Dataset Information

Insomnia, psychiatric disorders and suicidal ideation in a National Representative Sample of active Canadian Forces members.

ABSTRACT: BACKGROUND:Past research on the association between insomnia and suicidal ideation (SI) has produced mixed findings. The current study explored the relationship between insomnia, SI, and past-year mental health status among a large Canadian Forces (CF) sample. METHOD:Data was obtained from the 2013 Canadian Forces Mental Health Survey (CFMHS), and included a large representative sample of Canadian Regular Forces personnel (N = 6700). A series of univariate logistic regressions were conducted to test individual associations between past-year mental health status, insomnia, and potential confounds and SI. Mental health status included three groups: 0, 1, or two or more probable diagnoses of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), panic disorder (PD) and alcohol abuse/dependence. Stepwise multivariate logistic regression was used to assess the relationship between insomnia and SI with mental health status as a moderator. RESULTS:40.8% of respondents reported experiencing insomnia. Both insomnia and number of mental health conditions incrementally increased the risk of SI. However, past-year mental health status was a significant moderator of this relationship, such that for CF personnel with either no (AOR = 1.61, 1.37-1.89) or only one past-year mental health condition (AOR = 1.39, 1.12-1.73), an incremental increase in insomnia was associated with an increased likelihood of SI. However, in personnel with two or more past-year mental health disorders, insomnia was no longer significantly associated with SI (AOR = 1.04, 0.81-1.33). CONCLUSIONS:Insomnia significantly increased the odds of SI, but only among individuals with no or one mental health condition. Findings highlight the importance of assessing insomnia among CF members in order to further suicide prevention efforts.

SUBMITTER: Richardson JD

PROVIDER: S-EPMC5460415 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Insomnia, psychiatric disorders and suicidal ideation in a National Representative Sample of active Canadian Forces members.

Richardson J D JD Thompson A A King L L Corbett B B Shnaider P P St Cyr K K Nelson C C Sareen J J Elhai J J Zamorski M M

BMC psychiatry 20170606 1

<h4>Background</h4>Past research on the association between insomnia and suicidal ideation (SI) has produced mixed findings. The current study explored the relationship between insomnia, SI, and past-year mental health status among a large Canadian Forces (CF) sample.<h4>Method</h4>Data was obtained from the 2013 Canadian Forces Mental Health Survey (CFMHS), and included a large representative sample of Canadian Regular Forces personnel (N = 6700). A series of univariate logistic regressions wer ...[more]

PMID: 28583100

Similar Datasets

Project description:ObjectiveWith significant levels of mental distress reported by populations, globally, the magnitude of suicidal ideation during and beyond the COVID-19 pandemic is a central concern. The goal of this study was to quantify the extent of pandemic-related suicidal ideation in the Canadian population during the first ten months of the pandemic and identify sociodemographic and pandemic-related stressors associated with increased risk of ideation.MethodData were derived from three rounds of a mental health monitoring survey, nationally representative by age, gender, household income, and region, delivered online in May 2020, September 2020, and January 2021. Bivariate analyses were used to quantify the proportion of respondents in Canada reporting suicidal ideation by sociodemographic factors and pandemic-related stressors. Unadjusted and adjusted multivariable logistic regression was used to study the association between suicidal ideation and correlates within four pandemic-related stressor categories (financial, relationship, substance use, COVID-19 exposure).ResultsOf the 7002 respondents, 6.2% (n = 433) reported experiencing suicidal thoughts or feelings as a result of the pandemic within the two weeks prior to taking the survey. In terms of sociodemographic factors, suicidal ideation was more commonly reported among those who were not cisgender, <65 years-old, single, Indigenous, LGBT2Q+, and who experience a pre-existing mental health condition. After adjusting for sociodemographic factors, indicators across all four pandemic-related stressor categories were associated with two or more times the odds of suicidal ideation.ConclusionDisparities in COVID-19 related suicidal ideation have persisted throughout the first year of the pandemic for specific sociodemographic sub-groups and those who have faced stressors related to finances, relationships, increased substance use, and COVID-19 virus exposure. To best address these disparities and to prevent a transition from suicidal ideation to action, appropriate planning, resources, and policies are needed to ensure health and well-being for everyone.

