Prevalence of suicidal behaviour and associated factors in a large sample of Chinese adolescents

Aims.Suicidal behaviour is prevalent among adolescents and is a significant predictor of future suicide attempts (SAs) and suicide death. Data on the prevalence and epidemiological characteristics of suicidal behaviour in Chinese adolescents are limited. This study was aimed to examine the prevalence, characteristics and risk factors of suicidal behaviour, including suicidal thought (ST), suicide plan (SP) and SA, in a large sample of Chinese adolescents.Method.This report represents the first wave data of an ongoing longitudinal study, Shandong Adolescent Behavior and Health Cohort. Participants included 11 831 adolescent students from three counties of Shandong, China. The mean age of participants was 15.0 (s.d. = 1.5) and 51% were boys. In November–December 2015, participants completed a structured adolescent health questionnaire, including ST, SP and SA, characteristics of most recent SA, demographics, substance use, hopelessness, impulsivity and internalising and externalising behavioural problems.Results.The lifetime and last-year prevalence rates were 17.6 and 10.7% for ST in males, 23.5 and 14.7% for ST in females, 8.9 and 2.9% for SP in males, 10.7 and 3.8% for SP in females, 3.4 and 1.3% for SA in males, and 4.6 and 1.8% for SA in females, respectively. The mean age of first SA was 12–13 years. Stabbing/cutting was the most common method to attempt suicide. Approximately 24% of male attempters and 16% of female attempters were medically treated. More than 70% of attempters had no preparatory action. Female gender, smoking, drinking, internalising and externalising problems, hopelessness, suicidal history of friends and acquaintances, poor family economic status and poor parental relationship were all significantly associated with increased risk of suicidal behaviour.Conclusions.Suicidal behaviour in Chinese adolescents is prevalent but less than that previously reported in Western peers. While females are more likely to attempt suicide, males are more likely to use lethal methods. Multiple child and family factors are associated with suicidal behaviour. These findings highlight the importance of early screening and intervention of suicidal behaviour in Chinese adolescents.

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Has Bipolar Disorder become a predominantly female gender related condition? Analysis of recently published large sample studies

International Journal of Bipolar Disorders ◽

10.1186/s40345-020-00207-z ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Bernardo Dell’Osso ◽

Rita Cafaro ◽

Terence A. Ketter

Keyword(s):

Suicide Attempts ◽

Bipolar Disorders ◽

Female Gender ◽

Epidemiological Studies ◽

Related Condition ◽

Gender Distribution ◽

Adequate Treatment ◽

Large Sample ◽

Female Patients ◽

Gender Specific

AbstractBipolar Disorders (BD) are disabling and severe psychiatric disorders, commonly perceived as equally affecting both men and women. The prevalence of BD in the general population has been growing over the last decade, however, few epidemiological studies are available regarding BD gender distribution, leaving unanswered the question whether the often reported increment of BD diagnosis could be gender specific. In fact, BD in female patients can often be misdiagnosed as MDD, leaving such women non correctly treated for longer times than their male counterparts. From this perspective, we searched literature for large sample (> 1000 subjects) studies published in the last decade (2010 onward) on BD patients. We included ten large sample studies that reported the gender distribution of their samples, and we therefore analysed them. Our results show a higher preponderance of female patients in every sample and sub-sample of BDI and BDII, supporting our hypothesis of an increase in BD diagnosis in females. BD in women presents with higher rates of rapid cycling, depressive polarity and suicide attempts, characteristics of non inferior severity compared to males; prompt recognition and adequate treatment of BD is therefore crucial to reduce risks and improve quality of life of affected women. In this regard, our results could lead the way for national or international epidemiological studies with the aim of more accurately assessing gender-specific prevalence of BD.

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Has Bipolar Disorder become a predominantly female gender related condition? Analysis of recently published large sample studies

10.21203/rs.3.rs-53476/v1 ◽

2020 ◽

Author(s):

Bernardo Dell'Osso ◽

Rita Cafaro ◽

Terence A. Ketter

Keyword(s):

