Epidemiology of Suicidal Behavior in Malaga (Spain): An Approach From the Prehospital Emergency Service

Moreno‐Küstner, Berta; Campo-Ávila, José del; Ruíz-Ibáñez, Ana; Martínez-García, Ana I.; Zamudio, Serafina Castro; Ramos-Jiménez, Gonzalo; Guzmán‐Parra, José

doi:10.3389/fpsyt.2019.00111

Cited by 13 publications

(26 citation statements)

References 15 publications

(31 reference statements)

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“…Our null nding for a temporal cross-correlation in England and Wales is probably due in part to a relatively weak seasonal effect on suicide in these areas (Table 2), consistent with prior studies of this region reporting marginal [24,25] or undetectable [26] effects of season on suicide rates. The patterns we detected in this study are consistent with prior reports of seasonal patterns for circulatory system disease-related mortality [12,13,[27][28][29] and for suicide [10,11,24,25,[30][31][32][33][34][35][36][37][38][39][40][41][42].…”

Section: Discussionsupporting

confidence: 92%

Temporal patterns of suicide and circulatory system disease-related mortality are inversely correlated in several countries

Kaufman

Fitzmaurice

2020

Preprint

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Background Nearly 800,000 suicides occur worldwide annually and suicide rates are increasing faster than population growth. Unfortunately, the pathophysiology of suicide remains poorly understood, which has hindered suicide prevention efforts. However, mechanistic clues may be found by studying effects of seasonality on suicide and other mortality causes. Suicides tend to peak in spring-summer periods and nadir in fall-winter periods while circulatory system disease-related mortality tends to exhibit the opposite temporal trends. This study aimed to determine for the first time whether monthly temporal cross-correlations exist between suicide and circulatory system disease-related mortality at the population level. If so and if common biological factors moderate risks for both mortality types, such factors may be discoverable and utilized to improve suicide prevention.Methods We conducted time series analyses of monthly mortality data from northern (England and Wales, South Korea, United States) and southern (Australia, Brazil) hemisphere countries during the period 2009-2018 (N=41.8 million all-cause mortality cases). We used a Poisson regression variant of the standard cosinor model to determine cross-correlations between monthly mortality rates from suicide and from circulatory system diseases.Results Suicide and circulatory disease-related mortality temporal patterns were negatively correlated in Australia (-0.32), Brazil (-0.57), South Korea (-0.32), and in the United States (-0.66), but no temporal correlation was discernable in England and Wales.Conclusions The negative temporal cross-correlations between these mortality types we found in 4 of 5 countries studied suggest that seasonal factors broadly and inversely moderate risks for circulatory disease-related mortality and suicide. Since the seasonal factors of temperature and light exert opposite effects on suicide and circulatory disease-related mortality in several countries, we propose that physiologically-adaptive circulatory system responses to heat and light may increase risk for suicide and should be studied to determine whether they affect suicide risk. For example, heat and light increase production and release of the bioactive gas nitric oxide and reduce circulatory system disease by relaxing blood vessel tone, while elevated nitric oxide levels are associated with suicidal behavior, inverse effects that parallel the inverse temporal mortality patterns we detected.

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Section: Discussionsupporting

confidence: 92%

Temporal patterns of suicide and circulatory system disease-related mortality are inversely correlated in several countries

Kaufman

Fitzmaurice

2020

Preprint

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“…In Andalusia, the largest autonomous community in Spain, various research projects have focused on the analysis of requests related to suicidal behavior (Blanco-Sánchez et al, 2018;Mejías-Martín et al, 2018;2019) and observed that the highest rate occurs in the province of Málaga. Studies conducted in this province have found differential characteristics in requests related to suicidal behavior with respect to other OES requests (Guzmán-Parra et al, 2016;Jiménez-Hernández et al, 2017;Moreno-Küstner et al, 2019). However, results obtained in previous studies reveal differences in the classification of suicide attempts (Blanco-Sánchez et al, 2018;Guzmán-Parra et al, 2016;Jiménez-Hernández et al, 2017;Mejías-Martín et al, 2018;2019;Moreno-Küstner et al, 2019).…”

