scholarly journals Influencing Factors of Multiple Adverse Outcomes Among Schizophrenia Patients Using Count Regression Models: A Cross-Sectional Study

2021 ◽  
Author(s):  
Lichang Chen ◽  
Wenyan Tan ◽  
Xiao Lin ◽  
Haicheng Lin ◽  
Junyan Xi ◽  
...  
Keyword(s):  
Risk Factor ◽  
Influencing Factors ◽  
Violent Crime ◽  
Regression Models ◽  
Negative Binomial ◽  
Suicide Attempts ◽  
Adverse Outcomes ◽  
Different Types ◽  
History Of ◽  
Self Harm

Abstract Background: Schizophrenia patients have increased risks of several adverse outcomes, including violent crime, aggressiveness and suicide. However, studies of different adverse outcomes in the same population are rare and the influencing factors for these outcomes need clarification by appropriate models. This study aimed to identify influencing factors of these adverse outcomes by examining and comparing different count regression models.Methods: This study included schizophrenia patients who had at least once follow-up record in the Guangdong Mental Health Center Network Medical System during 2020. Three types of adverse outcomes including a) aggressiveness with police dispatch or violence crime, b) aggressiveness without police dispatch, and c) self-harm or suicide attempts. First, we investigated the incidence of these adverse outcomes in each type. Second, the Poisson, negative binomial (NB), zero-inflated Poisson (ZIP), and zero-inflated negative binomial (ZINB) regression models were fitted and compared for their intensity. Finally, We analysed associations between these adverse outcomes intensity and sociodemographic, clinical factors with the best model. Results: A total of 130474 schizophrenia patients were selected. Each type of adverse outcomes was reported by less than 1% of schizophrenia patients in 2020. NB regression model is the best model for fitting the number of aggressiveness without police dispatch because of the best goodness of fit and relatively simple interpretation, whereas ZINB models for the other two outcomes. Age, sex, and history of adverse outcomes were influencing factors shared across these adverse outcomes. Higher educational level, employment were protective factors shared between aggressiveness with police dispatch or violent crime , and aggressiveness without police dispatch. Aggressiveness without police dispatch , and self-harm or suicide attempts shared older onset age (≥18 years) as a risk factor. Family history of mental disease was a risk factor of self-harm or suicide attempts individually.Conclusions: NB and ZINB models were selected for fitting the number of adverse outcomes in our studies. Influencing factors for adverse outcomes intensity included both those shared across different types and those individual to specific types. Therefore, combined and customized tools in risk assessment and intervention for different types of these outcomes might be necessary.

scholarly journals The effect of sexual abuse and dissociation on suicide attempt

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Silje Støle Brokke ◽  
Thomas Bjerregaard Bertelsen ◽  
Nils Inge Landrø ◽  
Vegard Øksendal Haaland
Keyword(s):  
Sexual Abuse ◽  
Risk Factor ◽  
Suicide Attempt ◽  
Indirect Effects ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Suicidal Thoughts ◽  
Dissociative Experiences ◽  
Self Harm

Abstract Background Suicide attempt is the most predictive risk factor of suicide. Trauma – especially sexual abuse – is a risk factor for suicide attempt and suicide. A common reaction to sexual abuse is dissociation. Higher levels of dissociation are linked to self-harm, suicide ideation, and suicide attempt, but the role of dissociation in suicidal behavior is unclear. Methods In this naturalistic study, ninety-seven acute psychiatric patients with suicidal ideation, of whom 32 had experienced sexual abuse, were included. Suicidal behaviour was assessed with The Columbia suicide history form (CSHF). The Brief trauma questionnaire (BTQ) was used to identify sexual abuse. Dissociative symptoms were assessed with Dissociative experiences scale (DES). Results Patients who had experienced sexual abuse reported higher levels of dissociation and were younger at onset of suicidal thoughts, more likely to self-harm, and more likely to have attempted suicide; and they had made more suicide attempts. Mediation analysis found dissociative experiences to significantly mediate a substantive proportion of the relationship between sexual abuse and number of suicide attempts (indirect effects = 0.17, 95% CI = 0.05, 0.28, proportion mediated = 68%). Dissociative experiences significantly mediated the role of sexual abuse as a predictor of being in the patient group with more than four suicide attempts (indirect effects = 0.11, 95% CI = 0.02, 0.19, proportion mediated = 34%). Conclusion The results illustrate the importance of assessment and treatment of sexual abuse and trauma-related symptoms such as dissociation in suicide prevention. Dissociation can be a contributing factor to why some people act on their suicidal thoughts.

