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  • 1. Aluoja, Anu
    et al.
    Leinsalu, Mall
    Södertörn University, Department of Society and History, Sociology. Södertörn University, Department of Society and History, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Shlik, Jakov
    Vasar, Veiko
    Luuk, Kersti
    Symptoms of depression in the Estonian population: prevalence, sociodemographic correlates and social adjustment2004In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 78, no 1, p. 27-35Article in journal (Refereed)
  • 2.
    Jacob, L.
    et al.
    University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France / CIBERSAM, Barcelona, Spain.
    Smith, L.
    Anglia Ruskin University, Cambridge, United Kingdom.
    Haro, J. M.
    CIBERSAM, Barcelona, Spain.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
    Koyanagi, A.
    CIBERSAM, Barcelona, Spain / ICREA, Barcelona, Spain.
    Serious physical injury and depressive symptoms among adolescents aged 12–15 years from 21 low- and middle-income countries2020In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 264, p. 172-180Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about the relationship between physical injury and depression in youths from low- and middle-income countries (LMICs). Therefore, the aim of this study was to analyze the association between serious physical injury and depressive symptoms among adolescents in 21 LMICs. Methods: Data from the Global School-based Student Health Survey (2003–2008) were analyzed. Serious physical injury and depressive symptoms in the past 12 months were assessed with self-report measures. The association between serious physical injury and depressive symptoms was examined using multivariable logistic regression analysis and meta-analysis. Results: The final sample consisted of 44,333 adolescents aged 12–15 years. After adjustment for sex, age, food insecurity, alcohol consumption, and country, an increasing number of serious physical injuries in the past 12 months was associated with increments in the odds for depressive symptoms in a dose-dependent fashion. Those who had ≥6 serious injuries (vs. no injuries) were 2.79 (95%CI=2.23–3.48) times more likely to have depressive symptoms. The pooled odds ratio (OR) (95%CI) for the association between at least one serious physical injury and depressive symptoms obtained by meta-analysis based on country-wise estimates was 1.83 (1.67–2.01) with a moderate level of between-country heterogeneity (I2=56.0%). Limitations: This was a cross-sectional study and causality of the association cannot be deduced. Conclusions: Serious physical injury may be a risk factor for depressive symptoms among adolescents in LMICs. Efforts to prevent physical injury and the provision of adequate health care for those who are injured may improve mental wellbeing among adolescents in this setting.

  • 3.
    Ng, Chris Fook Sheng
    et al.
    Nagasaki Univiversity,Nagasaki , Japan / University of Tokyo, Tokyo, Japan.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tokyo, Tokyo, Japan.
    Konishi, Shoko
    University of Tokyo, Tokyo, Japan / University of Washington, Seattle, USA.
    Watanabe, Chiho
    University of Tokyo, Tokyo, Japan.
    Ambient air pollution and suicide in Tokyo, 2001-20112016In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 201, p. 194-202Article in journal (Refereed)
    Abstract [en]

    Background: Some evidence suggests an association may exist between the level of air pollution and suicide mortality. However, this relation has been little studied to date. The current study examined the association in Tokyo, Japan. Methods: Suicide mortality data for Tokyo for the 11-year period 2001-2011 were obtained together with data on four air pollutants: fine particulate matter (PM2.5), suspended particulate matter (SPM), sulphur dioxide (SO2) and nitrogen dioxide (NO2). A time-stratified case-crossover study design was used to examine the daily association between the level of air pollution and suicide mortality. Results: During the study period there were 29,939 suicide deaths. In stratified analyses an interquartile range (IQR) increase in the same-day concentration of NO2 was linked to increased suicide mortality among those aged under 30 (percentage change: 6.73%, 95% Cl: 0.69-13.12%). An IQR increase in PM25 and SO2 was associated with a 10.55% (95% Cl: 2.05-19.75%) and 11.47% (95% Cl: 3.60-19.93%) increase, respectively, in suicide mortality among widowed individuals for mean exposure on the first four days (average lags 0-3). Positive associations were observed for the air pollutants in the summer although associations were reversed in autumn. Limitations: We relied on monitoring data to approximate individual exposure to air pollutants. Conclusions: Higher levels of air pollution are associated with increased suicide mortality in some population subgroups in Tokyo. Further research is needed to elucidate the mechanisms linking air pollutants and suicide in this setting.

