scholarly journals Association between naturally occurring lithium in drinking water and suicide rates: systematic review and meta-analysis of ecological studies

2020 ◽  
Vol 217 (6) ◽  
pp. 667-678
Author(s):  
Anjum Memon ◽  
Imogen Rogers ◽  
Sophie M. D. D. Fitzsimmons ◽  
Ben Carter ◽  
Rebecca Strawbridge ◽  
...  
Keyword(s):  
Mental Health ◽  
Drinking Water ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Health Conditions ◽  
Suicide Mortality ◽  
Inverse Association ◽  
Ecological Studies ◽  
Suicide Rates ◽  
Naturally Occurring

BackgroundThe prevalence of mental health conditions and national suicide rates are increasing in many countries. Lithium is widely and effectively used in pharmacological doses for the treatment and prevention of manic/depressive episodes, stabilising mood and reducing the risk of suicide. Since the 1990s, several ecological studies have tested the hypothesis that trace doses of naturally occurring lithium in drinking water may have a protective effect against suicide in the general population.AimsTo synthesise the global evidence on the association between lithium levels in drinking water and suicide mortality rates.MethodThe MEDLINE, Embase, Web of Science and PsycINFO databases were searched to identify eligible ecological studies published between 1 January 1946 and 10 September 2018. Standardised regression coefficients for total (i.e. both genders combined), male and female suicide mortality rates were extracted and pooled using random-effects meta-analysis. The study was registered with PROSPERO (CRD42016041375).ResultsThe literature search identified 415 articles; of these, 15 ecological studies were included in the synthesis. The random-effects meta-analysis showed a consistent protective (or inverse) association between lithium levels/concentration in publicly available drinking water and total (pooled β = −0.27, 95% CI −0.47 to −0.08; P = 0.006, I2 = 83.3%), male (pooled β = −0.26, 95% CI −0.56 to 0.03; P = 0.08, I2 = 91.9%) and female (pooled β = −0.13, 95% CI −0.24 to −0.02; P = 0.03, I2 = 28.5%) suicide mortality rates. A similar protective association was observed in the six studies included in the narrative synthesis, and subgroup meta-analyses based on the higher/lower suicide mortality rates and lithium levels/concentration.ConclusionsThis synthesis of ecological studies, which are subject to the ecological fallacy/bias, supports the hypothesis that there is a protective (or inverse) association between lithium intakes from public drinking water and suicide mortality at the population level. Naturally occurring lithium in drinking water may have the potential to reduce the risk of suicide and may possibly help in mood stabilisation, particularly in populations with relatively high suicide rates and geographical areas with a greater range of lithium concentration in the drinking water. All the available evidence suggests that randomised community trials of lithium supplementation of the water supply might be a means of testing the hypothesis, particularly in communities (or settings) with demonstrated high prevalence of mental health conditions, violent criminal behaviour, chronic substance misuse and risk of suicide.

scholarly journals The association between lithium in drinking water and neuropsychiatric outcomes: A systematic review and meta-analysis from across 2678 regions containing 113 million

2020 ◽  
pp. 000486742096374 ◽  
Author(s):  
Brenton Eyre-Watt ◽  
Eesharnan Mahendran ◽  
Shuichi Suetani ◽  
Joseph Firth ◽  
Steve Kisely ◽  
...  
Keyword(s):  
Systematic Review ◽  
Drinking Water ◽  
Confidence Interval ◽  
Publication Bias ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Suicide Rates ◽  
Registration Number ◽  
Trim And Fill

Background: Lithium in drinking water may have significant mental health benefits. We investigated the evidence on the association between lithium concentrations in drinking water and their neuropsychiatric outcomes. Methods: We conducted a systematic review and meta-analysis and searched Pubmed, Embase, Web of Science, PsycINFO and CINAHL up to 19 January 2020, for peer-reviewed research examining the association between lithium concentrations in drinking water and neuropsychiatric outcomes. We used a pairwise analysis and a random effects model to meta-analyse suicide rates and psychiatric hospital admissions. We assessed for publication bias using Egger’s test and Duval and Tweedie’s Trim and Fill analysis. Results: Twenty-seven studies including 113 million subjects were included in this systematic review. Meta-analysis of 14 studies including 94 million people found higher lithium concentrations were associated with reduced suicide rates ( r = −0.191, 95% confidence interval = [−0.287, −0.090], p < 0.001) and meta-analysis of two studies including 5 million people found higher lithium concentrations were associated with fewer hospital admissions ( r = −0.413, 95% confidence interval = [−0.689, −0.031], p = 0.035). We found significant heterogeneity between studies ( Q = 67.4, p < 0.001, I2 = 80.7%) and the presence of publication bias (Egger’s test; t value = 2.90, p = 0.013). Other included studies did not provide sufficient data to analyse other neuropsychiatric outcomes quantitatively. Conclusion: Higher lithium concentrations in drinking water may be associated with reduced suicide rates and inpatient psychiatric admissions. The relationship with other neuropsychiatric outcomes and complications remains unclear. Further research is required before any public health recommendations can be made. Trial registration number: The study was registered with PROSPERO, number CRD42018090145.

