739 Association of hospital-diagnosed sleep disorders with suicide: A nationwide cohort study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A288-A289
Author(s):  
Nikolaj Høier ◽  
Adam Spira ◽  
Annette Erlangsen

Abstract Introduction Sleep disorders and psychiatric disease are closely related, and psychiatric diseases are associated with elevated suicide risks. Yet, it is not clear if sleep disorders are associated with suicide as previous studies were limited by self-reported measures. The aim of this study was to examine whether people with a hospital-diagnosis of sleep disorders had higher suicide rates than people with no diagnosis. Methods Using a retrospective cohort design, national data on all persons aged 15 years and over who lived in Denmark during 1980–2016 (males: 3,674,563, females: 3,688,164) were obtained. People with sleep disorders were identified in somatic hospital registers. The main outcome was death by suicide as recorded in the Danish Cause of Death register. Incidence Rate Ratios were obtained using Poisson regressions while adjusting for relevant covariates. Results Out of 23,927 male and 11,556 female suicide deaths, 299 and 117 had been diagnosed with a sleep disorder, respectively. Males with sleep disorders had a suicide rate of 47.4 (95% CI, 42.0–52.7) per 100,000 person-years compared to 29.9 (95% CI, 29.5–30.3) among those with no sleep disorders. For females the respective rates were 42.3 (95% CI, 34.7–50.0) versus 13.9 (95% CI, 13.6–14.1). An adjusted IRR of 1.6 (95% CI, 1.4–1.7) and 2.2 (95% CI, 1.8–2.6) was noted among males and females with sleep disorders, respectively, when compared to those with no disorders. Excess rates were noted with respect to insomnia, narcolepsy and, in males, sleep apnea. A difference with respect to age and sex was observed (p<0.001). Furthermore,IRRs of 4.1(95% CI, 3.1–5.5) and 7.0 (95% CI, 4.8–10.1) were noted for males and females, respectively, during the first 6 months of diagnosis when compared to those not diagnosed. The association between sleep disorders and suicide remained significant when adjusting for psychiatric disorders, although those with psychiatric disorders also had elevated rates, particularly amongst females. Conclusion In this study, individuals with sleep disorders had an increased suicide rate when compared to those with no sleep disorders. Higher suicide rates were found for individuals suffering from narcolepsy, insomnia and sleep apnea. More attention towards risks of suicide among people with sleep disorders might be needed. Support (if any):

2020 ◽  
Author(s):  
Lidija Injac Stevović ◽  
Selman Repišti ◽  
Tamara Radojičić ◽  
Olivera Injac

Abstract Background: This is an ecological study that analyzes suicides committed in Montenegro during the 2000-2018 period, taking into account gender, age and methods of suicide. Methods: Suicide rates and trends up until 2009 were obtained from the official registers of Bureau of Statistics of Montenegro (MONSTAT) while the later data were obtained from the Department of Interior’s. MONSTAT also provided data on unemployment and average salary. As per statistical methods, descriptive and correlations were calculated. Results: The average crude suicide rate was 21.06, for males 29.93 and for females 12.42. Crude suicide rates were not associated with unemployment rate or average salary. However, the unemployment rate was significantly correlated with lethal methods of suicide, namely suicide by firearm and by hanging. Average net salary was negatively correlated with suicide by firearm. Conclusions: The ratio of males and females who committed suicide was 2.41. In the last three years, this ratio continues to rise in favor of males (reaching 4.29 in 2018). This could be explained by specific cultural features where males are expected to be the main financial contributors to the households. The labor market of Montenegro does not offer adequate opportunities to set and maintain a stable economic situation which puts additional pressure and stress on males.


Author(s):  
Ahmed S. BaHammam ◽  
Sulaiman Alhifzi ◽  
Salih Aleissi

Breathing-related sleep disorders (BRSD) encompass obstructive sleep apnea (OSA), central sleep apnea, and hypoventilation disorders. Risk factors for BRSD include obesity, metabolic dysfunction, smoking, use of respiratory depressant medications (like opiates and benzodiazepines), and alcohol consumption, all of which are highly prevalent among patients with psychiatric disorders. BRSDs are associated with substantial morbidity, disturbed quality of life, and worse prognosis of comorbid psychiatric disorders. Therefore, it is essential for psychiatric care providers to have the clinical skills to recognize BRSDs. Recent studies suggest that the prevalence rates of OSA in psychiatric patients are higher than the general population. Moreover, BRSD’s share common symptoms and risk-factors with psychiatric disorders. A comprehensive clinical approach including a thorough sleep history and examination along with the use of validated screening questionnaires like the STOP-BANG questionnaire, particularly for at-risk patients, is effective in identifying BRSD.


2019 ◽  
Vol 74 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Annette Erlangsen ◽  
Sven Drefahl ◽  
Ann Haas ◽  
Charlotte Bjorkenstam ◽  
Merete Nordentoft ◽  
...  