  • 4.
    Oh, H.
    et al.
    University of Southern California, Los Angeles, USA.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute of Mental Health, Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / Instituto de Salud Carlos III, Madrid, Spain.
    Yau, Rebecca
    Pacific Institute for Research and Evaluation, Berkeley, USA.
    DeVylder, Jordan E.
    Fordham University, New York, USA.
    Discrimination and Suicidality amongst racial and ethnic minorities in the United States2018In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 245, p. 517-523Article in journal (Refereed)
    Abstract [en]

    Background: Over the past decade, suicide rates have increased among certain racial/ethnic minority groups in the United States. To better understand suicide vulnerability among people of color, studies have examined the relations between social risk factors –such as discrimination –and suicidal thoughts and behaviors. However, the literature has been inconsistent, calling for more population studies.

    Methods: This study analyzed data from two surveys: (1) The National Survey of American Life; and (2) The National Latino and Asian American Survey, which taken together are representative of Black, Latino, and Asians in the United States. Multivariable logistic regression models were used to examine the association between levels of discrimination on the Everyday Discrimination Scale and suicidal thoughts and behaviors. Additional models tested for effect modification by race and by psychiatric diagnosis.

    Results: We found that individuals who reported the highest levels of discrimination had greater odds of reporting lifetime suicidal thoughts, plans, and attempts, when compared with people who did not report discrimination, after adjusting for socio-demographic characteristics. Notably, discrimination increased odds of reporting an unplanned suicide attempt and a suicide attempt without the intent to die. Adjusting for psychiatric diagnoses attenuated these effects. We found no evidence of effect modification by race or by psychiatric diagnosis.

    Limitations: Data were cross-sectional, which did not allow for causal inferences.

    Conclusions: Future translational research can explore how screening for discrimination may help identify individuals and groups of racial/ethnic minorities at risk for suicidal thoughts and behaviors.

  • 5.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute of Mental Health, Tokyo, Japan.
    Koyanagi, A.
    CIBERSAM, Barcelona, Spain / ICREA, Barcelona, Spain.
    Ueda, M.
    Waseda University, Tokyo, Japan.
    Inoue, Y.
    The University of North Carolina at Chapel Hill, NC, USA.
    Waldman, K.
    Harvard University, Cambridge, MA, USA.
    Oh, H.
    University of Southern California, Los Angeles, CA, USA.
    Physical multimorbidity and suicidal behavior in the general population in the United States2020In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 260, p. 604-609Article in journal (Refereed)
    Abstract [en]

    Background: As yet, there has been little research on the association between physical multimorbidity (the co-occurrence of two or more physical illnesses) and suicide, and results have been mixed. This study examined if physical multimorbidity is associated with suicidal behavior in the general population in the United States. Method: Data were analyzed from 15,311 adults that were obtained from the Collaborative Psychiatric Epidemiology Surveys (CPES). Information was obtained on nine self-reported physical health conditions and lifetime suicidal behavior (suicidal ideation, plan, and attempts). Logistic regression analysis was used to examine associations. Results: An increasing number of physical health conditions was associated with higher odds for suicidal behavior. Compared to those with no physical conditions, individuals with ≥ 4 physical illnesses had 2.99, 4.82, and 4.39 times higher odds for reporting suicidal ideation, a suicide plan, and suicide attempts, respectively. An interaction analysis showed that for suicide attempts the association was stronger in younger rather than older adults. Limitations: The data were cross-sectional and information on physical conditions and suicidal behavior was self-reported and may have been subject to reporting bias. Conclusions: As multimorbidity has increased in recent decades in the United States, alerting medical practitioners to the increased risk of suicidal behavior in adults who have multiple medical conditions as well as screening for suicidality in this group may be important preventive measures to help reduce suicidal behavior in the general population.

  • 6.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Loneliness, common mental disorders and suicidal behavior: Findings from a general population survey2016In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 197, no June, p. 81-87Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Loneliness has been linked to an increased risk of engaging in suicidal behavior. To date, however, there has been comparatively little research on this in the general adult population, or on the role of common mental disorders (CMDs) in this association. The current study examined these associations using nationally representative data from England.

