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Matthew K Nock - One of the best experts on this subject based on the ideXlab platform.
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predicting Suicidal Behavior from longitudinal electronic health records
American Journal of Psychiatry, 2017Co-Authors: Yuval Barakcorren, Matthew K Nock, Victor M Castro, Solomon Javitt, Alison G Hoffnagle, Yael G Dai, Roy H Perlis, Jordan W Smoller, Ben Y ReisAbstract:Objective:The purpose of this article was to determine whether longitudinal historical data, commonly available in electronic health record (EHR) systems, can be used to predict patients’ future risk of Suicidal Behavior.Method:Bayesian models were developed using a retrospective cohort approach. EHR data from a large health care database spanning 15 years (1998–2012) of inpatient and outpatient visits were used to predict future documented Suicidal Behavior (i.e., suicide attempt or death). Patients with three or more visits (N=1,728,549) were included. ICD-9-based case definition for Suicidal Behavior was derived by expert clinician consensus review of 2,700 narrative EHR notes (from 520 patients), supplemented by state death certificates. Model performance was evaluated retrospectively using an independent testing set.Results:Among the study population, 1.2% (N=20,246) met the case definition for Suicidal Behavior. The model achieved sensitive (33%–45% sensitivity), specific (90%−95% specificity), and ...
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association between parental psychopathology and Suicidal Behavior among adult offspring results from the cross sectional south african stress and health survey
BMC Psychiatry, 2014Co-Authors: Matthew K Nock, Lukoye Atwoli, Daniel R Williams, Dan J SteinAbstract:Background Prior studies have demonstrated a link between parental psychopathology and offspring Suicidal Behavior. However, it remains unclear what aspects of Suicidal Behavior among adult offspring are predicted by specific parental mental disorders, especially in Africa. This study set out to investigate the association between parental psychopathology and Suicidal Behavior among their adult offspring in a South African general population sample.
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Improving the short-term prediction of Suicidal Behavior.
American journal of preventive medicine, 2014Co-Authors: Catherine R Glenn, Matthew K NockAbstract:Aspirational Goal 3 of the National Action Alliance for Suicide Prevention's Research Prioritization Task Force is to predict who is at risk for attempting suicide in the near future. Despite decades of research devoted to the study of risk and protective factors for suicide and Suicidal Behavior, surprisingly little is known about the short-term prediction of these Behaviors. In this paper, we propose several questions that, if answered, could improve the identification of short-term, or imminent, risk for Suicidal Behavior. First, what factors predict the transition from Suicidal thoughts to attempts? Second, what factors are particularly strong predictors of making this transition over the next hours, days, or weeks? Third, what are the most important objective markers of short-term risk for Suicidal Behavior? And fourth, what method of combining information about risk and protective factors yields the best prediction? We propose that the next generation of research on the assessment and prediction of Suicidal Behavior should shift, from cross-sectional studies of bivariate risk and protective factors, to prospective studies aimed at identifying multivariate, short-term prediction indices, examining methods of synthesizing this information, and testing the ability to predict and prevent Suicidal events.
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mental disorders comorbidity and Suicidal Behavior results from the national comorbidity survey replication
Molecular Psychiatry, 2010Co-Authors: Matthew K Nock, Irving Hwang, Nancy A Sampson, Ronald C KesslerAbstract:Mental disorders, comorbidity and Suicidal Behavior: Results from the National Comorbidity Survey Replication
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attentional bias toward suicide related stimuli predicts Suicidal Behavior
Journal of Abnormal Psychology, 2010Co-Authors: Christine B Cha, Sadia Najmi, Jennifer M Park, Christine T Finn, Matthew K NockAbstract:A long-standing challenge for scientific and clinical work on Suicidal Behavior is that people often are motivated to deny or conceal Suicidal thoughts. The authors proposed that people considering suicide would possess an objectively measurable attentional bias toward suicide-related stimuli and that this bias would predict future Suicidal Behavior. Participants were 124 adults presenting to a psychiatric emergency department who were administered a modified emotional Stroop task and followed for 6 months. Suicide attempters showed an attentional bias toward suicide-related words relative to neutral words, and this bias was strongest among those who had made a more recent attempt. Importantly, this suicide-specific attentional bias predicted which people made a suicide attempt over the next 6 months, above and beyond other clinical predictors. Attentional bias toward more general negatively valenced words did not predict any suicide-related outcomes, supporting the specificity of the observed effect. These results suggest that suicide-specific attentional bias can serve as a Behavioral marker for Suicidal risk, and ultimately improve scientific and clinical work on suicide-related outcomes.
