The Hippocratic Risk: Epidemiology of Suicide in a Sample of Medical Undergraduates.
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ABSTRACT:
SUBMITTER: Tarchi L
PROVIDER: S-EPMC8110500 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundInpatient suicide is one of the major issues related with hospital patient safety. Although there are many studies addressing suicide in the psychiatric unit, little is known about suicide in a medical setting. This study included the development and validation of a screening tool for the assessment of suicide risk, specialized for medical inpatients.MethodsThe preliminary questionnaire was based on review of previous suicide ideation scales, mood scales, and clinical experiences of psychiatrists and clinical psychologists in Korea. Initially, the questionnaire consisted of 12 questions. One hundred adult medical inpatients were asked to perform the questionnaire. Explorative factor analysis was used to examine construct validity. Concurrent validity was evaluated by comparison with the Korean versions of the Beck Scale for Suicide Ideation (BSI), the Beck Hopelessness Scale (BHS), and the Hospital Anxiety and Depression Scale (HADS).ResultsFive questions were removed from the preliminary questionnaire by explorative factor analysis and seven questions remained to comprise the Suicide Risk Scale for Medical inpatients (SRSM). Explorative factor analysis showed that the SRSM is composed of a single factor. SRSM was highly reliable in terms of internal consistency (Cronbach's alpha 0.91). Concurrent validity with the BSI, BHS, and HADS was statistically significant. The proposed cut-off score of the SRSM was five.ConclusionIn conclusion, the SRSM is a valid and reliable measure for screening suicide risks in medical inpatients.
| S-EPMC5729646 | biostudies-literature
Project description:IntroductionSuicide risk assessment based on self-report questionnaires is considered as problematic because risk states are dynamic and at-risk individuals may conceal suicidal intentions for several reasons. Therefore, recent research efforts increasingly focus on implicit risk markers such as the suicide attentional bias (SAB) measured with the Suicide Stroop Task (SST). However, most SST studies failed to demonstrate a SAB in individuals with suicide risk and repeatedly demonstrated insufficient psychometrics of the SST. This study aimed to investigate a SAB using a modified SST (M-SST) and to test its psychometric properties.MethodWe compared n = 61 healthy controls and a high-risk inpatient sample of n = 40 suicide ideators and n = 40 suicide attempters regarding interference scores of positive, negative and suicide-related words. Interference scores were calculated by subtracting the mean reaction time (mean RT) of the neutral words from the mean RT of the suicide-related words (mean RT Suicide -mean RT Neutral), resulting in a suicide-specific interference score. Similarly, interference scores were calculated for the positive and negative words by subtracting the mean RT of neutral words from the mean RT of positive and negative words.ResultsA Group × Interference ANOVA showed a significant interaction effect (p <.001, ηp2 = .09), indicating that group effects significantly vary across interference type. Post hoc comparisons revealed that both ideators and attempters demonstrated greater interferences only for suicide-related words compared to healthy controls, indicating a SAB in patients, while a difference between ideators and attempters was lacking. The suicide interference score classified with an AUC = 0.73, 95% CI [0.65 - 0.82], p <.001, between controls and patients with STBs. The M-SST demonstrated good internal consistency and convergent validity.DiscussionThe study adds evidence to the assumptions of the Cognitive Model of Suicide, viewing a SAB as a cognitive marker of suicide vulnerability independently of the engagement in suicidal behavior. The results' clinical implications are discussed in the context of recommended intervention strategies during an acute suicidal state. Future studies with the M-SST should include non-suicidal patient controls to investigate whether a SAB is uniquely related to suicidality.
| S-EPMC11335530 | biostudies-literature
Project description:OBJECTIVE: To assess the prevalence and level of dental fear among health related undergraduates and to identify factors causing such fear using Kleinknecht's Dental Fear Survey (DFS) questionnaire. METHODS: Kleinknecht's DFS questionnaire was used to assess dental fear and anxiety among the entire enrollment of the medical and dental undergraduates' of the University of Malaya. RESULTS: Overall response rate was 82.2%. Dental students reported higher prevalence of dental fear (96.0% versus 90.4%). However, most of the fear encountered among dental students was in the low fear category as compared to their medical counterpart (69.2 versus 51.2%). Significantly more medical students cancelled dental appointment due to fear compared to dental students (P = 0.004). "Heart beats faster" and "muscle being tensed" were the top two physiological responses experienced by the respondents. "Drill" and "anesthetic needle" were the most fear provoking objects among respondents of both faculties. CONCLUSION: Dental fear and anxiety are a common problem encountered among medical and dental undergraduates who represent future health care professionals. Also, high level of dental fear and anxiety leads to the avoidance of the dental services.
