Long-term economic and social outcomes of youth suicide attempts

2021 ◽  
pp. 1-7 ◽  
Author(s):  
Massimiliano Orri ◽  
Francis Vergunst ◽  
Gustavo Turecki ◽  
Cédric Galera ◽  
Eric Latimer ◽  
...  
Keyword(s):  
At Risk ◽  
Mental Disorders ◽  
Suicide Attempt ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Social Outcomes ◽  
Retirement Savings ◽  
Youth Suicide ◽  
Socioeconomic Outcomes

Background Youth who attempt suicide are more at risk for later mental disorders and suicide. However, little is known about their long-term socioeconomic outcomes. Aims We investigated associations between youth suicide attempts and adult economic and social outcomes. Method Participants were drawn from the Quebec Longitudinal Study of Kindergarten Children (n = 2140) and followed up from ages 6 to 37 years. Lifetime suicide attempt was assessed at 15 and 22 years. Economic (employment earnings, retirement savings, welfare support, bankruptcy) and social (romantic partnership, separation/divorce, number of children) outcomes were assessed through data linkage with government tax return records obtained from age 22 to 37 years (2002–2017). Generalised linear models were used to test the association between youth suicide attempt and outcomes adjusting for background characteristics, parental mental disorders and suicide, and youth concurrent mental disorders. Results By age 22, 210 youths (9.8%) had attempted suicide. In fully adjusted models, youth who attempted suicide had lower annual earnings (average last 5 years, US$ −4134, 95% CI −7950 to −317), retirement savings (average last 5 years, US$ −1387, 95% CI −2982 to 209), greater risk of receiving welfare support (risk ratio (RR) = 2.05, 95% CI 1.39 to 3.04) and were less likely to be married/cohabiting (RR = 0.82, 95% CI 0.73 to 0.93), compared with those who did not attempt suicide. Over a 40-year working career, the loss of individual earnings attributable to suicide attempts was estimated at US$98 384. Conclusions Youth who attempt suicide are at risk of poor adult socioeconomic outcomes. Findings underscore the importance of psychosocial interventions for young people who have attempted suicide to prevent long-term social and economic disadvantage.

scholarly journals Suicidal Career in Severe Depression among Long-Term Survivors: In a Followup after 37–53 Years Suicide Attempts Appeared to End Long before Depression

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Lisa Crona ◽  
Alexander Mossberg ◽  
Louise Brådvik
Keyword(s):  
Suicide Attempt ◽  
Depressive Episode ◽  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Healing Process ◽  
Severe Depression ◽  
Long Term Survivors ◽  
Course Of Depression

Objective. To describe the suicidal career in the long-term course of severe depression.Subjects and Method. Seventy-five former in-patients were interviewed by telephone about course of depression and suicide attempts 37–53 years after index admission. Medical records were read in many cases.Results. 29 subjects had attempted suicide, 13 repeated, 10 made severe, and 13 violent attempts. The risk of suicide attempt decreased by 10% for every decade spent depressed. Suicide attempts were made early in course of depression, and more time was spent depressed after suicide attempts than before.Conclusions. A healing process of the suicidal career, which may occur long before the end of the last depressive episode (sometimes decades), is proposed.

scholarly journals Characteristics of the Early Post-suicidal Period after Repeat Suicide Attempts in Patients with Mental Disorders

Doctor Ru ◽  
2020 ◽  
Vol 19 (9) ◽  
pp. 59-64
Author(s):  
N.S. Rutkovskaya ◽  
◽  
V.K. Shamrey ◽  
E.S. Kurasov ◽  
A.I. Kolchev ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Suicide Attempt ◽  
Social Adjustment ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Schizophrenia Spectrum Disorders ◽  
Study Objective ◽  
Study Results ◽  
Retrospective Clinical Study ◽  
The Mean

