scholarly journals A pilot project to identify individuals who died from suicide and visited an ED before death

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Jenny Robertson
Keyword(s):  
Risk Factors ◽  
Suicide Risk ◽  
Chart Review ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Salt Lake ◽  
Mortality Data ◽  
Lake County ◽  
History Of ◽  
Common Risk Factors

Objective: To explore the use of ED syndromic surveillance data to retrospectively identify individuals who died from suicide and visited an ED before death in order to improve suicide surveillance and inform planning and prevention efforts in Salt Lake County, Utah.Introduction: In 2015, suicide was the 8th leading cause of death in Salt Lake County, Utah, and has recently been identified as a priority public health issue. For suicide, suicide ideation and suicide attempts surveillance, Salt Lake County Health Department staff use National Violent Death Reporting System (NVDRS) mortality data to monitor historical trends and vital records mortality data and ESSENCE ED encounter morbidity data to monitor trends and populations in real time. To improve surveillance and better identify populations at higher risk of suicide, we tested whether we could retrospectively identify residents who died from suicide and visited an ED in the year before death.Methods: Data for all ESSENCE ED encounters from January 1, 2016, through June 30, 2017, were downloaded from the National Syndromic Surveillance Program BioSense platform. Salt Lake County residents who died from suicide from January 1, 2017, through June 30, 2017, were linked to this ESSENCE dataset using date of birth and zip code. We performed chart reviews of the matched patients’ ED encounters and collected sociodemographic (name, residence, race, ethnicity, marital status, military service, sexual orientation), socioeconomic status (education, occupation) and suicide risk factor data (social isolation, addiction, physical health, relationship, financial, job, school, criminal, civil legal problems, eviction or housing problem, recent suicide or other death of family/friend, current depressed mood, current or recent mental health diagnosis and/or treatment, current alcohol or other substance use disorder, perpetrator or victim of interpersonal violence, history of abuse, and history of suicide ideation, plan and attempt). We used descriptive epidemiology to describe risk factors and circumstances.Results: Fifteen Salt Lake County residents who died from suicide from January 1, 2017, through June 30, 2017, matched individuals in the ESSENCE ED dataset by date of birth and zip code. Upon chart review, 14/15 matched by medical record number; the remaining patient was excluded due to medical record number mismatch. Ultimately, 13% (14/105) of Salt Lake County residents who died from suicide from January 1, 2017, through June 30, 2017, were identified in ESSENCE as having visited an ED in the year before death. Among them, they visited an ED a total of 30 times. Based on chart review of 13/14 of these individuals, the most common suicide risk factors or circumstances were physical health problem (62%), current mental health diagnosis (62%), history of suicidal thoughts (54%) and current depressed mood (54%). The correlation between risk factors identified from ESSENCE and those identified from NVDRS was moderate (r= 0.57).Conclusions: It is possible to identify individuals who died from suicide and visited an ED before death. We are encouraged by the result that common risk factors found via chart review are similar to those we have found in our historical analyses of NVDRS suicide data. This risk factor information adds valuable context to real-time surveillance of suicide, suicide ideation and suicide attempts. Next steps in this pilot are to complete the final chart review and develop and test triage note search queries to monitor suicide and suicidal thoughts and behavior and identify populations who have these common risk factors and may be at higher risk for suicide. It should be noted that during this work, several facilities’ data feeds dropped and the quantity of data decreased dramatically. That we were still able to identify 13% of our residents who died from suicide in ESSENCE despite the large loss of data suggests the true percentage is likely to be much higher once facilities are re-onboarded. This gives us confidence that we will be able to develop a reliable ESSENCE query for suicide risk factors specific to our residents.

