Parental mental health and risk of poor mental health and death by suicide in offspring

BackgroundSuicide is a major public health concern. Identifying those most at risk is vital for effective targeting of interventions. Mental health (MH) has a genetic component and parental MH is associated with child’s MH. However, little is known onthe effect of parental MH on a child’s risk of death by suicide. MethodsData from 2011 Northern Ireland Census was linked to 5 years’ death records (2011-2015) to construct multi-level regression models to determine if children living with parents with poor self-rated MH are at an increased risk of poor MH themselves and an increased risk of death by suicide. Results618,970 individuals live with their parents; with almost 1 in 7 (13.7%) living with parents with poor MH and 225 (0.1%) dying by suicide during follow-up. Interim results suggest after full adjustment, children with 2 parents with poor MH were5 times more likely to have poor MH themselves (OR=5.30, 95% CI 4.62,6.09), and children with 1 parent with poor MH were 67% more likely to die by suicide compared to children of parents with good MH (OR=1.67, 95%CI 1.19, 2.33). ConclusionsParental MH is associated with child suicide risk even after adjustment for their own MH status.

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Are volunteering and caregiving associated with suicide risk? A Census-based longitudinal study

BMC Psychiatry ◽

10.1186/s12888-019-2255-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Michael Rosato ◽

Foteini Tseliou ◽

David M. Wright ◽

Aideen Maguire ◽

Dermot O’Reilly

Keyword(s):

Mental Health ◽

Longitudinal Study ◽

Record Linkage ◽

Suicide Risk ◽

Linkage Study ◽

Poor Mental Health ◽

Cox Models ◽

Good Mental Health ◽

Increased Risk

Abstract Background Opposing risks have been identified between different prosocial activities, with volunteering having been linked to better mental health while caregiving has been associated with higher prevalence and incidence of depression. This study explored suicide risk of people engaged in prosocial activities of caregiving and/or volunteering. Methods A Census-based record linkage study of 1,018,000 people aged 25–74 years (130,816 caregivers; 110,467 volunteers; and 42,099 engaged in both) was undertaken. Caregiving (light: 1–19; intense: ≥20 h/week), volunteering and mental health status were derived from 2011 Census records. Suicide risk (45 months follow-up) was assessed using Cox models adjusted for baseline mental health. Results Intense caregiving was associated with worse mental health (ORadj = 1.15: 95%CI = 1.12, 1.18) and volunteering with better mental health (OR = 0.87: 95%CI = 0.84, 0.89). For those engaged in both activities, likelihood of poor mental health was determined by caregiving level. There were 528 suicides during follow-up, with those engaged in both activities having the lowest risk of suicide (HR = 0.34: 95%CI = 0.14, 0.84). Engaging in either volunteering or caregiving was associated with lower suicide risk for those with good mental health at baseline (HR = 0.66: 95%CI = 0.49, 0.88) but not for their peers with baseline poor mental health (HR = 1.02: 95%CI = 0.69, 1.51). Conclusions Although an increased risk of poor mental health was identified amongst caregivers, there was no evidence of an increased risk of suicide.

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Parental mental health and risk of poor mental health and death by suicide in offspring: a population-wide data-linkage study

International Journal for Population Data Science ◽

10.23889/ijpds.v3i4.743 ◽

2018 ◽

Vol 3 (4) ◽

Author(s):

Dermot O'Reilly ◽

Aideen Maguire

Keyword(s):

Mental Health ◽

At Risk ◽

Health Status ◽

Data Linkage ◽

Linkage Study ◽

Poor Mental Health ◽

Mental Health Status ◽

Health Concern ◽

Risk Of Death ◽

Increased Risk

IntroductionSuicide is a major public health concern and identifying those most at risk is vital to ensure the implementation of effective interventions. There are known associations between parental and sibling mental health but little is known on the effect of parental mental on a child’s risk of death by suicide. Objectives and ApproachThis population-wide data linkage study utilised data from the 2011 Northern Ireland Census linked to 5 years’ death records (2011-2015) to construct multi-level regression models to determine if children living with parents with poor self-rated mental health are at an increased risk of poor mental health themselves and whether they are at an increased risk of death by suicide. ResultsOf the 618,970 individuals who live with their parents, 13.7% live with parents with poor mental health, 11.6% have poor mental health themselves and 0.1% (n=225) died by suicide. Living with a parent with poor mental health was associated with likelihood of poor mental health in children. After adjustment for age, gender, physical illness, socio-economic status and own mental health status, children with 1 parent with poor mental health were 67% more likely to die by suicide compared to children of parents with good mental health (OR=1.67, 95%CI 1.19, 2.33). The effect size increases for children living with 2 parents with poor mental health. Conclusion/ImplicationsParental mental health is associated with a child’s suicide risk even after adjustment for their own mental health status. This is an at-risk group.

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Are Volunteering and Caregiving Associated with Suicide Risk? A Census-based Longitudinal Study

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.273 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S87-S87

Author(s):

D. O’Reilly ◽

M. Rosato ◽

A. Maguire

Keyword(s):

Mental Health ◽

Lower Risk ◽

Suicide Risk ◽

Proportional Hazards ◽

Linkage Study ◽

Poor Mental Health ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

Competing Interest

BackgroundThis record linkage study explores the suicide risk of people engaged in caregiving and volunteering. Theory suggests opposing risks as volunteering is associated with better mental health and caregiving with a higher prevalence and incidence of depression.MethodsA 2011 census-based study of 1,018,000 people aged 25–74 years (130,816 caregivers and 110,467 volunteers; 42,099 engaged in both). All attributes were based on census records. Caregiving was categorised as either light (1–19 hours/week) or more intense (20+ hours/week). Suicide risk was based on 45 months of death records and assessed using Cox proportional hazards models with adjustment for and stratification by mental health status at census.ResultsMore intense caregiving was associated with worse mental health (ORadj = 1.15: 95%CI = 1.12, 1.18); volunteering with better mental health (OR 0.87; 95%CIs 0.84, 0.89). The cohort experienced 528 suicides during follow-up. Both volunteering and caregiving were associated with a lower risk of suicide though this was modified by baseline mental ill-health (P = 0.003), HR 0.66; 95%CIs 0.49, 0.88 for those engaged in either activity and with good mental health at baseline and HR 1.02; 95%CIs 0.69, 1.51 for their peers with poor mental health. There was some indication that those engaged in both activities had the lowest suicide risk (HR 0.34; 95%CIs 0.14, 0.84).ConclusionsDespite the poorer mental health amongst caregivers they are not at increased risk of suicide. The significant overlap between caregiving and volunteering and the lower risk of suicide for those engaged in both activities may indicate a synergism of action.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Mental health services, suicide and 7-day working

The British Journal of Psychiatry ◽

10.1192/bjp.bp.116.184788 ◽

2016 ◽

Vol 209 (4) ◽

pp. 334-339 ◽

Cited By ~ 5

Author(s):

Nav Kapur ◽

Saied Ibrahim ◽

Isabelle M. Hunt ◽

Pauline Turnbull ◽

Jenny Shaw ◽

...

Keyword(s):

Mental Health ◽

High Risk ◽

Mental Health Services ◽

Health Services ◽

Suicide Risk ◽

Weekend Effect ◽

Post Discharge ◽

Risk Of Death ◽

Increased Risk ◽

Mental Health Patients

BackgroundPatients admitted to hospital at the weekend appear to be at increased risk of death compared with those admitted at other times. However, a ‘weekend effect’ has rarely been explored in mental health and there may also be other times of year when patients are vulnerable.AimsTo investigate the timing of suicide in high-risk mental health patients.MethodWe compared the incidence of suicide at the weekend v. during the week, and also in August (the month of junior doctor changeover) v. other months in in-patients, patients within 3 months of discharge and patients under the care of crisis resolution home treatment (CRHT) teams (2001–2013).ResultsThe incidence of suicide was lower at the weekends for each group (incidence rate ratio (IRR) = 0.88 (95% CI 0.79–0.99) for in-patients, IRR = 0.85 (95% CI 0.78–0.92) for post-discharge patients, IRR = 0.87 (95% CI 0.78–0.97) for CRHT patients). Patients who died by suicide were also less likely to have been admitted at weekends than during the week (IRR = 0.52 (95% CI 0.45–0.60)). The incidence of suicide in August was not significantly different from other months.ConclusionsWe found evidence of a weekend effect for suicide risk among high-risk mental health patients, but with a 12–15% lower incidence at weekends. Our study does not support the claim that safety is compromised at weekends, at least in mental health services.

