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- Carli, V, et al.
(author)
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A Naturalistic, European Multi-Center Clinical Study of Electrodermal Reactivity and Suicide Risk Among Patients With Depression
- 2022
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In: Frontiers in psychiatry. - : Frontiers Media SA. - 1664-0640. ; 12, s. 765128-
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Journal article (peer-reviewed)abstract
- Background:Electrodermal hyporeactivity has been proposed as a marker of suicidal risk. The EUDOR-A study investigated the prevalence of electrodermal hyporeactivity among patients with depression and its association with attempted and completed suicide.Methods:Between August 2014 and March 2016, 1,573 in- and outpatients with a primary diagnosis of depression (active or remission phase) were recruited at 15 European psychiatric centers. Each patient was followed-up for 1 year. Electrodermal activity was assessed at baseline with the ElectroDermal Orienting Reactivity Test. Data on the sociodemographic characteristics, clinical diagnoses, and treatment of the subjects were also collected. The severity of the depressive symptoms was assessed through the Montgomery–Asberg Depression Rating Scale. Information regarding number, time, and method of suicide attempts was gathered at baseline and at the end of the 1-year follow-up. The same data were collected in case of completed suicide.Results:Hyporeactive patients were shown to be significantly more at risk of suicide attempt compared to reactive patients, both at baseline and follow-up. A sensitivity of 29.86% and a positive predictive value (PPV) of 46.77% were found for attempted suicide at baseline, while a sensitivity of 35.36% and a PPV of 8.92% were found for attempted suicide at follow-up. The sensitivity and PPV for completed suicide were 25.00 and 0.61%, respectively. However, when controlled for suicide attempt at baseline, the association between hyporeactivity and follow-up suicide attempt was no longer significant. The low number of completed suicides did not allow any analysis.
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- Santander, NM, et al.
(author)
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Relation between occupation, gender dominance in the occupation and workplace and suicide in Sweden: a longitudinal study
- 2022
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In: BMJ open. - : BMJ. - 2044-6055. ; 12:6, s. e060096-
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Journal article (peer-reviewed)abstract
- To describe the association between occupations and suicide, and to explore the effect of gender dominance in the occupation and in the workplace on the risk of suicide.DesignRegister-based cohort study.Participants3 318 050 workers in Sweden in 2005 and followed up until 2010. Exclusion criteria for the study were: missing information in the occupational codes, yearly income of <100 Swedish krona, missing information of the employer, death or migration, and registered occupational code reported from more than 5 years ago.OutcomeSuicides occurring during 2006–2010 identified in the cause of death register by the International Classification of Diagnoses-10 codes X60–84 and Y10–34.ResultsOccupations with increased suicide were life science and health professionals (OR: 2.8, 95% CI: 1.50 to 5.26) among women. In men, these were metal, machinery and related workers (OR: 1.5, 95% CI: 1.09 to 2.05) and personal and protective service workers (OR: 1.59, 95% CI: 1.14 to 2.22). In terms of gender dominance in the occupation, borderline associations with increased suicide risk were found for men in both male-dominated (OR: 1.32, 95% CI: 0.98 to 1.79) and female-dominated (OR: 1.37, 95% CI: 0.99 to 1.91) occupations. For women, borderline increased risk of suicide was found in female-dominated occupations (OR: 1.51, 95% CI: 0.95 to 2.40). Finally, men showed a borderline increased risk of suicide in female-dominated workplaces (OR: 1.31, 95% CI: 0.94 to 1.81).ConclusionsThis study found that women in the ‘life science and health professionals’ group and men in the ‘metal, machinery and related workers’ as well as ‘personal and protective service workers’ groups have increased incidence of suicide also when adjusting for sociodemographic characteristics, precariousness of the employment relationship, spells of unemployment, previous mental disorders and suicide attempts. Moreover, gender dominance at workplace and occupation seems to be associated with the risk of suicide among men. The results of our study are novel and are worth exploring in future qualitative studies.
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- Balazs, J, et al.