John J Mann - One of the best experts on this subject based on the ideXlab platform.
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the role of cytokines in the pathophysiology of Suicidal Behavior
Psychoneuroendocrinology, 2016Co-Authors: Maria A Oquendo, John J Mann, Licinia Gananca, Audrey R Tyrka, Sebastian Cisnerostrujillo, Elizabeth M SubletteAbstract:Abstract Objective Immune dysregulation has been implicated in depression and other psychiatric disorders. What is less clear is how immune dysregulation can affect risk of Suicidal Behavior. We reviewed the scientific literature concerning cytokines related to Suicidal ideation, Suicidal Behavior and suicide, and surveyed clinical and neurobiological factors associated with cytokine levels that may modulate effects of inflammation on suicide risk. Methods We searched PubMed, Embase, Scopus and PsycINFO for relevant studies published from 1980 through February, 2015. Papers were included if they were written in English and focused on cytokine measurements in patients with Suicidal Behaviors. Results The literature search yielded 22 studies concerning cytokines and Suicidal ideation, suicide attempts or suicide completion. The most consistent finding was elevated interleukin (IL)-6, found in 8 out of 14 studies, in CSF, blood, and postmortem brain. In one study, IL-6 in CSF was also found to be higher in violent than nonviolent attempters and to correlate with future suicide completion. Low plasma IL-2 was observed in 2 studies of suicide attempters, while divergent results were seen for tumor necrosis factor (TNF)-α, interferon (IFN)-γ, transforming growth factor (TGF)-β, IL-4, and soluble Il-2 receptors. Conclusions Given the complexity suggested by the heterogenous cytokine findings, putative mediators and moderators of inflammation on Suicidal Behavior merit further study. Elevated IL-6 was the most robust cytokine finding, associated with Suicidal ideation and both nonfatal suicide attempts and suicides. Future studies should evaluate the predictive value of high IL-6, consider how this may alter brain function to impact Suicidal Behavior, and explore the potential beneficial effects of reducing IL-6 on suicide risk.
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neuropsychological function and Suicidal Behavior attention control memory and executive dysfunction in suicide attempt
Psychological Medicine, 2013Co-Authors: John G Keilp, Maria A Oquendo, Ainsley K Burke, Marianne Gorlyn, M Russell, Jill M Harkavyfriedman, John J MannAbstract:Background Executive dysfunction, distinct from other cognitive deficits in depression, has been associated with Suicidal Behavior. However, this dysfunction is not found consistently across samples.
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family genetic studies suicide and Suicidal Behavior
American Journal of Medical Genetics Part C-seminars in Medical Genetics, 2005Co-Authors: David A. Brent, John J MannAbstract:The extant adoption, twin, and family studies of suicide and Suicidal Behavior are reviewed. Suicidal Behavior is highly familial, and on the basis of twin and adoption studies, heritable as well. Both completed and attempted suicide form part of the clinical phenotype that is familially transmitted, as rates of suicide attempt are elevated in the family members of suicide completers, and completion rates are elevated in the family members of attempters. A family history of Suicidal Behavior is associated with Suicidal Behavior in the proband, even after adjusting for presence of psychiatric disorders in the proband and family, indicating transmission of attempt that is distinct from family transmission of psychiatric disorder. Impulsive aggression in probands and family members is associated with family loading for Suicidal Behavior, and may contribute to familial transmission of Suicidal Behavior. Shared environment effects such as abuse, imitation, or transmission of psychopathology are other possible explanations.