Suicide Attempts ◽

Bipolar Disorders ◽

Female Gender ◽

Epidemiological Studies ◽

Related Condition ◽

Gender Distribution ◽

Adequate Treatment ◽

Large Sample ◽

Female Patients ◽

Gender Specific

Abstract Bipolar Disorders are disabling and severe psychiatric disorders, commonly perceived as equally affecting both men and women. The prevalence of BD in the general population has been growing over the last decade, however, few epidemiological studies are available regarding BD gender distribution, leaving unanswered the question whether the often reported increment of BD diagnosis could be gender specific. In fact, BD in female patients can often be misdiagnosed as MDD, leaving such women non correctly treated for longer times than their male counterparts. From this perspective, we searched literature for large sample (>1000 subjects) studies conducted in the last decade (2010 onward) on BD patients. We included ten large sample studies that reported the gender distribution of their samples, and we therefore analysed them. Our results show a higher preponderance of female patients in every sample and sub-sample of BDI and BDII, supporting our hypothesis of an increase in BD diagnosis in females. BD in women presents with higher rates of rapid cycling, depressive polarity and suicide attempts, characteristics of non inferior severity compared to males; prompt recognition and adequate treatment of BD is therefore crucial to reduce risks and improve quality of life of affected women. In this regard, our results could lead the way for national or international epidemiological studies with the aim of more accurately assessing gender-specific prevalence of BD.

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DSM-IV Axis II personality disorders and suicide and attempted suicide in China

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.151076 ◽

2016 ◽

Vol 209 (4) ◽

pp. 319-326 ◽

Cited By ~ 12

Author(s):

Yongsheng Tong ◽

Michael R. Phillips ◽

Kenneth R. Conner

Keyword(s):

Personality Disorders ◽

Suicidal Behaviour ◽

Attempted Suicide ◽

Suicide Attempts ◽

Control Group ◽

Axis Ii ◽

Clinical Interviews ◽

Increased Risk ◽

Axis I ◽

Dsm Iv

BackgroundThere are meagre data on Axis II personality disorders and suicidal behaviour in China.AimsTo describe the prevalence of Axis II personality disorders in suicides and suicide attempts in China and to estimate risk for these outcomes associated with personality disorders.MethodPeople who died by suicide (n = 151), people who attempted suicide (n = 118) and living community controls (n = 140) were randomly sampled from four Chinese counties and studied using the Structured Clinical Interviews for DSM-IV-TR Axis I Disorders (SCID-I) and Axis II Personality Disorders (SCID-II). We also determined the prevalence of subthreshold versions of ten DSM-IV personality disorders.ResultsAxis II personality disorders were present in 7% of the suicide group, 6% of the suicide attempt group and 1% of the control group. Threshold and subthreshold personality disorders had adjusted odds ratios (point estimates) in the range of 2.7–8.0 for suicide and for suicide attempts.ConclusionsAxis II personality disorders may confer increased risk for suicidal behaviour in China, but their low prevalence in the community and among people with suicidal behaviour suggests that other personality constructs such as select dimensional traits may be a more fruitful avenue for understanding and preventing suicide in China.

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Risk of Complications in Spine Surgery: A Prospective Study

The Open Orthopaedics Journal ◽

10.2174/1874325001509010020 ◽

2015 ◽

Vol 9 (1) ◽

pp. 20-25 ◽

Cited By ~ 9

Author(s):

Rodolfo Casimiro Reis ◽

Matheus Fernandes de Oliveira ◽

José Marcus Rotta ◽

Ricardo Vieira Botelho

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Spine Surgery ◽

Absolute Risk ◽

Surgical Site Infections ◽

Spine Instrumentation ◽

Increased Risk ◽

The Mean ◽

A Prospective Study ◽

Epidemiological Characteristics

Purpose : Complications are the chief concern of patients and physicians when considering spine surgery. The authors seek to assess the incidence of complications in patients undergoing spine surgery and identify risk factors for their occurrence. Methods : Prospective study of patients undergoing spine surgery from 1 February 2013 to 1 February 2014. Epidemiological characteristics and complications during the surgical hospitalization were recorded and analyzed. Results : The sample comprised 95 patients (mean age, 59 years). Overall, 23% of patients were obese (BMI =30). The mean BMI was 25.9. Approximately 53% of patients had comorbidities. Complications occurred in 23% of cases; surgical site infections were the most common (9%). There were no significant differences between patients who did and did not develop complications in terms of age (60.6 vs 59.9 years, p = 0.71), sex (56% female vs 54% female, p = 0.59), BMI (26.6 vs 27.2, p = 0.40), or presence of comorbidities (52% vs 52.8%, p = 0.87). The risk of complications was higher among patients submitted to spine instrumentation than those submitted to non-instrumented surgery (33% vs 22%), p=0.8. Conclusion : Just over one-quarter of patients in the sample developed complications. In this study, age, BMI, comorbidities were not associated with increased risk of complications after spine surgery. The use of instrumentation increased the absolute risk of complications.

