Opioid Use and Misuse and Suicidal Behaviors in a Nationally Representative Sample of US Adults

Abstract Prior research has shown associations between opioid misuse and suicidal behaviors, but the relationship between medical opioid use and suicidal behaviors is not known. We assessed associations of opioid use and misuse with suicidal ideation, suicide plans, and suicide attempts among adults aged 18–64 years (n = 86,186) using nationally representative cross-sectional data from the 2015 and 2016 administrations of the National Survey on Drug Use and Health. We used logistic regression to estimate associations between opioid use/misuse and suicidal behaviors and propensity score–weighted logistic regression analysis to examine the counterfactual scenario in which persons with misuse had instead not misused opioids. In propensity score–weighted analyses, compared with opioid misuse, opioid use without misuse was associated with lower odds of suicidal ideation (odds ratio (OR) = 0.57, 95% confidence interval (CI): 0.45, 0.72) and suicide plans (OR = 0.53, 95% CI: 0.35, 0.80), and no use was associated with lower odds of suicidal ideation (OR = 0.62, 95% CI: 0.49, 0.80), suicide plans (OR = 0.56, 95% CI: 0.39, 0.79), and suicide attempts (OR = 0.54, 95% CI: 0.33, 0.89). These findings suggest that opioid misuse is associated with greater odds of suicidal behaviors, but opioid use without misuse is not. Compared with persons with opioid misuse, similar persons without misuse have a reduced risk of suicidal behaviors. Clinical and public health interventions should focus on preventing misuse of opioids.

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Association of objective visual impairment with suicidal ideation and suicide attempts among adults aged ≥50 years in low/middle-income countries

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-318864 ◽

2021 ◽

pp. bjophthalmol-2021-318864

Author(s):

Lee Smith ◽

Jae Il Shin ◽

Yvonne Barnett ◽

Peter M Allen ◽

Rosie Lindsay ◽

...

Keyword(s):

Older Adults ◽

Suicidal Ideation ◽

Visual Impairment ◽

Suicide Attempts ◽

Adult Health ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Nationally Representative

BackgroundThere is currently limited literature on the association between visual impairment and suicidal thoughts and behaviours, especially among older adults from low/middle-income countries (LMICs). Thus, we aimed to investigate the associations of objectively measured distance visual impairment with suicidal ideation and suicide attempts among adults aged ≥50 years from six LMICs and to identify potential mediators.MethodsCross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health were analysed. Objective distance visual acuity was measured using the tumbling E logMAR chart, and vision impairment was categorised as none, mild, moderate and severe. Self-reported information on past 12-month suicidal ideation and suicide attempts was also collected. Multivariable logistic regression and mediation analysis were conducted.ResultsData on 34 129 individuals aged ≥50 years (mean (SD) age, 62.4 (16.0) years; 47.9% men) were analysed. After adjustment for potential confounders, compared with no visual impairment, severe visual impairment was significantly associated with suicidal ideation (OR=9.50; 95% CI=2.47 to 36.52). Moderate and severe visual impairment were significantly associated with a 2.22 (95% CI=1.14 to 4.35) and 11.50 (95% CI=1.44 to 91.88) times higher odds of suicide attempts, respectively. Disability, poor self-rated health, mobility and loneliness explained 14.0%, 9.3%, 7.2% and 6.3% of the association between moderate/severe visual impairment and suicide attempts, respectively.ConclusionInterventions to reduce suicidal ideation and suicide attempts among older adults with visual impairment in LMICs are required, targeting identified mediators, while using tested strategies for suicide prevention per se in LMICs may yield beneficial outcomes.

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The association of non-suicidal self-injurious and suicidal behaviors with religiosity in hospitalized Jewish adolescents

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104520918354 ◽

2020 ◽

Vol 25 (4) ◽

pp. 801-815

Author(s):

Efrat Malkosh-Tshopp ◽

Roy Ratzon ◽

Alex Gizunterman ◽

Tomer Levy ◽

David H Ben-Dor ◽

...

