Rising unemployment will lead to a rise in suicide rates

Rising unemployment will lead to a rise in suicide rates across Europe unless preventative action is taken, a study says

The stress triggered by job losses could see suicides rise across Europe if governments fail to take preventative action, a new study claims.

Researchers at the London School of Hygiene and Tropical Medicine in London and the University of Oxford examined economic downturns over the past 30 years and concluded that when unemployment rose by 3%, there was a corresponding increase of 4.5% in the number of suicides among people under 65.

In the study published today in medical journal the Lancet, the authors conclude that people who lose their jobs during a recession are at greater risk of suicide – and that for the least well-educated, the risks are even higher.

However, governments can help by providing social security safety nets, and programmes to help people cope with redundancy and get back to work.

Researcher David Stuckler said that while the study found differences between how countries classified and measured suicide, it was possible to look at how governments could reduce the likelihood of suicide during an economic crisis.

“Governments might be able to protect their populations specifically by budgeting for measures that keep people employed. This is a complex issue but we can see what has happened and hopefully use this to work out what to do about it.”

Joe Ferns, deputy director of the Samaritans, welcomed the report. “People who are unemployed are two to three times more likely to die by suicide than people who have jobs, because unemployment can lead to anxiety, depression, lowered self-esteem and feelings of hopelessness – all of which increase the likelihood that someone will think that life is not worth living,” he said.

Dr David Gunnell, a professor of epidemiology at the university of Bristol, cautioned against over-simplifying the link with unemployment. “Suicides are the tip of a much larger iceberg of emotional distress caused by job loss and economic hardship. It is important to appreciate that the causes of suicide are complex and most people who lose their jobs do not end their lives.”

Filed under: Suicide , recession, Suicide, suicide prevention, suicide rates

7 Year-Old Boy Is Youngest Case Of Suicide Attempt

A new medical report calls for caution following the recent case of a boy who tried to hang himself after watching a hanging depicted in a fictional film. This seems to be the first case of attempted copycat suicide in a child under 10 years old. Exposure to suicidal behaviour in the media has been strongly linked to copycat suicide attempts but never in someone so young. This case warns of the potential danger to young people who are exposed to suicide even when it is fictional, and exposes the previously ignored role of attention deficit and impulsive behavioural traits on suicide.

The case report, published in Cases Journal, describes how a seven year-old Iranian boy was found by his mother, semi-conscious, lying down with a torn band around his neck. It was apparent that the boy had hanged himself after watching a scene in a fictional film in which four soldiers were hanged before being rescued and escaping. The boy was taken to hospital and treated effectively.

There was no history of depression or anxiety in the boy and his medical record was insignificant. The boy’s family history also displayed no suicidal tendencies. However, the boy was diagnosed with attention deficit disorder (“ADHD”) and had a tendency for impulsive behaviour. Although the roles of anxiety and depression in suicide have been well documented, there has been no research into the role of ADHD and impulsivity in such cases, and these should be considered by doctors in future.

Cases Journal publishes case reports from medical professionals from all over the world. As an online journal, it does not have the space constraints of traditional medical journals, and allows the publication of a very broad range of cases. Typically, an important case such as this might never have achieved public exposure due to the high barriers to publication in major journals.

More information about Cases Journal can be found on the website: http://www.casesjournal.com Cases Journal is a peer-reviewed, open access journal. The editor-in-chief is Richard Smith, previously known for his role as editor of the British Medical Journal, and he is supported by an international editorial board. Unlike traditional medical journals, Cases Journal publishes any case report that is understandable, ethical and complete – the perceived interest level, or rarity of the case is not important. The journal’s ethos is that every case is important, just as every patient is important, and we can learn something from every case report.

All case reports published in the journal will be included in the forthcoming Cases Database, which will allow doctors to search all case reports to find those relevant to their practice. As an open access journal, all case reports are free for anyone to download without subscription.