Employment and suicidal rates during economic recession: A country-targeted integrative review

2020 ◽  
pp. 002076402096974
Author(s):  
Apostolos Kamekis ◽  
George Rachiotis ◽  
Adelais Markaki ◽  
Vasiliki Samara ◽  
Emmanouil K. Symvoulakis
Keyword(s):  
Economic Crisis ◽  
Economic Recession ◽  
Mortality Rates ◽  
Integrative Review ◽  
Suicide Mortality ◽  
Greek Language ◽  
Enabling Factors ◽  
Suicide Rates ◽  
Reported Data ◽  
Recession Period

Background: The economic crisis’ effects on suicide rates for countries undergoing or exiting austerity measures have been widely debated. This integrative review aimed to identify, appraise, and synthesize available evidence of employment status effect on suicide mortality rates in Greece during the recent economic recession period. Methods: A literature review of studies evaluating suicides in the general Greek population, as well as across age and gender groups, in relation to employment during the economic crisis period was performed. PubMed electronic database was searched for relevant articles published in English or Greek language from 2009 up to February 2020. Appraisal was carried out based on the Hierarchy of Evidence Rating System and the GRADE guidelines. Results: A total of 24 articles met all inclusion criteria with 20 of them at level IV, 2 at level VII, and 2 at level VIII. A total of 18 studies reported increase of suicide rates during the economic recession period. About 12 studies examined the co-relation between unemployment and suicide rate, with ten studies showing a positive correlation. Moreover, thirteen studies reported data on the effect of gender and age variables on suicide rates. Conclusion: Evidence shows that suicide mortality rates in Greece increased after the eruption of economic recession, particularly after the implementation of radical austerity measures (2011–2014). This increase was positively correlated with unemployment and was more prominent among males of working age. Further in depth epidemiological research of regional variations in terms of profile and contributing or enabling factors of suicidal behavior is needed.

Relationship between suicide mortality and lithium in drinking water: A systematic review and meta-analysis

2020 ◽  
Vol 264 ◽  
pp. 234-241 ◽  
Author(s):  
Fateme Barjasteh-Askari ◽  
Mojtaba Davoudi ◽  
Homayoun Amini ◽  
Mohammad Ghorbani ◽  
Mehdi Yaseri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Drinking Water ◽  
Meta Analysis ◽  
Suicide Mortality

scholarly journals Sex-specific and age-specific suicide mortality by method in 58 countries between 2000 and 2015

2020 ◽  
pp. injuryprev-2019-043601 ◽  
Author(s):  
Yue Wu ◽  
David C Schwebel ◽  
Yun Huang ◽  
Peishan Ning ◽  
Peixia Cheng ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Age Groups ◽  
Mortality Rates ◽  
Suicide Mortality ◽  
Mortality Data ◽  
Suicide Method ◽  
Suicide Rates ◽  
Males And Females ◽  
Binomial Models ◽  
Country Specific