Keyword(s):

Suicidal Ideation ◽

Protective Factor ◽

Suicide Attempts ◽

Cross Sectional Study ◽

Health Centers ◽

Suicidal Behaviors ◽

Cross Sectional ◽

History Of ◽

Mental Health Centers ◽

Jewish Adolescents

Religiosity may be a potent protective factor against self-injurious and suicidal behaviors. However, no previous study has addressed this relationship in adolescent psychiatric population. This study aimed to examine the association between religiosity and non-suicidal self-injurious (NSSI) and suicidal behaviors, among hospitalized Jewish adolescents. This is a cross-sectional study of 60 hospitalized Jewish adolescents in two mental health centers. They were evaluated for religiosity, NSSI, and suicidal behaviors. The following religiosity measures were found to be protective against NSSI: a higher degree of adherence to religious practices (extrinsic measure) (beta = −0.083, p = .006), a higher level of belief in religious principles (intrinsic measure) (beta = −0.063, p = .008) and a self-reported higher religious affinity (χ2 = 7.64, p = .022). The severity of suicidal ideation inversely correlated with the extrinsic measure (standardized beta = −0.2, t = −2.5, p = .015) and with self-reported degree of religious affinity (analysis of variance, F = 3.5, p = .035). History of transition in religious affinity was associated with worse suicidal ideation (3.77 ± 1.8 vs. 2.26 ± 1.99, t = −3.25, p = .004) and with suicide attempts (OR = 3.89 (95% CI: 1.08 – 14.03), p = .004); however, these relationships were mediated by history of abuse. This study provides first evidence of a protective effect of some religiosity measures on NSSI and suicidal behaviors in hospitalized Jewish adolescents.

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Estimating the Magnitude of the Relation Between Bullying, E-Bullying, and Suicidal Behaviors Among United States Youth, 2015

Crisis ◽

10.1027/0227-5910/a000544 ◽

2019 ◽

Vol 40 (3) ◽

pp. 157-165 ◽

Cited By ~ 3

Author(s):

Kevin S. Kuehn ◽

Annelise Wagner ◽

Jennifer Velloza

Keyword(s):

Adolescent Suicide ◽

Suicide Attempts ◽

Causal Effect ◽

Strong Association ◽

Cross Sectional ◽

Average Causal Effect ◽

Effects Of Bullying ◽

Pc Algorithm ◽

Nationally Representative ◽

Significant Covariates

Abstract. Background: Suicide is the second leading cause of death among US adolescents aged 12–19 years. Researchers would benefit from a better understanding of the direct effects of bullying and e-bullying on adolescent suicide to inform intervention work. Aims: To explore the direct and indirect effects of bullying and e-bullying on adolescent suicide attempts (SAs) and to estimate the magnitude of these effects controlling for significant covariates. Method: This study uses data from the 2015 Youth Risk Behavior Surveillance Survey (YRBS), a nationally representative sample of US high school youth. We quantified the association between bullying and the likelihood of SA, after adjusting for covariates (i.e., sexual orientation, obesity, sleep, etc.) identified with the PC algorithm. Results: Bullying and e-bullying were significantly associated with SA in logistic regression analyses. Bullying had an estimated average causal effect (ACE) of 2.46%, while e-bullying had an ACE of 4.16%. Limitations: Data are cross-sectional and temporal precedence is not known. Conclusion: These findings highlight the strong association between bullying, e-bullying, and SA.