Project description:ImportanceBecause of increased suicide rates among Black youth in the past 2 decades, there is a dire need for research on suicidal ideation and risk factors in this population.ObjectiveTo examine the direct and indirect associations between online racial discrimination and suicidal ideation through posttraumatic stress disorder symptoms among Black adolescents living in the US, with consideration of potential differential associations by gender and age.Design, setting, and participantsThis cross-sectional study used data drawn from the first wave of the National Survey of Critical Digital Literacy. Black adolescents aged 11 to 19 years were selected from a nationally representative probability-based sample. Data were collected from October 2020 to December 2020 and analyzed from August 2021 to October 2021.Main outcomes and measuresHypotheses of the current study were formulated during research design and grounded in empirical literature. The individual online racial discrimination subscale (Online Victimization Scale), the UCLA Child/Adolescent posttraumatic stress disorder Reaction Index for DSM-5, and an item from the second edition of the Children's Depression Inventory were used to assess constructs. Mediation was assessed through mediation models with path analyses using structural equation modeling.ResultsAmong a total 525 participants, 265 were girls (50.5%) and 251 were boys (47.8%); the mean (SD) age was 14.8 (2.5) years. Findings from structural equation modeling analysis indicated that individual online racial discrimination was associated with posttraumatic stress disorder symptoms (β = 0.49, SE = 0.06, P < .001), and posttraumatic stress disorder symptoms were associated with suicidal ideation (β = 0.51, SE = 0.06, P < .001). Posttraumatic stress disorder was identified as a full mediator between online racial discrimination and suicide (β = 0.25, SE = 0.04, P < .001). No differences by gender or age were found. Furthermore, no significant direct association between online racial discrimination and suicidal ideation was found.Conclusions and relevanceThis study found an association between individual online racial discrimination and posttraumatic stress disorder symptoms and between posttraumatic stress disorder symptoms and suicidal ideation. These risk factors are important to consider in continuing studies of the cause of suicidal ideation for Black adolescents in the US.

Project description:Study objectivesSleep disturbance is significantly associated with suicidal ideation. However, the majority of past research has examined the relationship between insomnia and suicidality. The current exploratory study examined the relationship of circadian rhythm dysregulation (eveningness, seasonality, and rhythmicity) with suicidality.MethodsWe examined the association of insomnia, eveningness, seasonality, and rhythmicity with suicidal ideation in 103 participants with depression, insomnia, and suicidality within a larger 8-week double-blinded randomized control trial primarily examining whether cautious use of zolpidem extended-release or placebo reduced suicidal ideation. All participants additionally received an open-label selective serotonin reuptake inhibitor. Methodological strengths of the current analyses included consideration of multiple sleep-wake constructs, adjustment for relevant covariates, investigation of relationships over the course of treatment, and use of both self-report measures and objective measurement with actigraphy.ResultsOver the course of treatment, self-reported eveningness and greater insomnia severity were independently correlated with greater suicidal ideation, whereas actigraphic delayed sleep timing was related to suicidal ideation at a trend level. At the end of treatment, those with greater suicidal ideation demonstrated lower actigraphic activity levels. There were no significant relationships between self-reported seasonality and actigraphic measures of sleep disturbance and suicidality.ConclusionsSelf-reported delays in sleep timing, objectively lower activity levels, and self-reported insomnia severity correlated independently with greater suicidal ideation in those with depression, insomnia, and suicidality. These exploratory findings highlight the need to consider sleep-wake constructs more broadly in those with suicidality in future research studies in order to improve more definitively both assessment and intervention efforts.Clinical trial registrationRegistry: ClinicalTrials.gov; Name: Reducing Suicidal Ideation through Insomnia Treatment; URL: https://clinicaltrials.gov/ct2/show/NCT01689909; Identifier: NCT01689909 Rumble ME, McCall MV, Dickson DA, Krystal AD, Rosenquist PB, Benca RM. An exploratory analysis of the association of circadian rhythm dysregulation and insomnia with suicidal ideation over the course of treatment in individuals with depression, insomnia, and suicidal ideation. J Clin Sleep Med. 2020;16(8):XXX-XXX.

