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1.
Curr Opin Psychiatry ; 35(5): 317-323, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2008720

ABSTRACT

PURPOSE OF REVIEW: Suicide is a major, global, public health issue. Those who attempt suicide represent a high-risk subgroup for eventual death by suicide. We provide an update on emerging evidence for interventions for attempted suicide to reduce subsequent suicidal behavior. RECENT FINDINGS: Major approaches that have been examined recently include pharmacological, psychosocial, brief active contact and outreach interventions, and digitally driven interventions. Notwithstanding the limited evidence base for most of these approaches, brief contact and follow-up interventions appear to have more robust effects on reduction of repeat suicidal behavior, including attempts; such approaches may have especial significance in emergency settings because of their brevity. Digital interventions for self-harm appear promising in the short-term whereas the evidence for pharmacological and psychosocial strategies remain inconclusive. SUMMARY: Although current evidence supports the use of brief interventions, contact, and outreach for reducing risk of subsequent suicide attempts and suicidal behavior, there are large gaps and limitations in the evidence base related to trial design, lack of long-term efficacy data, and implementational challenges. More robustly designed long-term trials that examine integrated intervention approaches with well defined outcomes are needed to develop recommendations in this area.


Subject(s)
Self-Injurious Behavior , Suicide, Attempted , Humans , Suicidal Ideation , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology
2.
J Affect Disord ; 307: 215-220, 2022 06 15.
Article in English | MEDLINE | ID: covidwho-1920986

ABSTRACT

BACKGROUND: There has been substantial discussion as to whether the mental health and socio-economic consequences of the COVID-19 pandemic might impact suicide rates. Although India accounts for the largest proportion of global suicides, the early impacts of the COVID-19 pandemic on suicide rates in this country are unknown. METHODS: National Crime Records Bureau (NCRB) data were used to calculate annual suicide rates for the period 2010-2020, stratified by sex and state. Rate Ratios (RRs) stratified by sex and state were calculated to estimate the extent of change in suicide rates. RESULTS: Suicide rates in India generally showed a decreasing trend from 2010 until 2017, with the trend reversing after this period, particularly for males. Among males and females, the highest increase post 2017 was noted in 2020 (compared to 2017) (males: RR = 1.18 95% UI 1.17-1.19; females: RR = 1.05 95% UI 1.03-1.06). LIMITATION: Suicide rates based on the NCRB data might be an underestimation of the true suicide rates. CONCLUSION: Suicide rates in India increased during the first year of the COVID-19 pandemic, and although the increase in suicide rates, especially among males, predates the pandemic, the increase in suicide rates was highest in 2020, compared to increases in previous years. Further research is warranted to understand the potential ongoing impact of the COVID-19 pandemic on suicide in India.


Subject(s)
COVID-19 , Suicide , COVID-19/epidemiology , Female , Humans , India/epidemiology , Male , Mental Health , Pandemics
3.
Indian journal of psychiatry ; 64(Suppl 3):S648-S649, 2022.
Article in English | EuropePMC | ID: covidwho-1871910

