Risk of suicide among operated and non-operated patients hospitalised for peptic ulcers

Bahmanyar, Shahram; Sparén, Pär; Rutz, Mittendorfer; Hultman, Christina M.

doi:10.1136/jech.2008.086348

Cited by 11 publications

(3 citation statements)

References 38 publications

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“…In this study, we determined that the risks of ulcer disease, pneumonia, and other forms of heart disease were significantly increased among adolescent suicide victims. The association between ulcer disease and suicide is consistent with previous data revealing a 60–70% excess risk of death due to suicide among adult patients hospitalized for peptic ulcers (Bahmanyar et al, 2009). Moreover, ulcer disease has been proposed to be strongly associated with stress and anxiety (Goodwin & Stein, 2002; Levenstein, Rosenstock, Jacobsen, & Jorgensen, 2015), partially explaining the high suicidality in this population.…”

Section: Discussionsupporting

confidence: 92%

“…The present study demonstrated that adolescent suicide victims had an increased risk of several physical illnesses 3 months before suicide; this finding is consistent with that of a previous study (Ahmedani et al, 2017). Studies have reported the association of several physical illnesses, including epilepsy, asthma, migraine, concussion, infection, and peptic ulcer disease, with an increased risk of suicide behavior (Bahmanyar, Sparen, Rutz, & Hultman, 2009; Fralick et al, 2019; Lund-Sorensen et al, 2016; Singhal, Ross, Seminog, Hawton, & Goldacre, 2014). In this study, we determined that the risks of ulcer disease, pneumonia, and other forms of heart disease were significantly increased among adolescent suicide victims.…”

Section: Discussionmentioning

confidence: 99%

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Healthcare utilization, psychiatric disorders, and physical illnesses shortly before suicide mortality in adolescents in Taiwan

et al. 2021

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Background This study examined the pattern of medical utilization and the distribution of comorbidities shortly before death among adolescents who died from suicide and compared these data with those of living controls. Methods From Taiwan's National Health Insurance Research Database, this study identified adolescents aged 10–19 years who died from suicide (n = 935) between 1 January 2000, and 31 December 2016, by linking each patient with the national mortality database. The researchers conducted a nested case–control study through risk set sampling, and for each case, 20 age- and sex-matched controls (n = 18 700) were selected from the general population. The researchers applied conditional logistic regression to investigate differences in medical utilization and physical and psychiatric comorbidities between cases and controls. Results Cases had a higher proportion of contact with the psychiatric department but a similar proportion of contact with any non-psychiatric medical department within 1 year before suicide compared with controls. There were 18.6% of adolescent suicide victims who only had contacted with a psychiatric department 3 months before suicide. Moreover, cases had a higher proportion of contact with non-psychiatric services within 3 months before suicide, particularly with emergency, surgery, and internal medicine departments. Cases had higher risks of several psychiatric disorders and physical illnesses, including heart diseases, pneumonia, and ulcer disease, than did controls. Conclusions The findings of increased medical utilization and higher risks of physical and psychiatric comorbidities in adolescent suicide victims are crucial for developing specific interventions to prevent suicide in this population.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Healthcare utilization, psychiatric disorders, and physical illnesses shortly before suicide mortality in adolescents in Taiwan

et al. 2021

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“…Many medical conditions have been associated with an increased risk for suicide, but these conditions have generally not been included in suicide risk assessment tools. These conditions include gastrointestinal conditions [25] , [26] , cardiopulmonary conditions [27] , [28] , [29] , [30] , oncologic conditions [31] , [32] , [33] , and pain conditions [34] , [35] . Finally, some research has emerged that links care processes to suicide risk.…”

