Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 21
Filter
1.
Front Public Health ; 9: 732284, 2021.
Article in English | MEDLINE | ID: covidwho-1775865

ABSTRACT

Introduction: As suicide rates increase with age, it is mandatory to carefully assess old age suicidal behaviors. Our aim was to describe the main socio-demographic and clinical features of a sample of suicide attempters aged 65 years and older, and to assess differences within the sample (men vs. women; patients with vs. without a previous history of suicide attempt; patients with vs. without a previous psychiatric history). Methods: Retrospective study conducted at the Maggiore della Carità University Hospital, Novara, Italy. Results: A higher percentage of female patients in our sample were treated by or referred to mental health services, while a greater percentage of male patients required a prolonged clinical observation in the Emergency Room (ER) or in non-psychiatric wards before psychiatric admission. The percentage of patients without previous psychiatric history taking anxiolytic and sedative medications was 25%. Conclusion: It is likely that different clusters and types of suicide attempters exist. Women in our sample appeared more proactive in asking for help, and more likely to be already treated by or referred to a psychiatric service, suggesting the need to facilitate the access to psychiatric services for the male population aged 65 years and older, or to offer support and care for the non-psychiatric reasons (comorbidities, pain, and loss of autonomy) possibly underlying suicidal behavior in this specific group. The use of medications deserves more attention considering the possible critical diagnostic issues in this age group.


Subject(s)
Psychiatry , Suicide, Attempted , Aged , Female , Hospitals, University , Humans , Italy/epidemiology , Male , Retrospective Studies , Suicide, Attempted/psychology
3.
Psychiatry Res ; 301: 113998, 2021 07.
Article in English | MEDLINE | ID: covidwho-1475002

ABSTRACT

COVID-19, and efforts to mitigate its spread, are creating extensive mental health problems. Experts have speculated the mental, economic, behavioral, and psychosocial problems linked to the COVID-19 pandemic may lead to a rise in suicide behavior. However, a quantitative synthesis is needed to reach an overall conclusion regarding the pandemic-suicide link. In the most comprehensive test of the COVID-19-suicidality link to date, we meta-analyzed data from 308,596 participants across 54 studies. Our results suggested increased event rates for suicide ideation (10.81%), suicide attempts (4.68%), and self-harm (9.63%) during the COVID-19 pandemic when considered against event rates from pre-pandemic studies. Moderation analysis indicated younger people, women, and individuals from democratic countries are most susceptible to suicide ideation during the COVID-19 pandemic. Policymakers and helping professionals are advised that suicide behaviors are alarmingly common during the COVID-19 pandemic and vary based upon age, gender, and geopolitics. Strong protections from governments (e.g., implementing best practices in suicide prevention) are urgently needed to reduce suicide behaviors during the COVID-19 pandemic.


Subject(s)
COVID-19/psychology , Suicidal Ideation , Suicide, Attempted/psychology , Suicide/prevention & control , COVID-19/epidemiology , Female , Humans , Male , Pandemics , SARS-CoV-2 , Self-Injurious Behavior/psychology , Suicide/psychology , Suicide, Attempted/statistics & numerical data
4.
Cardiovasc Toxicol ; 22(1): 63-66, 2022 01.
Article in English | MEDLINE | ID: covidwho-1465906