(author)
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Comorbidity of Physical and Anxiety Symptoms in Adolescent: Functional Impairment, Self-Rated Health and Subjective Well-Being
- 2018
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In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 15:8
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Journal article (peer-reviewed)abstract
- Physical disorders and anxiety are frequently comorbid. This study investigates the characteristics of physical disorders, self-rated heath, subjective well-being and anxiety in adolescents. Data were drawn from the Saving and Empowering Young Lives in Europe cohort study. From 11 countries 11,230 adolescents, aged 14–16 years were included. Zung Self-Rating Anxiety Scale (SAS), WHO-5 Well-Being Index and five questions prepared for this study to evaluate physical illnesses and self-rated heath were administered. Anxiety levels were significantly higher in adolescents who reported having physical disability (p < 0.001, Cohen’s d = 0.40), suffering from chronic illnesses (p < 0.001, Cohen’s d = 0.40), impairments associated to health conditions (p < 0.001, Cohen’s d = 0.61), or reported poor to very poor self-rated health (p < 0.001, Cohen’s d = 1.11). Mediational analyses revealed no direct effect of having a chronic illness/physical disability on subjective well-being, but the indirect effects through higher levels of anxiety were significant. Functional impairment related to health conditions was both directly and indirectly (through higher levels of anxiety) associated with lower well-being. The co-occurrence of anxiety and physical disorders may confer a greater level of disability and lower levels of subjective well-being. Clinicians have to screen anxiety, even in a subthreshold level in patients with choric physical illness or with medically unexplained physical symptoms.
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- Balazs, J, et al.
(author)
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INTRODUCING THE SUPREME PROJECT
- 2012
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In: INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE. - 1070-5503. ; 19, s. S148-S148
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Conference paper (other academic/artistic)
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- Carli, V, et al.
(author)
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The association between pathological internet use and comorbid psychopathology: a systematic review
- 2013
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In: Psychopathology. - : S. Karger AG. - 1423-033X .- 0254-4962. ; 46:1, s. 1-13
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Journal article (peer-reviewed)abstract
- <b><i>Background:</i></b> Pathological Internet use (PIU) has been conceptualized as an impulse-control disorder that shares characteristics with behavioral addiction. Research has indicated a potential link between PIU and psychopathology; however, the significance of the correlation remains ambiguous. The primary objective of this systematic review was to identify and evaluate studies performed on the correlation between PIU and comorbid psychopathology; the secondary aims were to map the geographical distribution of studies, present a current synthesis of the evidence, and assess the quality of available research. <b><i>Sampling and Methods:</i></b> An electronic literature search was conducted using the following databases: MEDLINE, PsycARTICLES, PsychINFO, Global Health, and Web of Science. PIU and known synonyms were included in the search. Data were extracted based on PIU and psychopathology, including depression, anxiety, symptoms of attention deficit and hyperactivity disorder (ADHD), obsessive-compulsive symptoms, social phobia and hostility/aggression. Effect sizes for the correlations observed were identified from either the respective publication or calculated using Cohen’s <i>d</i> or <i>R</i><sup>2</sup>. The potential effect of publication bias was assessed using a funnel plot model and evaluated by Egger’s test based on a linear regression. <b><i>Results:</i></b> The majority of research was conducted in Asia and comprised cross-sectional designs. Only one prospective study was identified. Twenty articles met the preset inclusion and exclusion criteria; 75% reported significant correlations of PIU with depression, 57% with anxiety, 100% with symptoms of ADHD, 60% with obsessive-compulsive symptoms, and 66% with hostility/aggression. No study reported associations between PIU and social phobia. The majority of studies reported a higher rate of PIU among males than females. The relative risks ranged from an OR of 1.02 to an OR of 11.66. The strongest correlations were observed between PIU and depression; the weakest was hostility/aggression. <b><i>Conclusions:</i></b> Depression and symptoms of ADHD appeared to have the most significant and consistent correlation with PIU. Associations were reported to be higher among males in all age groups. Limitations included heterogeneity in the definition and diagnosis of PIU. More studies with prospective designs in Western countries are critically needed.
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| 20. |
- Fleischmann, A, et al.