Suicide in prisons and remand centres

2021 ◽  
pp. 227-232
Author(s):  
Marco Sarchiapone ◽  
Miriam Iosue
Keyword(s):  
General Population ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Individual Vulnerability ◽  
High Prevalence ◽  
Common Causes ◽  
Prevention Programmes ◽  
History Of ◽  
Self Harm ◽  
High Level

Suicide is one of the most common causes of death in custodial settings worldwide, accounting for around 10% of prisoners’ deaths. Suicide attempts and suicidal ideation are also more common among prisoners compared to the general population. The high prevalence of suicidal behaviours among prisoners is likely the result of a complex interaction between individual vulnerability and the high level of stress and deprivation caused by the condition of confinement. Among prisoners and inmates, the prevalence of well-established suicide risk factors, such as a history of self-harm, psychopathological conditions, aggressive personality traits, and childhood trauma, is higher than in the general population. Moreover, the loss of freedom and autonomy, social isolation, lack of purposeful activity, and victimization are prison-specific stressors that showed to increase the suicide risk among inmates. Given this complexity, comprehensive multifactored prevention programmes involving the administrative, custodial, and clinical staff are the most effective in preventing suicide.

scholarly journals Comparison of suicide risk and other outcomes among boys and girls who self-harm

2020 ◽  
Vol 29 (12) ◽  
pp. 1741-1746 ◽  
Author(s):  
Anna Ohlis ◽  
Johan Bjureberg ◽  
Paul Lichtenstein ◽  
Brian M. D’Onofrio ◽  
Alan E. Fruzzetti ◽  
...  
Keyword(s):  
Sex Differences ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Economic Status ◽  
Adverse Outcomes ◽  
Hazard Ratios ◽  
Self Harm ◽  
Males And Females ◽  
Drug Use Disorder

Abstract Little is known about sex differences in outcomes of self-harm, and there are inconclusive results concerning the association between sex, self-harm, and suicide attempts. The aim of this study was to explore sex differences in outcomes of self-harm in adolescence. In this cohort study, all individuals (0–17 years) enrolled at the child- and adolescent mental health services (CAMHS) in Stockholm between 2001 and 2015 (N = 110,072) were followed in national registers from their last contact with the CAMHS, until end of 2015. Exposure was self-harm as reason for contact, outcome measures were: alcohol-/substance use disorder, psychiatric hospitalization, non-violent or violent crime, and suicide. Differences in outcomes rates between exposed versus unexposed males, and exposed versus unexposed females, were examined using Cox regressions, expressed as hazard ratios (HR) with 95% confidence intervals (CI). Median follow-up time was 5.8 years (Q1: 2.3 years; Q3: 9.7 years). Self-harm was documented in 2.2% (N = 1241) males and 8.7% (4716) females. Exposed individuals had higher HR for all outcomes as compared with unexposed individuals of their own sex. Exposed females had more pronounced risk for drug use disorder (HR 11.2; 95% CI 9.9–12.7) compared with exposed males (HR 6.5, 95% 5.2–8.0). Both males and females who had engaged in self-harm had elevated risks for future suicide. Adjusting for socio-economic status and age at start of follow-up only marginally affected the associations. Females and males with self-harm had similarly elevated risk for suicide, and self-harm was also an important risk marker for other adverse outcomes within both sexes.