Cases Journal

Filed under: Suicide , ADHD, hanging, Suicide, young people

Suicide: The Risk Factors

Date: 19 Apr 2009 – 0:00 PDT

http://www.medicalnewstoday.com/articles/146507.php

There are many factors which can increase the risk of suicide – including being male, previous self-harm, psychiatric and/or drug/alcohol disorders, upbringing, exposure to suicide in the media, and smoking. Among employed people, doctors (particularly women), vets, nurses, dentists and farmers are all at increased risk – because they have easy access to drugs or poisons which can be used for suicide. In a Seminar in this week’s edition of The Lancet, Professor Keith Hawton, Centre for Suicide Research, University of Oxford, UK, and Professor Kees van Heeringen, Unit for Suicide Research, University Hospital, Gent, Belgium, discuss these trends. An estimated one million people die from suicide each year, equating to one every 40 seconds – but suspected under-reporting in many countries means this is probably a big under-estimate. Suicide accounts for 1.5% of deaths worldwide and is the tenth leading cause of death. Within Europe, rates are generally higher in northern countries than in southern countries. An effect of latitude on suicide rates was found in Japan, suggesting an influence of the daily amounts of sunshine on suicide. However, countries at about the same latitude, such as the UK and Hungary, can have substantially different rates of suicide. Suicide is a major concern in former Soviet states. More than 30% of suicides worldwide happen in China, where 3.6% of all deaths are by suicide. In developed countries, the male-to-female ratio for suicide is between two and four to one, and this seems to be increasing. Asian countries typically show much lower male-to-female ratios, but these might also be increasing; although in China more women than men die by suicide. Suicide rates are highest in elderly people in most countries, but in the past 50 years rates have risen in young people, particularly men. Suicide rates peak in Spring, especially among men. People born in spring or early summer, particularly women, are at increased risk of suicide. European Americans have higher suicide rates than Hispanic or African Americans, though this gap is narrowing due to increased suicides in young black people. Indigenous populations, eg, Aboriginies in Australia and Native Americans, have higher suicide rates, possibly due to cultural/societal marginalisation and higher levels of alcohol abuse. Suicide rates are, not surprisingly, higher in unemployed than employed people – in part, high rates are associated with mental illness, which is also associated with unemployment. Among people in employment, some occupational groups are at increased risk of suicide. Medical practitioners have a high risk in most countries, but female doctors are generally most at risk. Nurses also have a high risk. In both these professional groups, access to poisons seems to be an important factor in determining the high rates. Among doctors, anaesthetists are particularly at risk, with anaesthetic drugs being used in many suicide deaths. Several other high-risk occupational groups (eg, dentists, pharmacists, veterinary surgeons, and farmers) also have easy access to means for suicide. In general, men tend to choose more violent means for suicide (eg, hanging or shooting) and women less violent methods (eg, self-poisoning). Different populations use differing suicide methods, eg, women in South Asia commonly set fire to themselves to commit suicide. Access to specific methods might be the factor that leads to translation of suicidal thoughts into action. In the USA, firearms are used in most suicides, with risk of their use being highest where guns are kept in households. In rural areas of many developing countries, ingestion of pesticides is the main method of suicide, reflecting toxicity, easy availability, and poor storage. As many as 30% of global suicide deaths may involve ingestion of pesticides. Mental health problems are a major factor in suicide. Some 90% of people who take their own life are believed to have some kind of psychiatric disorder. Depression increases the risk of suicide by 15 to 20 times, and about 4% of people with depression die by suicide. Clinical predictors of suicide in depressed people include previous self-harm, hopelessness, and suicidal tendencies. Around 10-15% of patients with bi-polar disorder die by suicide, with risk at its highest during the early part of the illness. Some 5% of people with schizophrenia also die by suicide. Alcohol misuse, anorexia nervosa, attention deficit hyperactivity disorder, and body dismorphic disorder all increase suicide risk – wit the last example partly explaining why risk increases in women after breast enlargement surgery. Physical health also plays its part, but with some strange findings. Surprisingly, while people with higher-body mass index are at increased risk of depression, they have a lower risk of suicide (15% decrease in suicide risk for each 5 kg / m2 increase in body-mass index). The reasons for this are unknown. Cancer, particularly of the head and neck, HIV/AIDS, multiple sclerosis, epilepsy, and a range of other conditions also increase suicide risk. Other factors that can increase suicide risk include physical and sexual abuse throughout childhood, population-wide events such as natural disasters and deaths of celebrities. Suicide rates rose by 17%* following the death of Diana, Princess of Wales in 1997, with the increase being more pronounced in women in her age group. War decreases suicide risk, perhaps due to the social cohesion it can create in communities. People bereaved by suicide are themselves at increased risk, and clusters of suicides can happen in communities or through internet contact. The authors add: “A substantial body of evidence indicates that certain types of media reporting and portrayal of suicidal behaviour can influence suicide and self-harm in the general population.” Post-mortems of suicide deaths have shown changes to the central neurotransmission functions, for example to the serotonin (mood-improving hormone) system. Low cholesterol concentrations are associated with increased suicide risk, but the risk is higher when low cholesterol has been achieved through diet rather than statins. The authors speculate this could be because people who diet are more at risk of mental health problems, but say there is little evidence to back this. Family history of suicide at least doubles the risk of suicide for girls and women. Suicide occurs in tandem more in identical twins compared with non-identical twins. While evidence is limited, high levels of lifetime aggression are associated with a high risk of suicide, while impulsivity also increases the risk. Suicide rates rise throughout teenage years, especially in boys, and family ‘transmission’ of suicide risk occurs, especially on the maternal side. Prevention of suicide is a difficult concept due to high number of factors involved, but strategies can target high risk groups or aim to reduce the risk to the population as a whole. Each person with depression should be screened for suicide risk by specifically asking about suicidal thoughts and plans. The authors say: “In cases of high or imminent suicide risk, immediate action is needed, including vigilance and supervision of patients, perhaps through hospitalisation, removal of potential methods of suicide, and initiation of vigorous treatment of associated psychiatric disorder.” They also discuss a recent meta-analysis of randomised trials which suggested that the risk of death and suicide in people with mood disorders was reduced by 60% in those taking lithium. Removal of means used for suicide is important in management of individuals, and modification of general access to dangerous means can also be effective in suicide prevention at the population level. The authors say: “One striking example of the effect of availability of a common means of suicide was the large reduction in suicides following the change of the UK gas supply from toxic coal gas, the most common method used for suicide during the early 1960s, to non-toxic North Sea gas.” Introduction of safety barriers on bridges and increased gun control can also decrease the risk of suicide, as can safer storage of pesticides and poisons, especially in rural areas of developing nations. School programmes to improve mental wellbeing, and more stringent control of media reporting of suicide could also have a preventive effect. The authors conclude: “Future research must focus on the development and assessment of empirically based suicide-prevention and treatment protocols. The challenges of preventing suicide in developing countries need particular attention, because most research comes from developed countries, but most deaths by suicides happen in developing countries. “Suicide” Prof Keith Hawton DSc, Prof Kees van Heeringen PhD The Lancet, Volume 373, Issue 9672, Pages 1372 – 1381, 18 April 2009 Source The Lancet