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genetics of the serotonergic system in Suicidal Behavior
Journal of Psychiatric Research, 2003Co-Authors: Victoria Arango, Yungyu Huang, Mark D Underwood, John J MannAbstract:Abstract Genetic factors contribute to the risk of psychopathology in many psychiatric conditions, but the specific genes are yet to be identified. Neurotransmitter alterations are implicated in the etiology of psychopathology based, in part, on studies of neurotransmitter receptors and their biosynthetic or degradative enzymes in postmortem tissue. Identification of the altered receptors and enzymes serves to identify candidate genes of potential etiological significance. Polymorphisms in these genes can contribute to alterations in protein function in vivo that are part of the neurochemical underpinnings of psychopathologies such as major depressive disorder, psychoses, alcoholism, personality disorders, aggressive–impulsive traits, or Suicidal Behavior. Altered serotonergic function is implicated in the etiology and pathogenesis of several major psychiatric conditions. In particular, there is much evidence for an association of lower serotonergic function and Suicidal Behavior. Thus genes related to the serotonergic system are candidate genes worthy of study as part of the genetic diathesis for Suicidal Behavior. This review examines the following polymorphisms in the serotonin biosynthetic enzyme tryptophan hydroxylase (TPH; A779C substitution), the serotonin transporter (5-HTT, 5-HTTLPR allele), the 5-HT 1B receptor (G861C, C129T substitution) and the 5-HT 2A receptor (T102C) for their relationship to Suicidal Behavior. For the TPH gene, we found the less common U or A allele variant of the A779C polymorphism was associated with suicide attempt. Other studies have found the U allele to be associated with aggression and lower serotonergic function in vivo. A 44 base pair insertion/deletion in the 5′ flanking promoter region of the 5-HTT gene may result in less 5-HTT expression and 5-HTT binding. We examined 220 cases postmortem and found no association between the promoter genotype and 5-HTT binding. We also found no association with major depressive disorder (MDD), suicide or pathological aggression, despite finding significantly fewer 5-HTT sites in the prefrontal cortex of depressed and/or suicide cases. In genomic DNA samples from 178 unrelated subjects, we detected two polymorphisms for the 5-HT 1B receptor at nucleotides 861 and 129. However, no association between either polymorphism and depression, suicide, aggression, or alcoholism was observed. There are two common polymorphisms for the 5-HT 2A receptor gene in humans. The results of studies of 5-HT 2A receptor gene polymorphisms do not indicate significant major associations with Suicidal Behavior. In contrast, the 5-HT 2A receptor itself is reported to be increased in suicide. Functional polymorphisms involving the promoter region that affect gene expression may explain this finding. Studies of candidate genes related to serotonergic function in brain are increasingly used to establish genetic alterations contributing to psychiatric illness. The most meaningful studies combine the study of candidate genes with direct measures of related proteins as well as psychopathology.
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cigarette smoking Suicidal Behavior and serotonin function in major psychiatric disorders
American Journal of Psychiatry, 2003Co-Authors: Kevin M Malone, Gretchen L Haas, Christine Waternaux, Thomas B Cooper, John J MannAbstract:OBJECTIVE: Cigarette smoking is associated with a higher risk for suicide and attempted suicide, but psychopathological or biological explanations for this association have not been explored. Lower serotonin function and impulsive/aggressive traits are associated with Suicidal acts, including completed suicide. The authors hypothesized that the relationship that may exist between cigarette smoking and Suicidal Behavior may be associated with lower serotonin function and the presence of impulsive/aggressive traits. METHOD: Study subjects were 347 patients with a psychiatric disorder (175 with depression, 127 with schizophrenia, and 45 with other disorders). Fifty-three percent of the subjects (N=184) had a lifetime history of suicide attempt, and 47% (N=163) had never attempted suicide. Smoking Behavior, lifetime Suicidal Behavior, and psychopathology were assessed. Serotonin function was assessed in a subgroup of patients with depression (N=162) by using a fenfluramine challenge test and/or measurement of...