ABSTRACT

Intoxication from calcium channel blockers exhibits almost 50% mortality rates. Amlodipine is a long-acting dihydropyridine and inappropriate dosage poses a great threat for profound vasodilation, hypotension, and refractory vasopressor-resistant shock. A 72-year-old woman with unremarkable medical history presented to the emergency department due to amlodipine overdose after a suicide attempt attributed to COVID-19 pandemic severe anxiety disorder. Vital signs at presentation: heart rate 82 beats/ min, arterial pressure 72/55 mmHg, and oxygen saturation 98%. Resuscitation was initiated with intravenous infusion of normal saline 0,9%, noradrenaline, and calcium chloride, while activated charcoal was orally administrated; however, blood pressure remained at 70/45 mmHg. Abruptly, she experienced acute pulmonary edema and was finally intubated. We commenced high-dose insulin infusion with Dextrose 10% infusion to maintain euglycemic hyperinsulinemia. Hemodynamic improvement occurred after 30 min, systolic blood pressure raised to 95 mmHg, and decongestion was achieved with intravenous furosemide. Insulin effect was dose-dependent and patient's hemodynamic status improved after insulin uptitration. Eight days later, the patient was weaned from the mechanical ventilation and she was successfully discharged after 14 days. High-dose intravenous infusion of insulin up to 10 units/kg per hour appears as an inotropic agent possibly through alterations in myocardial metabolism of fatty acids and augmentation of insulin secretion and uptake. This regimen possibly exhibits additional vasotropic properties. We conclude that euglycemic hyperinsulinemia is a potentially advantageous treatment in CCB toxicity.


Subject(s)
Amlodipine/toxicity , COVID-19 , Drug Overdose/drug therapy , Hyperinsulinism/chemically induced , Shock/drug therapy , Suicide, Attempted , Aged , COVID-19/psychology , Calcium Channel Blockers/toxicity , Drug Overdose/blood , Drug Overdose/diagnosis , Female , Humans , Hyperinsulinism/blood , Insulin/administration & dosage , Shock/blood , Shock/diagnosis , Suicide, Attempted/psychology
6.
Sci Rep ; 11(1): 15828, 2021 08 04.
Article in English | MEDLINE | ID: covidwho-1343475

ABSTRACT

Precise remote evaluation of both suicide risk and psychiatric disorders is critical for suicide prevention as well as for psychiatric well-being. Using questionnaires is an alternative to labor-intensive diagnostic interviews in a large general population, but previous models for predicting suicide attempts suffered from low sensitivity. We developed and validated a deep graph neural network model that increased the prediction sensitivity of suicide risk in young adults (n = 17,482 for training; n = 14,238 for testing) using multi-dimensional questionnaires and suicidal ideation within 2 weeks as the prediction target. The best model achieved a sensitivity of 76.3%, specificity of 83.4%, and an area under curve of 0.878 (95% confidence interval, 0.855-0.899). We demonstrated that multi-dimensional deep features covering depression, anxiety, resilience, self-esteem, and clinico-demographic information contribute to the prediction of suicidal ideation. Our model might be useful for the remote evaluation of suicide risk in the general population of young adults for specific situations such as the COVID-19 pandemic.


Subject(s)
Mental Disorders/diagnosis , Mental Disorders/psychology , Neural Networks, Computer , Suicidal Ideation , Suicide, Attempted/psychology , Adolescent , Adult , Anxiety/psychology , Area Under Curve , Depression/psychology , Female , Humans , Male , Mental Disorders/prevention & control , Prognosis , Psychiatric Status Rating Scales , Republic of Korea , Resilience, Psychological , Risk Factors , Self Concept , Sensitivity and Specificity , Suicide, Attempted/prevention & control , Surveys and Questionnaires , Young Adult
8.
Psychiatry Res ; 301: 113990, 2021 07.
Article in English | MEDLINE | ID: covidwho-1237855

ABSTRACT

This longitudinal study aimed to investigate the predictive factors of suicidal ideation during the second lockdown in Greece. The respondents presented a 4.32% suicidal ideation in the second lockdown, which did not differ significantly to the initial 4.81%. Anxiety, depression, suicidal ideation during the first lockdown and living with a person with frail health and vulnerable for COVID-19 severe infection emerged as significant risk factors for suicidal ideation during the second lockdown, after controlling for gender, age, and mental health history. Depression was found as the only significant prognostic factor for suicidal ideation incidence of the second lockdown.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Depression/psychology , Stress, Psychological , Suicidal Ideation , Suicide, Attempted/psychology , Suicide/psychology , Adult , Anxiety Disorders/epidemiology , Anxiety Disorders/psychology , COVID-19/epidemiology , Communicable Disease Control , Depression/epidemiology , Greece/epidemiology , Humans , Longitudinal Studies , Male , Mental Health , Middle Aged , Prevalence , Risk Factors , SARS-CoV-2 , Suicide/statistics & numerical data , Suicide, Attempted/statistics & numerical data
11.
Epidemiol Psychiatr Sci ; 30: e16, 2021 Jan 19.
Article in English | MEDLINE | ID: covidwho-1127120