Prediction and network modelling of self-harm through daily self-report and history of self-injury

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Michael J. Kyron ◽  
Geoff R. Hooke ◽  
Andrew C. Page
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Daily Basis ◽  
Adverse Outcomes ◽  
Self Report ◽  
Public Health Issue ◽  
Short Term ◽  
Wish To Die ◽  
History Of ◽  
Self Harm

Abstract Background Self-harm is a significant public health issue, and both our understanding and ability to predict adverse outcomes are currently inadequate. The current study explores how preventative efforts could be aided through short-term prediction and modelling of risk factors for self-harm. Methods Patients (72% female, Mage = 40.3 years) within an inpatient psychiatric facility self-reported their psychological distress, interpersonal circumstances, and wish to live and die on a daily basis during 3690 unique admissions. Hierarchical logistic regressions assessed whether daily changes in self-report and history of self-harm could predict self-harm, with machine learning used to train and test the model. To assess interrelationships between predictors, network and cross-lagged panel models were performed. Results Increases in a wish to die (β = 1.34) and psychological distress (β = 1.07) on a daily basis were associated with increased rates of self-harm, while a wish to die on the day prior [odds ratio (OR) 3.02] and a history of self-harm (OR 3.02) was also associated with self-harm. The model detected 77.7% of self-harm incidents (positive predictive value = 26.6%, specificity = 79.1%). Psychological distress, wish to live and die, and interpersonal factors were reciprocally related over the prior day. Conclusions Short-term fluctuations in self-reported mental health may provide an indication of when an individual is at-risk of self-harm. Routine monitoring may provide useful feedback to clinical staff to reduce risk of self-harm. Modifiable risk factors identified in the current study may be targeted during interventions to minimise risk of self-harm.

scholarly journals 109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e45-e45 ◽  
Author(s):  
Rachel Mitchell ◽  
Cornelius Ani ◽  
James Irvine ◽  
Claude Cyr ◽  
Ari Joffe ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Suicide Attempt ◽  
Mental Health Care ◽  
Family Conflict ◽  
Suicide Attempts ◽  
Suicide Mortality ◽  
Prevention Interventions ◽  
History Of ◽  
Self Harm

Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M>F; p<.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p<.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p<.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.

What Do We Know About Changing Economic Activity of Firms?

2019 ◽  
pp. 232102221886979
Author(s):  
Radhika Pandey ◽  
Amey Sapre ◽  
Pramod Sinha
Keyword(s):  
Economic Activity ◽  
Regression Models ◽  
Statistical Approach ◽  
Negative Binomial ◽  
Large Data ◽  
Poisson Model ◽  
Negative Binomial Regression ◽  
Data Set ◽  
Binomial Regression ◽  
History Of

Identification of primary economic activity of firms is a prerequisite for compiling several macro aggregates. In this paper, we take a statistical approach to understand the extent of changes in primary economic activity of firms over time and across different industries. We use the history of economic activity of over 46,000 firms spread over 25 years from CMIE Prowess to identify the number of times firms change the nature of their business. Using the count of changes, we estimate Poisson and Negative Binomial regression models to gain predictability over changing economic activity across industry groups. We show that a Poisson model accurately characterizes the distribution of count of changes across industries and that firms with a long history are more likely to have changed their primary economic activity over the years. Findings show that classification can be a crucial problem in a large data set like the MCA21 and can even lead to distortions in value addition estimates at the industry level. JEL Classifications: D22, E00, E01

scholarly journals S135. EXPOSURE TO COMMON INFECTIONS AND RISK OF SUICIDE AND SELF-HARM – A LONGITUDINAL GENERAL POPULATION STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S86-S87
Author(s):  
Maija Lindgren ◽  
Minna Holm ◽  
Niina Markkula ◽  
Tommi Härkänen ◽  
Faith Dickerson ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Regression Models ◽  
Suicide Attempts ◽  
Herpes Viruses ◽  
Suicidal Thoughts ◽  
Self Harm ◽  
Antibody Levels ◽  
Common Infections ◽  
Hsv 1

