Surveillance of temporal trends in clinically treated self-harm is an important component of suicide prevention in the dynamic context of COVID-19. There is little evidence beyond the initial months ...following the onset of the pandemic, despite national and regional restrictions persisting to mid-2021.
Descriptive time series analysis utilizing de-identified, primary care health records of 2.8 million patients from the Greater Manchester Care Record. Frequencies of self-harm episodes between 1st January 2019 and 31st May 2021 were examined, including stratification by sex, age group, ethnicity, and index of multiple deprivation quintile.
There were 33,444 episodes of self-harm by 13,148 individuals recorded during the study period. Frequency ratios of incident and all episodes of self-harm were 0.59 (95% CI 0.51 to 0.69) and 0.69 (CI 0.63 to 0.75) respectively in April 2020 compared to February 2020. Between August 2020 and May 2021 frequency ratios were 0.92 (CI 0.88 to 0.96) for incident episodes and 0.86 (CI 0.84 to 0.88) for all episodes compared to the same months in 2019. Reductions were largest among men and people living in the most deprived neighbourhoods, while an increase in all-episode self-harm was observed for adolescents aged 10–17.
Reductions in primary care-recorded self-harm persisted to May 2021, though they were less marked than in April 2020 during the first national lockdown. The observed reductions could represent longer term reluctance to seek help from health services. Our findings have implications for the ability for services to offer recommended care for patients who have harmed themselves.
This work was funded by the UK Research and Innovation/Medical Research Council COVID-19 Rapid Response Initiative (grant reference COV0499) (RTW & SS, NK, DMA, MJC) and by a University of Manchester Presidential Fellowship (SS). MJC, DMA, NK, NP, RW, DAJ and RTW are funded by the National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research center. GT and NP are funded by the National Institute for Health Research (NIHR) Manchester Biomedical Research center.
Classic findings from psychology and the behavioural sciences are increasingly being revisited. Methodological and technological advances provide opportunities to replicate studies across a wide ...range of countries and settings to investigate whether these findings are universally applicable, limited to specific countries, or vary in magnitude depending on settings. Researchers from around the world connect to revisit such findings collaboratively, adapt the original design to the Zeitgeist, integrate new knowledge to improve statistical analyses, and broaden the scope by testing effects globally – or at least in as many countries, as budget and feasibility allow. We currently observe multiple international consortia conducting large-scale multi-country replications. How do such collaborations form and how do they approach these complex investigations? This paper brings together researchers from different initiatives that conduct replications on an international scale to outline approaches and summarises what we have learned in applying them: Junior Researcher Programme (JRP), Psychological Science Accelerator (PSA), ManyBabies, Collaborative Open-science REsearch (CORE), and International Study of Metanorms (ISMN). We describe different ways for study selection, methodological approaches, statistical analyses, ethical issues, and most importantly, how the different collaborations formed and how team communication worked. We look in detail at challenges of including typically underrepresented countries in psychological science, not only in terms of data collection but also in making it possible for local researchers to contribute. This paper provides a structured insight into how different collaborations work and issues to consider for anyone who seeks to conduct a multi-country replication in psychology, or looking for additional perspectives to their existing plan. We close the article with a checklist built as a helpful tool for colleagues putting together their study protocols for such efforts – and invite them to collaboratively expand it in the future.
The association between previous convictions and perpetrating homicide has been previously described but little is known about the characteristics of homicide offenders without previous convictions. ...By utilizing the unique database on homicide offenders held by the National Confidential Inquiry into Suicide and Safety in Mental Health, this study aimed to describe the sample of homicide perpetrators in England and Wales who have committed homicide as their first offense based on their sociodemographic and clinical characteristics. Compared with those with previous convictions, homicide offenders without previous convictions were more likely to be female and a member of an ethnic minority group. More of those without previous convictions belonged to the youngest (<25) and oldest (>55) age groups and were more likely to kill somebody family member or a spouse. Schizophrenia and other delusional disorders as well as affective disorders were more prevalent in those without previous convictions as were mental illness/insanity as a circumstance in homicide, but those without previous convictions were less likely to have been in previous contact with mental health services. There are clear sociodemographic and clinical differences between homicide perpetrators with and without previous convictions. Implications of these findings are discussed.
The use of Open Science practices is often proposed as a way to improve research practice, especially in psychology. Open Science can increase transparency and therefore reduce questionable research ...practices, making research more accessible to students, scholars, policy makers, and the public. However, little is known about how widespread Open Science practices are taught and how students are educated about these practices. In addition, it remains unknown how informing students about Open Science actually impacts their understanding and adoption of such practices. This registered report proposes the validation of a questionnaire. The aim is to survey how much psychology students know about Open Science and to assess whether knowledge of and exposure to Open Science in general-be it through university curricula or social media-influences attitudes towards the concept and intentions to implement relevant practices.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Google search trends have shown promise for predicting suicide deaths. We examined the relationship between search trends data for suicide-related search terms and monthly suicide deaths (2014-2018) ...in Croatia. We identified two suicide prevention search terms, samoubojstvo and suicid (engl. suicide), where an increase in searches preceded a decrease in suicides, and one suicide risk term, kako se ubiti (engl. how to kill yourself), where an increase in searches preceded an increase in suicides. On webpages elicited by suicide-related search terms, factual information about suicide was most common. Results imply the need for a comprehensive online suicide prevention strategy.