ABSTRACT

AIMS: It remains unclear whether the coronavirus disease 2019 (COVID-19) pandemic is having an impact on suicide rates (SR). Economic insecurity and mental disorders are risk factors for suicide, which may increase during the pandemic. METHODS: Data on suicide events in a major city in Germany, and the corresponding life years (LY) were provided by the local authorities. For the year 2020, periods without restrictions on freedom of movement and social contact were compared with periods of moderate and severe COVID-19 restrictions. To avoid distortions due to seasonal fluctuations and linear time trends, suicide risk during the COVID-19 pandemic was compared with data from 2010 to 2019 using an interrupted time series analysis. RESULTS: A total of 643 suicides were registered and 6 032 690 LY were spent between 2010 and 2020. Of these, 53 suicides and 450 429 LY accounted for the year 2020.In 2020, SR (suicides per 100 000 LY) were lower in periods with severe COVID-19 restrictions (SR = 7.2, χ2 = 4.033, p = 0.045) compared with periods without restrictions (SR = 16.8). A comparison with previous years showed that this difference was caused by unusually high SR before the imposition of restrictions, while SR during the pandemic were within the trend corridor of previous years (expected suicides = 32.3, observed suicides = 35; IRR = 1.084, p = 0.682). CONCLUSIONS: SR during COVID-19 pandemic are in line with the trend in previous years. Careful monitoring of SR in the further course of the COVID-19 crisis is urgently needed. The findings have regional reference and should not be over-generalised.


Subject(s)
COVID-19/psychology , Pandemics , Physical Distancing , Quarantine/psychology , Social Isolation/psychology , Suicide/psychology , Suicide/trends , COVID-19/epidemiology , Female , Germany/epidemiology , Humans , Loneliness/psychology , SARS-CoV-2 , Suicide/statistics & numerical data , Suicide, Attempted/psychology
12.
Encephale ; 46(3S): S66-S72, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065052

ABSTRACT

OBJECTIVE: The COVID-19 pandemic affected today more than 3,000,000 worldwide, and more than half of humanity has been placed in quarantine. The scientific community and the political authorities fear an epidemic of suicide secondary to this crisis. The aim of this review is to analyze the impact of the COVID-19 pandemic on the dimensions of the suicidal process and its interaction with the various risk factors. We also propose innovative strategies to manage suicidal behavior in the context of pandemic. METHODS: We carried out a narrative review of international publications dealing with major pandemics (COVID-19, SARS) and their influence on suicidal vulnerability. RESULTS: Many factors are likely to increase the emergence of suicidal ideation and suicide attempts during this crisis. Social distancing and quarantine could increase the feeling of disconnection and the perception of social pain in vulnerable individuals. Some populations at high suicidal risk could be further impacted by the current pandemic: the elderly, medical staff and individuals exposed to economic insecurity. Several innovative tools adapted to the constraints of social distancing and quarantine may prevent suicide risk: e-health, VigilanS, buddhist-derived practices and art engagement. CONCLUSIONS: This unprecedented crisis may interact with certain dimensions of the suicidal process. However, it is time to innovate. Several suicide prevention tools all have their place in new modes of care and should be tested on a large scale.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Suicide/psychology , Alcoholic Intoxication/psychology , Artificial Intelligence , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Coronavirus Infections/psychology , Cost of Illness , Crisis Intervention/instrumentation , Economic Recession , France/epidemiology , Humans , Inflammation , Loneliness/psychology , Models, Neurological , Pneumonia, Viral/complications , Pneumonia, Viral/physiopathology , Pneumonia, Viral/psychology , Psychotherapy/methods , Psychotic Disorders/etiology , Psychotic Disorders/physiopathology , Psychotic Disorders/virology , Quarantine/psychology , Renin-Angiotensin System/physiology , SARS-CoV-2 , Severe Acute Respiratory Syndrome/epidemiology , Severe Acute Respiratory Syndrome/psychology , Social Isolation/psychology , Stress, Psychological/etiology , Stress, Psychological/therapy , Suicidal Ideation , Suicide/prevention & control , Suicide/statistics & numerical data , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology , Telemedicine , Vulnerable Populations
13.
JAMA Psychiatry ; 78(4): 372-379, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1060999

