International Journal of Environmental Research and Public Health

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15 pages, 2653 KiB

Open AccessArticle

Suicide Mortality Risk among Patients with Lung Cancer—A Systematic Review and Meta-Analysis

by Luisa Hofmann, Michael Heinrich, Hansjörg Baurecht, Berthold Langguth, Peter M. Kreuzer, Helge Knüttel, Michael F. Leitzmann and Corinna Seliger

Int. J. Environ. Res. Public Health 2023, 20(5), 4146; https://doi.org/10.3390/ijerph20054146 - 25 Feb 2023

Cited by 3 | Viewed by 1516

Abstract

The risk for suicide in patients with cancer is higher compared to the general population. However, little is known about patients with lung cancer specifically. We therefore implemented a systematic review and random-effects meta-analysis of retrospective cohort studies on suicide in patients with [...] Read more.

The risk for suicide in patients with cancer is higher compared to the general population. However, little is known about patients with lung cancer specifically. We therefore implemented a systematic review and random-effects meta-analysis of retrospective cohort studies on suicide in patients with lung cancer. We searched a high number of common databases up to 02/2021. For the systematic review, a total of 23 studies was included. To exclude bias due to patient sample overlap, the meta-analysis was performed on 12 studies. The pooled standardized mortality ratio (SMR) for suicide was 2.95 (95% Confidence Interval (CI) = 2.42–3.60) for patients with lung cancer as compared to the general population. Subgroups with a pronouncedly higher risk for suicide compared to the general population were found for patients living in the USA (SMR = 4.17, 95% CI = 3.88–4.48), with tumors of late stage (SMR = 4.68, 95% CI = 1.28–17.14), and within one year after diagnosis (SMR = 5.00, 95% CI = 4.11–6.08). An increased risk for suicide was found in patients with lung cancer, with subgroups at particular risk. Patients at increased risk should be monitored more closely for suicidality and should receive specialized psycho-oncological and psychiatric care. Further studies should clarify the role of smoking and depressive symptoms on suicidality among lung cancer patients. Full article

(This article belongs to the Special Issue Suicidal Behavior: Scientific Research to Guide Prevention)

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10 pages, 508 KiB

Open AccessArticle

Characteristics of Patients Who Complete Suicide and Suicide Attempts While Undergoing Treatment in Norway: Findings from Compensation Claims Records

by Sanja Krvavac, Martin Bystad, Rolf Wynn, Ida Rashida Khan Bukholm and Billy Jansson

Int. J. Environ. Res. Public Health 2023, 20(5), 4083; https://doi.org/10.3390/ijerph20054083 - 24 Feb 2023

Cited by 1 | Viewed by 1183

Abstract

The aim of this study was to identify characteristics that differentiate patients who complete suicide (SC) from patients with suicide attempts (SA) while undergoing treatment in Norway. We examined data from the Norwegian System of Patient Injury Compensation (Norsk Pasientskade Erstatning—NPE). Data were [...] Read more.

The aim of this study was to identify characteristics that differentiate patients who complete suicide (SC) from patients with suicide attempts (SA) while undergoing treatment in Norway. We examined data from the Norwegian System of Patient Injury Compensation (Norsk Pasientskade Erstatning—NPE). Data were extracted from NPE case records from a 10-year period (2009–2019) for 356 individuals who attempted (n = 78) or died by (n = 278) suicide. The two groups differed significantly in the types of medical errors identified by experts. Inadequate suicide risk assessment tended to be proportionally and significantly more prevalent among SC compared to SA. There was a weak but significant trend that SA had received medication only, whereas SC had received both medication and psychotherapy. There were no significant differences with respect to age group, gender, diagnostic category, number of previous suicide attempts, inpatient/outpatient status, or category of responsible clinic. We conclude that suicide attempters and suicide completers differed in terms of identified medical errors. Focusing on the prevention of these and other types of errors could help to reduce the number of suicides of patients in treatment. Full article

(This article belongs to the Special Issue Suicidal Behavior: Scientific Research to Guide Prevention)

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16 pages, 415 KiB

Open AccessArticle

Understanding for Prevention: Qualitative and Quantitative Analyses of Suicide Notes and Forensic Reports

by Yolanda Mejías-Martín, Celia Martí-García, Yolanda Rodríguez-Mejías, Ana Alejandra Esteban-Burgos, Víctor Cruz-García and María Paz García-Caro

Int. J. Environ. Res. Public Health 2023, 20(3), 2281; https://doi.org/10.3390/ijerph20032281 - 27 Jan 2023

Cited by 1 | Viewed by 3048

Abstract

Suicide risk is associated with vulnerabilities and specific life events. The study’s objective was to explore the relevance of data from forensic documentation on suicide deaths to the design of person-centered preventive strategies. Descriptive and thematic analyses were conducted of forensic observations of [...] Read more.