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Attitudes towards the New Zealand Government’s Smokefree 2025 goal associated with smoking and vaping in university students aged 18 to 24 years: results of a 2018 national cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2020-037362 ◽

2020 ◽

Vol 10 (11) ◽

pp. e037362

Author(s):

Ben Wamamili ◽

Mark Wallace-Bell ◽

Ann Richardson ◽

Randolph C Grace ◽

Pat Coope

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

New Zealand ◽

University Students ◽

Confidence Intervals ◽

Logistic Regression Analysis ◽

Smoking Prevalence ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Lower Odds

ObjectiveIn March 2011, New Zealand (NZ) launched an aspirational goal to reduce smoking prevalence to 5% or less by 2025 (Smokefree 2025 goal). Little is known about university students’ awareness of, support for and perceptions about this goal. We sought to narrow the knowledge gap.SettingUniversity students in NZ.MethodsWe analysed data from a 2018 cross-sectional survey of university students across NZ. Logistic regression analysis examined the associations between responses about the Smokefree goal with smoking and vaping, while controlling for age, sex and ethnicity. Confidence intervals (95% CI) were reported where appropriate.ParticipantsThe sample comprised 1476 students: 919 (62.3%) aged 18 to 20 and 557 (37.7%) aged 21 to 24 years; 569 (38.6%) male and 907 (61.4%) female; 117 (7.9%) Māori and 1359 (92.1%) non-Māori. Of these, 10.5% currently smoked (ie, smoked at least monthly) and 6.1% currently vaped (ie, used an e-cigarette or vaped at least once a month).ResultsOverall awareness of the Smokefree goal was 47.5% (95% CI: 44.9 to 50.1); support 96.9% (95% CI: 95.8 to 97.8); belief that it can be achieved 88.8% (95% CI: 86.8 to 90.7) and belief that e-cigarettes/vaping can help achieve it 88.1% (95% CI: 86.0 to 89.9).Dual users of tobacco cigarettes and e-cigarettes had greater odds of being aware of the Smokefree goal (OR=3.07, 95% CI: 1.19 to 7.92), current smokers had lower odds of supporting it (OR=0.13, 95% CI: 0.06 to 0.27) and of believing that it can be achieved (OR=0.15, 95% CI: 0.09 to 0.24) and current vapers had greater odds of believing that e-cigarettes/vaping can help to achieve it (OR=8.57, 95% CI: 1.18 to 62.52) compared with non-users.ConclusionsThe results suggest strong overall support for the Smokefree goal and belief that it can be achieved and that e-cigarettes/vaping can help achieve it. Smoking and vaping were associated with high awareness of the Smokefree goal, but lower support and optimism that it can be achieved.

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The Associations between Health Risk Behaviours and Suicidal Ideation and Attempts in a Nationally Representative Sample of Young Adolescents

The Canadian Journal of Psychiatry ◽

10.1177/070674370705201007 ◽

2007 ◽

Vol 52 (10) ◽

pp. 666-674 ◽

Cited By ~ 43

Author(s):

Tracie O Afifi ◽

Brian J Cox ◽

Laurence Y Katz

Keyword(s):

Suicidal Ideation ◽

Health Risk ◽

Sexual Intercourse ◽

Suicide Attempts ◽

Female Adolescents ◽

Risk Behaviours ◽

Young Adolescents ◽

Adolescent Boys ◽

Health Risk Behaviours ◽

Nationally Representative

Objective: To examine associations between health risk behaviours and suicidal ideation and attempts in Canadian adolescents aged 12 to 13 years. Young adolescents think about and attempt suicide. However, most existing research on suicide has been conducted on individuals aged 15 years and older. Method: The present study examined a nationally representative Canadian sample of adolescents aged 12 to 13 years ( n = 2090). Health risk behaviours included disruptive (shoplifting, physical fighting, damaging property, fighting with a weapon, carrying a knife, and gambling), sexual (petting below the waist and sexual intercourse), and substance use behaviours (smoking cigarettes, consuming alcohol, marijuana or hash, and glue or solvents). Unadjusted and adjusted (for all significant health risk behaviour and psychiatric symptoms) models were tested. Results: All health risk behaviours were common among male and female adolescents. In unadjusted models, almost all health risk behaviours were associated with suicidal ideation and attempts among adolescent boys. In adjusted models, only damaging property, sexual intercourse, and smoking cigarettes remained statistically associated with suicidal ideation, while smoking cigarettes and using marijuana or hash remained statistically associated with suicide attempts among adolescent boys. All health risk behaviours were statistically associated with suicidal ideation and attempts among female adolescents in unadjusted models. In adjusted models, only carrying a knife remained statistically associated with suicidal ideation, while shoplifting and gambling remained statistically associated with suicide attempts among adolescent girls. Conclusions: Health risk behaviours among young adolescents are associated with suicidal ideation and attempts among young adolescents. Recognizing health risk behaviours among young adolescents may be one means of understanding who among them is at increased risk of suicidality.