| S-EPMC4216710 | biostudies-other
Project description:Suicide is an increasing global concern with multiple risk factors, yet location-based understanding is limited. In Australia, surf lifesavers (SLS) and lifeguards patrol the coast, performing rescues and assisting injured people, including people who suicide. This study is a descriptive epidemiological analysis of Australian coastal suicide deaths. The results will be used to inform training and support surf lifesaving personnel and suicide prevention organisations. This is a population-based cross-sectional study of suicide deaths at Australian coastal locations (between 1 January 2005 and 31 December 2019). Data were sourced from the National Coronial Information System and SLS Australia's Incident Report Database. Analyses explored decedent, incident, and risk factors by sex and method. Across the study period, there were 666 coastal suicide deaths (71.0% male, 43.4% jumping from high places [X80]). Males were more likely to suicide by other means (hanging, self-poisoning, firearm discharge; n = 145, 83.8%), compared to females who were more likely to suicide by drowning ([X71]; n = 77, 37.7%). In one third (n = 225, 38.3%) toxicology was a contributing factor. The risk of coastal suicides was 10.3 times higher during the seven-days prior to their birthday (p<0.001). Evidence of mental ill health was reported in 61.4% (n = 409) of cases and evidence of suicidal behaviour was reported for 37.4% of decedents (n = 249), more prevalent in females. SLS responded in 10.7% (n = 71) of coastal suicides (most jumps from high places; n = 36, 50.7%). Coastal suicides differ to national trends suggesting that location-based differences should be considered during development of preventative and protective measures, especially at a community level. Accessibility, availability, perceived lethality and symbolic qualities are proposed to influence suicide location decisions. These results will guide support and education strategies for surf lifesaving personnel, contributes to established, ongoing suicide surveillance efforts (including hot-spot identification) and add to the limited literature exploring place-based suicide.
| S-EPMC8136651 | biostudies-literature
Project description:BACKGROUND:The role of radiology in medicine and healthcare is rapidly expanding worldwide, but awareness about this field among medical students is poor. This is the first study to assess Syrian medical students' knowledge and attitude regarding radiology. METHODS:This is a cross-sectional study conducted at the Syrian Private University, on November 8, 2019, on the International Day of Radiology during the war crisis. Data were collected through self-administered surveys and analyzed using the Statistical Package for Social Sciences version 25.0 (SPSS Inc., Chicago, IL, USA). RESULTS:The questionnaire was completed by 269 students whose ages ranged between 17 and 30 years old. Males constituted 63.6% of the respondents. The results revealed adequate knowledge about the basics of radiology. 73.6% of the students had previously heard about interventional radiology. There were slight misconceptions with certain points in each section, especially those pertaining to the radiation exposure of each imaging method. Finally, the students expressed low interest in radiology as a future career (24.5%). CONCLUSIONS:The level of awareness can affect a student's decision in considering radiology as a future career. Further evaluation of the methods of teaching, input from medical boards, curriculum advisors, and guidance from radiologists is required.
| S-EPMC7683655 | biostudies-literature
Project description:AimTo enable early identification of university students at high risk for suicide, we examined personality as a predictive factor for major depressive episodes and suicide-related ideation.MethodsFrom 2011 to 2013, we administered the Patient Health Questionnaire-9 (PHQ-9) and the Temperament and Character Inventory (TCI) to 1,997 university students at enrollment (T1). We previously conducted a study using the same data set; this is a re-analysis of the dataset. To prevent contamination of data, participants diagnosed with a depressive episode were excluded at T1. Three years after enrollment (T2), we re-administered the PHQ-9 to the same students. We statistically compared TCI scores at T1 among depressive episode groups and suicide-related ideation groups. Two-way ANOVA and Cochran-Armitage trend tests were used to analyze the relationships between personality traits, depressive episodes, and suicide-related ideation.ResultsThe PHQ-9 summary scores at baseline (T1) were 3.0 (±2.7), with female students scoring 4.6 (±2.9) and male students 2.9 (±2.6, p = 0.025). The major depressive episode group at T2 had lower self-directedness (SD) scores at T1 than the non-depressive episode control group. The suicide-related ideation (SI) group at T2 also had higher harm avoidance (HA), lower SD, and lower cooperativeness (C) scores than the non-SI group at T1. The Cochran-Armitage trend tests revealed significant associations between character configurations composed of SD and C, and both depressive episodes at T2 and SI at T2.ConclusionThe temperament feature of high HA at baseline and character configurations of low SD and low C at baseline are the most contributory predictors for the novel development of depressive episodes and SI among Japanese university students.
| S-EPMC8115841 | biostudies-literature
Project description:ObjectiveThe Suicide Risk Assessment and Management Decision Tree (DT) is a clinician-administered assessment that leads to risk categorizations that correspond with actionable strata. This study investigated the construct validity and test-retest reliability of the DT risk categories across two time points.MethodOutpatients (N = 731) completed a battery of self-report measures. Spearman's correlations were used to examine the relationships between DT suicide risk level and suicidal symptoms, theory-based risk factors, psychiatric correlates, and DT suicide risk level at Timepoint 2. Correlations were analyzed for significant differences to examine the divergent validity of the DT.ResultsResults, overall, were in line with hypotheses, with the exception of depression and thwarted belongingness.ConclusionsFindings provide evidence for the reliability, convergent validity, and discriminant validity of the DT. This clinician-administered suicide risk assessment may be useful for standardization of the assessment and management of suicide risk in outpatient clinical settings.