Filed under: Other Mental Health, Suicide , risk factors, statistics, Suicide

What’s it like to be a young person with mental health issues?

Three teenagers who have found it hard to forge their sense of identity as young people with mental health issues
guardian.co.uk, Wednesday 15 April 2009 00.05 BST

Rachel Haddon, 21, Preston, Lancashire

Who am I? A 21-year-old female? Student? Mental illness and eating disorder sufferer? Self-harmer? Vegetarian? Or an animal lover? I am all of these things, yet none of these things. I am just me. If diagnoses were put on the end of your surname, like qualifications, I would look rather qualified! But these labels don’t aid and benefit me like qualifications would. It is time professionals stopped treating people as disordered statistics, and instead saw us as people. Ordinary humans, who just happen to have problems. After all, everyone has problems, don’t they? Perhaps our problems just affect us a little more than normal. But what is normal? The only normal I know is the setting on a dishwasher. Over the years I have met many so-called “professionals” – doctors, nurses, social workers and psychiatrists who apparently excel in their field. But most have actually made me feel worse. I don’t doubt that on the majority of occasions their intentions have been good, but instead of helping me, they have just diagnosed, medicated and hospitalised me. Of course, that is often necessary and beneficial, but the most important and helpful “treatment” is to be listened to, and believed. Sadly, many professionals seemingly fail to do this. The attitude of these professionals and the general public is obviously influenced by the media to some extent. It’s not rare to see a headline such as “Prisoner with personality disorder attacks staff”. Is it any wonder that the majority of people think having a personality disorder indicates that you are a dangerous, reckless, violent criminal? Some could argue for freedom of speech, but for those like me who happen to be diagnosed with a personality disorder (regardless of my opinions on the use of this “label”), such statements and in­accurate beliefs only add to our problems. The hope of recovery sometimes seems impossible in a world that functions on stereotypes and stigma.