Abstract Background Common infectious agents, such as Toxoplasma gondii (T. gondii) and several human herpes viruses, have been linked to increased risk of self-harm. As the infections may be prevented and treated, information on the possible association on common infections and suicidal outcomes may help prevent self-harm. We aimed to investigate the associations between self-harm and seropositivity to T. gondii, Epstein-Barr virus (EBV), Herpes Simplex virus Type 1 (HSV-1), and Cytomegalovirus (CMV). As depression is a major risk factor for suicidality, we also investigated whether being seropositive to the studied herpes viruses was associated with depressive symptoms. Methods IgM and IgG antibodies to T. gondii, EBV, HSV-1, and CMV were measured in a large Finnish population survey, the Health 2000 project, in year 2000. The 6250 participants were followed for 15 years via health care register and causes of death register. In addition, lifetime suicidal ideation and suicide attempts were assessed in a smaller subsample of 694 participants, based on systematically-evaluated self-report, medical records, and register data. The participants in the subsample were screened for possible psychotic symptoms or were controls; we controlled for this screen status in the regression models. Results We found no significant cross-sectional associations between baseline depressive symptom and the herpes infections, when controlling for background variables related to infection seropositivity. During the follow-up, 18 of the 6250 participants (0.3%) had either died by suicide or had a self-harm diagnosis. In Cox regression models, serological evidence of lifetime or acute infections was not found to be associated with these suicidal outcomes. In the subsample, 31% had had suicidal thoughts and 13% had attempted suicide. There were no significant associations between suicidal thoughts and infection seropositivity / antibody levels. However, those seropositive for IgG class antibodies for CMV, measuring latent infection, had fewer suicide attempts compared to those seronegative in multinomial logistic regression models adjusting for gender, age, education, childhood family size, regional residence, and screen status (OR for multiple attempts compared to no attempts =0.45, 95% confidence interval 0.22‒0.91, p=.026). Genders were investigated separately in post-hoc analyses and there were significant associations only in males: suicide attempts were associated negatively with CMV and positively with EBV. Looking separately at diagnosis groups, the CMV association was significant among those with a mood disorder and not among those with a psychotic disorder. C-reactive protein (CRP) measuring inflammation seemed to explain some but not all of the associations. Discussion In a large sample nationally representative of the whole Finnish adult population, antibodies to CMV, EBV, or HSV-1 were not associated with depressive symptoms. Seropositivity or antibody levels of T. gondii or herpes viruses were not associated with risk of subsequent death by suicide or intentional self-harm diagnoses at a 15 year follow-up. In the subsample consisting mostly of participants with severe mental disorders, in males, EBV antibody level was associated with a history of a suicide attempt and none of the other infection variables were associated with a heightened risk for suicidal thoughts or acts. We found a heightened risk for multiple suicide attempts in persons belonging to the CMV seronegative minority. This “protective effect” of being infected with CMV calls for further research.

scholarly journals The impact of political instability upon the increase of terrorism in the Middle East

2021 ◽  
pp. 43-62
Author(s):  
Andrey Vadimovich Novikov
Keyword(s):  
Regression Models ◽  
Negative Binomial ◽  
Political Instability ◽  
Negative Binomial Regression ◽  
Severe Form ◽  
Political Regime ◽  
Level Of Education ◽  
Binomial Regression ◽  
Different Types ◽  
The Impact

The key goal of the article is to examine whether the domestic political instability associated with the “Arab Spring” caused the subsequent surge of global terrorism, which reached its peak in 2014. The author reviews six different types of domestic political instability: antigovernment demonstrations, national strikes, government crises, government repression, disturbances, and revolutions. Using the regression models, the author clarifies the impact of such factors as the level of education, Internet access, economic development, democratization indexes, and the degree of religious and ethnic fragmentariness. Analysis is conducted on the results of the models separately for different types of political regimes, forms of domestic political instability, and global regions. The results of construction and analysis a number of negative binomial regression models testify to the support of “escalation effect”, which implies that heightened intensity of domestic political instability leads to the surge of terrorist attacks. More severe forms of domestic political instability, namely repression and disturbances, generate a higher level of terrorism; however, revolution, as the most severe form of domestic political instability does not produce such effect. The formulated conclusions are also substantiated by the fact that certain forms of political instability have a different impact upon terrorism and its peculiarities, depending on the geographical region and the type of political regime.

