Diagnosed Mental Health Conditions and Risk of Suicide Mortality

Yeh, Hsueh‐Han; Westphal, Joslyn; Hu, Yu Jeffrey; Peterson, Edward L.; Williams, Keoki L; Prabhakar, Deepak; Frank, Catherine; Autio, Kirsti; Elsiss, Farah; Simon, Gregory E.; Beck, Arne; Lynch, Frances L.; Rossom, Rebecca C.; Lu, Christine Y.; Owen-Smith, Ashli; Waitzfelder, Beth E.; Ahmedani, Brian K.

doi:10.1176/appi.ps.201800346

Cited by 64 publications

(60 citation statements)

References 35 publications

(34 reference statements)

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“…Bipolar and schizophrenia spectrum disorders have the highest relative risk of suicide deaths, but both groups consist of smaller numbers of individuals with these disorders. They account for 8 % and 2 % of the suicides, respectively [ 19 ]. Also, neurocognitive disorders of the prefrontal cortex, an area of the brain responsible for executive decision making, have been associated with elderly suicides.…”

Section: Risk Factors For Firearm Suicidesmentioning

confidence: 99%

“…Also, mentally ill elderly may not always seek treatment and even if treated, they may continue to live with access to firearms. Epidemiological and clinical models solely focusing on mental illnesses cannot predict future suicide attempts very well, mental illnesses the in elderly may exist with comorbidities and substance use disorders posing a risk for suicides, and an overemphasis on mental illness may lead to stereotyping of mental illness and its association with firearm violence and suicides [ 19 , 20 , 37 , 40 , 44 , 48 , 21 ].…”

Section: Prevention Of Firearm-related Suicidesmentioning

confidence: 99%

“…Of the three groups of issues, mental health issues are most consistently and highly correlated with suicides in the elderly. Psychiatric disorders have been found in 51-97 % of elderly suicides [19,20]. The largest number of individuals with mental health issues who commit suicides are those diagnosed with a major depressive disorder [19][20][21][22][23][24].…”

Section: Risk Factors For Firearm Suicidesmentioning

confidence: 99%

“…Psychiatric disorders have been found in 51-97 % of elderly suicides [19,20]. The largest number of individuals with mental health issues who commit suicides are those diagnosed with a major depressive disorder [19][20][21][22][23][24]. A recent study found that 27 % of suicide deaths were attributed to major depression and 22 % to anxiety disorders [19].…”

Section: Risk Factors For Firearm Suicidesmentioning

confidence: 99%

“…The largest number of individuals with mental health issues who commit suicides are those diagnosed with a major depressive disorder [19][20][21][22][23][24]. A recent study found that 27 % of suicide deaths were attributed to major depression and 22 % to anxiety disorders [19]. Bipolar and schizophrenia spectrum disorders have the highest relative risk of suicide deaths, but both groups consist of smaller numbers of individuals with these disorders.…”

Section: Risk Factors For Firearm Suicidesmentioning

confidence: 99%

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Firearm Suicides in the Elderly: A Narrative Review and Call for Action

Price

Khubchandani

2021

J Community Health

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Firearm suicides are one of the leading causes of death for older Americans. The purpose of this review is to explore the risk factors associated with suicides in the elderly, provide an overview of the epidemiology of firearm-related suicides in older Americans, and explore methods of preventing firearm suicides in the elderly. The vast majority (70 %) of elderly suicides in the U.S were committed using a firearm. Elderly firearm suicides have increased by 49 % between 2010 and 2018, disproportionately affecting white males. Yearly firearm suicides in the elderly ranged from 4,276 in 2010 to 6,375 in 2018. In 2018, the rate of elderly male firearm suicides was 24.96/100,000 compared to a rate of 1.92/100,000 for elderly females, a rate ratio of 13 to 1 for males compared to females. The primary risk factors for elderly firearm suicides seem to be physical illnesses, mental illnesses, and social factors. Older Americans engage in suicidal behaviors with greater planning and lethality of intent than do young adults. Of all the strategies to prevent suicides with firearms, the most efficacious measures based on current research seem to be state firearm legislation and improving mental healthcare, but these effects are not specific to the elderly. Strengthening state firearm laws and improving mental healthcare for the elderly may have promise in preventing elderly firearm-related suicides. Additional implications for practice and research are discussed in this review.

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Section: Risk Factors For Firearm Suicidesmentioning

confidence: 99%

Section: Prevention Of Firearm-related Suicidesmentioning

confidence: 99%

Section: Risk Factors For Firearm Suicidesmentioning

confidence: 99%

Section: Risk Factors For Firearm Suicidesmentioning

confidence: 99%

Section: Risk Factors For Firearm Suicidesmentioning

confidence: 99%

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Firearm Suicides in the Elderly: A Narrative Review and Call for Action

