Suicide in Canada: impact of injuries with undetermined intent on regional rankings

Auger, Nathalie; Burrows, Stephanie; Gamache, Philippe; Hamel, Denis

doi:10.1136/injuryprev-2015-041613

Cited by 14 publications

(9 citation statements)

References 12 publications

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“…The rate of suicide underreporting for different sexes, age groups, sexuality tendencies and types of suicide are diverse [ 7 – 10 ], which authors superficially mentioned. In addition to subpopulations, there are systematic reasons for underreporting including low accuracy in determining the underlying causes of deaths [ 11 ], inaccurate collection and coding (misclassifying of suicides as injuries) that are problematic for data stakeholders [ 12 ], stigma [ 13 ] and high standards of proof [ 12 ]. Majority of these reasons, for example, are different for urban population with high exposure to ambient air pollution and rural residents in which air pollution is low.…”

mentioning

confidence: 99%

Reported association of air pollution and suicide rate could be confounded

Afshari

2017

Environ Health

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A statistical association between ambient air pollution and suicide mortality has been recently reported in Environmental Health, which seems not to be scientifically supported by their data.In this article, very low (unrealistic) suicide rate is reported, which is subjected to selection bias. Their justification is also flawed as high exposure to ambient air pollution in rural areas is lower as compared to urban residents. Weekends, holidays, time of death … are also both air pollution and suicide rate related. Reported statistical association of air pollution and suicide in this study is heavily confound.Please see article under discussion: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-016-0177-1.

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confidence: 99%

Reported association of air pollution and suicide rate could be confounded

Afshari

2017

Environ Health

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“…These data include Vital Statistics records for the province of Manitoba, where the recorded cause of death is coded using the International Classification of Diseases, 10th Revision, with Canadian Enhancements (ICD‐10‐CA). The following codes were considered as markers of death from suicide and were intentionally broad to capture the recognized underclassification of suicide deaths (Auger, Burrows, Gamache, & Hamel, ; Donaldson, Larsen, Fullerton‐Gleason, & Olson, ; Moyer, Boyle, & Pollock, ) and are consistent with previous literature for classification of definite and probable suicides (John et al., ): Intentional self‐harm: ICD‐10 codes X60–X84. Late effects of intentional self‐harm: ICD‐10‐CA code Y87.0. Poisoning of undetermined intent: ICD‐10 codes Y10–Y19. Other events of undetermined intent: ICD‐10 codes Y20–Y34. …”

Section: Methodsmentioning

confidence: 78%

“…Fourth, the classification of a suicide death is limited to the coroner classification of death. It is known that suicide deaths are often misclassified, such as accident and undetermined intent injuries (O'Carroll, ; Rockett, Kapusta, & Bhandari, ), which occurs in up to 30% of the cases (Auger et al., ). This underreporting bias was addressed by including codes to improve sensitivity but does introduce the potential for false positive suicide deaths.…”

Section: Discussionmentioning

confidence: 99%

Predicting suicide with the SAD PERSONS scale

et al. 2017

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Background Suicide is a major public health issue, and a priority requirement is accurately identifying high‐risk individuals. The SAD PERSONS suicide risk assessment scale is widely implemented in clinical settings despite limited supporting evidence. This article aims to determine the ability of the SAD PERSONS scale (SPS) to predict future suicide in the emergency department. Methods Five thousand four hundred sixty‐two consecutive adults were seen by psychiatry consultation teams in two tertiary emergency departments with linkage to population‐based administrative data to determine suicide deaths within 6 months, 1, and 5 years. Results Seventy‐seven (1.4%) individuals died by suicide during the study period. When predicting suicide at 12 months, medium‐ and high‐risk scores on SPS had a sensitivity of 49% and a specificity of 60%; the positive and negative predictive values were 0.9 and 99%, respectively. Half of the suicides at both 6‐ and 12‐month intervals were classified as low risk by SPS at index visit. The area under the curve at 12 months for the Modified SPS was 0.59 (95% confidence interval [CI] range 0.51–0.67). High‐risk scores (compared to low risk) were significantly associated with death by suicide over the 5‐year study period using the SPS (hazard ratio 2.49; 95% CI 1.34–4.61) and modified version (hazard ratio 2.29; 95% CI 1.24–2.29). Conclusions Although widely used in educational and clinical settings, these findings do not support the use of the SPS and Modified SPS to predict suicide in adults seen by psychiatric services in the emergency department.

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“…Even suicide mortality is at high risk of misclassification due to the difficulty of inferring intent when determining cause of death. [26][27][28] Despite the potential for measurement challenges, variations in study designs (eg, cohorts, registry data), and heterogeneity among survivor samples, Cancer December 15, 2020 continuing to examine risk factors associated with suicidal ideation is important given the potential severity of any reported ideation.…”

Section: Discussionmentioning

confidence: 99%

Suicidality among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study

Lubas

Salehabadi

Lavecchia

et al. 2020

Cancer

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BACKGROUND: Suicide is a serious public health concern. An increased risk of suicide ideation previously has been reported among survivors of childhood cancer. METHODS: Suicide mortality was assessed for all potentially eligible survivors (those aged ≥18 years who were ≥5 years after their cancer diagnosis; 7312 survivors). Risk factors for acute suicidal ideation were assessed among clinically evaluated survivors (3096 survivors) and the prevalence of acute ideation was compared with that of community controls (429 individuals). The prevalence of 12-month suicidality was assessed among survivors who could be compared with population data (1255 survivors). Standardized mortality ratios compared rates of suicide mortality among survivors with those of the general population. Risk ratios (RRs) and 95% confidence intervals (95% CIs) derived from generalized linear models identified risk factors associated with acute suicidal ideation. Standardized incidence ratios (SIRs) compared the prevalence of 12-month suicidality among survivors with that of a matched sample from the general population. RESULTS: Survivors reported a similar 12-month prevalence of ideation compared with the general population (SIR, 0.68; 95% CI, 0.35-1.01

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Suicide in Canada: impact of injuries with undetermined intent on regional rankings

Cited by 14 publications

References 12 publications

Reported association of air pollution and suicide rate could be confounded

Reported association of air pollution and suicide rate could be confounded

Predicting suicide with the SAD PERSONS scale

Suicidality among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study

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