Saad Butt, 21, London

It has been six years since my father died of a heart attack. Being the eldest, I looked after my mum and my younger brother and sister, as well as myself. I was 15. My GCSEs were a pressurised time and things weren’t easy. I had to grow up fast. My father and I didn’t always have the best of times. Why was it that we were so close and yet so distant? Why is it we wait so long to tell those close to us the way we feel about them? To lose someone close and still live and breathe each day was a big struggle. I had attacks of depression, identity crises and suicidal thoughts. There didn’t seem to be anyone who could help and it didn’t feel like counselling services were available either. But I kept on going, suffering in silence, living in the hope that one day things would be better. Before my dad died, I was involved in my community with the local youth parliament. That kept me going, but when I found a mentor through my community work to talk things through with, things started to change. At 18, I found in him the dad I never had. He became my guardian, had a deep-rooted concern for me, and took an interest in my studies and my extracurricular life. My emotions started to become a positive driver in my life. I love him more than anything in the world. Now I never take anything for granted; I’ve become more focused, more concentrated on what I want in life. My relationship with my mother has become closer. I’m studying for a law degree and I’m still involved with local youth issues – for example, as a member of the British Transport Police youth board. I’m getting married in the summer and looking forward to that and the new life that comes with it. I’ve also learned that it’s important to get help and talk to someone you trust. Above all, have faith, stay positive and cool about life, and go with the flow – it isn’t always as bad as it may look.
Celeste Ingrams, 24, Southampton

The most difficult thing is how people have reacted to my mental health problems. It made me think I was dangerous due to what was going on inside my head. This perception became almost a sense of identity that made me feel secure and reaffirmed my belief that I was “crazy” and uncontrollable. It took me a long time to realise that my “craziness” was my mind coping with the emotions that were reactions to me feeling unsafe and anxious. It is hard to admit vulnerable emotions and this denial came out in my behaviour, which I’m not proud of, but I couldn’t communicate my feelings in any other way. I often kicked against everything, which was self-destructive and led to people being hurt. Although I feel guilty about this, if I’d not gone through this process then I wouldn’t have been able to learn from my mistakes. How I manage is I don’t get too caught up in what’s wrong with me or how others make sense of what I do, but I stay in touch with my emotions. I use coping skills to steady myself, and prevent things getting out of control, often by spending my time expressing myself in more creative ways with art and writing. My experience of living in institutions – NHS or local authority psychiatric units, or residential therapeutic communities – was about feeling controlled and not supported. I think this affected my ability to believe or trust in myself. I try now not to feel caged by stigmas and stereotypes. I know it can be extremely difficult to do this in our society.

• Rachel, Saad and Celeste are all members of mental health charity YoungMinds

Filed under: Other Mental Health, Suicide, self-harm , mental health, Young Minds, young people

Working to understand men’s mental health

More can be done to help men in this little studied area of wellbeing

Men’s mental health is a particularly salient issue in these troubled times. Worldwide, more than one million people kill themselves each year. In the UK, men are four times more likely than women to kill themselves and there have been over 6,500 male suicides in the past six years.

Incidence data from the last century show suicide rates have peaked during past economic recessions. Gay men are two to three times more likely to have a mental health problem and 4.3 times more likely to attempt suicide than straight men, and have around double the rate of depression and anxiety. 94% of young offenders are male and 80-90% have mental health problems.

Furthermore, while the rate of deliberate self-harm is higher in females (associated with problems in interpersonal relationships), it is four times more likely to lead to suicide in males, and is associated with alcohol, employment, financial and housing difficulties. One question is, will we see an escalation of distress and suicide in males during the current economic downturn?

Men’s mental health is a dramatically understudied and poorly understood area of human wellbeing. Men are half as likely as women to be diagnosed with depression, yet twice as likely to abuse alcohol and drugs.

What’s going on here? One compelling possibility is that what society teaches men about what it means to be a man leads us to express our pain in ways that differ from women. Among the more striking differences is that men are more likely to keep their problems to themselves. We frequently suffer in silence, and sometimes with dire consequences. Our research at Clark University in the US has shown that men who are more likely to value self-reliance and stoicism are more likely to have significant symptoms of depression; they are also more likely to report feeling ashamed of being depressed, and more likely to keep the problem to themselves.