    METHODS: Data came from the Adult Psychiatric Morbidity Survey 2007. Information was obtained from 7403 household residents aged ≥16 years on perceived loneliness and lifetime and past 12-month suicide ideation and attempts. The Clinical Interview Schedule Revised (CIS-R) was used to assess six forms of CMD. Logistic regression analysis was used to examine these associations.

    RESULTS: Loneliness was associated with suicidal behavior. Although adjusting for CMDs attenuated associations, higher levels of loneliness were still significantly associated with suicidal ideation and suicide attempts with odds ratios (OR) for those in the most severe loneliness category ranging from 3.45 (lifetime suicide attempt) to 17.37 (past 12-month suicide attempt). Further analyses showed that ORs for suicidal behavior were similar for individuals who were lonely without CMDs, and for those respondents with CMDs who were not lonely. Lonely individuals with CMDs had especially elevated odds for suicidal ideation.

    LIMITATIONS: This study used cross-sectional data and a single-item measure to obtain information on loneliness.

    CONCLUSION: Loneliness is associated with suicidal behavior in the general adult population. This highlights the importance of efforts to reduce loneliness in order to mitigate its harmful effects on health and well-being.

  • 7.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). London School of Hygiene and Tropical Medicine, London, United Kingdom / University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Parc Sanitari Sant Joan de Déu, Barcelona, Spain / Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
    Roberts, Bayard
    London School of Hygiene and Tropical Medicine, London, United Kingdom.
    McKee, Martin
    London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Urban-rural differences in psychological distress in nine countries of the former Soviet Union2015In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 178, p. 142-148Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Studies have shown that the prevalence of mental illness can vary between urban and rural locations. This study extended research to the countries of the former Soviet Union (fSU) by assessing the association between settlement type and psychological distress and whether factors associated with psychological distress vary by settlement type.

    METHODS: Data on 18,000 adults aged ≥18 years from the Health in Times of Transition (HITT) survey undertaken in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine in 2010/11 were analyzed. Settlement types were country capitals, regional capitals, cities/other urban settlements, and villages. Psychological distress was defined as the country-specific highest quintile of a composite score based on 11 questions. Logistic regression analysis with random effects was used to examine associations.

    RESULTS: In a pooled country analysis, living in a smaller urban settlement or village was associated with significantly higher odds for psychological distress compared to living in the country capital. Lower social support was a strong correlate of psychological distress in all locations except capital cities.

    LIMITATIONS: The psychological distress measure has not been formally validated in the study countries.

    CONCLUSIONS: Lower levels of urbanicity are associated with greater psychological distress in the fSU countries. As many Western studies have linked greater urbanization to poorer mental health, this highlights the need for caution in extrapolating findings from one part of the world to others and the importance of undertaking research on the geographical correlates of mental health in different world regions.

  • 8.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Center for Neurology and Psychiatry (NCNP), Tokyo, Japan / University of Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Spain / Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
    Ruchkin, Vladislav
    Uppsala universitet / Yale University, USA / Säter Forensic Psychiatric Clinic.
    Kamio, Yoko
    National Institute of Mental Health, National Center for Neurology and Psychiatry (NCNP), Tokyo, Japan.
    Attention-deficit/hyperactivity disorder symptoms and suicide ideation and attempts: Findings from the Adult Psychiatric Morbidity Survey 20072016In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 189, p. 321-328Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Adults with attention-deficit/hyperactivity disorder (ADHD) may have an increased risk of engaging in suicidal behavior. This study examined this association in the general adult population where there has been little research.

    METHODS: Data came from the Adult Psychiatric Morbidity Survey 2007. This was a representative sample of the English adult household population aged ≥16 years (N=7403). The Adult ADHD Self-Report Scale (ASRS) was used to obtain information on ADHD symptoms. The Clinical Interview Schedule Revised (CIS-R) was used to assess six forms of common mental disorder (CMD). Information was also obtained on the lifetime and past 12-month occurrence of suicide ideation and attempts. Logistic regression analysis was used to examine these associations.

    RESULTS: After adjusting for comorbid disorders, adults with more ADHD symptoms had significantly higher odds for suicidal behavior. When a single cut-off point was used to classify ADHD (ASRS score ≥14), odds ratios ranged from 1.62 (lifetime suicide attempt) to 2.43 (past 12-month suicide ideation). When ADHD symptoms were categorized by strata (I: a score of 0-9; II: 10-13; III: 14-17; IV: 18-24), compared to adults in stratum I, those in stratum IV had odds ratios ranging from 2.16 (lifetime suicide ideation) to 3.68 (past 12-month suicide attempt).