Study Objective: To study characteristics of the early post-suicidal period after suicide attempts in patients with mental disorders. Study Design: This was a retrospective clinical study. Materials and Methods: The study looked at the characteristics of the early post-suicidal period after suicide attempts in a group of 260 subjects with mental disorders (schizophrenia-spectrum disorders, organic, affective, neurotic, addictive, or personality disorders, or intellectual disability). The mean age of patients who attempted suicide was 43.5 ± 17.7 years. The numbers of men and women were almost equal: 134 (51.5%) and 126 (48.5%), respectively (p>0.05). The mean duration of hospitalization was 42.7 ± 43.2 bed-days. The study methods included clinical examinations, psychopathological assessments, psychometrics, and statistical-mathematical methods. Study Results: The authors identified the following main types of early post-suicidal period: the critical type (n = 73, 28.1%) and denial of a suicide attempt (n = 55, 21.2%) were the most common and the analytical type (n = 23, 8.8%) was the least common. The study determined that 77 (29.6%) psychiatric inpatients with a history of attempting suicide made another attempt. The most common methods of attempted suicide in this group of patients included poisoning with medications (n = 41, 53.2%) and self-cutting (n = 26, 33.8%), and 40.3% were under the influence of alcohol at the time of the repeat suicide attempt. Among the patients who made a repeat suicide attempt, manipulative and suicide-fixated types of post-suicidal period were observed significantly more often. Patients with mental disorders who made repeat suicide attempts showed poor social adjustment in their professional life and overall attitude toward life. Conclusion: The characteristics of the post-suicidal period identified in patients with mental disorders who have made a repeat suicide attempt should be taken into consideration when planning and providing secondary preventive mental healthcare services. Further investigation of these characteristics in various groups of patients, combined with a search for predictive factors for repeat suicide attempts, as well as evaluation of the effectiveness of previously provided preventive mental health care, will make it possible to better tailor these services and reduce the overall risk of suicidal behavior in people with mental disorders. Keywords: suicide, repeat suicide attempt, type of post-suicidal period, mental disorder, social adjustment.

Suicide Attempts During Adolescence: Systematic Hospitalization and Crisis Treatment

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Jérôme Ottino
Keyword(s):  
Attempted Suicide ◽  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Health Workers ◽  
Inpatient Unit ◽  
Theoretical Hypothesis ◽  
Initial Resistance ◽  
Provision Of Care ◽  
Suicidal Crisis

This paper deals with an inpatient unit that recently opened in Geneva, specializing in the treatment of patients aged 16-21 years who had attempted suicide or felt the desire to commit suicide. This particular center was established because of the significant weaknesses found in the provision of care to adolescents who had attempted suicide. Despite the growing interest of health workers in this area of study over recent years, the frequency of suicide among the young has not decreased and there are numerous recurrences of the suicide attempts. Further, all efforts to improve the adolescents' compliance with psychiatric treatment have failed to date. The number of drop-outs from treatment is still very high. Thus, the objectives of our inpatient unit are as follows: (1) to overcome initial resistance to treatment and to improve long-term compliance; (2) to decrease the number of recurrent attempts as a consequence of the above, thus increasing life expectancy; (3) to offer the adolescents who have tried (or have contemplated) committing suicide an improved quality of life, after first helping them overcome the suicidal crisis. To achieve these goals, the therapeutic team of the unit proposes short stays during which the work with the adolescents consists of a very intensive psychoanalytic-oriented crisis intervention. Numerous practical aspects of our therapeutic approach in the inpatient unit are related here in detail, always with reference to our theoretical hypothesis.

scholarly journals Rethinking Lethality in Youth Suicide Attempts: First Suicide Attempt Outcomes in Youth Ages 10 to 24

2018 ◽  
Vol 57 (10) ◽  
pp. 786-791 ◽  
Author(s):  
Alastair J.S. McKean ◽  
Chaitanya P. Pabbati ◽  
Jennifer R. Geske ◽  
J. Michael Bostwick
Keyword(s):  
Suicide Attempt ◽  
Suicide Attempts ◽  
Youth Suicide

Risk of suicide after attempted suicide in the population of Slovenia from 1970 to 1996