(author)
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Overview evidence on interventions for population suicide with an eye to identifying best-supported strategies for LMICs
- 2016
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In: Global mental health (Cambridge, England). - : Cambridge University Press (CUP). - 2054-4251. ; 3, s. e5-
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Journal article (peer-reviewed)abstract
- Globally, over 800 000 people died by suicide in 2012 and there are indications that for each adult who died of suicide there were likely to be many more attempting suicide. There are many millions of people every year who are affected by suicide and suicide attempts, taking into consideration the family members, friends, work colleagues and communities, who are bereaved by suicide. In the WHO Mental Health Action Plan 2013–2020, Member States committed themselves to work towards the global target of reducing the suicide rate in countries by 10% by 2020. Hence, the first-ever WHO report on suicide prevention, Preventing suicide: a global imperative, published in September 2014, is a timely call to take action using effective evidence-based interventions. Their relevance for low- and middle-income countries is discussed in this paper, highlighting restricting access to means, responsible media reporting, introducing mental health and alcohol policies, early identification and treatment, training of health workers, and follow-up care and community support following a suicide attempt.
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- Fredin-Knutzén, J., et al.
(author)
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A pilot study evaluating the effectiveness of preventing railway suicides by mid-track fencing, which restrict easy access to high-speed train tracks
- 2022
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In: Journal of Safety Research. - : Elsevier BV. - 0022-4375 .- 1879-1247. ; 83, s. 232-237
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Journal article (peer-reviewed)abstract
- Background: Suicides in the railway system is a serious health, societal, and transportation concern. Restriction of the access to suicide methods in the form of different physical barriers is a promising approach for suicide prevention. Method: Mid-track fencing, which is fencing placed in-between the high-speed and commuter train tracks, was installed at one out of seven stations along a train line outside of Stockholm in the years 2013/2014. The number of suicides at the intervention station was compared to six other stations used as controls, over a total period of 20 years (2002–2021). Results: Suicides at high-speed tracks occurring at stations was the major cause of death on the investigated railway line. Prior to the year 2014, the intervention and control stations displayed similar time trends in the number of suicides. After installation of the mid-track fencing in 2014, there was a 62.5% reduction in the rate of suicides occurring at the intervention station. Compared to the six other control stations, the intervention station displayed a significant reduction in the number of suicides during the years 2014–2021 (OR = 0.14, 95%CI 0.013–0.95). Suicides at the railway lines in-between stations were not increased post-intervention. However, nearby control stations showed a 162% increase in suicides after the intervention, suggesting the induction of transfer effects. Conclusion: Mid-track fences restricting access to high-speed train tracks may have a large effect on reducing the number of railway suicides at intervention stations, but may also induce an increase in suicides at nearby stations without mid-track fences. Practical applications: Partial physical barriers such as mid-track fencing is deemed to be relatively easy and cheap to install (as compared to full barriers; e.g., full height platform screen doors) and should be considered at all stations on railway lines that have high-speed trains passing by. © 2022 The Author(s)
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- Gambadauro, Pietro, et al.
(author)
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Correlates of sexual initiation among European adolescents
- 2018
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:2
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Journal article (peer-reviewed)abstract
- BackgroundSexuality is a physiological component of adolescent development, though early initiation is associated with reproductive health risk. This study aimed at identifying correlates and predictors of sexual initiation in a large multinational cohort of European adolescents.MethodsA questionnaire addressing socio-demographics, behaviours, mental health and sexual activity, was delivered to 11,110 adolescents recruited from 168 randomly selected schools in 10 European countries between 2009 and 2011. A follow-up questionnaire was delivered after 12 months. The longitudinal association of baseline risk behaviors, psychological attributes and contextual vulnerabilities, with sexual initiation during follow-up was evaluated through simple and multivariable age/sex stratified logistic regression. Multinomial logistic regression measured the association between predictors and sexual initiation with or without coexisting reproductive risk factors, such as multiple partners or infrequent condom use.ResultsBaseline sexual experience was reported by 19.2% of 10,757 respondents (median age 15; IQR 14–15; females 59.6%). This was significantly more frequent among pupils older than 15 (41%) and males (20.8%). Of 7,111 pupils without previous experience who were available at follow-up (response rate 81.8%), 17% reported sexual initiation, without differences between females and males. Baseline smoking (age/sex adjusted odds ratio [aOR] 3.63), alcohol use (aOR 2.95), illegal drugs use (aOR 2.72), and poor sleep (aOR 1.71) predicted sexual initiation. Stratified analyses showed a particularly strong association in case of younger and female pupils, and, among girls, when initiation was reported together with multiple partners and/or infrequent condom use. Externalizing (i.e. conduct and hyperactivity) symptoms independently predicted sexual initiation. Internalizing difficulties (i.e. emotional and peer problems) were negatively associated with early and risky sexual initiation among boys. Significant predictors included also being bullied, fighting, truancy, and low parental involvement.ConclusionsAdolescent sexual behaviours are related to non-sexual risk behaviours, psychological difficulties and contextual vulnerabilities. While gateway effects explain some associations, a comprehensive model is needed to understand adolescent sexual behaviours, their physical, mental, and social health outcomes, and their potential positive effects on wellbeing. Tailored interventions may need to consider younger girls as a particularly vulnerable group in view of a strong association between non-sexual and sexual behaviors.