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Factors associated with non-initiation of mental healthcare after detection of poor mental health at a scheduled health check: a cohort study

BMJ Open ◽

10.1136/bmjopen-2020-037731 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037731

Author(s):

Christine Geyti ◽

Kaj Sparle Christensen ◽

Else-Marie Dalsgaard ◽

Bodil Hammer Bech ◽

Jane Gunn ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Short Form ◽

Mental Component Summary Score ◽

Mental Healthcare ◽

Poor Mental Health ◽

Health Check ◽

Health Concern ◽

Factors Associated

IntroductionPoor mental health is an important public health concern, but mental health problems are often under-recognised. Providing feedback to general practitioners (GPs) on their patients’ mental health status may improve the identification of cases in need of mental healthcare.ObjectivesTo investigate the extent of initiation of mental healthcare after identification of poor mental health and to identify factors associated with non-initiation.DesignProspective cohort study with 1-year follow-up.SettingIn a population-based health preventive programme, Check Your Health, we conducted a combined mental and physical health check in Randers Municipality, Denmark, in 2012–2015 in collaboration with local GPs.ParticipantsParticipants were 350 individuals aged 30–49 years old with screen-detected poor mental health who had not received mental healthcare within the past year. The cohort was derived from 14 167 randomly selected individuals of whom 52% (n=7348) participated. Mental health was assessed by the mental component summary score of the 12-item Short-Form Health Survey.OutcomeThe outcome was initiation of mental healthcare. Mental healthcare included psychometric testing by GP, talk therapy by GP, contact with a psychologist, contact with a psychiatrist and psychotropic medication.ResultsWithin 1 year, 22% (95% CI 18 to 27) of individuals with screen-detected poor mental health initiated mental healthcare. Among individuals who initiated mental healthcare within follow-up, one in six had visited their GP once or less in the preceding year. Male sex (OR: 0.49 (95% CI 0.28 to 0.86)) and less impaired mental health (OR: 0.93 (95% CI 0.89 to 0.98)) were associated with non-initiation of mental healthcare. We found no overall association between socioeconomic factors and initiating mental healthcare.ConclusionSystematic provision of mental health test results to GPs may improve the identification of cases in need of mental healthcare, but does not translate into initiation of mental healthcare. Further research should focus on methods to improve initiation of mental healthcare, especially among men.Trial registration numberNCT02028195.

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Prognostic role of neoplastic markers in Takotsubo syndrome

Scientific Reports ◽

10.1038/s41598-021-95990-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Francesco Santoro ◽

Tecla Zimotti ◽

Adriana Mallardi ◽

Alessandra Leopizzi ◽

Enrica Vitale ◽

...

Keyword(s):

Serum Levels ◽

Takotsubo Syndrome ◽

Ca 15.3 ◽

Risk Of Death ◽

Increased Risk ◽

Ca 19.9 ◽

Long Term Follow Up

AbstractTakotsubo syndrome (TTS) is an acute heart failure syndrome with significant rates of in and out-of-hospital mayor cardiac adverse events (MACE). To evaluate the possible role of neoplastic biomarkers [CA-15.3, CA-19.9 and Carcinoembryonic Antigen (CEA)] as prognostic marker at short- and long-term follow-up in subjects with TTS. Ninety consecutive subjects with TTS were enrolled and followed for a median of 3 years. Circulating levels of CA-15.3, CA-19.9 and CEA were evaluated at admission, after 72 h and at discharge. Incidence of MACE during hospitalization and follow-up were recorded. Forty-three (46%) patients experienced MACE during hospitalization. These patients had increased admission levels of CEA (4.3 ± 6.2 vs. 2.2 ± 1.5 ng/mL, p = 0.03). CEA levels were higher in subjects with in-hospital MACE. At long term follow-up, CEA and CA-19.9 levels were associated with increased risk of death (log rank p < 0.01, HR = 5.3, 95% CI 1.9–14.8, HR = 7.8 95% CI 2.4–25.1, respectively, p < 0.01). At multivariable analysis levels higher than median of CEA, CA-19.9 or both were independent predictors of death at long term (Log-Rank p < 0.01). Having both CEA and CA-19.9 levels above median (> 2 ng/mL, > 8 UI/mL respectively) was associated with an increased risk of mortality of 11.8 (95% CI 2.6–52.5, p = 0.001) at follow up. Increased CEA and CA-19.9 serum levels are associated with higher risk of death at long-term follow up in patients with TTS. CEA serum levels are correlated with in-hospital MACE.