2006 ◽  
Vol 21 (6) ◽  
pp. 396-400 ◽  
Author(s):  
Slavko Ziherl ◽  
Bojan Zalar
Keyword(s):  
Suicide Attempt ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Categorical Variables ◽  
Frequency Table ◽  
Completed Suicide ◽  
The Republic ◽  
And Gender ◽  
Log Linear ◽  
Commit Suicide

AbstractObjective:All suicide attempts cannot predict suicide, therefore we examined those characteristics of suicide attempt which could most accurately predict completed suicide.Subject and methods:Subjects were all individuals registered as committed suicides (N = 16,522) or attempted suicides (N = 15,057) in the register of suicides of the Republic of Slovenia between 1970 and 1996. Log linear analysis of a frequency table was used to uncover relationship between categorical variables.Results:The model we found fit between variables: mode, number of repetitions and type, then between number of repetitions, type and gender, and between mode, type and gender.Discussion:The risk of suicide in those who previously attempted suicide is approximately 773 times higher than the risk of suicide without a previous suicide attempt. Those who attempt suicide by hanging (hanging being in Slovenia the most frequent mode of completed suicide) are at even greater risk to commit suicide.Conclusion:Our data suggests that clinicians should heighten their awareness that any suicide attempt can in some 20% predict suicide. Someone who has attempted suicide by hanging is at the highest risk of suicide.

The Risk of Child Abuse among Mothers who Attempt Suicide

1985 ◽  
Vol 146 (5) ◽  
pp. 486-489 ◽  
Author(s):  
Keith Hawton ◽  
Jacqueline Roberts ◽  
Guy Goodwin
Keyword(s):  
At Risk ◽  
Child Abuse ◽  
General Population ◽  
Young Children ◽  
General Hospital ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Population Control ◽  
Not At Risk ◽  
The Relationship

SummaryThe association between parental attempted suicide and child abuse was investigated in 114 mothers with children aged five years and under, referred to a general hospital following suicide attempts. The risk was greatly increased in the attempted suicide mothers, compared with both similar mothers at risk for depression and general population control mothers; well-documented risk of child abuse was identified in 29.8% of those who attempted suicide. No major differences were found between the attempted suicide mothers whose children were at risk and those whose children were not at risk. During the general hospital assessment of mothers with young children who attempt suicide, careful enquiry concerning the relationship with the children is essential

Increased risk of attempted suicide in Australian veterans is associated with total and permanent incapacitation, unemployment and posttraumatic stress disorder severity

2017 ◽  
Vol 52 (6) ◽  
pp. 552-560 ◽  
Author(s):  
Katelyn Kerr ◽  
Madeline Romaniuk ◽  
Sarah McLeay ◽  
Andrew Khoo ◽  
Michael T Dent ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Suicide Attempt ◽  
Posttraumatic Stress ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Stress Disorder ◽  
Self Report ◽  
Depression Symptoms ◽  
Increased Risk ◽  
History Of

Background: Military veterans have higher rates of suicidality and completed suicides compared to the general population. Previous research has demonstrated suicidal behaviour is higher in US combat veterans who are younger, suffer from posttraumatic stress disorder, depression and anxiety and score lower on measures of health. However, research on predictors of suicide for Australian veterans is limited. The aim of this study was to identify significant demographic and psychological differences between veterans with posttraumatic stress disorder who had attempted suicide and those with posttraumatic stress disorder who had not, as well as determine predictors of suicide attempts within an Australian cohort. Methods: A retrospective analysis was conducted on 229 ex-service personnel diagnosed with posttraumatic stress disorder who had attended a Military Service Trauma Recovery Day Program as outpatients at Toowong Private Hospital from 2007 to 2014. Patients completed a battery of mental health self-report questionnaires assessing symptoms of posttraumatic stress disorder, alcohol use, anger, depression, anxiety and quality of life. Demographic information and self-reported history of suicide attempts were also recorded. Results: Results indicated the average age was significantly lower, and the rates of posttraumatic stress disorder, anger, anxiety and depression symptoms were significantly higher in those veterans with history of a suicide attempt. Multivariate logistic regression analyses indicated posttraumatic stress disorder symptom severity, unemployment or total and permanent incapacity pension status significantly predicted suicide attempt history. Conclusion: Among a cohort of Australian veterans with posttraumatic stress disorder, psychopathology severity, unemployment and total and permanent incapacity status are significantly associated with suicidality. This study highlights the importance of early identification of posttraumatic stress disorder and psychopathology, therapeutic and social engagement, and prioritisation of tangible employment options or meaningful and goal-directed activities for veterans deemed unable to work.