Section: Discussionmentioning

confidence: 99%

Predicting the Risk of Suicide by Analyzing the Text of Clinical Notes

et al. 2014

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We developed linguistics-driven prediction models to estimate the risk of suicide. These models were generated from unstructured clinical notes taken from a national sample of U.S. Veterans Administration (VA) medical records. We created three matched cohorts: veterans who committed suicide, veterans who used mental health services and did not commit suicide, and veterans who did not use mental health services and did not commit suicide during the observation period (n = 70 in each group). From the clinical notes, we generated datasets of single keywords and multi-word phrases, and constructed prediction models using a machine-learning algorithm based on a genetic programming framework. The resulting inference accuracy was consistently 65% or more. Our data therefore suggests that computerized text analytics can be applied to unstructured medical records to estimate the risk of suicide. The resulting system could allow clinicians to potentially screen seemingly healthy patients at the primary care level, and to continuously evaluate the suicide risk among psychiatric patients.

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‘Bariatric surgery for type 2 diabetes always produces a good outcome’

Chen

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2014

Practical Diabetes

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Weight is very important in type 2 diabetes (T2DM); 1 kg of weight gained annually over 10 years is associated with a 49% increase in risk of developing T2DM in the subsequent 10 years. In patients with T2DM a weight loss of 5-10% results in a 0.5% reduction in HbA1c, a 5mmHg decrease in systolic blood pressure and diastolic blood pressure, a 0.13mmol/L increase in HDL cholesterol, and a 0.45mmol/L decrease in triglycerides. 1 For these reasons the ADA and EASD recommend that weight loss should be strived for in all patients who have T2DM.In spite of this recommendation, few patients with T2DM are offered comprehensive weight loss programmes; instead treatment focuses on using medication to control glucose, blood pressure and lipids, with many of these medications causing weight gain. In the past, excuses for not targeting weight loss have been that it is hard to maintain weight loss in the long-term without high levels of contact or continuation of weight loss drugs.Bariatric surgery, however, does not suffer from the above problems. The mean 20 years' weight reduction in the Swedish Obese Subjects study, a very large prospective study, was 15-25% dependent on the type of surgery performed, and contact levels required post surgery were low. 2 This and other studies have led NICE to state that bariatric surgery should be offered to patients with a BMI of 35-40kg/m 2 who have obesity-related conditions such as diabetes mellitus or obstructive sleep apnoea, or in those with a BMI of 40kg/m 2 or greater regardless of weightrelated comorbidities. Updated NICE guidance due in the New Year is likely to suggest that the BMI cut-off for surgery in patients with T2DM should be lowered to 30kg/m 2 .In spite of these NICE recommendations, many physicians are reluctant to refer patients for bariatric surgery. The common reasons stated for this are: there are no long-term data that bariatric surgery improves diabetes control; there are no outcome data on macro-and microvasular diabetes complications; there are no data that bariatric surgery is better than medical therapy; bariatric surgery is very risky; complication rates are high and can be very serious; there are no cost-effective data; and most of our patients do not want surgery. The following takes each of these statements in turn.There are no long-term data that bariatric surgery improves diabetes controlThere is no doubt that bariatric surgery improves glucose control in patients with T2DM. A systematic review that looked at 22 094 patients in 136 studies, of which five were randomised controlled trials (RCTs), found that 86.6% of patients showed improvement in their glycaemia, with 78.1% achieving remission. 3 A recent review of long-term outcomes of bariatric surgery found two high-quality studies with data on 80% of patients for longer than five years out from surgery. Adams et al. report a 62% remission rate in 88 patients six years after a Roux-en-Y gastric bypass (RYGB), 4 and Caiazzo et al. demonstrate a 14% remission rate but a 63% ideal control rate (HbA1...

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Risk of suicide among operated and non-operated patients hospitalised for peptic ulcers

Cited by 11 publications

References 38 publications

Healthcare utilization, psychiatric disorders, and physical illnesses shortly before suicide mortality in adolescents in Taiwan

Healthcare utilization, psychiatric disorders, and physical illnesses shortly before suicide mortality in adolescents in Taiwan

Predicting the Risk of Suicide by Analyzing the Text of Clinical Notes

‘Bariatric surgery for type 2 diabetes always produces a good outcome’

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