ObjectiveTo examine recent changes in sex-specific and age-specific suicide mortality by method across countries.MethodsUsing mortality data from the WHO mortality database, we compared sex-specific, age-specific and country-specific suicide mortality by method between 2000 and 2015. We considered seven major suicide methods: poisoning by pesticides, all other poisoning, firearms and explosives, hanging, jumping from height, drowning and other methods. Changes in suicide mortality were quantified using negative binomial models among three age groups (15–44 years, 45–64 years, and 65 years and above) for males and females separately.ResultsSuicide mortality declined substantially for both sexes and all three age groups studied in 37 of the 58 included countries between 2000 and 2015. Males consistently had much higher suicide mortality rates than females in all 58 countries. Hanging was the most common suicide method in the majority of 58 countries. Sex-specific suicide mortality varied across 58 countries significantly for all three age groups. The spectrum of suicide method generally remained stable for 28 of 58 included countries; notable changes occurred in the other 30 countries, including especially Colombia, Finland and Trinidad and Tobago.ConclusionLikely as a result of prevention efforts as well as sociodemographic changes, suicide mortality decreased substantially in 37 of the included 58 countries between 2000 and 2015. Further actions are needed to explore specific drivers of the recent changes (particularly for increases in eight countries), to understand substantial disparities in suicide rates across countries, and to develop interventions to reduce suicide rates globally.

scholarly journals Effectiveness of eHealth interventions for reducing mental health conditions in employees: A systematic review and meta-analysis

PLoS ONE ◽  
2017 ◽  
Vol 12 (12) ◽  
pp. e0189904 ◽  
Author(s):  
Elizabeth Stratton ◽  
Amit Lampit ◽  
Isabella Choi ◽  
Rafael A. Calvo ◽  
Samuel B. Harvey ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Meta Analysis ◽  
Health Conditions ◽  
Mental Health Conditions

scholarly journals Regional Variation and Socio-Economic Determinants of Suicide Mortality in Greece before and during Economic Crisis

2020 ◽  
Vol 10 (17) ◽  
pp. 6117
Author(s):  
Christos Zilidis ◽  
Dimitrios Papagiannis ◽  
Georgios Rachiotis
Keyword(s):  
Mental Health ◽  
Economic Crisis ◽  
Regional Variation ◽  
Correlation Coefficients ◽  
Mortality Rates ◽  
Suicide Mortality ◽  
Related Factors ◽  
Before And After ◽  
Health Related ◽  
The Impact

Background. Suicide mortality increased in Greece after the 2008 financial crisis. This study aimed to explore the regional variation of suicide mortality before and after the economic crisis, and its correlation with socio-economic and mental health-related variables factors. Methods. This is a quasi-experimental ecological study. Data from the national mortality statistics were analyzed, and standardized death rates and age-specific mortality rates were calculated. The effect of economic crisis was explored by comparing mortality rates before and after crisis onset. Pearson’s and Spearman’s correlation coefficients and multiple linear regression were used to assess the impact of socioeconomic and mental health-related factors on suicide mortality. Results. Trends of suicide mortality showed a rise during 2011–2014, followed by a decline during 2015–2016. Significant differences were observed between regions, ranging from 27.6% lower to 54% higher than the national average. Unemployment, income, and change of gross domestic product were significantly correlated with regional variation. No association was found with mental disorder mortality rates and psychotropic drug consumption. Conclusions. Socio-economic factors explained only a part of the suicide mortality variation. Mental health-related factors were not significantly correlated with suicide mortality. More research is needed to investigate other possible determinants of suicides.

scholarly journals Lithium in drinking water and suicide mortality: Interplay with lithium prescriptions

2015 ◽  
Vol 207 (1) ◽  
pp. 64-71 ◽  
Author(s):  
Marco Helbich ◽  
Michael Leitner ◽  
Nestor D. Kapusta
Keyword(s):  
Drinking Water ◽  
Suicide Mortality ◽  
Inverse Association ◽  
Protective Effects ◽  
Natural Rock ◽  
Gender Specific Differences ◽  
Local Risk ◽  
The Relationship ◽  
Gender Specific ◽  
Rock And Soil

BackgroundLittle is known about the effects of lithium intake through drinking water on suicide. This intake originates either from natural rock and soil elution and/or accumulation of lithium-based pharmaceuticals in ground water.AimsTo examine the interplay between natural lithium in drinking water, prescribed lithium-based pharmaceuticals and suicide in Austria.MethodSpatial Bayesian regressions for males, females and pooled suicide mortality rates were estimated.ResultsAlthough the expected inverse association between lithium levels in drinking water and suicide mortality was confirmed for males and for total suicide rates, the relationship for females was not significant. The models do not indicate that lithium from prescriptions, assumed to accumulate in drinking water, is related to suicide risk patterns either as an individual effect or as a moderator of lithium levels in drinking water. Gender-specific differences in risk factors and local risk hot spots are confirmed.ConclusionsThe findings do not support the hypotheses that lithium prescriptions have measureable protective effects on suicide or that they interact with lithium in drinking water.