Suicide and Personality: Focus on Old Age

2011 ◽  
Vol 26 (S2) ◽  
pp. 2018-2018
Author(s):  
D. Rujescu
Keyword(s):  
Suicide Attempt ◽  
Causes Of Death ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Anger Expression ◽  
Borderline Personality ◽  
Harm Avoidance ◽  
Temperament And Character Inventory ◽  
State Anger ◽  
Character Inventory

Suicide is one of the leading causes of death worldwide, mortality from suicide being approximately 2%. Attempted suicide appears to be a major risk factor for suicide completion. Anger, aggression and impulsivity are personality traits associated with suicide attempt. We analysed anger, impulsivity and temperament/character scales as predictors of aggression and self-aggression in suicide attempters and compared this to anger- and aggression-related traits between impulsive and premeditated suicide attempts as well as between violent and non-violent suicide methods.The State-Trait Anger Expression Inventory (STAXI), the Questionnaire for Measuring Factors of Aggression (FAF), and the Temperament and Character Inventory (TCI) were assessed.Higher aggression scores, as measured by FAF, were predicted by being male, meeting criteria for borderline personality disorder and having higher angry temperament scores as assessed by STAXI. TCI dimensions associated with self-aggression were high harm avoidance, high impulsivity and low selfdirectedness.State anger, inwardly directed anger and inhibition of aggression were also predictors of self-aggression.In conclusion, impulsivity and harm avoidance have emerged as temperament dimensions independently associated with self-aggressive tendencies in personality. Such interactions could explain the correlation between temperament and suicidality but further research is needed. Anger and selfdirectedness appear to have some effects on suicide attempt.

scholarly journals Development and validation of the Durham Risk Score for estimating suicide attempt risk: A prospective cohort analysis

PLoS Medicine ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. e1003713
Author(s):  
Nathan A. Kimbrel ◽  
Jean C. Beckham ◽  
Patrick S. Calhoun ◽  
Bryann B. DeBeer ◽  
Terence M. Keane ◽  
...  
Keyword(s):  
At Risk ◽  
Suicide Attempt ◽  
Risk Score ◽  
Prospective Cohort ◽  
Suicide Attempts ◽  
Cohort Analysis ◽  
The United States ◽  
Lower Income ◽  
Younger Adults ◽  
The Future