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An investigation on the frequency of thoughts, readiness and suicide attempt in individuals with thalassemia

10.53350/pjmhs211561847 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1847-1853

Author(s):

Sahar Attar ◽

Nour Mohammad Bakhshani ◽

Qasem Miri Aliabad

Keyword(s):

Suicidal Ideation ◽

Suicide Attempts ◽

Statistical Tests ◽

Genetic Diseases ◽

Thalassemia Major ◽

Cross Sectional Study ◽

World Health ◽

Cross Sectional ◽

Significant Difference ◽

The World

Background and Aim: Thalassemia major is one of the most common chronic genetic diseases in the world and in Iran that can impose many adverse effects on the self and society. Psychologically, patients with thalassemia are under stress. According to the World Health Organization (WHO), suicide is one of the leading causes of death worldwide. It is important to identify the people who have the highest risk factors for suicide. The present research investigates the frequency of thoughts, readiness and suicide attempts in people with thalassemia. Methods: This was a cross-sectional study. Its sample was 150 patients with thalassemia in the age range of 10 to 46 years whom we selected through census by sampling at convenience. We gave to patients a standardized Beck Suicide Thought Assessment Questionnaire. We analyzed the research data using descriptive and inferential statistical tests. Results: From among 150 patients with thalassemia in this study, 57.3% of the respondents were male and 42.7% were female. The results showed that there was a negative and significant relationship between suicide thoughts and attempts and age (-0.234) (P <0.05). The mean prevalence of suicide in men (1.89) was significantly higher compared to women (0.79) (P <0.05). We did not observe significant difference in prevalence of suicide thoughts and attempts between married and single groups with a mean difference (0.69) (P <0.05) and, in different educational groups, no significant difference was reported (P> 0.05). Conclusion: The findings of this research showed that among patients with thalassemia, the prevalence of suicidal ideation has a significant percentage. Since suicidal ideation provides a platform for preparation and attempt to commit suicide, so by providing mental health services and regular screening, we can take an effective step to prevent this problem among patients with thalassemia. Keywords: Thalassemia, Suicidal ideation, Suicide.

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Associations between Abortion, Mental Disorders, and Suicidal Behaviour in a Nationally Representative Sample

The Canadian Journal of Psychiatry ◽

10.1177/070674371005500407 ◽

2010 ◽

Vol 55 (4) ◽

pp. 239-247 ◽

Cited By ~ 35

Author(s):

Natalie P Mota ◽

Margaret Burnett ◽

Jitender Sareen

Keyword(s):