scholarly journals A systematic review and meta-analysis of group peer support interventions for people experiencing mental health conditions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Natasha Lyons ◽  
Chris Cooper ◽  
Brynmor Lloyd-Evans
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Services ◽  
Peer Support ◽  
Support Groups ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Health Conditions ◽  
Mental Health Conditions ◽  
Meta Analyses

Abstract Background Peer support is being integrated within mental health services to further the development of a recovery approach. However, the most effective models and formats of intervention delivery are unknown. We conducted this systematic review and meta-analysis to determine the effectiveness of peer support for improving outcomes for people with lived experience of mental health conditions, when delivered as group interventions. Methods Studies reporting randomised controlled trials of group peer support interventions for people experiencing mental health conditions were identified by searching MEDLINE, PsycINFO, Embase and Cochrane CENTRAL, from inception until July 12th 2019 and undertaking supplementary searches. Included studies were assessed for risk of bias and meta-analyses were conducted if three or more trials provided usable data. Results Eight trials met eligibility criteria, providing data from 2131 participants. Six trials had either high or unclear risk of bias. Interventions were categorised as mutual support groups, or peer support groups, sub-categorised as anti-stigma or self-management interventions. Meta-analyses were only possible for peer support groups and five outcomes. We found evidence that group peer support may make small improvements to overall recovery but not hope or empowerment individually, or to clinical symptoms. Evidence for effectiveness for outcomes which could not be meta-analysed was mixed. Conclusions Findings from the few eligible trials suggest group peer support interventions may be specifically effective for supporting personal recovery and have a limited impact on other outcomes, though there were some risks of bias to study findings. Interventions were heterogeneous and most social outcomes were absent in the literature, highlighting further limitations to the current evidence-base. There is insufficient evidence available from trials of group peer support torecommend the routine implementation of these interventions across mainstream mental health services at present. More high-quality trials of peer-developed, group peer support interventions are needed in order tomake firm conclusions about intervention effectiveness.

scholarly journals Suicidal Behavior in the Mediterranean Countries

2020 ◽  
Vol 16 (1) ◽  
pp. 93-100
Author(s):  
Mehmet Eskin
Keyword(s):  
Suicidal Behavior ◽  
Mortality Rates ◽  
Suicide Mortality ◽  
World Average ◽  
Suicide Rates ◽  
Muslim Countries ◽  
Mediterranean Countries ◽  
Arab Muslim ◽  
The World ◽  
The Mediterranean

Introduction: Suicidal behavior is a serious public health problem worldwide and shows large intersocietal variation. This study aimed at comparatively investigating the aspects of suicidal behavior in 22 countries surrounding the Mediterranean Sea. Methods: The study was conducted with official data retrieved from several sources. The suicidal mortality data were collected from World Health Organization’s data repository. Descriptive statistics, group comparison, correlational and regression statistical analyses were used to summarize the data. Results: The average age standardized suicide rates in the Mediterranean countries are lower than the world average. Except in Morocco, more men kill themselves than women. Suicide rates are lower in Mediterranean Muslim than in Mediterranean Christian countries. Slovenia, France and Croatia have the highest suicide mortality rates. Greatest percentages of suicidal ideation are seen in Croatia, Turkey and Slovenia and the greatest percentages of suicidal attempts are seen in Palestine, Cyprus, Greece and Slovenia. According to the results of the multiple regression analyses, the coefficient of human inequality index was associated with lower both-sex and male suicide rates. Greater percentages of people saying religion is unimportant in daily life in a country were found to be related to higher female suicide rates. Conclusion: The findings from the study have shown that the prevalence of suicidal deaths, thoughts and attempts vary between the Mediterranean countries. Lower suicide rates are observed in the Muslim Mediterranean nations than in the Judeo-Christian ones. However, the rates of suicide mortality in non-Arab Muslim nations being comparable to the rates in non-Muslim countries confirm the concerns over mis/underreporting of suicidal behavior in Arab Muslim countries due to religio-cultural stigma attached to suicide. The average suicidal mortality rates are lower in Mediterranean countries than the world average. Generally, more men than women kill themselves. Results from the multivariate analysis revealed that as the level of human inequality increases the rates for both-sex and male suicidal mortality decreases. Religion seem to be protective against female suicides. The study has also shown that more research is needed about suicidal behavior in the Mediterranean countries.

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