Factors that may lead to mental wellbeing or ill-health are multiple and have complex interrelationships. Comparatively little is understood about how these manifest in men differently to women. There is lack of public knowledge about mental health problems generally. During their lifetime, 25% of the population will experience a mental health difficulty. However, when asked, half of company bosses estimated levels at 0% in their workforce.

Stigma is associated with mental health problems and their perceived effect on employment. In western cultures, boys are taught that it is better to express emotions such as anger than fear or pain and there are cultural sanctions for those who deviate from this. Depression and anxiety may get expressed as anger. Men are socialised to fix problems. As one service user put it “men deal with it – I’m not dealing with it, therefore I’m not a man”. No wonder men may have a tendency to play down their problems, overestimate their ability to deal with them and have a reluctance to seek help. Nor is it surprising that it is commonly hard for those around them to spot the symptoms.

So, what can be done? Men and women need educating in what symptoms to look out for in themselves and others. Signs may include inability to concentrate; being unable to engage with people; a change in appetite; feelings of worthlessness or hopelessness; change in sleeping patterns; and increase in use of alcohol or drugs.

Some men have faulty perceptions about, and place low value on, therapy. As a society, we need to associate help-seeking with strength and courage. Media campaigns in the UK, such as Time to Change, aim to start addressing this. The effects of redundancy on men and women need consideration and employers need educating. At Clark University there are plans to establish the first centre devoted to the study of men’s mental health.

Half of people experiencing depression, after a relatively short course of therapy, go on to make a full and lasting recovery. However, sitting and talking about problems is not what many men are comfortable doing. Therapists need to develop more effective methods of engaging them.

The national strategy, Increasing Access to Psychological Therapies (IAPT), is aimed at identifying and treating anxiety and depression more effectively in the general population. Early statistics show lower take-up of this service among men. While research indicates that higher numbers of women experience mental health difficulties than men, it is unclear whether this is because it is a hidden problem and self-referral to the new IAPT services might help. Linking commissioning of educatio n, social care and health care services may lead to men’s needs being more comprehensively addressed in future.

• Michael Addis is professor of psychology at Clark University, Massachusetts

Filed under: Other Mental Health, Suicide, self-harm

Prozac, used by 40m people, does not work say scientists

I am posting this because on a recent course on responding to suicidal behaviour, I suggested that fluoxetine (Prozac), paroxetine (Seroxat), venlafaxine (Effexor) and nefazodone (Serzone) were far less effective than previously thought. One participant asked about the evidence, so here it is. happy reading! Iain Bourne

Analysis of unseen trials and other data concludes it is no better than placebo

Prozac, the bestselling antidepressant taken by 40 million people worldwide, does not work and nor do similar drugs in the same class, according to a major review released today.

The study examined all available data on the drugs, including results from clinical trials that the manufacturers chose not to publish at the time. The trials compared the effect on patients taking the drugs with those given a placebo or sugar pill.

When all the data was pulled together, it appeared that patients had improved – but those on placebo improved just as much as those on the drugs.

The only exception is in the most severely depressed patients, according to the authors – Prof Irving Kirsch from the department of psychology at Hull University and colleagues in the US and Canada. But that is probably because the placebo stopped working so well, they say, rather than the drugs having worked better.

“Given these results, there seems little reason to prescribe antidepressant medication to any but the most severely depressed patients, unless alternative treatments have failed,” says Kirsch. “This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported.”

The paper, published today in the journal PLoS (Public Library of Science) Medicine, is likely to have a significant impact on the prescribing of the drugs. The National Institute for Health and Clinical Excellence (Nice) already recommends that counselling should be tried before doctors prescribe antidepressants. Kirsch, who was one of the consultants for the guidelines, says the new analysis “would suggest that the prescription of antidepressant medications might be restricted even more”.

The review breaks new ground because Kirsch and his colleagues have obtained for the first time what they believe is a full set of trial data for four antidepressants.

They requested the full data under freedom of information rules from the Food and Drug Administration, which licenses medicines in the US and requires all data when it makes a decision.

The pattern they saw from the trial results of fluoxetine (Prozac), paroxetine (Seroxat), venlafaxine (Effexor) and nefazodone (Serzone) was consistent. “Using complete data sets (including unpublished data) and a substantially larger data set of this type than has been previously reported, we find the overall effect of new-generation antidepressant medication is below recommended criteria for clinical significance,” they write.