Project description:OBJECTIVE:The authors sought to determine whether targeted treatment of insomnia with controlled-release zolpidem (zolpidem-CR) in suicidal adults with insomnia would provide a reduction in suicidal ideation superior to placebo. METHODS:Reducing Suicidal Ideation Through Insomnia Treatment was an 8-week three-site double-blind placebo-controlled parallel-group randomized controlled trial of zolpidem-CR hypnotic therapy compared with placebo, in conjunction with an open-label selective serotonin reuptake inhibitor. Participants were medication-free 18- to 65-year-olds with major depressive disorder, insomnia, and suicidal ideation. Suicidal ideation was the main outcome, measured first by the Scale for Suicide Ideation and second by the Columbia-Suicide Severity Rating Scale (C-SSRS). RESULTS:A total of 103 participants were randomly assigned to receive zolpidem-CR (N=51) or placebo (N=52) (64 women and 39 men; mean age=40.5 years). Zolpidem-CR had a robust anti-insomnia effect, especially in patients with the most severe insomnia symptoms. No significant treatment effect was observed on the Scale for Suicide Ideation (least squares mean estimate=-0.56, SE=0.83, 95% CI=-2.19, 1.08), but the reduction in scores was significantly positively related to improvement in insomnia after accounting for the effect of other depression symptoms. The C-SSRS indicated that zolpidem-CR had a significant treatment effect (least squares mean estimate=-0.26, SE=0.12, 95% CI=-0.50, -0.02). The advantage for zolpidem-CR in reducing suicidal ideation on the C-SSRS was greater in patients with more severe insomnia. No deaths or suicide attempts occurred. CONCLUSIONS:Although the results do not support the routine prescription of hypnotic medication for mitigating suicidal ideation in all depressed outpatients with insomnia, they suggest that coprescription of a hypnotic during initiation of an antidepressant may be beneficial in suicidal outpatients, especially in patients with severe insomnia.

Project description:ObjectiveInsomnia has been linked to suicidal ideas and suicide death in cross-sectional and longitudinal population-based studies. A link between insomnia and suicide has not been previously examined in the setting of a clinical trial. Herein we describe the relationship between insomnia and suicidal thinking during the course of a clinical trial for depression with insomnia.MethodsSixty patients aged 41.5±12.5 years (2/3 women) with major depressive episode and symptoms of insomnia received open-label fluoxetine for 9 weeks and also received blinded, randomized eszopiclone 3mg or placebo at bedtime after the first week of fluoxetine. Insomnia symptoms were assessed with the Insomnia Severity Index (ISI), and suicidal ideation was assessed with The Scale for Suicide Ideation (SSI). Depression symptoms were assessed with the depressed mood item and the anhedonia item from the Hamilton Rating Scale for Depression-24 (HRSD24), as well as a sum score for all non-sleep and non-suicide items from the HRSD (HRSD20). Measurements were taken at baseline and weeks 1, 2, 4, 6, and 8. SSI was examined by generalized linear mixed models for repeated measures as the outcome of interest for all 60 participants with ISI and various mood symptoms as independent variables, with adjustment for age, gender, treatment assignment, and baseline SSI.ResultsHigher levels of insomnia corresponded to significantly greater intensity of suicidal thinking (p<0.01). The depressed mood item of the HRSD, and the sum of the HRSD20, both corresponded to greater suicidal thinking (p<0.001). The anhedonia item did not correspond with suicidal thinking. When both ISI and the depressed mood item, or ISI and the anhedonia item, were included together in the same model, the ISI remained an independent predictor of suicidal thinking.ConclusionsThe results support the concept that insomnia may be a useful indicator for suicidal ideation and now extend this idea into clinical trials. Insomnia remains an independent indicator of suicidal ideation, even taking into account the core symptoms of depression such as depressed mood and anhedonia. The complaint of insomnia during a depression clinical trial might indicate that more direct questioning about suicide is warranted.

Dataset Information

Insomnia, psychiatric disorders and suicidal ideation in a National Representative Sample of active Canadian Forces members.

Publications

Insomnia, psychiatric disorders and suicidal ideation in a National Representative Sample of active Canadian Forces members.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets