Reducing nonfatal suicidal behaviour among university students: actuarial analysis of potential effects of treating common mental disorders

2020 ◽  
pp. 008124632097383
Author(s):  
Jason Bantjes ◽  
Elsie Breet ◽  
Christine Lochner ◽  
Janine Roos ◽  
Ronald C Kessler ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Mental Disorders ◽  
Risk Analysis ◽  
Suicidal Behaviour ◽  
Suicide Ideation ◽  
Common Mental Disorders ◽  
Population Attributable Risk ◽  
Attributable Risk ◽  
Potential Reduction ◽  
Increased Risk

Campus-based suicide prevention is an important priority for universities. One approach could be to identify and treat common mental disorders, but it is unclear what potential reduction in suicide might be achieved by such an approach. Our aim was to quantify this potential effect on prevalence of nonfatal suicidal behaviour among first-year students. Data were collected from students at two South African universities ( N = 633) via an online survey. We assessed prevalence of nonfatal suicidal behaviour and six common mental disorders and used logistic regression models to identify all main and interaction associations of sociodemographic variables and common mental disorders as predictors of nonfatal suicidal behaviour. Population attributable risk analysis was used to quantify the potential reduction in nonfatal suicidal behaviour achieved by effectively treating common mental disorders, based on the simplifying assumption that the logistic regression coefficients of the common mental disorders represented causal effects on nonfatal suicidal behaviour. Twelve-month prevalence of suicidal ideation, plan, and attempt were 40.9%, 22.3%, and 3.9%, respectively. Increased risk was associated with identifying as Black, female and reporting an atypical sexual orientation. Of the six common mental disorders, major depressive disorder and generalised anxiety disorder were associated with all dimensions of nonfatal suicidal behaviour, bipolar spectrum disorder with increased risk of ideation and plan, attention-deficit/hyperactivity disorder with ideation, and alcohol use disorder with suicide plan. Population attributable risk analysis suggests that treating common mental disorders could yield absolute reductions in suicide ideation, plan, and attempt of 17.0%, 55.0% and 73.8%, respectively. Pragmatic trials are needed to evaluate the effects on nonfatal suicidal behaviour of identifying and treating students with a prior history of common mental disorder early in their university careers.

scholarly journals Deployment-Related Traumatic Events and Suicidal Behaviours in a Nationally Representative Sample of Canadian Armed Forces Personnel

2017 ◽  
Vol 62 (11) ◽  
pp. 795-804 ◽  
Author(s):  
Jitender Sareen ◽  
Tracie O. Afifi ◽  
Tamara Taillieu ◽  
Kristene Cheung ◽  
Sarah Turner ◽  
...  
Keyword(s):  
Child Abuse ◽  
Mental Disorders ◽  
Suicidal Behaviour ◽  
Traumatic Events ◽  
Armed Forces ◽  
Canadian Armed Forces ◽  
Increased Risk ◽  
Nationally Representative ◽  
The Individual ◽  
Suicidal Plans

Objective: Worldwide, there has been substantial controversy with respect to whether military deployment is a risk factor for suicidal behaviour. The present study examined the relationship between lifetime exposure to deployment and deployment-related traumatic events (DRTEs) and past-year suicidal ideation (SI), suicidal plans (SP), and suicidal attempts (SA). Method: Data were analysed from the 2013 Canadian Forces Mental Health Survey (8161 respondents; response rate, 79.8%; aged 18-60 years). A total of 12 individual items assessed exposure to DRTEs (e.g., combat, witnessing human atrocities, feeling responsible for the death of Canadian or ally personnel, knowing someone who was injured or killed). We examined each individual DRTE type as well as the number of types of DRTEs in relation to suicidal behaviour. Results: Lifetime deployment was not significantly associated with suicidal behaviour. In models adjusted for sociodemographic variables, most of the individual DRTE items and the DRTE count variable were significantly associated with suicidal behaviours (adjusted odds ratio ranged between 1.10 and 5.32). When further adjusting for child abuse exposure, these associations were minimally attenuated, and some became nonsignificant. In models adjusting for mental disorders and child abuse, most DRTEs and number of types of DRTEs became nonsignificant in relation to SI, SP, and SA. Conclusions: Active military personnel exposed to increasing number of DRTEs are at increased risk for SI, SP, and SA. However, most of the association between DRTEs and suicidal behaviour is accounted for by child abuse exposure and mental disorders.