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Emotional and Cognitive Empathy in Caregivers of People With Neurodegenerative Disease: Relationships With Caregiver Mental Health

Clinical Psychological Science ◽

10.1177/2167702620974368 ◽

2021 ◽

pp. 216770262097436

Author(s):

Alice Y. Hua ◽

Jenna L. Wells ◽

Casey L. Brown ◽

Robert W. Levenson

Keyword(s):

Mental Health ◽

Neurodegenerative Disease ◽

Mental Health Problems ◽

Emotional Responses ◽

Cognitive Empathy ◽

Poor Mental Health ◽

Risk Indicators ◽

Health Concern ◽

Emotional Empathy ◽

People With Dementia

Caregiving for a person with dementia or neurodegenerative disease is associated with increased rates of depression and anxiety. As the population ages and dementia prevalence increases worldwide, mental health problems related to dementia caregiving will become an even more pressing public health concern. In the present study, we assessed emotional empathy (physiological, behavioral, and self-reported emotional responses to a film depicting others suffering) and two measures of cognitive empathy (identifying the primary emotion experienced by another person and providing continuous ratings of the valence of another person’s changing emotions) in relation to mental health (standard questionnaires) in 78 caregivers of people with dementia or neurodegenerative disease. Greater emotional empathy (self-reported emotional responses) was associated with worse mental health even after accounting for known risk factors. Neither measure of cognitive empathy was associated with mental health. A relationship between high levels of emotional empathy and poor mental health in caregivers suggests possible risk indicators and intervention targets.

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Predictors of clinical deterioration in patients with suspected COVID-19 managed in a ‘virtual hospital’ setting: a cohort study

BMJ Open ◽

10.1136/bmjopen-2020-045356 ◽

2021 ◽

Vol 11 (3) ◽

pp. e045356

Author(s):

Nick A Francis ◽

Beth Stuart ◽

Matthew Knight ◽

Rama Vancheeswaran ◽

Charles Oliver ◽

...

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Hospital Setting ◽

Health Problems ◽

Clinical Deterioration ◽

Care Services ◽

Increased Risk ◽

Remote Assessment ◽

History Of

ObjectiveIdentify predictors of clinical deterioration in a virtual hospital (VH) setting for COVID-19.DesignReal-world prospective observational study.SettingVH remote assessment service in West Hertfordshire NHS Trust, UK.ParticipantsPatients with suspected COVID-19 illness enrolled directly from the community (postaccident and emergency (A&E) or medical intake assessment) or postinpatient admission.Main outcome measureDeath or (re-)admission to inpatient hospital care during VH follow-up and for 2 weeks post-VH discharge.Results900 patients with a clinical diagnosis of COVID-19 (455 referred from A&E or medical intake and 445 postinpatient) were included in the analysis. 76 (8.4%) of these experienced clinical deterioration (15 deaths in admitted patients, 3 deaths in patients not admitted and 58 additional inpatient admissions). Predictors of clinical deterioration were increase in age (OR 1.04 (95% CI 1.02 to 1.06) per year of age), history of cancer (OR 2.87 (95% CI 1.41 to 5.82)), history of mental health problems (OR 1.76 (95% CI 1.02 to 3.04)), severely impaired renal function (OR for eGFR <30=9.09 (95% CI 2.01 to 41.09)) and having a positive SARS-CoV-2 PCR result (OR 2.0 (95% CI 1.11 to 3.60)).ConclusionsThese predictors may help direct intensity of monitoring for patients with suspected or confirmed COVID-19 who are being remotely monitored by primary or secondary care services. Further research is needed to confirm our findings and identify the reasons for increased risk of clinical deterioration associated with cancer and mental health problems.