Two more frequently prescribed antidepressants were omitted from the study because scientists were unable to obtain all the data.

Concerns have been raised in recent years about the side-effects of this class of antidepressant. Evidence that they could prompt some young people to consider suicide led to a warning to doctors not to prescribe them for the under-18s – with the exception of Prozac, which was considered more effective than the rest.

In adults, however, the depression-beating benefits were thought to outweigh the risks. Since its launch in the US in 1988, some 40 million people have taken Prozac, earning tens of billions of dollars for the manufacturer, Eli Lilly. Although the patent lapsed in 2001, fluoxetine continues to make the company money – it is now the active ingredient in Sarafem, a pill sold by Lilly for premenstrual syndrome.

Eli Lilly was defiant last night. “Extensive scientific and medical experience has demonstrated that fluoxetine is an effective antidepressant,” it said in a statement. “Since its discovery in 1972, fluoxetine has become one of the world’s most-studied medicines. Lilly is proud of the difference fluoxetine has made to millions of people living with depression.”

A spokesman for GlaxoSmithKline, which makes Seroxat, said the authors had failed to acknowledge the “very positive” benefits of the treatment and their conclusions were “at odds with what has been seen in actual clinical practice”.

He added: “This analysis has only examined a small subset of the total data available while regulatory bodies around the world have conducted extensive reviews and evaluations of all the data available, and this one study should not be used to cause unnecessary alarm and concern for patients.”

Filed under: Impact Training, Other Mental Health, Suicide, psychosis , anti-depressants, fluxetine, prozac

Study Links Increased Risk Of Suicidal Behaviour In Adults To Sleep Problems

Article Date: 01 Apr 2009 – 6:00 PDT

Adults who suffer chronic sleep problems may face an increased risk of suicidal behaviour, new research indicates.

In a study to be presented on April 1, 2009 at the World Psychiatric Association international congress “Treatments in Psychiatry,” scientists found that the more types of sleep disturbances people had, the more likely they were to have thoughts of killing themselves, engage in planning a suicidal act or make a suicide attempt.

“People with two or more sleep symptoms were 2.6 times more likely to report a suicide attempt than those without any insomnia complaints,” said the study’s leader, Dr. Marcin Wojnar, a research fellow at the Department of Psychiatry at the University of Michigan in the United States and Associate Professor of Psychiatry at the Department of Psychiatry at the Medical University of Warsaw in Poland.

The World Health Organization estimates that about 877,000 people worldwide die by suicide every year. The UN health agency says surveys indicate that for every death by suicide, anywhere from 10-40 suicide attempts are made.

“Identifying those at high risk of suicide is important for preventing it and these findings indicate that insomnia may be a modifiable risk factor for suicide in the general population,” Wojnar said. “This has implications for public health as the presence of sleep problems should alert doctors to assess such patients for a heightened risk of suicide even if they don’t have a psychiatric condition. Our findings also raise the possibility that addressing sleep problems could reduce the risk of suicidal behaviours.”

Scientists have consistently linked sleep disturbances to an increased risk of suicidal behaviour in people with psychiatric disorders and in adolescents, but it has been unclear whether the association also exists in the general adult population.

In the study, the broadest and most rigorously conducted of its kind, scientists examined the relationship over one year between three characteristics of insomnia (difficulty falling asleep, difficulty staying asleep and waking at least two hours earlier than desired) and three suicidal behaviours (suicidal thoughts, planning and attempts) in 5,692 Americans. About 35 percent of those studied reported experiencing at least one type of sleep disturbance in the preceding 12 months.

The most consistent link was seen for early morning awakening, which was related to all suicidal behaviours. People with this problem were twice as likely as those with no sleep problems to have had suicidal thoughts in the preceding 12 months, 2.1 times more likely to have planned suicide and 2.7 times more likely to have tried to kill themselves.

Difficulty falling asleep was a significant predictor of suicidal thoughts and planning. Compared with people who reported no sleep problems, those who had trouble initiating sleep had 1.9 times the risk of suicidal ideas and 2.2 times the risk of planning suicide.

People who had trouble sleeping through the night – waking up nearly every night and taking an hour or more to get back to sleep were twice as likely to have thought of suicide in the last year and were three times more likely to have attempted it than those who had no sleep problems.