BackgroundPeople belonging to sexual minority groups have higher levels of suicidality than heterosexuals. However, findings regarding suicide death are sparse. Using unique national data from two countries, we investigated whether individuals entering a same-sex marriage (SSM), a proxy group of sexual minority individuals, had higher suicide rates than those entering opposite-sex marriage (OSM).MethodsA cohort study of all males and females who entered an SSM (n=28 649) or OSM (n=3 918 617) in Denmark and Sweden during 1989–2016 was conducted. Incidence rate ratios (IRRs) for suicide were calculated using adjusted Poisson regression models.ResultsIn total, 97 suicides occurred among individuals who had entered an SSM compared with 6074 among those who entered an OSM, corresponding to an adjusted IRR of 2.3 (95% CI 1.9 to 2.8). For people who entered SSM, a 46% decline was noted over time from an IRR of 2.8 (95% CI 1.9 to 4.0) during 1989–2002 to 1.5 (95% CI 1.2 to 1.9) during 2003–2016. The excess suicide mortality was present in all age groups but most pronounced among younger individuals aged 18–34 years of age (IRR 2.7, 95% CI 1.5 to 4.8) and females (IRR 2.7, 95% CI 1.8 to 3.9).ConclusionThis large register-based study found higher suicide rates among individuals who entered an SSM, compared with those who entered an OSM. A lower suicide rate was noted for individuals in SSMs in recent years. More research is needed to identify the unique suicide risk and protective factors for sexual minority people.


2020 ◽  
Vol 21 (19) ◽  
pp. 7244
Author(s):  
Elke Humer ◽  
Christoph Pieh ◽  
Georg Brandmayr

Sleep-wake disorders are highly prevalent disorders, which can lead to negative effects on cognitive, emotional and interpersonal functioning, and can cause maladaptive metabolic changes. Recent studies support the notion that metabolic processes correlate with sleep. The study of metabolite biomarkers (metabolomics) in a large-scale manner offers unique opportunities to provide insights into the pathology of diseases by revealing alterations in metabolic pathways. This review aims to summarize the status of metabolomic analyses-based knowledge on sleep disorders and to present knowledge in understanding the metabolic role of sleep in psychiatric disorders. Overall, findings suggest that sleep-wake disorders lead to pronounced alterations in specific metabolic pathways, which might contribute to the association of sleep disorders with other psychiatric disorders and medical conditions. These alterations are mainly related to changes in the metabolism of branched-chain amino acids, as well as glucose and lipid metabolism. In insomnia, alterations in branched-chain amino acid and glucose metabolism were shown among studies. In obstructive sleep apnea, biomarkers related to lipid metabolism seem to be of special importance. Future studies are needed to examine severity, subtypes and treatment of sleep-wake disorders in the context of metabolite levels.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Lidija Injac Stevović ◽  
Selman Repišti ◽  
Tamara Radojičić ◽  
Olivera Injac

Abstract Background This is an ecological study that analyzes suicides committed in Montenegro during the 2000–2018 period, taking into account gender, age and methods of suicide. Methods Suicide rates and trends up until 2009 were obtained from the official registers of Bureau of Statistics of Montenegro (MONSTAT) while the later data were obtained from the Department of Interior’s. MONSTAT also provided data on unemployment and average salary. As per statistical methods, descriptive and correlations were calculated. Results The average crude suicide rate was 21.06, for males 29.93 and for females 12.42. Crude suicide rates were not associated with unemployment rate or average salary. However, the unemployment rate was significantly correlated with lethal methods of suicide, namely suicide by firearm and by hanging. Average net salary was negatively correlated with suicide by firearm. Conclusions The ratio of males and females who committed suicide was 2.41. In the last three years, this ratio continues to rise in favor of males (reaching 4.29 in 2018). This could be explained by specific cultural features where males are expected to be the main financial contributors to the households. The labor market of Montenegro does not offer adequate opportunities to set and maintain a stable economic situation which puts additional pressure and stress on males.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Humaira Maheen

Abstract Background Emerging evidence suggests that people working in the welfare and health care industry have poorer mental health than other occupational groups; however, there has been little examination of suicide among this group. In this study, we examine suicide rates amongst welfare and care support workers and compare them to rates among human service workers, and all other occupations in Australia. Methods We used data from the National Coroners Information System (NCIS) to obtain records of death due to intentional self-harm between the years 2001 to 2016. We calculated age-standardised suicide rates and incident rate ratios to compare the suicide rates across different occupational groups. Results The age-standardised suicide rate of males is the highest amongst welfare and carers (24.1 per 100,000). After adjusting for age and year of death, we found that men working as welfare workers and carers have a significantly higher suicide rate than men working in other occupations (IRR 1.43, CI 1.2-1.7). Furthermore, male human service workers have a slightly lower rate of suicide than those working in other occupations (IRR 0.73: CI 0.66-0.82). The finding was similarly noted in female suicide deaths, however, the higher suicide rate in female welfare workers was not statistically significant (IRR 1.12 CI 0.9-1.39). Conclusion The suicide rates of welfare and care-related occupations are as high as occupations which are identified as at-risk occupations for male suicide in Australia. Key message There is a need for targeted programs to improve the suicide health literacy among welfare and care support workers.