ABSTRACT

Importance: The coronavirus disease 2019 (COVID-19) pandemic, associated mitigation measures, and social and economic impacts may affect mental health, suicidal behavior, substance use, and violence. Objective: To examine changes in US emergency department (ED) visits for mental health conditions (MHCs), suicide attempts (SAs), overdose (OD), and violence outcomes during the COVID-19 pandemic. Design, Setting, and Participants: This cross-sectional study used data from the Centers for Disease Control and Prevention's National Syndromic Surveillance Program to examine national changes in ED visits for MHCs, SAs, ODs, and violence from December 30, 2018, to October 10, 2020 (before and during the COVID-19 pandemic). The National Syndromic Surveillance Program captures approximately 70% of US ED visits from more than 3500 EDs that cover 48 states and Washington, DC. Main Outcomes and Measures: Outcome measures were MHCs, SAs, all drug ODs, opioid ODs, intimate partner violence (IPV), and suspected child abuse and neglect (SCAN) ED visit counts and rates. Weekly ED visit counts and rates were computed overall and stratified by sex. Results: From December 30, 2018, to October 10, 2020, a total of 187 508 065 total ED visits (53.6% female and 46.1% male) were captured; 6 018 318 included at least 1 study outcome (visits not mutually exclusive). Total ED visit volume decreased after COVID-19 mitigation measures were implemented in the US beginning on March 16, 2020. Weekly ED visit counts for all 6 outcomes decreased between March 8 and 28, 2020 (March 8: MHCs = 42 903, SAs = 5212, all ODs = 14 543, opioid ODs = 4752, IPV = 444, and SCAN = 1090; March 28: MHCs = 17 574, SAs = 4241, all ODs = 12 399, opioid ODs = 4306, IPV = 347, and SCAN = 487). Conversely, ED visit rates increased beginning the week of March 22 to 28, 2020. When the median ED visit counts between March 15 and October 10, 2020, were compared with the same period in 2019, the 2020 counts were significantly higher for SAs (n = 4940 vs 4656, P = .02), all ODs (n = 15 604 vs 13 371, P < .001), and opioid ODs (n = 5502 vs 4168, P < .001); counts were significantly lower for IPV ED visits (n = 442 vs 484, P < .001) and SCAN ED visits (n = 884 vs 1038, P < .001). Median rates during the same period were significantly higher in 2020 compared with 2019 for all outcomes except IPV. Conclusions and Relevance: These findings suggest that ED care seeking shifts during a pandemic, underscoring the need to integrate mental health, substance use, and violence screening and prevention services into response activities during public health crises.


Subject(s)
COVID-19/epidemiology , Drug Overdose , Emergency Service, Hospital , Mental Disorders , Suicide, Attempted , Violence , Adult , Drug Overdose/epidemiology , Emergency Service, Hospital/statistics & numerical data , Emergency Service, Hospital/trends , Epidemiological Monitoring , Female , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health/statistics & numerical data , Outcome Assessment, Health Care/trends , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , SARS-CoV-2 , Suicide, Attempted/psychology , Suicide, Attempted/statistics & numerical data , United States/epidemiology , Violence/psychology , Violence/statistics & numerical data
14.
J Psychiatr Res ; 134: 32-38, 2021 02.
Article in English | MEDLINE | ID: covidwho-997202