Examining Time Perspective Orientation in Suicide Ideation and Suicide Attempts

2019 ◽  
Vol 38 (8) ◽  
pp. 627-646
Author(s):  
Arezoo Shahnaz ◽  
Boaz Y. Saffer ◽  
E. David Klonsky
Keyword(s):  
Psychological Functioning ◽  
Suicide Risk ◽  
Time Perspective ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Time Perspectives ◽  
The Past ◽  
History Of ◽  
Negative Orientation ◽  
Two Measures

Introduction: Time perspective orientation (TPO) refers to the way an individual psychologically and behaviorally connects to temporal concepts of past, present, and future. Previous studies have hypothesized that certain types of time perspectives, such as a negative orientation towards the past, predict negative psychological functioning and outcomes, including suicide risk. The current study examines whether differences in TPOs are linked to suicidal thoughts or suicidal acts using two measures of time perspective. Methods: We recruited a large online U.S.-based sample comprised of three groups: participants with (a) a history of suicide attempts (attempters; n = 107), (b) a history of suicide ideation but no history of attempts (ideators; n = 164), and (c) no history of ideation or attempts (nonsuicidal; n = 194). Results: A Positive Past (d = 0.71) and Negative Past (d = 0.89) orientation yielded large differences between individuals with a history of suicide ideation and nonsuicidal participants, where Positive Past was elevated among nonsuicidal participants and Negative Past among ideators. These differences were not accounted for by depression or anxiety. However, TPO differences between individuals with a history of suicide ideation and individuals with a history of attempts ranged from negligible to small (d range = 0.03—0.33). Discussion: The findings suggest that time perspective may be robustly associated with the development of suicide ideation, but only minimally related to suicide attempts among ideators.

Suicide in Developing Countries (2)

Crisis ◽  
2005 ◽  
Vol 26 (3) ◽  
pp. 112-119 ◽  
Author(s):  
Lakshmi Vijayakumar ◽  
Sujit John ◽  
Jane Pirkis ◽  
Harvey Whiteford
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Life Events ◽  
Suicide Risk ◽  
Stressful Life Events ◽  
Suicide Attempts ◽  
Developed Countries ◽  
Low Socioeconomic ◽  
History Of ◽  
Developing And Developed Countries

Abstract. The majority of studies on risk factors for suicide have been conducted in developed countries, and less work has been done to systematically profile risk factors in developing countries. The current paper presents a selective review of sociodemographic, clinical, and environmental/situational risk factors in developing countries. Taken together, the evidence suggests that the profiles of risk factors in developing countries demonstrate some differences from those in developed countries. In some developing countries, at least, being female, living in a rural area, and holding religious beliefs that sanction suicide may be of more relevance to suicide risk than these factors are in developed countries. Conversely, being single or having a history of mental illness may be of less relevance. Risk factors that appear to be universal include youth or old age, low socioeconomic standing, substance use, and previous suicide attempts. Recent stressful life events play a role in both developing and developed countries, although their nature may differ (e.g., social change may have more of an influence in the former). Likewise, access to means heightens risk in both, but the specific means may vary (e.g., access to pesticides is of more relevance in developing countries). These findings have clear implications for suicide prevention, suggesting that preventive efforts that have shown promise in developed countries may need to be tailored differently to address the risk factor profile of developing countries.

Risk Factors for Medically Serious Suicide Attempts

2012 ◽  
Vol 60 (3) ◽  
pp. 555-576 ◽  
Author(s):  
J. Christopher Fowler ◽  
Mark J. Hilsenroth ◽  
Michael Groat ◽  
Spencer Biel ◽  
Christina Biedermann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Suicide Attempt ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Psychiatric Symptoms ◽  
Baseline Risk ◽  
High Risk Behaviors ◽  
Reality Testing ◽  
Life Threatening ◽  
History Of

