s) of ACT therapeutic ineffectiveness in the past 4 weeks (OR = 2.9, 95% CI, 1.62-5.12) and HCPs from northern (vs central; OR = 0.5, 95% CI, 0.28-0.93) and western (vs central; OR = 0.4, 95% CI, 0.17-0.77) parts of Uganda.Conclusion One in five HCPs reported ACT therapeutic ineffectiveness, mostly verbally to supervisors. The existing adverse drug reaction (ADR)-reporting infrastructure could be leveraged to promote the PV of ACT therapeutic ineffectiveness.

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Panic disorder and subthreshold panic in the UK general population: Epidemiology, comorbidity and functional limitation

European Psychiatry ◽

10.1016/j.eurpsy.2010.06.004 ◽

2011 ◽

Vol 26 (6) ◽

pp. 354-362 ◽

Cited By ~ 25

Author(s):

P. Skapinakis ◽

G. Lewis ◽

S. Davies ◽

T. Brugha ◽

M. Prince ◽

...

Keyword(s):

Panic Disorder ◽

Functional Impairment ◽

Psychiatric Morbidity ◽

Functional Limitation ◽

Interview Schedule ◽

Important Public Health ◽

National Statistics ◽

The Past ◽

Nationally Representative ◽

The Uk

AbstractObjectiveThe epidemiology of panic disorder has not been investigated in the past in the UK using a nationally representative sample of the population. The aim of the present paper was to examine the epidemiology, comorbidity and functional impairment of subthreshold panic and panic disorder with or without agoraphobia.MethodWe used data from the 2000 Office for National Statistics Psychiatric Morbidity survey (N = 8580). Panic disorder and agoraphobia were assessed with the Revised Clinical Interview Schedule (CIS-R).ResultThe prevalence of panic disorder with or without agoraphobia was 1.70% (95% confidence interval: 1.41–2.03%). Subthreshold panic was more common. Economic inactivity was consistently associated with all syndromes. The comorbidity pattern of the panic syndromes and the associated functional impairment show that panic-related conditions are important public health problems, even in subthreshold status.ConclusionsThe findings show that efforts to reduce the disability associated with psychiatric disorders should include detection and management of panic disorder.

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The spectrum of suicidal ideation in Great Britain: comparisons across a 16–74 years age range

Psychological Medicine ◽

10.1017/s0033291707000013 ◽

2007 ◽

Vol 37 (6) ◽

pp. 795-805 ◽

Cited By ~ 41

Author(s):

MICHAEL DENNIS ◽

SARAH BAILLON ◽

TRAOLACH BRUGHA ◽

JAMES LINDESAY ◽

ROBERT STEWART ◽

...

Keyword(s):

Great Britain ◽

Suicidal Ideation ◽

Psychiatric Disorder ◽

Older People ◽

Psychiatric Morbidity ◽

Older Age ◽

Age Group ◽

Suicidal Thoughts ◽

Death Wishes ◽

Age Range

Background. Previous studies have examined suicidal ideation in older populations and emphasized the strong association with the presence of psychiatric disorder. However, associations with the presence of psychiatric disorder across the age range are unclear. Representative epidemiological estimates are needed.Method. In a national survey of psychiatric morbidity in Great Britain, 8580 randomly selected adults were interviewed. Three questions were asked to assess suicidal ideation, and psychiatric disorder was identified using the revised Clinical Interview Schedule (CIS-R).Results. Suicidal ideation was up to three times commoner in younger adults than in those aged 55–74 years but the odds of depression in those with suicidal thoughts was significantly greater in the older age group (p<0·01). Tiredness with life (p<0·01) and thoughts of death (p<0·01) were also more strongly associated with depression in the older age group. Other major associations of suicidal ideation for all ages were: smaller social support group, being divorced or separated, poor self-rated general health, and limitations in activities of daily living (ADL). Being single was an important factor for younger age groups, and widowhood for older people. Life events were also important in younger people, but not in those aged 55–74 years.Conclusions. Suicidal thoughts and death wishes are comparatively more unusual in older people; however, they are more likely to be associated with clinical depression. In terms of suicide prevention this study emphasizes the importance of improving rates of recognition and treatment of depression in older people.