The results were adjusted for several factors known to influence suicide, including substance abuse, depression, anxiety disorder and other mood disorders, as well as chronic medical conditions such as stroke, heart disease, lung disease and cancer. They were also adjusted for the influence of sociodemographic factors such as age, gender, and marital and financial status.

How sleep disturbance might increase the risk of suicide is still poorly understood, Wojnar said. Scientists have proposed that insufficient sleep may affect cognitive function and lead to poorer judgement, less impulse control and increased hopelessness. A dysfunction involving serotonin a brain chemical involved in mood regulation that plays an important role in sleep, psychiatric disorders and suicide is also suspected.

Further research is needed to determine whether other sleep problems, such as sleep apnoea (interrupted breathing during sleep) and non-restorative sleep, where people feel unrefreshed after an adequate amount of sleep, are also associated with suicidal behaviour, Wojnar added.

The study was funded by the US Department of Veterans Affairs, the US National Institute on Drug Abuse, the US National Institute on Alcohol Abuse and Alcoholism and the US National Institute of Mental Health.

World Psychiatric Association
http://www.wpanet.org

Filed under: Suicide , insomnia, serotonin, sleep, Suicide

Rise in suicidal children calling ChildLine

By Charlotte Goddard Children & Young People Now 23 March 2009 The number of suicidal children counselled by ChildLine has tripled in the last five years. The NSPCC said today that nearly 60 suicidal children a week call the helpline, with one in 14 in immediate danger or needing urgent medical care. Some made suicide attempts while on the phone to a counsellor. Of those children who gave their age, more than half were 12- to 15-year-olds and one in 16 was 11 or under. Sue Minto, head of ChildLine, said: “Children feel suicidal for complex and different reasons, but often say they have a history of abuse, neglect, family problems or mental health issues. Others have been driven to the brink by bullying, their parents’ divorce, the death of someone close or exam stress.” The charity is calling for parents to be given guidance on how to spot possible signs of suicide, how to listen to their child’s worries and where to find help. It also wants teachers and doctors to be trained to identify suicide distress signs before children reach crisis point.

Filed under: Other Mental Health, Suicide

Depressed People Have Trouble Learning ‘Good Things In Life

ScienceDaily (Mar. 19, 2009) — While depression is often linked to negative thoughts and emotions, a new study suggests the real problem may be a failure to appreciate positive experiences.

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Researchers at Ohio State University found that depressed and non-depressed people were about equal in their ability to learn negative information that was presented to them.

But depressed people weren’t nearly as successful at learning positive information as were their non-depressed counterparts.

“Since depression is characterized by negative thinking, it is easy to assume that depressed people learn the negative lessons of life better than non-depressed people – but that’s not true,” said Laren Conklin, co-author of the study and a graduate student in psychology at Ohio State.

The study appears in the March issue of the Journal of Behavior Therapy and Experimental Psychiatry.

Researchers tested 34 college students, 17 of whom met criteria for clinical depression and 17 of whom were not depressed.

This study is one of the first to be able to link clinical levels of depression to how people form attitudes when they encounter new events or information, said Daniel Strunk, co-author of the study and assistant professor of psychology at Ohio State.

Strunk said the key to conducting this study was the use of a computer game paradigm co-developed at Ohio State in 2004 by Russell Fazio, a professor of psychology and co-author of this new study.  Fazio and his collaborators, Natalie Shook, a PhD graduate of Ohio State now at Virginia Commonwealth University and J. Richard Eiser of the University of Sheffield (England) have used the game in many studies examining differences in the development of positive and negative attitudes.

The developers affectionately call the game “BeanFest.”  It involves people encountering images of beans on the computer screen.  The beans could be good or bad, depending on their shape and the number of speckles they had.

Good beans earned the players points, while bad beans took points away.  The goal was to earn as many points as possible.

While the game may seem trivial to a naive audience, Strunk said it offers a unique and powerful way to measure how people learn new attitudes.

“Before, if researchers wanted to investigate how people formed new attitudes, it was very difficult to do,” Strunk said.  If researchers asked about real-life issues, the problem is that prior learning and attitudes may impact how people respond to new information.  But in this game, participants don’t have any prior knowledge or attitudes about the beans so researchers could learn how they formed their attitudes in a novel situation, without interference from past experiences.