ABSTRACT

Introduction1 The Corona Virus Disease 2019 (COVID-19) has ignited many debates and has undoubtedly shaken up the core foundations of the health-care system worldwide. There has been plenty of evidence that pandemic and the effects of lockdown have Studies have resulted in elevated levels of psychological symptoms such as depression, anxiety, phobia, trauma, etc. Concerning the COVID-19 outbreak (since late January 2020 in India), the first case that was reported in India is stated to be due to fear of being infected with COVID-19. Similarly, COVID-19 suicide occurrences were reported as of fear of infection, economic crisis and social boycott in Bangladesh and Pakistan, from the neighbouring countries of India. Though the report of the National Crime Record Bureau (NCRB) was released as last as October’21 this year, many of the incidents were reported by press and over social media platforms. The NCRB Statistics - 20202 A total of 1,53,052 suicides were reported in the country during 2020 showing an increase of 10.0% in comparison to 2019 & the rate of suicides has increased by 8.7% during 2020 over 2019. Majority of suicides were reported in Maharashtra (13.0%) followed by Tamil Nadu (11.0%), Madhya Pradesh (9.5%), West Bengal (8.6%) & Karnataka (8.0%). These 5 States together accounted for 50.1% of the total suicides reported in the country. Family Problems (33.6%) & Illness (18.0%)’ were the major causes of suicides. Drug Abuse/Addiction (6.0%), Marriage Related Issues(5.0%), Love Affairs (4.4%), Bankruptcy or Indebtedness (3.4%), Unemployment (2.3%), Failure in Examination (1.4%) & Poverty (1.2%) were other causes. Daily wage earners accounted for the maximum percentage (24.6%). Hanging’ (57.8%), consuming ‘Poison’ (25.0%), ‘Drowning’ (5.2%) and ‘Fire/Self Immolation’ (3.0%) were the prominent means/mode. Beyond the NCRB Statistics3 The NCRB report has some significant limitations. NCRB underestimates suicide rates due to under- reporting of cases & this data is usually made available after a significant delay of between 12 and 24 months. Furthermore, NCRB releases summary annual data rather than weekly or monthly data to analyse trends (Important during COVID19). NCRB does not keep any record of attempted suicides as well. Analysis of media reports reveals that the rates of suicide and attempted suicide between 24 March to 3 May 2020 compared to the same dates in 2019 showed a 67.7% increase in reported suicides and attempted suicides during the lockdown. More suicides & attempted suicides were by older employed men. Suicides increased in 2020 in states which traditionally have low suicide rates such as Bihar, Uttar Pradesh, Rajasthan, Haryana, and Chandigarh (also economically less developed & inadequate health infrastructure). There were 39 alcohol-related suicides & 7 attempted suicides as compared to no such suicide/ attempted suicide cases in 2019. Conclusion3 The possibility that the pandemic may have increased the risk of suicide as reflected from the media reports has been attested by the recently released NCRB data. However, both the reports are an underestimate of the true figures. The pandemic however has now provided an opportunity for cross- sectoral collaboration for suicide prevention rather than restricting suicide prevention to the health sector Symposium Proposal: Digital Phenotyping in Mental Health This symposium explores the emerging field of digital phenotyping in mental health. Despite developments, psychiatry heavily relies on patients’ interviews and self-reporting to match the diagnostic criteria of the ICD or DSM and is still handicapped by the lack of objective measurements for diagnosis and management. Smartphones and wearables, which have emerged as new tools for health investigation, generate many digital fingerprints that provide insights into human behavior. They collect data in naturalistic settings in-situ, leveraging the lived experiences of patients and no longer confined to clinics or research laboratories. However, such technology with revolutionary p tential is also associated with challenges and controversies. Various legal, ethical, and security issues concern digital phenotyping in mental health. The first presentation by Vijay Gogoi of LGBRIMH sets the scene for what follows1. He discusses the advent and concept of using digital devices and the Internet of Things (IoT) for personal sensing in the context of mental health. Terminologies like computational behavioral analysis, personal sensing, continuous measurement are being applied in similar research approaches. Hence, some researchers also view digital phenotyping as a variant of deep phenotyping, closely aligned with the goals of precision medicine and a new tool for the National Institute of Mental Health’s Research Domain Criteria. Dhrubajyoti Chetia of LGBRIMH then discusses the various research trends in mental health using digital devices2. The features studied as behavioral markers for social context, stress, sleep, mood, and clinical disorders like depression, schizophrenia, and bipolar disorder will be discussed. Changes in location and activity patterns, keyboard interaction dynamics, voice modulation, social communication logs are used to predict depressive and manic states. Proactive screening in online environments and automatic natural language processing of social media posts have been used successfully to identify individuals with evidence of psychological distress. Signals from smartphones and clinical measurements may provide a safety net for patients at risk of self-harm or suicide. The challenges and limitations of using digital technology are highlighted by Sajjadur Rehman of Lady Hardinge Medical College3. Results are not comparable across studies because of varying data collection techniques and research designs. As most research is currently being carried out in small samples as proof of concept studies, replicating the same in a large population is a challenge. Variability from geographical location, characteristics of people, data types, environments, etc., is a barrier. With rapid technological advancements, and people changing their usage, machine learning algorithms are bound to become inaccurate. Finally, as health care professionals, the ethical and security concerns were discussed by Kunal Deb of LGBRIMH4. Accountability for safety and efficacy, usually assessed by government agencies, is still not well developed for digital health technologies. Strict data privacy and protection regulations also need to be in place. The use of various data streams may assist the third party in re-identifying individuals without their knowledge, with the potential impacts of mental health diagnosis and predictions on employment, insurance, litigation, and other contexts. 1.Vijay Gogoi, Associate Professor, Psychiatry, LGBRIMH, Tezpur, Assam 2.Dhrubajyoti Chetia, Associate Professor, LGBRIMH, Tezpur Assam. 3.Sajjadur Rehman, Assistant Professor, Psychiatry, Lady Hardinge Medical College, Delhi 4.Kunal Deb, Assistant Professor, Psychiatry, LGBRIMH, Tezpur, Assam.