Price

Khubchandani

2021

J Community Health

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Clinical Profiles and Health Services Patterns of Medicaid-Enrolled Youths Who Died by Suicide

et al. 2020

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IMPORTANCE Youth suicide is a major public health problem, and health care settings play a critical role in suicide prevention efforts, but limited data are available to date on health and mental health service use patterns before suicide.OBJECTIVE To compare the clinical profiles and patterns of use of health and mental health care services among children and adolescents who died by suicide and a matched living control group. DESIGN, SETTING, AND PARTICIPANTS This population-based case-control study used Medicaid data from 16 states merged with mortality data. Suicide cases (n = 910) included all youths aged 10 to 18 years who died by suicide from January 1, 2009, to December 31, 2013. Controls (n = 6346) were matched to suicide cases on sex, race, ethnicity, Medicaid eligibility category, state, and age. Data were analyzed from July 18 to November 19, 2019. EXPOSURES Use of health and mental health care services.MAIN OUTCOMES AND MEASURES Health and behavioral health care visits in the 6-month period before the index date (date of suicide). Associations among visits, clinical characteristics, and suicide were examined using logistic regression. RESULTSThe study population of 7256 Medicaid-enrolled youths included 5292 males (72.9%) with a mean (SD) age of 15.7 (2.0) years at the index date; 3619 (49.9%) were non-Hispanic white. Three hundred seventy-six suicide decedents (41.3%) had a mental health diagnosis in the 6 months before death compared with 1111 controls (17.5%; P < .001). A greater proportion of suicide decedents than controls used services before the index date (in 6 months, 687 suicide decedents [75.5%] vs 3669 controls [57.8%]; odds ratio [OR], 2.39 [95% CI, 2.02-2.82]). Suicide risk was highest among youths with epilepsy (OR, 4.89; 95% CI, 2.81-8.48; P < .001), depression (OR, 3.19; 95% CI, 2.49-4.09; P < .001), schizophrenia (OR, 3.18; 95% CI, 2.00-5.06; P < .001), substance use disorder (OR, 2.65; 95% CI, 1.67-4.20; P < .001), and bipolar disorder (OR, 2.09; 95% CI, 1.58-2.76; P < .001). More mental health visits within the 30 days before the index date were associated with decreased odds of suicide (OR, 0.78; 95% CI, 0.65-0.92; P = .005).CONCLUSIONS AND RELEVANCE This study found that among youths aged 10 to 18 years who were enrolled in Medicaid, clinical characteristics and patterns of use of health care services among suicide decedents were distinct from those of nonsuicide controls. Implementation of suicide screening protocols for youths enrolled in Medicaid, targeted based on the frequency of visits, psychiatric diagnoses, and epilepsy, may have the potential to decrease suicide rates.

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Mortality in Persons With Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder

et al. 2022

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IMPORTANCE Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are childhood-onset disorders that may persist into adulthood. Several studies have suggested that they may be associated with an increased risk of mortality; however, the results are inconsistent.OBJECTIVE To assess the risk of mortality among persons with ASD or ADHD and their first-degree relatives.DATA SOURCES A search of MEDLINE, Embase, Scopus, Web of Science, and PsycINFO (published from inception to April 1, 2021) was supplemented by searching reference lists of the retrieved articles.STUDY SELECTION Cohort and case-control studies that reported mortality rate ratios (RRs) in persons with ASD or ADHD and/or their first-degree relatives compared with the general population or those without ASD/ADHD were included.DATA EXTRACTION AND SYNTHESIS Screening, data extraction, and quality assessment were performed by at least 2 researchers independently. A random-effects model was used to meta-analyze individual studies and assessed heterogeneity (I 2 ). MAIN OUTCOMES AND MEASURESAll-cause mortality in association with ASD or ADHD. Secondary outcome was cause-specific mortality.RESULTS Twenty-seven studies were included, with a total of 642 260 individuals. All-cause mortality was found to be higher for persons with ASD (154 238 participants; 12 studies; RR, 2.37; 95% CI, 1.97-2.85; I 2 , 89%; moderate confidence) and persons with ADHD (396 488 participants; 8 studies; RR, 2.13; 95% CI, 1.13-4.02; I 2 , 98%; low confidence) than for the general population. Among persons with ASD, deaths from natural causes (4 studies; RR, 3.80; 95% CI, 2.06-7.01; I 2 , 96%; low confidence) and deaths from unnatural causes were increased (6 studies; RR, 2.50; 95% CI, 1.49-4.18; I 2 , 95%; low confidence). Among persons with ADHD, deaths from natural causes were not significantly increased (4 studies; RR, 1.62; 95% CI, 0.89-2.96; I 2 , 88%; low confidence), but deaths from unnatural causes were higher than expected (10 studies; RR, 2.81; 95% CI, 1.73-4.55; I 2 , 92%; low confidence).CONCLUSIONS AND RELEVANCE This systematic review and meta-analysis found that ASD and ADHD are associated with a significantly increased risk of mortality. Understanding the mechanisms of these associations may lead to targeted strategies to prevent avoidable deaths in high-risk groups. The substantial heterogeneity between studies should be explored further.

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Diagnosed Mental Health Conditions and Risk of Suicide Mortality

Cited by 64 publications

References 35 publications

Firearm Suicides in the Elderly: A Narrative Review and Call for Action

Firearm Suicides in the Elderly: A Narrative Review and Call for Action

Clinical Profiles and Health Services Patterns of Medicaid-Enrolled Youths Who Died by Suicide

Mortality in Persons With Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder

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