Excess mortality of mental disorder

1998 ◽  
Vol 173 (1) ◽  
pp. 11-53 ◽  
Author(s):  
Clare Harris ◽  
Brian Barraclough
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
English Language ◽  
Common Mental Disorders ◽  
Premature Death ◽  
Medline Search ◽  
Risk Of Death ◽  
Increased Risk ◽  
Standardised Mortality Ratios ◽  
The Common

BackgroundWe describe the increased risk of premature death from natural and from unnatural causes for the common mental disorders.MethodWith a Medline search (1966–1995) we found 152 English language reports on the mortality of mental disorder which met our inclusion criteria. From these reports, covering 27 mental disorder categories and eight treatment categories, we calculated standardised mortality ratios (SMRs) and 95% confidence intervals (CIs) for all causes of death, all natural causes and all unnatural causes; and for most, SMRs for suicide, other violent causes and specific natural causes.ResultsHighest risks of premature death, from both natural and unnatural causes, are for substance abuse and eating disorders. Risk of death from unnatural causes is especially high for the functional disorders, particularly schizophrenia and major depression. Deaths from natural causes are markedly increased for organic mental disorders, mental retardation and epilepsy.ConclusionAll mental disorders have an increased risk of premature death.

scholarly journals Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months

2011 ◽  
Vol 199 (6) ◽  
pp. 459-466 ◽  
Author(s):  
Vikram Patel ◽  
Helen A. Weiss ◽  
Neerja Chowdhary ◽  
Smita Naik ◽  
Sulochana Pednekar ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Suicidal Behaviour ◽  
Common Mental Disorders ◽  
Stepped Care ◽  
Psychological Morbidity ◽  
Public Facilities ◽  
Care Facilities ◽  
Icd 10

BackgroundDepressive and anxiety disorders (common mental disorders) are the most common psychiatric condition encountered in primary healthcare.AimsTo test the effectiveness of an intervention led by lay health counsellors in primary care settings (the MANAS intervention) to improve the outcomes of people with common mental disorders.MethodTwenty-four primary care facilities (12 public, 12 private) in Goa (India) were randomised to provide either collaborative stepped care or enhanced usual care to adults who screened positive for common mental disorders. Participants were assessed at 2, 6 and 12 months for presence of ICD-10 common mental disorders, the severity of symptoms of depression and anxiety, suicidal behaviour and disability levels. All analyses were intention to treat and carried out separately for private and public facilities and adjusted for the design. The trial has been registered with clinicaltrials.gov (NCT00446407).ResultsA total of 2796 participants were recruited. In public facilities, the intervention was consistently associated with strong beneficial effects over the 12 months on all outcomes. There was a 30% decrease in the prevalence of common mental disorders among those with baseline ICD-10 diagnoses (risk ratio (RR) = 0.70, 95% CI 0.53–0.92); and a similar effect among the subgroup of participants with depression (RR = 0.76, 95% CI 0.59–0.98). Suicide attempts/plans showed a 36% reduction over 12 months (RR = 0.64, 95% CI 0.42–0.98) among baseline ICD-10 cases. Strong effects were observed on days out of work and psychological morbidity, and modest effects on overall disability. In contrast, there was little evidence of impact of the intervention on any outcome among participants attending private facilities.ConclusionsTrained lay counsellors working within a collaborative-care model can reduce prevalence of common mental disorders, suicidal behaviour, psychological morbidity and disability days among those attending public primary care facilities.

scholarly journals Population attributable risk for multimorbidity among adult women in India: Do smoking tobacco, chewing tobacco and consuming alcohol make a difference?

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259578
Author(s):  
Vivek K. Mishra ◽  
Shobhit Srivastava ◽  
Muhammad T. ◽  
P. V. Murthy
Keyword(s):  
Population Attributable Risk ◽  
Family Health ◽  
Attributable Risk ◽  
Bivariate Analysis ◽  
Binary Logistic Regression Analysis ◽  
Effective Sample Size ◽  
Adult Women ◽  
Chewing Tobacco ◽  
Increased Risk ◽  
Smoke Tobacco

Background The present study aims to estimate the prevalence and correlates of multimorbidity among women aged 15–49 years in India. Additionally, the population attributable risk for multi-morbidity in reference to those women who smoke tobacco, chew tobacco, and consume alcohol is estimated. Methods The data was derived from the National Family Health Survey which was conducted in 2015–16. The effective sample size for the present paper 699,686 women aged 15–49 years in India. Descriptive statistics along with bivariate analysis were used to do the preliminary analysis. Additionally, binary logistic regression analysis was used to fulfil the objectives. Results About 1.6% of women had multimorbidity in India. The prevalence of multimorbidity was high among women from southern region of India. Women who smoke tobacco, chew tobacco and consume alcohol had 87% [AOR: 1.87CI: 1.65, 2.10], 18% [AOR: 1.18; CI: 1.10, 1.26] and 18% [AOR: 1.18; CI: 1.04, 1.33] significantly higher likelihood to suffer from multi-morbidity than their counterparts respectively. Population Attributable Risk for women who smoke tobacco was 1.2% (p<0.001), chew tobacco was 0.2% (p<0.001) and it was 0.2% (p<0.001) among women who consumed alcohol. Conclusion The findings indicate the important role of lifestyle and behavioural factors such as smoking and chewing tobacco and consuming alcohol in the prevalence of multimorbidity among adult Indian women. The subgroups identified as at increased risk in the present study can be targeted while making policies and health decisions and appropriate comorbidity management can be implemented.