This study explored a psychodynamic model for suicide risk by examining risk factors for medically serious suicide attempts, including assessments of affect flooding, negative self-schema / fragmentation, and impaired reality testing, closely approximating Maltsberger’s psycho-dynamic formulation of suicide crisis. Baseline risk factors including age, gender, psychiatric symptoms, high-risk behaviors, and the Implicit Risk for Suicide Index (IRSI) were used to detect medically serious suicide attempts monitored for up to a year after the assessment. Twenty-five psychiatric inpatients who made life-threatening suicide attempts after assessment were compared to 25 inpatients and 25 psychotherapy outpatients who made no suicide attempts during follow-up. Statistical analysis revealed that a history of at least one suicide attempt and elevated IRSI scores accounted for 60 percent of the variance in detecting medically serious suicide attempts. Elevated IRSI accurately identified suicide attempt status above and beyond past suicide attempts and other empirically validated risk factors. Results are discussed in light of psychodynamic formulations of suicide risk.

scholarly journals Suicidal ideation and suicide attempts in bipolar disorder type I: an update for the clinician

2009 ◽  
Vol 31 (3) ◽  
pp. 271-280 ◽  
Author(s):  
Lena Nabuco de Abreu ◽  
Beny Lafer ◽  
Enrique Baca-Garcia ◽  
Maria A. Oquendo
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Suicidal Ideation ◽  
Suicidal Behavior ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Clinical Samples ◽  
Type I ◽  
History Of ◽  
Axis I

OBJECTIVE: This article reviews the evidence for the major risk factors associated with suicidal behavior in bipolar disorder. METHOD: Review of the literature studies on bipolar disorder, suicidal behavior and suicidal ideation. RESULTS: Bipolar disorder is strongly associated with suicide ideation and suicide attempts. In clinical samples between 14-59% of the patients have suicide ideation and 25-56% present at least one suicide attempt during lifetime. Approximately 15% to 19% of patients with bipolar disorder die from suicide. The causes of suicidal behavior are multiple and complex. Some strong predictors of suicidal behavior have emerged in the literature such as current mood state, severity of depression, anxiety, aggressiveness, hostility, hopelessness, comorbidity with others Axis I and Axis II disorders, lifetime history of mixed states, and history of physical or sexual abuse. CONCLUSION: Bipolar disorder is the psychiatric condition associated with highest lifetime risk for suicide attempts and suicide completion. Thus it is important to clinicians to understand the major risk factors for suicidal behavior in order to choose better strategies to deal with this complex behavior.

scholarly journals Suicidal Ideation and Suicide Attempt Among Adolescents in Western Jamaica

Crisis ◽  
2010 ◽  
Vol 31 (6) ◽  
pp. 317-327 ◽  
Author(s):  
Omobolawa Y. Kukoyi ◽  
Faisal M. Shuaib ◽  
Sheila Campbell-Forrester ◽  
Lisabeth Crossman ◽  
Pauline E. Jolly
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Sexual Abuse ◽  
Suicide Attempt ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
The United States ◽  
History Of ◽  
Mental Health Diagnoses ◽  
Risk Factors For Suicide

Background: Although extensive studies on adolescent suicidal behavior have been conducted in developed countries such as the United States, little data exist on risk factors for suicide among adolescents in culturally and socially disadvantages settings, such as Jamaica. Aims: To conduct a preliminary investigation of risk factors associated with suicide ideation and attempt among youths in Western Jamaica. Methods: We conducted a cross-sectional study of 342 adolescents aged 10–19 years from 19 schools. Results: Multivariate analysis showed that a history of self-violence, violent thoughts toward others, mental health diagnoses other than depression, and a history of sexual abuse were positively associated with suicide attempt. Sexual abuse, mental health diagnoses other than depression, self-violence, and ease of access to lethal substances/weapons were positively associated with suicide ideation. Conclusions: We found a relatively high prevalence of suicide ideation and suicide attempts among adolescents living in Western Jamaica. An accurate understanding of the prevailing risk factors for suicide attempts will promote a more sympathetic approach to victims and facilitate prevention efforts.