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Suicidal behaviour and nonsuicidal self-injury among patients with eating disorders

Oxford Textbook of Suicidology and Suicide Prevention ◽

10.1093/med/9780198834441.003.0036 ◽

2021 ◽

pp. 301-306

Author(s):

Judit Balazs ◽

Lili Olga Horvath

Keyword(s):

Risk Factors ◽

Eating Disorders ◽

Suicidal Behaviour ◽

Emotion Dysregulation ◽

Suicide Attempts ◽

The Self ◽

Self Injury ◽

Duration Of Illness ◽

Increased Risk ◽

Comorbid Psychopathology

Eating disorders (EDs), especially anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) often co-occur with suicidal behaviour and non-suicidal self-injury (NSSI). The shared epidemiological and risk factors of EDs, suicidal behaviour, and NSSI include the self-destructive and body-focused characteristics of these behaviours; body dissatisfaction, interoceptive deficits, emotion dysregulation, impulsivity, and several environmental risk factors. Compared to the general population, lifetime rates of suicidal ideation, suicide attempts, and NSSI are increased among patients with AN, BN, or BED. Risk factors play a role in the development of suicidal behaviour in patients with EDs, including comorbid psychopathology that is associated with an increased risk of suicide itself, increased impulsive behaviours including NSSI, the duration of illness, and the number of previous treatments. Being aware of the increased risk and the ED-specific risk factors of suicidal behaviour are essential for preventing suicide and treating clinical risk factors in patients with EDs.

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Suicide Attempts in Turkey: Results of the WHO—EURO Multicentre Study on Suicidal Behaviour

The Canadian Journal of Psychiatry ◽

10.1177/070674370304800508 ◽

2003 ◽

Vol 48 (5) ◽

pp. 324-329 ◽

Cited By ~ 28

Author(s):

Halise Devrimci-Ozguven ◽

Isık Sayıl

Keyword(s):

Multicentre Study ◽

Suicidal Behaviour ◽

Catchment Area ◽

Attempted Suicide ◽

Suicide Attempts ◽

Risk Groups ◽

Upward Trend ◽

Rapid Social Change ◽

The Mean ◽

Research Centres

Objective: To investigate the rate and method of attempted suicides in a catchment area in Turkey as part of the WHO–EURO Multicentre Study on Suicidal Behaviour. Method: All hospitals in the catchment area were screened to identify suicide attempts for 4 years between January 1, 1998, and December 31, 2001. Results: In the 4-year period, 737 individuals attempted suicide (514 women and 223 men). The mean annual rate per 100 000 was 46.89 for men and 112.89 for women. The parasuicide rate increased by 93.59% between 1998 and 2001. The most frequent method used by both men and women was self-poisoning. Conclusion: Compared with the results from other European research centres, attempted suicide rates in Turkey were relatively low. However, the increase in rates was striking. This upward trend may be related to the intense economic difficulties, increasing unemployment, and rapid social change experienced in Turkey in recent years. The risk groups appeared to be younger and female. Information on author affiliations appears at the end of the article.

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Suicide attempts in chronic pain patients. A register-based study

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2013.09.001 ◽

2014 ◽

Vol 5 (1) ◽

pp. 4-7 ◽

Cited By ~ 17

Author(s):

Elsebeth Stenager ◽

Erik Christiansen ◽

Gitte Handberg ◽

Børge Jensen

Keyword(s):