Mental health and academic failure among first-year university students in South Africa

2020 ◽  
pp. 008124632096320
Author(s):  
Jason Bantjes ◽  
Wylene Saal ◽  
Franco Gericke ◽  
Christine Lochner ◽  
Janine Roos ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Regression Models ◽  
Common Mental Disorders ◽  
Population Attributable Risk ◽  
Academic Failure ◽  
Sociodemographic Factors ◽  
First Year ◽  
Major Depressive ◽  
Logistic Regression Models ◽  
Hyperactivity Disorder

Universities in South Africa face ongoing challenges with low rates of academic attainment and high rates of attrition. Our aims were to (1) investigate the extent to which common mental disorders evaluated early in the first year predict academic failure at the end of the year, controlling for sociodemographic factors and (2) establish the potential reduction in prevalence of failure that could be achieved by effectively treating associated mental disorders. Self-report data were collected from first-year students ( n = 1402) via an online survey at the end of the first semester. Participants were assessed for six common mental disorders. Academic performance data were subsequently obtained from institutional records at the end of the year. Bivariate and multivariate logistic regression models were used to identify the best sociodemographic and mental health predictors of academic failure. Population attributable risk analysis was used to assess the potential impact of treating associated mental disorders. In multivariate logistic regression models controlling for significant sociodemographic factors, the odds of failure were elevated among students with major depressive disorder (aOR = 3.69) and attention deficit hyperactivity disorder (aOR = 2.05). Population attributable risk analysis suggests that providing effective treatment to students with major depressive disorder and/or attention deficit hyperactivity disorder could yield a 6.5% absolute reduction in prevalence of academic failure (equivalent to a 23.0% proportional reduction in prevalence of academic failure). Providing effective and accessible campus-based mental healthcare services is integral to supporting students’ academic attainment and promoting transformation at South African universities.

Suicide as an outcome for mental disorders

1997 ◽  
Vol 170 (3) ◽  
pp. 205-228 ◽  
Author(s):  
E. Clare Harris ◽  
Brian Barraclough
Keyword(s):  
Mental Disorders ◽  
Suicide Risk ◽  
English Language ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Strong Association ◽  
Search Terms ◽  
Increased Risk ◽  
Mortality Ratio

BackgroundMental disorders have a strong association with suicide. This meta-analysis, or statistical overview, of the literature gives an estimate of the suicide risk of the common mental disorders.MethodWe searched the medical literature to find reports on the mortality of mental disorders. English language reports were located on MEDLINE (1966–1993) with the search terms mental disorders', ‘brain injury’, ‘eating disorders’, ‘epilepsy’, ‘suicide attempt’, ‘psychosurgery’, with ‘mortality’ and ‘follow-up studies’, and from the reference lists of these reports. We abstracted 249 reports with two years or more follow-up and less than 10% loss of subjects, and compared observed numbers of suicides with those expected. A standardised mortality ratio (SMR) was calculated for each disorder.ResultsOf 44 disorders considered, 36 have a significantly raised SMR for suicide, five have a raised SMR which fails to reach significance, one SMR is not raised and for two entries the SMR could not be calculated.ConclusionsIf these results can be generalised then virtually all mental disorders have an increased risk of suicide excepting mental retardation and dementia. The suicide risk is highest for functional and lowest for organic disorders with substance misuse disorders lying between. However, within these broad groupings the suicide risk varies widely.

scholarly journals Common mental disorders and associated factors: a study of women from a rural area

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Bibiane Dias Miranda Parreira ◽  
Bethania Ferreira Goulart ◽  
Vanderlei José Haas ◽  
Sueli Riul da Silva ◽  
Juliana Cristina dos Santos Monteiro ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Mental Disorders ◽  
Reproductive Health ◽  
Rural Area ◽  
Rural Women ◽  
Common Mental Disorders ◽  
Childbearing Age ◽  
Cross Sectional ◽  
Individualized Care ◽  
Self Reporting Questionnaire

Abstract OBJECTIVE Identifying the prevalence of Common Mental Disorders and analyzing the influence of sociodemographic, economic, behavioral and reproductive health variables on Common Mental Disorders in women of childbearing age living in the rural area of Uberaba-MG, Brazil. METHOD An observational and cross-sectional study. Socio-demographic, economic, behavioral and reproductive health instruments were used, along with the Self-Reporting Questionnaire (SRQ-20) to identify common mental disorders. Multiple logistic regression was used for multivariate data analysis. RESULTS 280 women participated in the study. The prevalence of Common Mental Disorders was 35.7%. In the logistic regression analysis, the variables of living with a partner and education level were associated with Common Mental Disorders, even after adjusting for the other variables. CONCLUSION Our findings evidenced an association of social and behavioral factors with Common Mental Disorders among rural women. Identification and individualized care in primary health care are essential for the quality of life of these women.

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