    LIMITATIONS: ADHD and suicide data came from self-reports which may have been affected by socially desirable responding.

    CONCLUSIONS: ADHD symptoms were linked to suicidal behavior after controlling for comorbid conditions. Health care professionals should be alerted to the increased suicide risk among adults with ADHD symptoms.

  • 9.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Childhood hunger and depressive symptoms in adulthood: findings from a population-based study2018In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 226, p. 332-338Article in journal (Refereed)
    Abstract [en]

    Background: Several studies have linked childhood hunger to an increased risk for later depression. However, as yet, there has been little research on this relation in adults of all ages or whether there are sex differences in this association. The current study examined these issues using data from a national population-based sample.

    Methods: Data were analyzed from 5095 adults aged 25–84 collected during the Estonian Health Interview Survey 2006. Information was obtained on the frequency of going to bed hungry in childhood and on depressive symptoms using the Emotional State Questionnaire (EST-Q). Logistic regression analysis was used to examine the association between hunger and depression while controlling for other demographic, socioeconomic and health-related variables.

    Results: In a fully adjusted model, going to bed hungry in childhood either sometimes or often was associated with significantly increased odds for adult depressive symptoms. When the analysis was stratified by sex the association was more evident in men where any frequency of childhood hunger was linked to adult depression while only women who had experienced hunger often had higher odds for depressive symptoms in the final model.

    Limitations: Data on childhood hunger were retrospectively reported and may have been affected by recall bias. We also lacked information on potentially relevant variables such as other childhood adversities that might have been important for the observed associations.

    Conclusion: Childhood hunger is associated with an increased risk for depressive symptoms among adults. Preventing hunger in childhood may be important for mental health across the life course.

  • 10.
    Stickley, Andrew
    et al.
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tokyo, Tokyo, Japan.
    Ng, Chris Fook Sheng
    University of Tokyo, Tokyo, JapanUniversity of Tokyo, Tokyo, Japan / Nagasaki Univiversity, Nagasaki, Japan.
    Inoue, Yosuke
    University of Tokyo, Tokyo, Japan.
    Yazawa, Aki
    University of Tokyo, Tokyo, Japan.
    Koyanagi, Ai
    Universitat de Barcelona, Barcelona, Spain / CIBERSAM, Madrid, Spain.
    Kodaka, Manami
    National Center of Neurology and Psychiatry, Tokyo, Japan.
    DeVylder, Jordan E.
    University of Maryland, Baltimore, USA.
    Watanabe, Chiho
    University of Tokyo, Tokyo, Japan.
    Birthdays are associated with an increased risk of suicide in Japan: Evidence from 27,007 deaths in Tokyo in 2001-20102016In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 200, p. 259-265Article in journal (Refereed)
    Abstract [en]

    Background: Previous research has produced conflicting findings concerning whether birthdays are associated with an increased risk of suicide. This study examined the association in Tokyo, Japan. Methods: Suicide data (ICD-10 codes X60-X84) for the period 2001-2010 were obtained from the Japanese Ministry of Health, Labour and Welfare. A time-stratified case-crossover design was used with conditional logistic regression analysis being performed to estimate within-subject birthday exposures' while controlling for meteorological conditions and public holidays. Results: There were 27,007 suicides in the study period. For males the 5 days before the birthday and the week after the birthday were associated with significantly higher odds for suicide with the odds ratio being highest on the actual birthday (OR =1.677, 95% CI: 1.294, 2.172). For females, significantly higher odds for completed suicide were observed 7-11 days before the birthday. Stratified analyses showed different at risk time patterns among men from different age groups, and that married men had higher odds for suicide on, and for the 4 days before and in the 2 weeks after their birthday. Limitations: We lacked detailed information on suicides which would have enabled a better understanding of the observed associations. Conclusions: Birthdays are associated with an increased risk for suicide in Tokyo, Japan. Health professionals who work with individuals at risk of suicide should be made aware that birthdays are associated with an elevated suicide risk. This information should also be communicated in wider suicide prevention campaigns.

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