Suicide risk is associated with vulnerabilities and specific life events. The study’s objective was to explore the relevance of data from forensic documentation on suicide deaths to the design of person-centered preventive strategies. Descriptive and thematic analyses were conducted of forensic observations of 286 deaths by suicide, including some with suicide notes. Key findings included the influence of health-and family-related adverse events, emotional states of loss and sadness, and failures of the health system to detect and act on signs of vulnerability, as confirmed by the suicide notes. Forensic documentation provides useful information to improve the targeting of preventive campaigns. Full article

(This article belongs to the Special Issue Suicidal Behavior: Scientific Research to Guide Prevention)

11 pages, 1328 KiB

Open AccessArticle

Scrutinizing the Profile and Risk Factors of Suicide: A Perspective from a Case–Control Study Focused on a Northern Region of Spain

by María Sáenz-Aldea, María T. Zarrabeitia, Ana García Blanco and Ana Santurtún

Int. J. Environ. Res. Public Health 2022, 19(23), 15867; https://doi.org/10.3390/ijerph192315867 - 29 Nov 2022

Viewed by 1377

Abstract

Suicide is a major public health problem the prevention of which has become a priority, and, to this end, knowledge of its risk factors is essential. This study aims to evaluate the impact of some social, medico-legal, and clinical issues on suicide deaths. [...] Read more.

Suicide is a major public health problem the prevention of which has become a priority, and, to this end, knowledge of its risk factors is essential. This study aims to evaluate the impact of some social, medico-legal, and clinical issues on suicide deaths. A total of 135 cases were identified as suicides that occurred in a region of northern Spain between 2018 and 2020. Controls (three for each case) were matched by age, sex, and urban–rural areas. The information was collected retrospectively through electronic health record systems. A binary logistic regression analysis was performed to study the association between individual risk factors and suicide. Being male (78.5%), between 40 and 60 years of age, unmarried (70.9%), and unemployed (85%) were associated with suicide deaths. Although the existence of a previous self-harm attempt is presented as the most robust risk factor (OR 22.121 [8.997–54.389]), the presence of a psychiatric diagnosis (OR 12.583 [7.686–20.601]) and cancer (OR 3.729 [1.845–7.536]) also showed a significant relationship with suicide (p < 0.05). Defining and knowing the risk factors for suicide helps to better understand the profiles of those individuals who are vulnerable, and enables prevention actions to be taken in both social and medical spheres. Full article

(This article belongs to the Special Issue Suicidal Behavior: Scientific Research to Guide Prevention)

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12 pages, 924 KiB

Open AccessArticle

High Serum Levels of IL-6 Are Associated with Suicide Attempt but Not with High Lethality Suicide Attempts: A Preliminary Case–Control Study

by Rosa Giannina Castillo-Avila, Alma Delia Genis-Mendoza, Isela Esther Juárez-Rojop, María Lilia López-Narváez, Diana María Dionisio-García, Germán Alberto Nolasco-Rosales, Miguel Ángel Ramos-Méndez, Yazmín Hernández-Díaz, Carlos Alfonso Tovilla-Zárate, Thelma Beatriz González-Castro and Humberto Nicolini

Int. J. Environ. Res. Public Health 2022, 19(22), 14735; https://doi.org/10.3390/ijerph192214735 - 9 Nov 2022

Cited by 3 | Viewed by 1458

Abstract

Suicide attempts are an emerging health problem around the world. Increased levels of IL-6 have been associated with suicidal behavior. Therefore, the aims of this study were to evaluate the serum levels of IL-6 in individuals with suicide attempts and a comparison group [...] Read more.

Suicide attempts are an emerging health problem around the world. Increased levels of IL-6 have been associated with suicidal behavior. Therefore, the aims of this study were to evaluate the serum levels of IL-6 in individuals with suicide attempts and a comparison group and to associate the IL-6 levels with the lethality of the suicide attempt. Additionally, we associated the rs2228145 polymorphism of the IL6R gene with suicide attempts or with the IL-6 serum levels. Suicide attempts and their lethality were evaluated using the Columbia Suicide Severity Rating Scale. The serum concentrations of IL-6 were measured by the ELISA technique in individuals with suicide attempts and then compared to a control group. The rs2228145 polymorphism of the IL6R gene was analyzed by real-time polymerase chain reaction. We found elevated serum levels of IL-6 in the suicide attempt group when compared to the control group (F = 10.37, p = 0.002). However, we found no differences of the IL-6 levels between high and low lethality. The IL6R gene polymorphism rs2479409 was not associated with suicide attempts. Our data suggest that IL-6 serum is increased in individuals with suicide attempts. Full article

