Browsing by Author "Beautrais, Annette"

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Chronic Physical Conditions and Their Association With First Onset of Suicidal Behavior in the World Mental Health Surveys
(LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA, 2010) Scott, Kate M.; Hwang, Irving; Chiu, Wai-Tat; Kessler, Ronald C.; Sampson, Nancy A.; Angermeyer, Matthias; Beautrais, Annette; Borges, Guilherme; Bruffaerts, Ronny; De Graaf, Ron; Florescu, Silvia; Fukao, Akira; Haro, Josep Maria; Hu, Chiyi; Kovess, Viviane; Levinson, Daphna; Posada-Villa, José; Scocco, Paolo; Nock, Matthew K.; Univ Otago, Dept Psychol Med, Sch Med & Hlth Sci, Wellington, New Zealand; kate.scott@otago.ac.nz
Objective: To investigate the association of a range of temporally prior physical conditions with the subsequent first onset of suicidal ideation, plans, and attempts in large, general population, cross-national sample. The associations between physical conditions and suicidal behavior remain unclear due to sparse data and varied methodology. Methods: Predictive associations between 13 temporally prior physical conditions and first onset of suicidal ideation, plans, and attempts were examined in a 14-country sample (n = 37,915) after controlling for demographic, socioeconomic, and psychosocial covariates, with and without adjustment for mental disorders. Results: Most physical conditions were associated with suicidal ideation in the total sample; high blood pressure, heart attack/stroke, arthritis, chronic headache, other chronic pain, and respiratory conditions were associated with attempts in the total sample; epilepsy, cancer, and heart attack/stroke were associated with planned attempts. Epilepsy was the physical condition most strongly associated with the suicidal outcomes. Physical conditions were especially predictive of suicidality if they occurred early in life. As the number of physical conditions increased, the risk of suicidal outcomes also increased, however the added risk conferred was generally smaller with each additional condition. Adjustment for mental disorders made little substantive difference to these results. Physical conditions were equally predictive of suicidality in higher and lower income countries. Conclusions: The presence of physical conditions is a risk factor for suicidal behavior even in the absence of mental disorder.
Cross-National Analysis of the Associations among Mental Disorders and Suicidal Behavior: Findings from the WHO World Mental Health Surveys
(PUBLIC LIBRARY SCIENCE, 185 BERRY ST, STE 1300, SAN FRANCISCO, CA 94107 USA, 2009) Nock, Matthew K.; Hwang, Irving; Sampson, Nancy; Kessler, Ronald C.; Angermeyer, Matthias; Beautrais, Annette; Borges, Guilherme; Bromet, Evelyn; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hu, Chiyi; Huang, Yueqin; Karam, Elie G.; Kawakami, Norito; Kovess, Viviane; Levinson, Daphna; Posada-Villa, José; Sagar, Rajesh; Tomov, Toma; Viana, María Carmen; Williams, David R.; Harvard Univ, Dept Psychol, Cambridge, MA 02138 USA; nock@wjh.harvard.edu
Background: Suicide is a leading cause of death worldwide. Mental disorders are among the strongest predictors of suicide; however, little is known about which disorders are uniquely predictive of suicidal behavior, the extent to which disorders predict suicide attempts beyond their association with suicidal thoughts, and whether these associations are similar across developed and developing countries. This study was designed to test each of these questions with a focus on nonfatal suicide attempts. Methods and Findings: Data on the lifetime presence and age-of-onset of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) mental disorders and nonfatal suicidal behaviors were collected via structured face-to-face interviews with 108,664 respondents from 21 countries participating in the WHO World Mental Health Surveys. The results show that each lifetime disorder examined significantly predicts the subsequent first onset of suicide attempt (odds ratios [ORs] = 2.9-8.9). After controlling for comorbidity, these associations decreased substantially (ORs = 1.5-5.6) but remained significant in most cases. Overall, mental disorders were equally predictive in developed and developing countries, with a key difference being that the strongest predictors of suicide attempts in developed countries were mood disorders, whereas in developing countries impulse-control, substance use, and post-traumatic stress disorders were most predictive. Disaggregation of the associations between mental disorders and nonfatal suicide attempts showed that these associations are largely due to disorders predicting the onset of suicidal thoughts rather than predicting progression from thoughts to attempts. In the few instances where mental disorders predicted the transition from suicidal thoughts to attempts, the significant disorders are characterized by anxiety and poor impulse-control. The limitations of this study include the use of retrospective self-reports of lifetime occurrence and age-of-onset of mental disorders and suicidal behaviors, as well as the narrow focus on mental disorders as predictors of nonfatal suicidal behaviors, each of which must be addressed in future studies. Conclusions: This study found that a wide range of mental disorders increased the odds of experiencing suicide ideation. However, after controlling for psychiatric comorbidity, only disorders characterized by anxiety and poor impulse-control predict which people with suicide ideation act on such thoughts. These findings provide a more fine-grained understanding of the associations between mental disorders and subsequent suicidal behavior than previously available and indicate that mental disorders predict suicidal behaviors similarly in both developed and developing countries. Future research is needed to delineate the mechanisms through which people come to think about suicide and subsequently progress from ideation to attempts.