Comparing Suicide Risk Factors Among Individuals with a History of Aborted, Interrupted, and Actual Suicide Attempts

2018 ◽  
Vol 24 (sup1) ◽  
pp. 57-74 ◽  
Author(s):  
Megan L. Rogers ◽  
Melanie A. Hom ◽  
Sean P. Dougherty ◽  
Austin J. Gallyer ◽  
Thomas E. Joiner
Keyword(s):  
Risk Factors ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
History Of ◽  
Actual Suicide ◽  
Suicide Risk Factors

Attachment Organization in Suicide Prevention Research

Crisis ◽  
2014 ◽  
Vol 35 (1) ◽  
pp. 60-66 ◽  
Author(s):  
Amanda Venta ◽  
Carla Sharp
Keyword(s):  
Risk Factors ◽  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Interpersonal Relationships ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Critical Role ◽  
Self Report ◽  
Future Research ◽  
Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

Stress, Cortisol and Suicide Risk

2019 ◽  
Author(s):  
Daryl Brian O'Connor
Keyword(s):  
Risk Factors ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Stressful Events ◽  
Additional Risk ◽  
Global Health Issue ◽  
History Of ◽  
Hpa Axis Activity ◽  
The Impact

Suicide is a global health issue accounting for at least 800,000 deaths per annum. Numerous models have been proposed that differ in their emphasis on the role of psychological, social, psychiatric and neurobiological factors in explaining suicide risk. Central to many models is a stress-diathesis component which states that suicidal behavior is the result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). This article presents an overview of studies that demonstrate that stress and dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, are important additional risk factors for suicide. Evidence for other putative stress-related suicide risk factors including childhood trauma, impaired executive function, impulsivity and disrupted sleep are considered together with the impact of family history of suicide, perinatal and epigenetic influences on suicide risk.

scholarly journals Identification of Risk Factors to Predict the Occurrences of Relapses in Individuals with Schizophrenia Spectrum Disorder in Iran

2021 ◽  
Vol 18 (2) ◽  
pp. 546
Author(s):  
Omran Davarinejad ◽  
Tahereh Mohammadi Majd ◽  
Farzaneh Golmohammadi ◽  
Payam Mohammadi ◽  
Farnaz Radmehr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Suicide Attempts ◽  
Disease Onset ◽  
Sudden Onset ◽  
Spectrum Disorder ◽  
Therapeutic Interventions ◽  
Schizophrenia Spectrum Disorder ◽  
Schizophrenia Spectrum ◽  
History Of ◽  
Log Normal

Schizophrenia Spectrum Disorder (SSD) is a chronic psychiatric disorder with a modest treatment outcome. In addition, relapses are commonplace. Here, we sought to identify factors that predict relapse latency and frequency. To this end, we retrospectively analyzed data for individuals with SSD. Medical records of 401 individuals with SSD were analyzed (mean age: 25.51 years; 63.6% males) covering a five-year period. Univariate and multivariate Penalized Likelihood Models with Shared Log-Normal Frailty were used to determine the correlation between discharge time and relapse and to identify risk factors. A total of 683 relapses were observed in males, and 422 relapses in females. The Relapse Hazard Ratio (RHR) decreased with age (RHR = 0.99, CI: (0.98–0.998)) and with participants’ adherence to pharmacological treatment (HR = 0.71, CI: 0.58–0.86). In contrast, RHR increased with a history of suicide attempts (HR = 1.32, CI: 1.09–1.60), and a gradual compared to a sudden onset of disease (HR = 1.45, CI: 1.02–2.05). Gender was not predictive. Data indicate that preventive and therapeutic interventions may be particularly important for individuals who are younger at disease onset, have a history of suicide attempts, have experienced a gradual onset of disease, and have difficulties adhering to medication.

Suicide attempts preceding completed suicide

1998 ◽  
Vol 173 (6) ◽  
pp. 531-535 ◽  
Author(s):  
Erkki T. Isometsä ◽  
Jouko K. Lönnqvist
Keyword(s):  
Suicide Attempt ◽  
Suicide Prevention ◽  
Suicide Risk ◽  
Suicide Attempts ◽  
Early Recognition ◽  
Preventive Measure ◽  
Time Interval ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
History Of

BackgroundThis study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide.MethodThe lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987–1988.ResultsOverall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included).ConclusionsMost male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.

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