(This article belongs to the Special Issue Suicidal Behavior: Scientific Research to Guide Prevention)

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11 pages, 374 KiB

Open AccessArticle

The Meaning of Suicidal Behaviour for Portuguese Nursing Students

by Kelly Graziani Giacchero Vedana, José Carlos dos Santos and Tiago Carlos Zortea

Int. J. Environ. Res. Public Health 2022, 19(21), 14153; https://doi.org/10.3390/ijerph192114153 - 29 Oct 2022

Cited by 1 | Viewed by 1412

Abstract

Background: The nursing perspectives on suicidal behaviors may influence the quality of assistance and suicidal prevention. This phenomenon is scarcely investigated among nursing students. Aims: The aim of this study is to understand the meanings of suicidal behavior for Portuguese undergraduate students. Methods: [...] Read more.

Background: The nursing perspectives on suicidal behaviors may influence the quality of assistance and suicidal prevention. This phenomenon is scarcely investigated among nursing students. Aims: The aim of this study is to understand the meanings of suicidal behavior for Portuguese undergraduate students. Methods: This qualitative study utilized Grounded Theory and Symbolic Interactionism. We collected data in Portugal in 2017–2018 with 13 undergraduate students. Results: Students compared suicidal behavior to “A complex and close haze” and considered it “A neglected phenomenon”. Suicidal behavior was predominantly perceived as an emotional distress that requires assistance. The students compared the person and society as “The car and the road: behavior influenced by communication and interaction” and valorized social dimensions and repercussions of suicidal behavior. Limitations: Lack of triangulation in the data and the sampling restricted to nursing students of a single institution are considered limitations of this study. Conclusions: This study can contribute to the development of academic education strategies and psychosocial support for nursing students. Full article

(This article belongs to the Special Issue Suicidal Behavior: Scientific Research to Guide Prevention)

15 pages, 1020 KiB

Open AccessArticle

A Pilot Study of Ketamine Infusion after Suicide Attempt: New Frontiers in Treating Acute Suicidality in a Real-World Medical Setting

by Sharvari Shivanekar, Priya Gopalan, Anthony Pizon, Crystal Spotts, Nicolas Cruz, Michael Lightfoot, Rebecca Rohac, Andrew Baumeister, Angela Griffo, Benjamin Panny, Shelly Kucherer, Alex Israel, Manivel Rengasamy and Rebecca Price

Int. J. Environ. Res. Public Health 2022, 19(21), 13792; https://doi.org/10.3390/ijerph192113792 - 24 Oct 2022

Cited by 3 | Viewed by 2394

Abstract

Ketamine, in research settings, rapidly reduces suicidal thoughts 2–24 h after a single infusion in patients with high suicidal ideation. In this study, the authors investigate ketamine’s effects on suicidality in a real-world sample of recent suicide attempters on a tertiary-care Consultation-Liaison (CL) [...] Read more.

Ketamine, in research settings, rapidly reduces suicidal thoughts 2–24 h after a single infusion in patients with high suicidal ideation. In this study, the authors investigate ketamine’s effects on suicidality in a real-world sample of recent suicide attempters on a tertiary-care Consultation-Liaison (CL) psychiatry service. Using an open-label design, 16 transdiagnostic CL patients were recruited, 18–65 years old, to receive a single dose of intravenous ketamine (0.5 mg/kg) in the acute medical setting. All were psychiatrically hospitalized post-infusion. Baseline suicidality and depression measures were compared to ratings taken at 24 h, 5 days, 12 days, and 1, 3 and 6 months post-infusion using paired t-tests. Across all measures, rapid, statistically significant decreases (p’s < 0.001) were observed with large to very large effect sizes (Cohen’s d’s: 1.7–8.8) at acute timepoints (24 h; 5 days). These gains were uniformly maintained to 6 months post-infusion. Open-label ketamine appeared to rapidly and robustly reduced suicidal symptoms in an ultra-high-risk, heterogeneous, real-world sample. Ketamine infusion may therefore be a safe, feasible, viable method to rapidly reduce suicidality among medically hospitalized patients after a suicide attempt, with potentially enduring benefits. The current pilot findings suggest ketamine could be readily integrated into the settings where high-risk CL patients already receive healthcare, with the potential to become an important and novel tool in the treatment of suicidality. Full article

(This article belongs to the Special Issue Suicidal Behavior: Scientific Research to Guide Prevention)

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11 pages, 326 KiB

Open AccessArticle

Patients Who Die by Suicide: A Study of Treatment Patterns and Patient Safety Incidents in Norway

by Sanja Krvavac, Billy Jansson, Ida Rashida Khan Bukholm, Rolf Wynn and Martin Bystad

Int. J. Environ. Res. Public Health 2022, 19(17), 10686; https://doi.org/10.3390/ijerph191710686 - 27 Aug 2022

Cited by 1 | Viewed by 1601

Abstract

Underlying patterns and factors behind suicides of patients in treatment are still unclear and there is a pressing need for more studies to address this knowledge gap. We analysed 278 cases of suicide reported to The Norwegian System of Patient Injury Compensation, drawing [...] Read more.