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Association between spousal violence and the incidence of acute respiratory infection among children under five: random-effect modelling using data from Nigeria and Bangladesh

Journal of Biosocial Science ◽

10.1017/s0021932018000329 ◽

2018 ◽

Vol 51 (4) ◽

pp. 534-548 ◽

Cited By ~ 1

Author(s):

Mian B. Hossain ◽

Ifeyinwa Udo ◽

James F. Phillips

Keyword(s):

Respiratory Infection ◽

Partner Violence ◽

Acute Respiratory Infection ◽

Random Effect ◽

Spousal Violence ◽

Gender Based Violence ◽

Nigerian Women ◽

Logistic Regression Models ◽

The Past ◽

Nationally Representative

AbstractAcute respiratory infection (ARI) is a major cause of mortality among children under the age of five in developing countries. This paper examines Demographic and Health Survey (DHS) data on maternal recall of episodes of ARI in the contrasting settings of Bangladesh and Nigeria, where about 11.1% and 3.3% of under-5 children, respectively, are reported to have symptoms of ARI. The surveys found that about 25.6% of married Bangladeshi women and 15.4% of married Nigerian women reported experiencing spousal violence in the past year. To test the proposition that women’s experience of intimate partner violence (IPV) is associated with adversity in their children, the study examined the relationship between spousal violence in the past year and childhood ARI in the past 2 weeks among children under the age of five in Bangladesh and Nigeria. Data were taken from a nationally representative sample of mothers aged 15–49 years obtained from the 2007 Bangladesh DHS and 2008 Nigeria DHS. Random-effects multiple logistic regression models were estimated to assess the association of maternal exposure to IPV with the incidence of ARI in the past 2 weeks among under-5 children after controlling for the potentially confounding effects of maternal social and demographic characteristics. Results from Nigeria suggest that the odds of ARI incidence among children of mothers who were IPV victims were almost two times higher than among their counterparts whose mothers had not experienced IPV (OR = 1.78; 95% CI: 1.45–2.19; p <0.001). Similarly, the odds for the children of Bangladeshi IPV victims were elevated one and half times (OR = 1.61; 95% CI: 1.21–2.14; p <0.001). The findings suggest that under-5 children suffer indirect health consequences of gender-based violence.

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Pharmacovigilance of suspected or confirmed therapeutic ineffectiveness of artemisinin-based combination therapy: extent, associated factors, challenges and solutions to reporting

Malaria Journal ◽

10.1186/s12936-020-03463-7 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Ronald Kiguba ◽

Helen Byomire Ndagije ◽

Victoria Nambasa ◽

Leonard Manirakiza ◽

Elijah Kirabira ◽

...

Keyword(s):

Combination Therapy ◽

Associated Factors ◽

Sub Saharan Africa ◽

Pharmacovigilance Centre ◽

Public And Private ◽

Logistic Regression Models ◽

The Past ◽

National Pharmacovigilance Centre ◽

Nationally Representative ◽

Sub Saharan

Abstract Background Therapeutic ineffectiveness of artemisinin-based combination therapy (ACT) increases the risk of malaria-related morbidity and mortality, and raises healthcare costs. Yet, little has been done to promote the pharmacovigilance (PV) of ACT ineffectiveness in sub-Saharan Africa, particularly in Uganda. This study aimed to determine the extent and associated factors of the past 6 months reporting of suspected or confirmed ACT therapeutic ineffectiveness by healthcare professionals (HCPs), and difficulties and potential solutions to the PV of ACT therapeutic ineffectiveness. Methods Survey of 685 HCPs conducted using a self-administered questionnaire from June to July 2018 in a nationally representative sample of public and private health facilities in Uganda. HCPs disclosed if they had spontaneously reported ACT therapeutic ineffectiveness to appropriate authorities in the previous 6 months. Multivariable logistic regression models were used to identify determinants of past 6-months, HCP-reported ACT therapeutic ineffectiveness. Results One in five (20%, 137/685; 95% CI 17–23%) HCPs reported ACT therapeutic ineffectiveness to an appropriate authority in the previous 6 months. HCPs commonly reported ACT therapeutic ineffectiveness to immediate supervisors (72%, 106/147), mostly verbally only (80%, 109/137); none had ever submitted a written report of ACT therapeutic ineffectiveness to Uganda’s National Pharmacovigilance Centre. Common difficulties of reporting ACT therapeutic ineffectiveness were: unavailability of reporting procedures (31%, 129/421), poor follow-up of treated patients (22%, 93/421) and absence of reporting tools (16%, 68/421). Factors associated with reporting ACT therapeutic ineffectiveness in the past 6 months were: hospital-status (vs other; OR = 2.4, 95% CI 1.41–4.21), HCPs aged under 25 years (OR = 2.2, 95% CI 1.29–3.76), suspicion of ACT therapeutic ineffectiveness in the past 4 weeks (OR = 2.3, 95% CI 1.29–3.92), receipt of patient-complaint(s) of ACT therapeutic ineffectiveness in the past 4 weeks (OR = 2.9, 95% CI 1.62–5.12) and HCPs from northern (vs central; OR = 0.5, 95% CI 0.28–0.93) and western (vs central; OR = 0.4, 95% CI 0.17–0.77) parts of Uganda. Conclusion One in five HCPs reported ACT therapeutic ineffectiveness, mostly verbally to supervisors. The existing adverse drug reaction (ADR)-reporting infrastructure could be leveraged to promote the PV of ACT therapeutic ineffectiveness.