ABSTRACT

Evidence suggests that the negative consequences of COVID-19 may extend far beyond its considerable death toll, having a significant impact on psychological well-being. Despite work highlighting the link between previous epidemics and elevated suicide rates, there is limited research on the relationship between the COVID-19 pandemic and suicidal thoughts and behaviors. Utilizing an online survey, the current study aimed to better understand the presence, and extent, of the association between COVID-19-related experiences and past-month suicidal thoughts and behaviors among adults in the United States recruited via Amazon Mechanical Turk (n = 907). Results support an association between several COVID-19-related experiences (i.e., general distress, fear of physical harm, effects of social distancing policies) and past-month suicidal ideation and suicide attempts. Further, a significant proportion of those with recent suicidal ideation explicitly link their suicidal thoughts to COVID-19. Exploratory analyses highlight a potential additional link between COVID-19 and suicidal behavior, suggesting that a portion of individuals may be intentionally exposing themselves to the virus with intent to kill themselves. These findings underscore the need for suicide risk screening and access to mental health services during the current pandemic. Particular attention should be paid to employing public health campaigns to disseminate information on such services to reduce the enormity of distress and emotional impairment associated with COVID-19 in the United States.


Subject(s)
COVID-19/psychology , Quarantine/psychology , Suicidal Ideation , Suicide, Attempted/psychology , Suicide, Attempted/statistics & numerical data , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Risk , SARS-CoV-2 , United States , Young Adult
15.
Arch Suicide Res ; 24(4): 477-482, 2020.
Article in English | MEDLINE | ID: covidwho-926062

ABSTRACT

The coronavirus (COVID-19) pandemic presents us with unusual challenges to the global health system and economics. The pandemic may not have an immediate impact on suicide rates, however, given that it is likely to result in a confluence of risk factors for suicide and economic crisis, it is highly possibly that it will lead to increases in suicide rates in the long-run. Elderly persons are more likely to live alone, be socially isolated during COVID-19 and have physical health problems, which are risk factors for suicide. Young children and health professionals may also be population at risk. Isolation, quarantine and the economic crisis that follows may impact mental health significantly. The International Academy of Suicide Research (IASR) is an organization dedicated to promote high standards of research and scholarship in the field of suicidal behaviour to support efforts to prevent suicide globally. This IASR's board position paper gives recommendations for suicide research during the COVID-10 pandemic. Clinical research has to be modified due to COVID-19 shutdown.


Subject(s)
COVID-19/psychology , Quarantine/psychology , Resilience, Psychological , Suicide, Attempted/prevention & control , Suicide/prevention & control , Adaptation, Psychological , Humans , Risk Factors , Social Support , Suicidal Ideation , Suicide/psychology , Suicide, Attempted/psychology
18.
Prim Care Companion CNS Disord ; 22(5)2020 Oct 22.
Article in English | MEDLINE | ID: covidwho-890457

ABSTRACT

OBJECTIVE: To expand knowledge during the coronavirus disease 2019 (COVID-19) pandemic with regard to suicide prevention among the elderly population by providing recommendations for interview strategies using 3 suicide theories. METHODS: Two hypothetical geriatric suicide cases (1 low lethality and 1 high lethality) are presented and categorized according to 3 suicide theories: interpersonal theory of suicide, three-step theory of suicide, and hopelessness theory of depression. RESULTS: In crisis intervention, the clinician's interview must match the intrinsic belief of the suicide attempter to enable engagement and rapport. Use of different aspects of the 3 suicide theories can be useful but are dependent on the emergent nature of the attempt. CONCLUSION: The need for identification and treatment of those with mental health issues, especially among the elderly population, and collaborative multidiscipline management teams is increasing during the current global pandemic. Specific interview strategies are needed when engaging with elderly suicidal patients. Suicide prevention in elderly patients is worthy of strong public attention.