Cross-national prevalence and risk factors for suicidal ideation, plans and attempts
(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2008) Nock, Matthew K.; Borges, Guilherme; Bromet, Evelyn J.; Alonso, Jordi; Angermeyer, Matthias; Beautrais, Annette; Bruffaerts, Ronny; Chiu, Wai Tat; De Girolamo, Giovanni; Gluzman, Semyon; De Graaf, Ron; Gureje, Oye; Haro, Josep Maria; Huang, Yueqin; Karam, Elie; Kessler, Ronald C.; Lepine, Jean Pierre; Levinson, Daphna; Medina-Mora, María Elena; Ono, Yutaka; Posada-Villa, José; Williams, David; Harvard Univ, Dept Psychol, Cambridge, MA 02138 USA; nock@wjh.harvard.edu
Background: Suicide is a leading cause of death worldwide; however, the prevalence and risk factors for the immediate precursors to suicide - suicidal ideation, plans and attempts - are not well-known, especially in low- and middle-income countries. Aims: To report on the prevalence and risk factors for suicidal behaviours across 17 countries. Method: A total of 84850 adults were interviewed regarding suicidal behaviours and socio-demographic and psychiatric risk factors. Results: The cross-national lifetime prevalence of suicidal ideation, plans, and attempts is 9.2% (s.e.=0.1), 3.1% (s.e.=0.1), and 2.7% (s.e.=0.1). Across all countries, 60% of transitions from ideation to plan and attempt occur within the first year after ideation onset. Consistent cross-national risk factors included being female, younger, less educated, unmarried and having a mental disorder. interestingly, the strongest diagnostic risk factors were mood disorders in high-income countries but impulse control disorders in low- and middle-income countries. Conclusion: There is cross-national variability in the prevalence of suicidal behaviours, but strong consistency in the characteristics and risk factors for these behaviours. These findings have significant implications for the prediction and prevention of suicidal behaviours. Declaration of interests: None. Funding detailed in Acknowledgements.
Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys
(PHYSICIANS POSTGRADUATE PRESS, P O BOX 752870, MEMPHIS, TN 38175-2870 USA, 2010) Borges, Guilherme; Nock, Matthew K.; Haro Abad, Josep M.; Hwang, Irving; Sampson, Nancy A.; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Beautrais, Annette; Bromet, Evelyn; Bruffaerts, Ronny; De Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Karam, Elie G.; Kovess-Masfety, Viviane; Lee, Sing; Levinson, Daphna; Medina-Mora, María Elena; Ormel, Johan; Posada-Villa, José; Sagar, Rajesh; Tomov, Toma; Uda, Hidenori; Williams, David R.; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; Kessler@hcp.med.harvard.edu
Objective: Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Method: Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including socio-demographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Results: Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). Conclusions: Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. J Clin Psychiatry 2010;71(12):1617-1628 (C) Copyright 2010 Physicians Postgraduate Press, Inc.