2021 ◽  
Vol 78 (5) ◽  
pp. 336-341
Author(s):  
Humaira Maheen ◽  
Stefanie Dimov ◽  
Matthew J Spittal ◽  
Tania L King

ObjectivesEmployees working in the welfare and healthcare industry have poorer mental health than other occupational groups; however, there has been little examination of suicide among this group. In this study, we examined suicide rates among welfare support workers and compared them to other occupations in Australia.MethodsWe used data from the National Coroners Information System to obtain suicide deaths between the years 2001 and 2016. Using the Australian standard population from 2001 and Census data from 2006, 2011 and 2016, we calculated age-standardised suicide rates and rate ratios to compare suicide rates across different occupational groups.ResultsOverall, the age-standardised suicide rate of welfare support workers was 8.6 per 100 000 people. The gender-stratified results show that male welfare support workers have a high suicide rate (23.8 per 100 000 people) which is similar to male social workers and nurses (25.4 per 100 000). After adjusting for age and year of death, both males (rate ratio 1.48, 95% CI 1.23 to 1.78) and female welfare support workers (rate ratio 1.49, 95% CI 1.20 to 1.86) have higher suicide rate ratios compared with the reference group (excluding occupations from the comparison groups).ConclusionThe age-standardised suicide rates of male welfare support workers are comparable to occupations which have been identified as high-risk occupations for suicide. Both female and male welfare support workers are at elevated risk of suicide compared with other occupations. Further research is required to understand the drivers of the elevated risk in this group.


Crisis ◽  
1999 ◽  
Vol 20 (2) ◽  
pp. 64-70 ◽  
Author(s):  
Tamás Zonda

The author examined completed suicides occurring over a period of 25 years in a county of Hungary with a traditionally low (relatively speaking) suicide rate of 25.8. The rates are clearly higher in villages than in the towns. The male/female ratio was close to 4:1, among elderly though only 1.5:1. The high risk groups are the elderly, divorced, and widowed. Violent methods are chosen in 66.4% of the cases. The rates are particularly high in the period April-July. Prior communication of suicidal intention was revealed in 16.3% of all cases. Previous attempts had been undertaken by 17%, which in turn means that 83% of suicides were first attempts. In our material 10% the victims left suicide notes. Psychiatric disorders were present in 60.1% of the cases, and severe, multiple somatic illnesses (including malignomas) were present in 8.8%. The majority of the data resemble those found in the literature.


Crisis ◽  
2011 ◽  
Vol 32 (4) ◽  
pp. 178-185 ◽  
Author(s):  
Maurizio Pompili ◽  
Marco Innamorati ◽  
Monica Vichi ◽  
Maria Masocco ◽  
Nicola Vanacore ◽  
...  

Background: Suicide is a major cause of premature death in Italy and occurs at different rates in the various regions. Aims: The aim of the present study was to provide a comprehensive overview of suicide in the Italian population aged 15 years and older for the years 1980–2006. Methods: Mortality data were extracted from the Italian Mortality Database. Results: Mortality rates for suicide in Italy reached a peak in 1985 and declined thereafter. The different patterns observed by age and sex indicated that the decrease in the suicide rate in Italy was initially the result of declining rates in those aged 45+ while, from 1997 on, the decrease was attributable principally to a reduction in suicide rates among the younger age groups. It was found that socioeconomic factors underlined major differences in the suicide rate across regions. Conclusions: The present study confirmed that suicide is a multifaceted phenomenon that may be determined by an array of factors. Suicide prevention should, therefore, be targeted to identifiable high-risk sociocultural groups in each country.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Till F. M. Andlauer ◽  
Thomas W. Mühleisen ◽  
Felix Hoffstaedter ◽  
Alexander Teumer ◽  
Katharina Wittfeld ◽  
...  

AbstractA retrospective meta-analysis of magnetic resonance imaging voxel-based morphometry studies proposed that reduced gray matter volumes in the dorsal anterior cingulate and the left and right anterior insular cortex—areas that constitute hub nodes of the salience network—represent a common substrate for major psychiatric disorders. Here, we investigated the hypothesis that the common substrate serves as an intermediate phenotype to detect genetic risk variants relevant for psychiatric disease. To this end, after a data reduction step, we conducted genome-wide association studies of a combined common substrate measure in four population-based cohorts (n = 2271), followed by meta-analysis and replication in a fifth cohort (n = 865). After correction for covariates, the heritability of the common substrate was estimated at 0.50 (standard error 0.18). The top single-nucleotide polymorphism (SNP) rs17076061 was associated with the common substrate at genome-wide significance and replicated, explaining 1.2% of the common substrate variance. This SNP mapped to a locus on chromosome 5q35.2 harboring genes involved in neuronal development and regeneration. In follow-up analyses, rs17076061 was not robustly associated with psychiatric disease, and no overlap was found between the broader genetic architecture of the common substrate and genetic risk for major depressive disorder, bipolar disorder, or schizophrenia. In conclusion, our study identified that common genetic variation indeed influences the common substrate, but that these variants do not directly translate to increased disease risk. Future studies should investigate gene-by-environment interactions and employ functional imaging to understand how salience network structure translates to psychiatric disorder risk.


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