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Personal debt and suicidal ideation

Psychological Medicine ◽

10.1017/s0033291710001261 ◽

2010 ◽

Vol 41 (4) ◽

pp. 771-778 ◽

Cited By ~ 84

Author(s):

H. Meltzer ◽

P. Bebbington ◽

T. Brugha ◽

R. Jenkins ◽

S. McManus ◽

...

Keyword(s):

Suicidal Ideation ◽

Credit Card ◽

Psychiatric Morbidity ◽

Sociodemographic Factors ◽

Psychiatric Evaluation ◽

Suicidal Thoughts ◽

The Past ◽

Relationship Breakdown ◽

Anxiety Depression ◽

The Relationship

BackgroundPersonal debt is one of many factors associated with anxiety, depression and suicidality. The aim of this study was to examine the relationship between personal debt and suicidal ideation in the context of sociodemographic factors, employment and income, lifestyle behaviours, and recently experienced traumatic events.MethodInterviews were conducted with a random probability sample comprising 7461 respondents for the third national survey of psychiatric morbidity of adults in England. Fieldwork was carried out throughout 2007. The prevalence of suicidal thoughts in the past week, past year and lifetime was assessed and current sources of debt were recorded.ResultsIn 2007, 4.3% of adults in England had thought about taking their own life in the past 12 months, ranging from 1.8% of men aged ⩾55 years to 7.0% of women aged 35–54 years. Those in debt were twice as likely to think about suicide after controlling for sociodemographic, economic, social and lifestyle factors. Difficulty in making hire purchase or mail order repayments and paying off credit card debt, in addition to housing-related debt (rent and mortgage arrears), was strongly associated with suicidal thoughts. Feelings of hopelessness partially mediated the relationship between debt and suicidal ideation.ConclusionsThe number of debts, source of the debt and reasons for debt are key correlates of suicidal ideation. Individuals experiencing difficulties in repaying their debts because they are unemployed or have had a relationship breakdown or have heavy caring responsibilities may require psychiatric evaluation in addition to debt counselling.

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What is the extent of COVID-19 vaccine hesitancy in Bangladesh? A cross-sectional rapid national survey

BMJ Open ◽

10.1136/bmjopen-2021-050303 ◽

2021 ◽

Vol 11 (8) ◽

pp. e050303

Author(s):

Mohammad Ali ◽

Ahmed Hossain

Keyword(s):

Logistic Regression ◽

Low Income ◽

Vaccine Hesitancy ◽

Multiple Logistic Regression ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

The Past ◽

Nationally Representative ◽

The Government

ObjectivesTo assess COVID-19 vaccine hesitancy in Bangladesh and identify population subgroups with higher odds of vaccine hesitancy.DesignA nationally representative cross-sectional survey was used for this study. Descriptive analyses helped to compute vaccine hesitancy proportions and compare them across groups. Multiple logistic regression analyses were performed to compute the adjusted OR.SettingBangladesh.ParticipantsA total of 1134 participants from the general population, aged 18 years and above participated in this study.Outcome measuresPrevalence and predictors of vaccine hesitancy.ResultsOf the total participants, 32.5% showed COVID-19 vaccine hesitancy. Hesitancy was high among respondents who were men, over 60, unemployed, from low-income families, from central Bangladesh, including Dhaka, living in rented houses, tobacco users, politically affiliated, doubtful of the vaccine’s efficacy for Bangladeshis and those who did not have any physical illnesses in the past year. In the multiple logistic regression models, transgender respondents (adjusted OR, AOR=3.62), married individuals (AOR=1.49), tobacco users (AOR=1.33), those who had not experienced any physical illnesses in the past year (AOR=1.49), those with political affiliations with opposition parties (AOR=1.48), those who believed COVID-19 vaccines would not be effective for Bangladeshis (AOR=3.20), and those who were slightly concerned (AOR=2.87) or not concerned at all (AOR=7.45) about themselves or a family member getting infected with COVID-19 in the next year were significantly associated with vaccine hesitancy (p<0.05).ConclusionsGiven the high prevalence of COVID-19 vaccine hesitancy, in order to guarantee that COVID-19 vaccinations are widely distributed, the government and public health experts must be prepared to handle vaccine hesitancy and increase vaccine awareness among potential recipients. To address these issues and support COVID-19 immunisation programs, evidence-based educational and policy-level initiatives must be undertaken especially for the poor, older and chronically diseased individuals.

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