In the game phase of this study, participants had to choose whether they would accept a bean when it appeared on the screen.  If they accepted the bean, the points were added or deducted from their total.  If they rejected the bean, they were still told how many points they would have earned or lost if they had accepted it.

Each of the 34 beans was shown three times during the game phase, giving the participants a good opportunity to learn which beans were good and which were bad.

Then, in the test phase, participants had to indicate whether beans they learned about in the game phase were “good” (choosing it would increase points) or “bad” (choosing it would decrease points).  The researchers tallied how well participants did in correctly identifying positive and negative beans.

The non-depressed students correctly identified 61 percent of the negative beans, which was about the same as the depressed students, who correctly identified 66 percent of the “bad” beans.

But while the non-depressed students correctly identified 60 percent of the positive beans, depressed students correctly classified only 49 percent of these good beans.  Non-depressed students identified the good beans better than the depressed students, who failed to identify good beans better than chance.

“The depressed people showed a bias against learning positive information although they had no trouble learning the negative,” Strunk said.

One of measures researchers used in the study classified whether the depressed participants were currently undergoing a mild, moderate or severe episode of depression.  In the study, those undergoing a severe depressive episode did more poorly on correctly choosing positive beans than those with mild depression, further strengthening the results.

While more research is needed, Conklin and Strunk said this study suggests possible ways to improve treatment of depressed people.

“Depressed people may have a tendency to remember the negative experiences in a situation, but not remember the good things that happened,” Conklin said. “Therapists need to be aware of that.”

For example, a depressed person who is trying out a new exercise program may mention how it makes him feel sore and tired – but not consider the weight he has lost as a result of the exercise.

“Therapists might focus more on helping their depressed clients recognize and remember the positive aspects of their new experiences,” Strunk said.

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Adapted from materials provided by Ohio State University.

Filed under: Other Mental Health, Suicide , depression, information processing, positive thinking

Reducing Suicidal Behaviors Among Adolescents

ScienceDaily (Mar. 15, 2009) — Adolescent girls who view themselves as too fat may display more suicidal behaviors than those who are actually overweight, according to a study by Inas Rashad, an assistant professor of economics at Georgia State University.

Although studies have shown a link between obesity, depressive disorders and suicidal behaviors, Rashad and Dhaval Dave of Bentley University, analyze these indicators in conjunction with an individual’s perception of their weight. The study, which was accepted for publication in February, will be published in Social Science and Medicine.

“Both obesity and suicide have been highlighted by the Surgeon General as areas of focus for adolescents and areas of great concern,” Rashad said. “We find that the role perception has independently of actual overweight status is an important one, which has implications in terms of any solutions to the obesity epidemic that are put forth.”

The researchers utilized data from 1999 to 2007 from the Youth Risk Behavioral Surveillance System, which indicated that 17 percent of high school students have seriously considered committing suicide. The data were used to not only investigate whether overweight status or perception are causal factors affecting suicidal thoughts and attempts among high school students, but also to estimate the potential economic costs.

“If being overweight not only imposes the usual health care and labor market costs, but also increases the risk of suicide, we need to take these costs into account when offering solutions,” Rashad said.

The study revealed that body dissatisfaction had a strong impact on all suicidal behaviors for girls and was generally insignificant for males. For instance, any perception of being overweight by girls raised the probability of suicidal thoughts by 5.6 percent, the probability of a suicide attempts by 3.2 percent, and the probability of an injury causing suicide attempts by 0.6 percent. The researchers also state that the risk of suicide by adolescent females could potentially add about $280 to $350 million to the costs of adolescent obesity, which includes the direct cost of illnesses and associated health care and indirect costs such as productivity losses, reduced income and premature mortality.

Rashad hopes more research will be done on the topic, but she recommends efforts aimed at preventing youth suicides focus on educating youths and fostering healthy attitudes with regard to weight.

“The prevalence of body dissatisfaction, among special populations of youths such as non-black girls, is significantly higher than the general youth population, even when the underlying weight is in a healthy range,” Rashad said. “Interventions that identify and assist these youths and educate them regarding a healthy body image will succeed in lowering suicide attempts.”
Adapted from materials provided by Georgia State University, via EurekAlert!, a service of AAAS.

Filed under: Suicide , depression, obesity, Suicide, suicide prevention, young people