Subject(s)
Coronavirus Infections/psychology , Pandemics , Pneumonia, Viral/psychology , Psychiatry/methods , Suicide/prevention & control , Aged , Aged, 80 and over , COVID-19 , Coronavirus Infections/complications , Depression/etiology , Depression/psychology , Female , Humans , Male , Pneumonia, Viral/complications , Suicidal Ideation , Suicide/psychology , Suicide, Attempted/psychology
19.
Prev Med ; 141: 106264, 2020 12.
Article in English | MEDLINE | ID: covidwho-813914

ABSTRACT

The current COVID-19 pandemic is the most severe pandemic of the 21st century, on track to having a rising death toll. Beyond causing respiratory distress, COVID-19 may also cause mortality by way of suicide. The pathways by which emerging viral disease outbreaks (EVDOs) and suicide are related are complex and not entirely understood. We aimed to systematically review the evidence on the association between EVDOs and suicidal behaviors and/or ideation. An electronic search was conducted using five databases: Medline, Embase, Web of Science, PsycINFO and Scopus in April 2020. A rapid systematic review was carried out, which involved separately and independently extracting quantitative data of selected articles. The electronic search yielded 2480 articles, of which 9 met the inclusion criteria. Most of the data were collected in Hong Kong (n = 3) and the USA (n = 3). Four studies reported a slight but significant increase in deaths by suicide during EVDOs. The increase in deaths by suicide was mainly reported during the peak epidemic and in older adults. Psychosocial factors such as the fear of being infected by the virus or social isolation related to quarantine measures were the most prominent factors associated with deaths by suicide during EVDOs. Overall, we found scarce and weak evidence for an increased risk of deaths by suicide during EVDOs. Our results inform the need to orient public health policies toward suicide prevention strategies targeting the psychosocial effects of EVDOs. High-quality research on suicide risk and prevention are warranted during the current pandemic.


Subject(s)
Disease Outbreaks/statistics & numerical data , Suicidal Ideation , Suicide, Attempted/psychology , Suicide, Attempted/statistics & numerical data , Suicide/psychology , Suicide/statistics & numerical data , Virus Diseases/psychology , Aged , COVID-19 , Female , Hong Kong , Humans , Pandemics/statistics & numerical data , SARS-CoV-2
20.
Suicide Life Threat Behav ; 50(6): 1223-1229, 2020 12.
Article in English | MEDLINE | ID: covidwho-617135

ABSTRACT

PURPOSE: The purpose of this study was to identify leading sources of stress, describe rates of mental health outcomes, and examine their associations among U.S. adults during the first months of the COVID-19 pandemic. METHOD: In a cross-sectional, general population survey conducted from March 18 to April 4, 2020, U.S. adults (n = 10,625) were recruited through Qualtrics Panels using quota sampling methods. RESULTS: Life stressors, probable depression, past-month suicide ideation, and past-month suicide attempts were not elevated among participants subject to state-level stay-at-home orders and/or large gathering bans. Multiple life stressors were associated with increased rates of probable depression. Past-month suicide ideation was significantly higher among participants reporting ongoing arguments with a partner and serious legal problems. Past-month suicide attempt was significantly higher among participants reporting concerns about a life-threatening illness or injury, but was significantly lower among participants reporting an unexpected bill or expense. CONCLUSIONS: Results failed to support the conclusion that physical distancing measures are correlated with worse mental health outcomes. Concerns about life-threatening illness or injury were uniquely associated with increased risk of suicide attempt.


Subject(s)
Physical Distancing , Stress, Psychological , Suicide, Attempted , Adult , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Catastrophic Illness/psychology , Cross-Sectional Studies , Fear , Female , Humans , Male , Mental Health/trends , SARS-CoV-2 , Stress, Psychological/etiology , Stress, Psychological/psychology , Suicidal Ideation , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology , Suicide, Attempted/statistics & numerical data
SELECTION OF CITATIONS
SEARCH DETAIL