Paul Avillach - One of the best experts on this subject based on the ideXlab platform.
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use of natural language processing in electronic medical records to identify pregnant women with Suicidal Behavior towards a solution to the complex classification problem
European Journal of Epidemiology, 2019Co-Authors: Qiuyue Zhong, Bizu Gelaye, Paul Avillach, Sean Finan, Leena Mittal, Margo Nathan, Kara M Brown, Deborah Knudson Gonzalez, Tianrun CaiAbstract:We developed algorithms to identify pregnant women with Suicidal Behavior using information extracted from clinical notes by natural language processing (NLP) in electronic medical records. Using both codified data and NLP applied to unstructured clinical notes, we first screened pregnant women in Partners HealthCare for Suicidal Behavior. Psychiatrists manually reviewed clinical charts to identify relevant features for Suicidal Behavior and to obtain gold-standard labels. Using the adaptive elastic net, we developed algorithms to classify Suicidal Behavior. We then validated algorithms in an independent validation dataset. From 275,843 women with codes related to pregnancy or delivery, 9331 women screened positive for Suicidal Behavior by either codified data (N = 196) or NLP (N = 9,145). Using expert-curated features, our algorithm achieved an area under the curve of 0.83. By setting a positive predictive value comparable to that of diagnostic codes related to Suicidal Behavior (0.71), we obtained a sensitivity of 0.34, specificity of 0.96, and negative predictive value of 0.83. The algorithm identified 1423 pregnant women with Suicidal Behavior among 9331 women screened positive. Mining unstructured clinical notes using NLP resulted in a 11-fold increase in the number of pregnant women identified with Suicidal Behavior, as compared to solely reliance on diagnostic codes.
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screening pregnant women for Suicidal Behavior in electronic medical records diagnostic codes vs clinical notes processed by natural language processing
BMC Medical Informatics and Decision Making, 2018Co-Authors: Qiuyue Zhong, Jordan W Smoller, Bizu Gelaye, Paul Avillach, Tianxi Cai, Elizabeth W Karlson, Sean Finan, Michelle A WilliamsAbstract:We examined the comparative performance of structured, diagnostic codes vs. natural language processing (NLP) of unstructured text for screening Suicidal Behavior among pregnant women in electronic medical records (EMRs). Women aged 10–64 years with at least one diagnostic code related to pregnancy or delivery (N = 275,843) from Partners HealthCare were included as our “datamart.” Diagnostic codes related to Suicidal Behavior were applied to the datamart to screen women for Suicidal Behavior. Among women without any diagnostic codes related to Suicidal Behavior (n = 273,410), 5880 women were randomly sampled, of whom 1120 had at least one mention of terms related to Suicidal Behavior in clinical notes. NLP was then used to process clinical notes for the 1120 women. Chart reviews were performed for subsamples of women. Using diagnostic codes, 196 pregnant women were screened positive for Suicidal Behavior, among whom 149 (76%) had confirmed Suicidal Behavior by chart review. Using NLP among those without diagnostic codes, 486 pregnant women were screened positive for Suicidal Behavior, among whom 146 (30%) had confirmed Suicidal Behavior by chart review. The use of NLP substantially improves the sensitivity of screening Suicidal Behavior in EMRs. However, the prevalence of confirmed Suicidal Behavior was lower among women who did not have diagnostic codes for Suicidal Behavior but screened positive by NLP. NLP should be used together with diagnostic codes for future EMR-based phenotyping studies for Suicidal Behavior.