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- Hadlaczky, G, et al.
(author)
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The state of psychiatry in Sweden
- 2012
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In: International review of psychiatry (Abingdon, England). - : Informa UK Limited. - 1369-1627 .- 0954-0261. ; 24:4, s. 356-362
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Journal article (peer-reviewed)
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- Ramberg, IL, et al.
(author)
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Measuring Attitudes toward Suicide Prevention among Occupational Staff Frequently Exposed to Suicidal Individuals: Psychometric Evaluation and Validation
- 2021
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In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:8
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Journal article (peer-reviewed)abstract
- As the attitudes of healthcare staff are thought to influence the quality and effectiveness of interventions targeting patients’ suicide risk, attitudes are often used as an outcome in the evaluation of suicide-preventive training. Due to various problems related to the validity and reliability of commonly used scales, there is a lack of overall agreement on how to measure these attitudes. Confirmatory factor analysis (CFA) was used to cross-validate previously used models and to investigate new models to measure professionals’ attitudes toward work with suicidal individuals and to test the longitudinal stability of the models by analyzing new sets of data. The population in the first study consisted of a heterogenous group of 1350 professionals who managed suicidal individuals relatively frequently. The second study included 640 professionals. The results of the cross-validation of previous models were described and a new questionnaire measuring attitudes toward suicide prevention, suicidal individuals, and organizational-facilitated self-efficacy (OSAQ-12) was presented. The three presented models retained a good fit and were stable over time. Valid and reliable measurement models that measure aspects of attitudes toward suicide are a prerequisite for conducting both cross-sectional and intervention studies.
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- Snir, A, et al.
(author)
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Explicit Motives, Antecedents, and Consequences of Direct Self-Injurious Behaviors
- 2018
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In: Crisis. - : Hogrefe Publishing Group. - 2151-2396 .- 0227-5910. ; 39:4, s. 255-266
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Journal article (peer-reviewed)abstract
- Abstract. Background: Self-injurious behaviors in adolescence are a serious public health concern. Aims: The current study aims to expand our understanding of motives for direct self-injurious behaviors (D-SIB). We examined the explicit motives but also the actual antecedents and consequences of D-SIB over time. Method: As part of the Saving and Empowering Young Lives in Europe (SEYLE) study, adolescents between the ages of 14 and 18 years from Israel completed self-report questionnaires at baseline, 3-month, and 12-month follow-ups. Results: Decreases in social support predicted later increases in D-SIB, an effect mediated by negative affect. Both peer and parental support also exerted quadratic effects on D-SIB. Thus, low as well as high support predicted subsequent D-SIB. In turn, D-SIB was followed by increased peer and parental support. Limitations: Our methodology relies on self-reports, affected by social desirability and recall biases. Conclusion: The findings support a causal path for the development of D-SIB: from interpersonal distress to emotional distress and then to D-SIB. They also point to interesting avenues regarding subgroupings of adolescents who self-injure depending on their motives. Finally, our results reveal that D-SIB, although of negative import, might paradoxically be effective in serving certain functions such as gaining support from parents and peers.
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