Section: Introductionmentioning

confidence: 86%

“…Studies conducted in this province have found differential characteristics in requests related to suicidal behavior with respect to other OES requests (Guzmán-Parra et al, 2016;Jiménez-Hernández et al, 2017;Moreno-Küstner et al, 2019). However, results obtained in previous studies reveal differences in the classification of suicide attempts (Blanco-Sánchez et al, 2018;Guzmán-Parra et al, 2016;Jiménez-Hernández et al, 2017;Mejías-Martín et al, 2018;2019;Moreno-Küstner et al, 2019). Some studies classify a request as involving suicidal behavior when the operator answering the call and the doctor attending the patient consider it as such (Mejías-Martín et al, 2018;2019;Moreno-Küstner et al, 2019).…”

Section: Introductionmentioning

confidence: 96%

Validity of the classification of emergency service requests related to suicidal behavior

Ramos-Martín¹,

Rueda-Artero²,

Campo-Ávila³

et al. 2022

Salud Ment

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Introduction. Suicide attempts are the most predictive risk factor for suicide deaths. Most people who attempt suicide receive care from out-of-hospital Emergency Services (OES), where these requests are managed and classified. Objective. Validate the Emergency Coordination Center (ECC) classification for the detection of suicidal behavior requests. Method. A descriptive, cross-sectional study of requests to the ECC of Málaga (Spain) during 2013 and 2014 was conducted. To classify the requests, the authors considered the ECC categorization when answering the call and the clinical assessment of the healthcare professional when attending the person who had made the call at the scene, which was considered the reference standard. To analyze the validity of the ECC classification system, sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated. Results. The total number of requests for medical assistance analyzed was 112,599. The validity indicators of the classification system for suicidal behavior were sensitivity = 44.78%, specificity = 99.34%, PPV = 46.91% and NPV = 99.28%. Discussion and conclusion. The ECC classification system has a lower capacity to detect the presence of suicidal behavior and a higher capacity to identify its absence in the requests received. OES provide key information on suicidal behavior requests as they can be one of the first places people with this problem go to. It would therefore be extremely useful to improve the classification systems for requests related to suicidal behavior.

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“…We calculated the 95% CIs through a normal approximate method. The following formula was used to calculate the CIs [ 16 , 17 ]:…”

Section: Methodsmentioning

confidence: 99%

Determining the Case Fatality Rate of COVID-19 in Italy: Novel Epidemiological Study

Yan

Kang

Guo

et al. 2022

JMIR Public Health Surveill

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Background COVID-19, which emerged in December 2019, has spread rapidly around the world and has become a serious public health event endangering human life. With regard to COVID-19, there are still many unknowns, such as the exact case fatality rate (CFR). Objective The main objective of this study was to explore the value of the discharged CFR (DCFR) to make more accurate forecasts of epidemic trends of COVID-19 in Italy. Methods We retrieved the epidemiological data of COVID-19 in Italy published by the John Hopkins Coronavirus Resource Center. We then used the proportion of deaths to discharged cases（including deaths and recovered cases） to calculate the total DCFR (tDCFR), monthly DCFR (mDCFR), and stage DCFR (sDCFR). Furthermore, we analyzed the trend in the mDCFR between January and December 2020 using joinpoint regression analysis, used ArcGIS version 10.7 to visualize the spatial distribution of the epidemic CFR, and assigned different colors to each province based on the CFR or tDCFR. Results We calculated the numbers and obtained the new indices of the tDCFR and mDCFR for calculating the fatality rate. The results showed that the tDCFR and mDCFR fluctuated greatly from January to May. They first showed a rapid increase followed by a rapid decline after reaching the peak. The map showed that the provinces with a high tDCFR were Emilia-Romagna, Puglia, and Lombardia. The change trend of the mDCFR over time was divided into the following 2 stages: the first stage (from January to May) and the second stage (from June to December). With regard to worldwide COVID-19 statistics, among 6 selected countries, the United States had the highest tDCFR (4.26%), while the tDCFR of the remaining countries was between 0.98% and 2.72%. Conclusions We provide a new perspective for assessing the fatality of COVID-19 in Italy, which can use ever-changing data to calculate a more accurate CFR and scientifically predict the development trend of the epidemic.

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Epidemiology of Suicidal Behavior in Malaga (Spain): An Approach From the Prehospital Emergency Service

Cited by 13 publications

References 15 publications

Temporal patterns of suicide and circulatory system disease-related mortality are inversely correlated in several countries

Temporal patterns of suicide and circulatory system disease-related mortality are inversely correlated in several countries

Validity of the classification of emergency service requests related to suicidal behavior

Determining the Case Fatality Rate of COVID-19 in Italy: Novel Epidemiological Study

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