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Association of source country gender inequality with experiencing assault and poor mental health among young female immigrants to Ontario, Canada

BMC Public Health ◽

10.1186/s12889-021-10720-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Michael Lebenbaum ◽

Therese A. Stukel ◽

Natasha Ruth Saunders ◽

Hong Lu ◽

Marcelo Urquia ◽

...

Keyword(s):

Mental Health ◽

Violence Against Women ◽

Gender Inequality ◽

Poor Mental Health ◽

Sub Saharan Africa ◽

Source Country ◽

Community Based Research ◽

Increased Risk ◽

Female Immigrants ◽

Self Harm

Abstract Background Gender inequality varies across countries and is associated with poor outcomes including violence against women and depression. Little is known about the relationship of source county gender inequality and poor health outcomes in female immigrants. Methods We used administrative databases to conduct a cohort study of 299,228 female immigrants ages 6–29 years becoming permanent residence in Ontario, Canada between 2003 and 2017 and followed up to March 31, 2020 for severe presentations of suffering assault, and selected mental health disorders (mood or anxiety, self-harm) as measured by hospital visits or death. Poisson regression examined the influence of source-country Gender Inequality Index (GII) quartile (Q) accounting for individual and country level characteristics. Results Immigrants from countries with the highest gender inequality (GII Q4) accounted for 40% of the sample, of whom 83% were from South Asia (SA) or Sub-Saharan Africa (SSA). The overall rate of assault was 10.9/10,000 person years (PY) while the rate of the poor mental health outcome was 77.5/10,000 PY. Both GII Q2 (Incident Rate Ratio (IRR): 1.48, 95% Confidence Interval (CI): 1.08, 2.01) and GII Q4 (IRR: 1.58, 95%CI: 1.08, 2.31) were significantly associated with experiencing assault but not with poor mental health. For females from countries with the highest gender inequality, there were significant regional differences in rates of assault, with SSA migrants experiencing high rates compared with those from SA. Relative to economic immigrants, refugees were at increased risk of sustaining assaults (IRR: 2.96, 95%CI: 2.32, 3.76) and poor mental health (IRR: 1.73, 95%CI: 1.50, 2.01). Higher educational attainment (bachelor’s degree or higher) at immigration was protective (assaults IRR: 0.64, 95%CI: 0.51, 0.80; poor mental health IRR: 0.69, 95% CI: 0.60, 0.80). Conclusion Source country gender inequality is not consistently associated with post-migration violence against women or severe depression, anxiety and self-harm in Ontario, Canada. Community-based research and intervention to address the documented socio-demographic disparities in outcomes of female immigrants is needed.

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Repetition of deliberate self-harm and subsequent suicide risk: Long-term follow-up study of 11 583 patients

The British Journal of Psychiatry ◽

10.1192/bjp.185.1.70 ◽

2004 ◽

Vol 185 (1) ◽

pp. 70-75 ◽

Cited By ~ 264

Author(s):

Daniel Louis Zahl ◽

Keith Hawton

Keyword(s):

Relative Risk ◽

Suicide Risk ◽

Single Episode ◽

Deliberate Self Harm ◽

Young Females ◽

Follow Up Study ◽

Increased Risk ◽

Self Harm

BackgroundRepetition of deliberate self-harm (DSH) is a risk factor for suicide. Little information is available on the risk for specific groups of people who deliberately harm themselves repeatedly.AimsTo investigate the long-term risk of suicide associated with repetition of DSH by gender, age and frequency of repetition.MethodA mortality follow-up study to the year 2000 was conducted on 11583 people who presented to the general hospital in Oxford between 1978 and 1997. Repetition of DSH was determined from reported episodes prior to the index episode and episodes presenting to the same hospital during the follow-up period. Deaths were identified through national registers.ResultsThirty-nine percent of patients repeated the DSH. They were at greater relative risk of suicide than the single-episode DSH group (2.24; 95% CI 1.77–2.84). The relative risk of suicide in the repeated DSH group compared with the single-episode DSH group was greater in females (3.5; 95% C11.3–2.4) than males (1.8; 95% C1 2.3–5.3) and was inversely related to age (up to 54 years). Suicide risk increased further with multiple repeat episodes of DSH in females.ConclusionsRepetition of DSH is associated with an increased risk of suicide in males and females. Repetition may be a better indicator of risk in females, especially young females.

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