| S-EPMC7666059 | biostudies-literature
Project description:ObjectivesPrevious research has suggested that medical marijuana policies lead to reductions in suicide rates. In this study, we further investigate the association between these policies and within-state changes in suicide risk.MethodsData on suicide deaths (n=662,993) from the National Vital Statistics System Multiple Cause of Death files were combined with living population data. Fixed-effects regression methods were employed to control for state differences in suicide rates and national and state secular trends. Analyses extended prior research that suggested a protective effect of medical marijuana policies by incorporating newer data and additional covariates.ResultsAfter adjustment for race/ethnicity, tobacco control policies, and other covariates, we found no association between medical marijuana policy and suicide risk in the population ages 15 and older (OR=1.000; 95% CI: 0.956, 1.045; p=0.98), among men overall (OR=0.996; 95% CI: 0.951, 1.043; p=0.87) or for any other age-by-sex groups.ConclusionWe find no statistically significant association between medical marijuana policy and suicide risk. These results contradict prior analyses which did not control for race/ethnicity and certain state characteristics such as tobacco control policies. Failure to control for these factors in future analyses would likely bias estimates of the associations between medical marijuana policy and health outcomes.
| S-EPMC4459507 | biostudies-literature
Project description:BackgroundAdolescent suicide is a major health problem in the US marked by a recent increase in risk of suicidal behavior among Black/African American youth. While genetic factors partly account for familial transmission of suicidal behavior, it is not clear whether polygenic risk scores of suicide attempt can contribute to suicide risk classification.ObjectivesTo evaluate the contribution of a polygenic risk score for suicide attempt (PRS-SA) in explaining variance in suicide attempt by early adolescence.MethodsWe studied N = 5,214 non-related youth of African and European genetic ancestry from the Adolescent Brain Cognitive Development (ABCD) Study (ages 8.9-13.8 years) who were evaluated between 2016 and 2021. Regression models tested associations between PRS-SA and parental history of suicide attempt/death with youth-reported suicide attempt. Covariates included age and sex.ResultsOver three waves of assessments, 182 youth (3.5%) reported a past suicide attempt, with Black youth reporting significantly more suicide attempts than their White counterparts (6.1 vs. 2.8%, p < 0.001). PRS-SA was associated with suicide attempt [odds ratio (OR) = 1.3, 95% confidence interval (CI) 1.1-1.5, p = 0.001]. Parental history of suicide attempt/death was also associated with youth suicide attempt (OR = 3.1, 95% CI, 2.0-4.7, p < 0.001). PRS-SA remained significantly associated with suicide attempt even when accounting for parental history (OR = 1.29, 95% CI = 1.1-1.5, p = 0.002). In European ancestry youth (n = 4,128), inclusion of PRS-SA in models containing parental history explained more variance in suicide attempt compared to models that included only parental history (ΔR 2 = 0.7%, p = 0.009).ConclusionsFindings suggest that PRS-SA may be useful for youth suicide risk classification in addition to established risk factors.
| S-EPMC9515424 | biostudies-literature
Project description:Misconduct during medical school predicts subsequent fitness to practise (FtP) events in doctors, but relatively little is known about which factors are associated with such issues during undergraduate education. This study exploits the newly created UK medical education database (UKMED), with the aim of identifying predictors of conduct or health-related issues that could potentially impair FtP. The findings would have implications for policies related to both the selection and support of medical students.Data were available for 14,379 students obtaining provisional registration with the General Medical Council who started medical school in 2007 and 2008. FtP declarations made by students were available, as were various educational and demographic predictor variables, including self-report 'personality measures' for students who participated in UK Clinical Aptitude Test (UKCAT) pilot studies. Univariable and multivariable logistic regression models were developed to evaluate the predictors of FtP declarations.Significant univariable predictors (p?<?0.05) for conduct-related declarations included male gender, white ethnicity and a non-professional parental background. Male gender (OR 3.07) and higher 'self-esteem' (OR 1.45) were independently associated with an increased risk of a conduct issue. Female gender, a non-professional background, and lower self-reported 'confidence' were, among others, associated with increased odds of a health-related declaration. Only 'confidence' was a significant independent predictor of a health declaration (OR 0.69). Female gender, higher UKCAT score, a non-professional background and lower 'confidence' scores were significant predictors of reported depression, and the latter two variables were independent predictors of declared depression.White ethnicity and UK nationality were associated with increased odds of both conduct and health-related declarations, as were certain personality traits. Students from non-professional backgrounds may be at increased risk of depression and therefore could benefit from targeted support. The small effect sizes observed for the 'personality measures' suggest they would offer little potential benefit for selection, over and above those measures already in use.
| S-EPMC5887261 | biostudies-literature