Psychosocial and Clinical Predictors of Attempted Suicide, Hopelessness and Non-Suicidal Self-Injury in Adolescents on Venlafaxine

2018 ◽  
Author(s):  
Saad Salman ◽  
Fahad Hassan Shah ◽  
Jawaria Idrees ◽  
Ameerzada Khan ◽  
Muniba Tariq ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Clinical Symptoms ◽  
Clinical Predictors ◽  
Family Responsibilities ◽  
Self Injury ◽  
Causative Agents ◽  
History Of ◽  
Self Harm ◽  
Parental Marriage ◽  
Suicidal Thoughts And Behaviors

Suicide and self-harm are very common among adolescents, especially females in western and Asian countries. The Psychosocial predictors, along with hopelessness and non-suicidal harm, have not been studied properly before. Therefore, there is a need to address these issues. The objective of the study was to ascertain the psychosocial and clinical features predicting suicide attempts and non-suicidal self-injury (NSSI) in adolescents with major depression in Pakistan. The Methodology comprised of Adolescent patients (n = 121) with major depressive disorder who were hospitalized in the LRH (Lady Reading Hospital), Peshawar. The patient’s clinical symptoms, family role (family responsibilities), quality of life, physical health and relationship with friends and family members were evaluated. Participants’ suicidal thoughts and behaviors and NSSI (self-inflicted, deliberate self-harm with no intent of suicide) were analyzed and assessed during hospitalization and followed up for 28 weeks. Poor family functions, as well as family problems and social problems, were the causative agents for adolescent’s high suicidality and non-suicidal self-harm. A history of Non-suicidal self-harm treatment is a clinical marker for suicidality. The previous suicidal attempts should be evaluated in depressed juvenile patients as indicators of future suicidal intent and behavior. Both suicidal and NSSI during the therapy and after treatment persisted in depressed adolescents who participated in the study. Major causes of suicide among our study participants were lost friend(s), drug abuse, living alone or not living with the family, disturbed parental marriage, sexual abuse, and other domestic problems.

scholarly journals Prevalence of comorbid mental and physical illnesses and risks for self-harm and premature death among primary care patients diagnosed with fatigue syndromes

2019 ◽  
Vol 50 (7) ◽  
pp. 1156-1163
Author(s):  
Matthew J. Carr ◽  
Darren M. Ashcroft ◽  
Peter D. White ◽  
Nav Kapur ◽  
Roger T. Webb
Keyword(s):  
Cox Regression ◽  
Premature Mortality ◽  
Premature Death ◽  
Epidemiological Studies ◽  
Adverse Outcomes ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Hazard Ratios ◽  
History Of ◽  
Self Harm

AbstractBackgroundFatigue syndromes (FSs) affect large numbers of individuals, yet evidence from epidemiological studies on adverse outcomes, such as premature death, is limited.MethodsCohort study involving 385 general practices in England that contributed to the Clinical Practice Research Datalink (CPRD) with linked inpatient Hospital Episode Statistics (HES) and Office for National Statistics (ONS) cause of death information. A total of 10 477 patients aged 15 years and above, diagnosed with a FS during 2000–2014, were individually matched with up to 20 comparator patients without a history of having a FS. Prevalence ratios (PRs) were estimated to compare the FS and comparison cohorts on clinical characteristics. Adjusted hazard ratios (HRs) for subsequent adverse outcomes were estimated from stratified Cox regression models.ResultsAmong patients diagnosed with FSs, we found elevated baseline prevalence of: any psychiatric illness (PR 1.77; 95% CI 1.72–1.82), anxiety disorders (PR 1.92; 1.85–1.99), depression (PR 1.89; 1.83–1.96), psychotropic prescriptions (PR 1.68; 1.64–1.72) and comorbid physical illness (PR 1.28; 1.23–1.32). We found no significant differences in risks for: all-cause mortality (HR 0.99; 0.91–1.09), natural death (HR 0.99; 0.90–1.09), unnatural death (HR 1.00; 0.59–1.72) or suicide (HR 1.68; 0.78–3.63). We did, however, observe a significantly elevated non-fatal self-harm risk: HR 1.83; 1.56–2.15.ConclusionsThe absence of elevated premature mortality risk is reassuring. The raised prevalence of mental illness and increased non-fatal self-harm risk indicate a need for enhanced assessment and management of psychopathology associated with fatigue syndromes.

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