Chronic Pain ◽

Incidence Rate ◽

Patient Group ◽

Suicidal Behaviour ◽

Suicide Attempts ◽

University Hospital ◽

Pain Clinic ◽

Increased Risk ◽

Chronic Pain Patients ◽

Pain Patients

AbstractBackgroundThere are several studies about the relationship between depression and chronic non-malignant pain. These studies have shown that up to 50% of chronic pain patients are suffering from depression.It is, therefore, reasonable to expect that pain patients would also have an increased risk of suicidal behaviour. This problem is not well studied.Since 1990 the Centre for Suicide Research, Odense, Denmark has registered all suicide attempts in patients residing in the Region of Funen, Denmark.The Pain Clinic, Odense University Hospital receives patients with chronic pain from the entire Region of Southern Denmark.PurposeThe purpose of the study has been:To investigate, whether patients treated in the Pain Clinic during the period from 1 January 2004 to 31 December 2009 had an increased risk of suicide attempts compared with the background population.Materials and methodsThe Register for Suicide Attempts (RSA) is a product of the WHO research programme WHO/EURO Multicentre Study on Para suicide. The RSA is a longitudinal person-based register. It contains information about people who have been in contact with the health care system in the County of Funen as a result of a suicide attempt.The Pain Clinic, Odense University Hospital receives patients with non-malignant chronic pain from the Region of Southern Denmark with 1,194,659 inhabitants. Data about age, sex, and time of treatment for patients treated in the Pain Clinic during the period were registered. Time and method of the suicide attempts were registered in the RSA. By registry linkages between the patient registers it was possible to calculate any excess risk of suicide attempts in chronic pain patients in the study period.We used a cohort design and calculated incidence rates (IR) and incidence rate ratios (IRRs) for suicide attempts, based on data from RSA. Poisson Regression analyses were used for calculation of IR and IRR for suicide attempts.ResultsIn the study period from 1 January 2004 to 31 December 2009 1871 patients residing in the Region of Funen in Denmark were referred to The Pain Clinic.In the patient group 258 suicide attempts in 110 persons were registered. In all 6% of the patient group had attempted suicide.An increased risk of suicide attempts was found in the pain population as the incidence rate ratio (IRR) was 3.76 95% CI (3.22; 4.40). No statistical significant differences between men and women were found.ConclusionIn a chronic non-malignant pain population, referred to a pain clinic, the risk of suicide attempts was increased.ImplicationsIt is important to be aware of risk factors for suicidal behaviour, i.e. pain history, depression, anxiety, abuse problems, and social problems when caring for patients with chronic pain. More knowledge and training of the staff caring for chronic pain patients are needed to decrease the risk of suicidal behaviour.

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Sexual minority status and suicidal behaviour among Chinese adolescents: a nationally representative cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-020969 ◽

2018 ◽

Vol 8 (8) ◽

pp. e020969 ◽

Cited By ~ 6

Author(s):

Yeen Huang ◽

Pengsheng Li ◽

Lan Guo ◽

Xue Gao ◽

Yan Xu ◽

...

Keyword(s):

Suicidal Ideation ◽

Sexual Minority ◽

Suicidal Behaviour ◽

Suicide Attempts ◽

Chinese Adolescents ◽

Minority Status ◽

Same Sex ◽

Cross Sectional ◽

Romantic Attraction ◽

Minority Adolescents

ObjectivesSuicidality among sexual minority adolescents has generated worldwide concern in recent decades, and previous Western studies have demonstrated that sexual minority status is associated with adolescent suicidality. However, whether this association exists in Chinese adolescents remains largely unknown. This study aimed to estimate the associations between sexual minority status and suicidal behaviour among Chinese adolescents.DesignCross-sectional survey.SettingA total of 506 high schools in 7 provinces of China.ParticipantsA total of 150 822 students in grades 7–12 who completed the questionnaires (response rate of 95.9%) were included.Main outcome measuresSuicidal ideation and suicide attempts were used to measure suicidal behaviour, and sexual attraction (opposite sex, same sex or both sex) was used as a measure for sexual minority status.ResultsOf the 150 822 adolescents analysed, 4.1% self-reported as sexual minorities and 17.3% were unsure. Compared with heterosexual and unsure adolescents, same-sex romantic attraction (SSA) and both-sex romantic attraction (BSA) adolescents reported a higher prevalence of past-year suicidal ideation (SSA: 21.6% for males and 30.4% for females; BSA: 34.7% for males and 42.3% for females) and suicide attempts (SSA: 6.9% for males and 8.9% for females; BSA: 12.2% for males and 10.9% for females). After adjustment for covariates, SSA and BSA adolescents were more likely to have past-year suicidal ideation and suicide attempts than their heterosexual and unsure peers. BSA adolescents reported the highest risk of suicidal ideation (males: adjusted OR (AOR) 2.42, 95% CI 2.03 to 2.88; females: AOR 2.61, 95% CI 2.41 to 2.82) and suicide attempts (males: AOR 3.83, 95% CI 2.85 to 5.14; females: AOR 2.59, 95% CI 2.19 to 3.06).ConclusionsOur study suggested that Chinese sexual minority adolescents were at increased risk of suicidality, and those with BSA had an especially high risk in this population. These findings emphasised the urgent need to develop targeted interventions to effectively address suicide-related problems among Chinese sexual minority adolescents.