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adverse obstetric outcomes during delivery hospitalizations complicated by Suicidal Behavior among us pregnant women
PLOS ONE, 2018Co-Authors: Qiuyue Zhong, Jordan W Smoller, Bizu Gelaye, Paul Avillach, Tianxi Cai, Michelle A WilliamsAbstract:Objective The effects of Suicidal Behavior on obstetric outcomes remain dangerously unquantified. We sought to report on the risk of adverse obstetric outcomes for US women with Suicidal Behavior at the time of delivery. Methods We performed a cross-sectional analysis of delivery hospitalizations from 2007–2012 National (Nationwide) Inpatient Sample. From the same hospitalization record, International Classification of Diseases codes were used to identify Suicidal Behavior and adverse obstetric outcomes. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were obtained using logistic regression. Results Of the 23,507,597 delivery hospitalizations, 2,180 were complicated by Suicidal Behavior. Women with Suicidal Behavior were at a heightened risk for outcomes including antepartum hemorrhage (aOR = 2.34; 95% CI: 1.47–3.74), placental abruption (aOR = 2.07; 95% CI: 1.17–3.66), postpartum hemorrhage (aOR = 2.33; 95% CI: 1.61–3.37), premature delivery (aOR = 3.08; 95% CI: 2.43–3.90), stillbirth (aOR = 10.73; 95% CI: 7.41–15.56), poor fetal growth (aOR = 1.70; 95% CI: 1.10–2.62), and fetal anomalies (aOR = 3.72; 95% CI: 2.57–5.40). No significant association was observed for maternal Suicidal Behavior with cesarean delivery, induction of labor, premature rupture of membranes, excessive fetal growth, and fetal distress. The mean length of stay was longer for women with Suicidal Behavior. Conclusion During delivery hospitalization, women with Suicidal Behavior are at increased risk for many adverse obstetric outcomes, highlighting the importance of screening for and providing appropriate clinical care for women with Suicidal Behavior during pregnancy.
Andrew Stickley - One of the best experts on this subject based on the ideXlab platform.
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childhood neglect and Suicidal Behavior findings from the national comorbidity survey replication
Child Abuse & Neglect, 2020Co-Authors: Andrew Stickley, Yosuke Inoue, Ai Koyanagi, Michiko Ueda, Kyle Waldman, Tomiki Sumiyoshi, Zui Narita, Jordan E DevylderAbstract:Abstract Background Although child neglect is common, there has been comparatively little research on it or its specific forms and their effects on mental health in adulthood. Objective This study aimed to examine the association between exposure to different forms of childhood neglect and lifetime Suicidal Behavior among a nationally representative sample of adults in the U.S. general population. Methods Data were analyzed from 5665 adults that were drawn from the National Comorbidity Survey Replication (NCS-R). Information was obtained on ‘care’, ‘supervisory’ and ‘medical’ neglect in childhood and lifetime Suicidal Behavior (ideation, plan, attempt). Lifetime psychiatric disorders were based on the World Mental Health - Composite International Diagnostic Interview. Logistic regression analysis was used to examine the associations. Results In fully adjusted models, any neglect was associated with significantly increased odds for all forms of Suicidal Behavior (Suicidal ideation, odds ratio [OR]: 1.80, 95 % confidence interval [CI]: 1.42–2.29; plan, OR: 2.27, 95 % CI: 1.78–2.91; attempt, OR: 2.05, 95 % CI: 1.63–2.59, all p Conclusion Different forms of childhood neglect are associated with Suicidal Behavior in adults independent of common mental disorders. Future studies should focus on childhood neglect subtypes in order to better understand the effects of neglect on adult mental health.
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physical multimorbidity and Suicidal Behavior in the general population in the united states
Journal of Affective Disorders, 2020Co-Authors: Andrew Stickley, Yosuke Inoue, Ai Koyanagi, Michiko Ueda, Kyle WaldmanAbstract:Abstract Background As yet, there has been little research on the association between physical multimorbidity (the co-occurrence of two or more physical illnesses) and suicide, and results have been mixed. This study examined if physical multimorbidity is associated with Suicidal Behavior in the general population in the United States. Method Data were analyzed from 15,311 adults that were obtained from the Collaborative Psychiatric Epidemiology Surveys (CPES). Information was obtained on nine self-reported physical health conditions and lifetime Suicidal Behavior (Suicidal ideation, plan, and attempts). Logistic regression analysis was used to examine associations. Results An increasing number of physical health conditions was associated with higher odds for Suicidal Behavior. Compared to those with no physical conditions, individuals with ≥ 4 physical illnesses had 2.99, 4.82, and 4.39 times higher odds for reporting Suicidal ideation, a suicide plan, and suicide attempts, respectively. An interaction analysis showed that for suicide attempts the association was stronger in younger rather than older adults. Limitations The data were cross-sectional and information on physical conditions and Suicidal Behavior was self-reported and may have been subject to reporting bias. Conclusions As multimorbidity has increased in recent decades in the United States, alerting medical practitioners to the increased risk of Suicidal Behavior in adults who have multiple medical conditions as well as screening for Suicidality in this group may be important preventive measures to help reduce Suicidal Behavior in the general population.