Substance Use ◽

Suicidal Ideation ◽

Mental Disorders ◽

Mental Disorder ◽

Representative Sample ◽

Suicide Attempts ◽

World Health ◽

Population Attributable Fractions ◽

Attributable Fractions ◽

Nationally Representative

Objective: Most previous studies that have investigated the relation between abortion and mental illness have presented mixed findings. We examined the relation between abortion, mental disorders, and suicidality using a US nationally representative sample. Methods: Data came from the National Comorbidity Survey Replication ( n = 3310 women, aged 18 years and older). The World Health Organization-Composite International Diagnostic Interview was used to assess mental disorders based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and lifetime abortion in women. Multiple logistic regression analyses were employed to examine associations between abortion and lifetime mood, anxiety, substance use, eating, and disruptive behaviour disorders, as well as suicidal ideation and suicide attempts. We calculated the percentage of respondents whose mental disorder came after the first abortion. The role of violence was also explored. Population attributable fractions were calculated for significant associations between abortion and mental disorders. Results: After adjusting for sociodemographics, abortion was associated with an increased likelihood of several mental disorders—mood disorders (adjusted odds ratio [AOR] ranging from 1.75 to 1.91), anxiety disorders (AOR ranging from 1.87 to 1.91), substance use disorders (AOR ranging from 3.14 to 4.99), as well as suicidal ideation and suicide attempts (AOR ranging from 1.97 to 2.18). Adjusting for violence weakened some of these associations. Forall disorders examined, less than one-half of women reported that their mental disorder had begun after the first abortion. Population attributable fractions ranged from 5.8% (suicidal ideation) to 24.7% (drug abuse). Conclusions: Our study confirms a strong association between abortion and mental disorders. Possible mechanisms of this relation are discussed.

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Suicidal Ideation and Behaviors Among Irish Travellers Presenting for Emergency Care

Crisis ◽

10.1027/0227-5910/a000769 ◽

2021 ◽

pp. 1-8

Author(s):

Bryan Tanner ◽

Anne M. Doherty

Keyword(s):

Suicidal Ideation ◽

General Population ◽

Psychiatric Treatment ◽

Local Population ◽

Clinical Information ◽

Population Data ◽

Tertiary Hospital ◽

Suicidal Behaviors ◽

Cross Sectional ◽

Significant Difference

Abstract. Background: Suicide is a serious problem in the Traveller community, with rates estimated at 11%: over 6 times that of the general population. Aims: We aimed to establish the prevalence and correlates of suicidal ideation (SI) and self-harm (SH) among Irish Travellers. Method: This was an observational cross-sectional cohort study of patients presenting with SH and SI to a tertiary hospital in Ireland, in an area with a large local Traveller population. Data were analyzed from the anonymized database ( n = 2,016), comparing characteristics of Travellers and the general population. Results: This study found that Travellers (1.6% of the local population) represent 4.3% of the population seen in hospital with SH and SI, and 14.8% of episodes. There was a significant difference in SH methods used: Travellers were significantly more likely to present following attempted hanging, ( OR = 21.8; p = .004). Travellers were more commonly diagnosed with depression or substance abuse, referred from critical care, and transferred for inpatient psychiatric treatment. Limitations: Limitations include the use of retrospective data from a service activity database rather than clinical information collected prospectively. Conclusion: There are significant differences in patterns of suicidal behaviors between Irish Travellers and the general population. Further research is required to understand and address the high rates of suicidal behaviors in this population.

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Primary Purpose for Committing a Crime and Past-30 Day Opioid Misuse: A Statewide Sample of Justice-Involved Children

Journal of Drug Issues ◽

10.1177/00220426211037608 ◽

2021 ◽

pp. 002204262110376

Author(s):

Dylan J. Shaw ◽

Micah E. Johnson

Keyword(s):

Mental Health ◽

Logistic Regression ◽

General Population ◽

Drug Courts ◽

Regression Analyses ◽

Opioid Misuse ◽

Care Model ◽

Cross Sectional ◽

Material Gain ◽

Cascade Of Care

The prevalence of opioid misuse (OM) among justice-involved children (JIC) is significantly higher than children in the general population, yet little research has examined the predictors of OM among JIC. Goldstein’s “economic compulsive model” hypothesizes that JIC who commit crimes for material gain will have a higher likelihood of meeting past-30 day (P30D) OM criteria. The data in this study were cross-sectional and represented 79,960 Florida JIC. To test the hypothesis, logistic regression analyses were utilized. Over 2000 JIC (2.67%) met P30D OM criteria and JIC who committed crimes for material gain were 2.55 times as likely to meet P30D OM criteria. Findings indicate that children may be incarcerated due to an inability to afford their addiction, contributing to the criminalization of mental health. JIC could benefit from the increased utilization of drug courts and the implementation of a cascade of care model.

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