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Prospective predictors of onset, maintenance and cessation of self-injurious behavior during adolescence

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.416 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S432-S432

Author(s):

R. Brunner ◽

J. König ◽

P. Parzer ◽

F. Resch ◽

M. Kaess

Keyword(s):

Peer Relationships ◽

Suicidal Behaviour ◽

Suicide Attempts ◽

Remission Rate ◽

Normal Population ◽

Epidemiological Studies ◽

Population Based ◽

Increased Risk ◽

Competing Interest

IntroductionEpidemiological studies indicate a high prevalence of self-injurious behavior in adolescents in the general population. So far, there are only very few studies on the course of self-injurious behavior in adolescents and young adults.ObjectivesThe aim of the present population-based study was the analysis of prospective predictors of onset, maintenance and cessation self-injurious behavior in adolescents.MethodsA representative sample of the normal population of adolescents from Germany (initial sample: n = 1444; mean age = 14.7, SD = 0.80, 52% female adolescents) was studied over a two years period on 4 consecutive points of measurement in the context of the European school-based intervention study SEYLE.ResultsThere was a high remission rate (70.4%) of self-injurious behaviors at 24-month follow-up investigation. However, there was a substantial rate (29.6%) of adolescents who continued the self-injurious behavior, as well as a group of “new starters”. Self-injurious behavior during the baseline examination proved to be the strongest predictor of self-injurious behavior 2 years later. The extent of depressive symptoms and quality of peer relationships were significantly associated with maintaining self-injurious behavior two years later. Furthermore continued self-injurious behavior over the first 12-month was highly associated with suicide plans/suicide attempts at 24-month follow-up investigation.ConclusionsWhile both, onset and maintenance of SIB are prospectively associated with an increased risk for suicidal behaviour in late adolescence, SIB cessation significantly reduces the risk for later suicidal behaviour.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Suicidal behaviour among persons with attention-deficit hyperactivity disorder

The British Journal of Psychiatry ◽

10.1192/bjp.2019.128 ◽

2019 ◽

Vol 215 (04) ◽

pp. 615-620 ◽

Cited By ~ 3

Author(s):

Cecilie Fitzgerald ◽

Søren Dalsgaard ◽

Merete Nordentoft ◽

Annette Erlangsen

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Psychiatric Disorders ◽

Attention Deficit ◽

Suicidal Behaviour ◽

Suicide Attempts ◽

Comorbid Psychiatric Disorders ◽

Hyperactivity Disorder ◽

Increased Risk ◽

Elevated Rate ◽

Rate Ratios

BackgroundPersons diagnosed with attention-deficit hyperactivity disorder (ADHD) have been found to have an increased risk of suicidal behaviour, but the pathway remains to be thoroughly explored.AimsTo determine whether persons with ADHD are more likely to present with suicidal behaviour (i.e. suicide attempts and deaths by suicide) if they have a comorbid psychiatric disorder.MethodUsing nationwide registers covering the entire population of Denmark, this cohort study of 2.9 million individuals followed from 1 January 1995 until 31 December 2014, covers more than 46 million person-years. All persons aged ≥10 years with Danish-born parents were identified and persons with a diagnosis of ADHD were compared with persons without. Incidence rate ratios (IRRs) were calculated by Poisson regression, with adjustments for sociodemographics and parental suicidal behaviour.ResultsPersons with ADHD were followed for 164 113 person-years and 697 suicidal outcomes were observed. This group was found to have an IRR of suicidal behaviour of 4.7 (95% CI, 4.3–5.1) compared with those without ADHD. Persons with ADHD only had a 4.1-fold higher rate (95% CI, 3.5–4.7) when compared with those without any psychiatric diagnoses. For persons with ADHD and comorbid disorders the IRR was higher yet (IRR: 10.4; 95% CI, 9.5–11.4).ConclusionsThis study underlines the link between ADHD and an elevated rate of suicidal behaviour, which is significantly elevated by comorbid psychiatric disorders. In sum, these results suggest that persons with ADHD and comorbid psychiatric disorders are targets for suicide preventive interventions.Declaration of interestNone.

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