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attention deficit hyperactivity disorder symptoms and Suicidal Behavior in adult psychiatric outpatients
Psychiatry and Clinical Neurosciences, 2018Co-Authors: Andrew Stickley, Hisateru Tachimori, Yosuke Inoue, Takahiro Shinkai, Reiji Yoshimura, Jun Nakamura, Gihei Morita, Shigeki Nishii, Yuki Tokutsu, Yuka OtsukaAbstract:AIM: We aimed to examine the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and Suicidal Behavior in psychiatric outpatients and whether this association differs among patients with different psychiatric disorders. METHODS: Cross-sectional data came from the Japan Prevalence Study of Adult ADHD at Psychiatric Outpatient Care, which included psychiatric outpatients aged 18-65 years recruited from one university hospital and three general psychiatric outpatient clinics in Kitakyushu City, Fukuoka, Japan from April 2014 to January 2015 (N = 864). The Adult ADHD Self-Report Scale (ASRS) Screener was used to collect information on ADHD symptoms. Reports of current and lifetime Suicidal Behavior were also obtained. A multivariable Poisson regression analysis was used to examine the association between ADHD symptoms and Suicidal Behavior. RESULTS: After adjusting for covariates there was a strong association between possible ADHD (ASRS ≥14) and Suicidal Behavior with prevalence ratios ranging from 1.17 (lifetime Suicidal ideation) to 1.59 (lifetime suicide attempt) and 2.36 (current Suicidal ideation). When ASRS strata were used, there was a dose-response association between increasing ADHD symptoms and Suicidal ideation and suicide attempts. Analyses of individual ICD-10 psychiatric disorders showed that associations varied across disorders and that for anxiety disorder, ADHD symptoms were significantly linked to all forms of Suicidal Behavior. CONCLUSION: ADHD symptom severity is associated with an increased risk for Suicidal Behavior in general psychiatric outpatients. As ADHD symptoms are common among adult psychiatric outpatients, detecting and treating ADHD in this population may be important for preventing Suicidal Behavior.
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loneliness common mental disorders and Suicidal Behavior findings from a general population survey
Journal of Affective Disorders, 2016Co-Authors: Andrew Stickley, Ai KoyanagiAbstract:Abstract Background Loneliness has been linked to an increased risk of engaging in Suicidal Behavior. To date, however, there has been comparatively little research on this in the general adult population, or on the role of common mental disorders (CMDs) in this association. The current study examined these associations using nationally representative data from England. Methods Data came from the Adult Psychiatric Morbidity Survey 2007. Information was obtained from 7403 household residents aged ≥16 years on perceived loneliness and lifetime and past 12-month suicide ideation and attempts. The Clinical Interview Schedule Revised (CIS-R) was used to assess six forms of CMD. Logistic regression analysis was used to examine these associations. Results Loneliness was associated with Suicidal Behavior. Although adjusting for CMDs attenuated associations, higher levels of loneliness were still significantly associated with Suicidal ideation and suicide attempts with odds ratios (OR) for those in the most severe loneliness category ranging from 3.45 (lifetime suicide attempt) to 17.37 (past 12-month suicide attempt). Further analyses showed that ORs for Suicidal Behavior were similar for individuals who were lonely without CMDs, and for those respondents with CMDs who were not lonely. Lonely individuals with CMDs had especially elevated odds for Suicidal ideation. Limitations This study used cross-sectional data and a single-item measure to obtain information on loneliness. Conclusion Loneliness is associated with Suicidal Behavior in the general adult population. This highlights the importance of efforts to reduce loneliness in order to mitigate its harmful effects on health and well-being.