Background Worldwide, nearly 800,000 individuals die by suicide each year; however, longitudinal prediction of suicide attempts remains a major challenge within the field of psychiatry. The objective of the present research was to develop and evaluate an evidence-based suicide attempt risk checklist [i.e., the Durham Risk Score (DRS)] to aid clinicians in the identification of individuals at risk for attempting suicide in the future. Methods and findings Three prospective cohort studies, including a population-based study from the United States [i.e., the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study] as well as 2 smaller US veteran cohorts [i.e., the Assessing and Reducing Post-Deployment Violence Risk (REHAB) and the Veterans After-Discharge Longitudinal Registry (VALOR) studies], were used to develop and validate the DRS. From a total sample size of 35,654 participants, 17,630 participants were selected to develop the checklist, whereas the remaining participants (N = 18,024) were used to validate it. The main outcome measure was future suicide attempts (i.e., actual suicide attempts that occurred after the baseline assessment during the 1- to 3-year follow-up period). Measure development began with a review of the extant literature to identify potential variables that had substantial empirical support as longitudinal predictors of suicide attempts and deaths. Next, receiver operating characteristic (ROC) curve analysis was utilized to identify variables from the literature review that uniquely contributed to the longitudinal prediction of suicide attempts in the development cohorts. We observed that the DRS was a robust prospective predictor of future suicide attempts in both the combined development (area under the curve [AUC] = 0.91) and validation (AUC = 0.92) cohorts. A concentration of risk analysis found that across all 35,654 participants, 82% of prospective suicide attempts occurred among individuals in the top 15% of DRS scores, whereas 27% occurred in the top 1%. The DRS also performed well among important subgroups, including women (AUC = 0.91), men (AUC = 0.93), Black (AUC = 0.92), White (AUC = 0.93), Hispanic (AUC = 0.89), veterans (AUC = 0.91), lower-income individuals (AUC = 0.90), younger adults (AUC = 0.88), and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) individuals (AUC = 0.88). The primary limitation of the present study was its its reliance on secondary data analyses to develop and validate the risk score. Conclusions In this study, we observed that the DRS was a strong predictor of future suicide attempts in both the combined development (AUC = 0.91) and validation (AUC = 0.92) cohorts. It also demonstrated good utility in many important subgroups, including women, men, Black, White, Hispanic, veterans, lower-income individuals, younger adults, and LGBTQ individuals. We further observed that 82% of prospective suicide attempts occurred among individuals in the top 15% of DRS scores, whereas 27% occurred in the top 1%. Taken together, these findings suggest that the DRS represents a significant advancement in suicide risk prediction over traditional clinical assessment approaches. While more work is needed to independently validate the DRS in prospective studies and to identify the optimal methods to assess the constructs used to calculate the score, our findings suggest that the DRS is a promising new tool that has the potential to significantly enhance clinicians’ ability to identify individuals at risk for attempting suicide in the future.

scholarly journals Mental disorders and suicidal behavior in refugees and Swedish-born individuals: is the association affected by work disability?

2020 ◽  
Vol 55 (8) ◽  
pp. 1061-1071
Author(s):  
Emma Björkenstam ◽  
Magnus Helgesson ◽  
Ridwanul Amin ◽  
Theis Lange ◽  
Ellenor Mittendorfer-Rutz
Keyword(s):  
Mental Disorders ◽  
Suicide Attempt ◽  
Suicidal Behavior ◽  
Work Disability ◽  
Mediating Effect ◽  
Study Cohort ◽  
Hazard Ratios ◽  
The Relationship

Abstract Background Among potential pathways to suicidal behavior in individuals with mental disorders (MD), work disability (WD) may play an important role. We examined the role of WD in the relationship between MD and suicidal behavior in Swedish-born individuals and refugees. Methods The study cohort consisted of 4,195,058 individuals aged 16–64, residing in Sweden in 2004–2005, whereof 163,160 refugees were followed during 2006–2013 with respect to suicidal behavior. Risk estimates were calculated as hazard ratios (HR) with 95% confidence intervals (CI). The reference groups comprised individuals with neither MD nor WD. WD factors (sickness absence (SA) and disability pension (DP)) were explored as potential modifiers and mediators. Results In both Swedish-born and refugees, SA and DP were associated with an elevated risk of suicide attempt regardless of MD. In refugees, HRs for suicide attempt in long-term SA ranged from 2.96 (95% CI: 2.14–4.09) (no MD) to 6.23 (95% CI: 3.21–12.08) (MD). Similar associations were observed in Swedish-born. Elevated suicide attempt risks were also observed in DP. In Swedish-born individuals, there was a synergy effect between MD, and SA and DP regarding suicidal behavior. Both SA and DP were found to mediate the studied associations in Swedish-born, but not in refugees. Conclusion There is an effect modification and a mediating effect between mental disorders and WD for subsequent suicidal behavior in Swedish-born individuals. Also for refugees without MD, WD is a risk factor for subsequent suicidal behavior. Particularly for Swedish-born individuals with MD, information on WD is vital in a clinical suicide risk assessment.

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