5.
Int J Environ Res Public Health ; 18(12)2021 06 08.
Article in English | MEDLINE | ID: covidwho-1282461

ABSTRACT

BACKGROUND: Each year there are more than 800,000 deaths by suicide across the world, while India alone accounts for one third of female suicides and one fourth of male suicides worldwide. Responsible media reporting of suicide is an important suicide prevention intervention at the population level. There is sufficient evidence to show that the way suicide is reported and portrayed in the media can have a significant impact on individuals experiencing suicidal thoughts and behaviors. Recognizing the important role of the media in suicide prevention, the World Health Organization (WHO) issued guidelines for responsible reporting of suicides by the media. The Press Council of India, in 2019 endorsed WHO's guidelines for media reporting of suicides, however there is no evidence that the Indian media is complying with these guidelines. METHODS: To encourage responsible media reporting, we developed a scorecard to assess and rate media reports on suicide. We reviewed several resource documents that contained guidelines on responsible reporting of suicide. After consulting with a team of experts, we arrived at a scorecard that consisted of 10 positive and 10 negative parameters. RESULTS: We applied the scorecard to 1318 reports on suicide from 9 English language newspapers, with the highest readership in India between the dates of 1 April to 30 June 2020. For the articles analyzed, the average positive score across all newspapers was 1.32 and the average negative score was 3.31. DISCUSSION: The scorecard can be a useful tool to assess media reports on suicide and provide metrics for the same. It can facilitate improved monitoring and engagement with media organizations, who can quickly check their own reporting compliance to the WHO guidelines and compare how well they are performing compared to their peers over time.


Subject(s)
Suicide , Female , Humans , India/epidemiology , Male , Mass Media , Suicidal Ideation , World Health Organization
6.
Int J Ment Health Syst ; 14(1): 88, 2020 Dec 03.
Article in English | MEDLINE | ID: covidwho-961329

ABSTRACT

BACKGROUND: Based on previous experience there is justifiable concern about suicidal behaviour and news media reporting of it during COVID-19 pandemic. METHODS: This study used a systematic search of online news media reports (versions of newspapers, magazine and other digital publications) of suicidal behaviour during India's COVID-19 lockdown and compared it to corresponding dates in 2019. Data was gathered using a uniform search strategy from 56 online news media publications 24 March to 3 May for the years 2019 and 2020 using keywords, suicide, attempted suicide, hangs self and kills self. Demographic variables and methods used for suicide were compared for suicide and attempts between the 2 years using chi-squared tests (χ2). RESULTS: There were online news media reports of 369 cases of suicides and attempted suicides during COVID lockdown vs 220 reports in 2019, a 67.7% increase in online news media reports of suicidal behaviour. Compared to 2019, suicides reported during lockdown were significantly older (30 vs 50 years, p < 0.05), men (71.2% vs 58.7%; p < 0.01), married (77.7% vs 49%; p < 0.01) and employed (82.9% vs 59.5%; p < 0.01). During the lockdown, significantly more suicides were by hanging (64.4% vs 42%), while poisoning (8.5% vs 21.5%) and jumping in front of a train (2% vs 9.4%) (p < 0.05) were significantly reduced. Comparison of COVID and non-COVID groups showed that online news media reports of COVID cases of suicide and attempted suicide were significantly more likely to be men (84.7% vs 60.4%; p < 0.01), older (31-50 years 52.9% vs 25.8%; p < 0.01) employed (91.5% vs 64.3%; p < 0.01), had poor mental (40.1% vs 20.8%; p < 0.01) and poor physical health (24.8% vs 7.9%;11.8, p < 0.01). CONCLUSION: Increase in online news media reports of suicides and attempts during COVID-19 lockdown may indicate an increase in journalists' awareness about suicide or more sensational media reporting or may be a proxy indicator of a real community increase in suicidal behaviour. It is difficult to attribute changes in demographic profile and methods used only to changes in journalists' reporting behaviour and should be further explored. We therefore call upon the Government of India to urgently release national suicide data to help devise a comprehensive suicide prevention strategy to address COVID-19 suicidal behaviour.

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