Underlying patterns and factors behind suicides of patients in treatment are still unclear and there is a pressing need for more studies to address this knowledge gap. We analysed 278 cases of suicide reported to The Norwegian System of Patient Injury Compensation, drawing on anonymised data, i.e., age group, gender, diagnostic category, type of treatment provided, inpatient vs. outpatient status, type of treatment facility, and expert assessments of medical errors. The data originated from compensation claim forms, expert assessments, and medical records. Chi-square tests for independence, multinominal logistic regression, and Bayes factors for independence were used to analyse whether the age group, gender, diagnostic category, inpatient/outpatient status, type of institution, and type of treatment received by patients that had died by suicide were associated with different types of medical errors. Patients who received medication tended to be proportionally more exposed to an insufficient level of observation. Those who received medication and psychotherapy tended to be proportionally more exposed to inadequate treatment, including inadequate medication. Inpatients were more likely to be exposed to inappropriate diagnostics and inadequate treatment and follow up while outpatients to insufficient level of observation and inadequate suicide risk assessment. We conclude that the patients who had received medication as their main treatment tended to have been insufficiently observed, while patients who had received psychotherapy and medication tended to have been provided insufficient treatment, including inadequate medication. These observations may be used as learning points for the suicide prevention of patients in treatment in Norwegian psychiatric services. Full article

(This article belongs to the Special Issue Suicidal Behavior: Scientific Research to Guide Prevention)

Review

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12 pages, 730 KiB

Open AccessReview

Facebook and Suicidal Behaviour: User Experiences of Suicide Notes, Live-Streaming, Grieving and Preventive Strategies—A Scoping Review

by Sheikh Shoib, Miyuru Chandradasa, Mahsa Nahidi, Tan Weiling Amanda, Sonia Khan, Fahimeh Saeed, Sarya Swed, Marianna Mazza, Marco Di Nicola, Giovanni Martinotti, Massimo Di Giannantonio, Aishatu Yusha’u Armiya’u and Domenico De Berardis

Int. J. Environ. Res. Public Health 2022, 19(20), 13001; https://doi.org/10.3390/ijerph192013001 - 11 Oct 2022

Cited by 6 | Viewed by 2774

Abstract

Background: Facebook represents a new dimension for global information sharing. Suicidal behaviours and attempts are increasingly reported on Facebook. This scoping review explores the various aspects of suicidal behaviours associated with Facebook, discussing the challenges and preventive measures. Methods: PubMed, Google Scholar, and [...] Read more.

Background: Facebook represents a new dimension for global information sharing. Suicidal behaviours and attempts are increasingly reported on Facebook. This scoping review explores the various aspects of suicidal behaviours associated with Facebook, discussing the challenges and preventive measures. Methods: PubMed, Google Scholar, and Scopus were searched for related articles published in English up to October 2021, using different combinations of “Facebook” and “suicide”. A group of experts comprising consultant psychiatrists screened the records and read the full-text articles to extract relevant data. Twenty-eight articles were chosen as relevant and included in the review under four selected themes. Results: Facebook impacts on suicidal behaviours in different aspects. Announcing suicides through sharing notes or personal information may lead to the prediction of suicide but be harmful to the online audience. Live-streaming videos of suicide is another aspect that questions Facebook’s ability to monitor shared contents that can negatively affect the audience. A positive impact is helping bereaved families to share feelings and seek support online, commemorating the lost person by sharing their photos. Moreover, it can provide real-world details of everyday user behaviours, which help predict suicide risk, primarily through novel machine-learning techniques, and provide early warning and valuable help to prevent it. It can also provide a timeline of the user’s activities and state of mind before suicide. Conclusions: Social media can detect suicidal tendencies, support those seeking help, comfort family and friends with their grief, and provide insights via timelining the users’ activities leading to their suicide. One of the limitations was the lack of quantitative studies evaluating preventative efforts on Facebook. The creators’ commitment and the users’ social responsibility will be required to create a mentally healthy Facebook environment. Full article

(This article belongs to the Special Issue Suicidal Behavior: Scientific Research to Guide Prevention)

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