Ronald C Kessler - One of the best experts on this subject based on the ideXlab platform.
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mental disorders comorbidity and Suicidal Behavior results from the national comorbidity survey replication
Molecular Psychiatry, 2010Co-Authors: Matthew K Nock, Irving Hwang, Nancy A Sampson, Ronald C KesslerAbstract:Mental disorders, comorbidity and Suicidal Behavior: Results from the National Comorbidity Survey Replication
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cross national analysis of the associations between traumatic events and Suicidal Behavior findings from the who world mental health surveys
PLOS ONE, 2010Co-Authors: Dan J Stein, E. Bromet, Ronny Bruffaerts, Irving Hwang, Nancy A Sampson, Ronald C Kessler, Guilherme Borges, Wai Tat Chiu, Giovanni De GirolamoAbstract:Background: Community and clinical data have suggested there is an association between trauma exposure and Suicidal Behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of Suicidal Behavior, the progression from suicide ideation to plans and attempts, or the persistence of each form of Suicidal Behavior over time. Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues. Methodology/Principal Findings: Data on trauma exposure and subsequent first onset of Suicidal Behavior were collected via structured interviews conducted in the households of 102,245 (age 18+) respondents from 21 countries participating in the WHO World Mental Health Surveys. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and subsequent Suicidal Behavior. A range of traumatic events are associated with Suicidal Behavior, with sexual and interpersonal violence consistently showing the strongest effects. There is a dose-response relationship between the number of traumatic events and suicide ideation/attempt; however, there is decay in the strength of the association with more events. Although a range of traumatic events are associated with the onset of suicide ideation, fewer events predict which people with suicide ideation progress to suicide plan and attempt, or the persistence of Suicidal Behavior over time. Associations generally are consistent across high-, middle-, and low-income countries. Conclusions/Significance: This study provides more detailed information than previously available on the relationship between traumatic events and Suicidal Behavior and indicates that this association is fairly consistent across developed and developing countries. These data reinforce the importance of psychological trauma as a major public health problem, and highlight the significance of screening for the presence and accumulation of traumatic exposures as a risk factor for suicide ideation and attempt. Citation: Stein DJ, Chiu WT, Hwang I, Kessler RC, Sampson N, et al. (2010) Cross-National Analysis of the Associations between Traumatic Events and Suicidal
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Suicide and Suicidal Behavior
Epidemiologic reviews, 2008Co-Authors: Matthew K Nock, E. Bromet, Ronald C Kessler, Guilherme Borges, Christine B Cha, S. LeeAbstract:Suicidal Behavior is a leading cause of injury and death worldwide. Information about the epidemiology of such Behavior is important for policy-making and prevention. The authors reviewed government data on suicide and Suicidal Behavior and conducted a systematic review of studies on the epidemiology of suicide published from 1997 to 2007. The authors' aims were to examine the prevalence of, trends in, and risk and protective factors for Suicidal Behavior in the United States and cross-nationally. The data revealed significant cross-national variability in the prevalence of Suicidal Behavior but consistency in age of onset, transition probabilities, and key risk factors. Suicide is more prevalent among men, whereas nonfatal Suicidal Behaviors are more prevalent among women and persons who are young, are unmarried, or have a psychiatric disorder. Despite an increase in the treatment of Suicidal persons over the past decade, incidence rates of Suicidal Behavior have remained largely unchanged. Most epidemiologic research on Suicidal Behavior has focused on patterns and correlates of prevalence. The next generation of studies must examine synergistic effects among modifiable risk and protective factors. New studies must incorporate recent advances in survey methods and clinical assessment. Results should be used in ongoing efforts to decrease the significant loss of life caused by Suicidal Behavior.