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BFBNIB, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Parricide is a rare type of homicide in which mental illness is often an important factor. The aims of this study were (a) to describe the characteristics of parricide offenders with a focus on ...mental illness and clinical care and (b) to examine Heide's widely used typology of parricide through a data‐driven approach. We analyzed all homicides in England and Wales between 1997 and 2014. Parricide offenders in our sample were most often male, unmarried, and unemployed, with a third of offenders diagnosed with schizophrenia; 28% had been in contact with mental health services before the offense. The latent class analysis resulted in three types of parricide offenders: middle‐aged with affective disorder, previously abused, and seriously mentally Ill, which confirmed, to an extent, Heide's typology. Health and social care services should actively engage with carers of people with mental illness and support to those caring for older relatives and victims of abuse.
Suicide is the leading cause of unnatural death among people with schizophrenia. Substance use is a highly prevalent comorbid feature of schizophrenia and a modifiable risk factor for suicide. ...However, no studies have examined changes in the frequency of substance use or self-poisoning in those who died by suicide over time. Knowing this could support more tailored approaches to reducing specific risk factors and access to means in those with schizophrenia who are at risk of suicide. We conducted an 11-year observational study on a clinical survey of people with schizophrenia in the UK who died by suicide within 12 months of contact with mental health services between 2010 and 2020 (n = 2718). Overall, alcohol, cannabis and stimulants were the most frequently reported substances. The odds of lifetime use significantly increased over time for cannabis, stimulants, heroin, and benzodiazepines. There were differences in socio-demographic, behavioural and clinical factors between those with recent and historical alcohol and drug use before death. Deaths by hanging, jumping and self-poisoning were the most common suicide methods. Though deaths by hanging significantly increased over time, deaths by self-poisoning significantly decreased, especially by means of psychotropic medication and opioids. To improve risk management, clinical efforts should focus on identifying and treating people with schizophrenia using specific substances. Nationwide initiatives for improving safety in prescribing could be contributing to reduced risks of suicide via self-poisoning in this group.
Studies on suicide by recently discharged mental health patients have reported a high number of deaths in the early post-discharge period, which has led to recommendations of follow-up within 7 days ...(d). More recently, the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) proposed a more "stringent" follow-up period of 2-3 days (d) after discharge. Patients who died within this early time-frame post-discharge were more likely to die before the follow-up appointment occurred. They more often had a primary diagnosis of a personality disorder, self-discharged, and had a higher frequency of death by jumping from a height or in front of the vehicle compared to later deaths. This study provides practical implications for post-discharge management and safety planning. Clinicians should be aware of (1) the increased risk of immediate suicide in the post-discharge period by people with a diagnosis of personality disorder, (2) immediate suicide risk in patients who initiate their own discharge, and (3) the increased risk of death by jumping from a height or in front of the vehicle in the immediate post-discharge period. Our findings support the recent recommendation from NCISH that follow-up should occur within 3 d of discharge from in-patient care.
Reducing suicide risk in middle-aged males (40-54 years) is a national priority. People have often presented to their GP within 3 months before suicide thus highlighting an opportunity for early ...intervention.
To describe the sociodemographic characteristics and identify antecedents in middle-aged males who recently consulted a GP before dying by suicide.
This study was a descriptive examination of suicide in a national consecutive sample of middle-aged males in 2017 in England, Scotland, and Wales.
General population mortality data were obtained from the Office for National Statistics and National Records of Scotland. Information was collected about antecedents considered relevant to suicide from data sources. Logistic regression examined associations with final recent GP consultation. Males with lived experience were consulted during the study.
In 2017, a quarter (
= 1516) of all suicide deaths were in middle-aged males. Data were attained on 242 males: 43% had their last GP consultation within 3 months of suicide; and a third of these males were unemployed and nearly half were living alone. Males who saw a GP recently before suicide were more likely to have had recent self-harm and work-related problems than males who had not. Having a current major physical illness, recent self-harm, presenting with a mental health problem, and recent work-related issues were associated with having a last GP consultation close to suicide.
Clinical factors were identified that GPs should be alert to when assessing middle-aged males. Personalised holistic management may have a role in preventing suicide in these individuals.
There are comparatively few international studies investigating suicide in military veterans and no recent UK-wide studies. This is important because the wider context of being a UK Armed Forces ...(UKAF) veteran has changed in recent years following a period of intensive operations. We aimed to investigate the rate, timing, and risk factors for suicide in personnel who left the UKAF over a 23-year period.
We carried out a retrospective cohort study of suicide in personnel who left the regular UKAF between 1996 and 2018 linking national databases of discharged personnel and suicide deaths, using survival analysis to examine the risk of suicide in veterans compared to the general population and conditional logistic regression to investigate factors most strongly associated with suicide after discharge. The 458,058 individuals who left the UKAF accumulated over 5,852,100 person years at risk, with a median length of follow-up of 13 years, were mostly male (91%), and had a median age of 26 years at discharge. 1,086 (0.2%) died by suicide. The overall rate of suicide in veterans was slightly lower than the general population (standardised mortality ratio, SMR 95% confidence interval, CI 94 88 to 99). However, suicide risk was 2 to 3 times higher in male and female veterans aged under 25 years than in the same age groups in the general population (age-specific mortality ratios ranging from 160 to 409). Male veterans aged 35 years and older were at reduced risk of suicide (age-specific mortality ratios 47 to 80). Male sex, Army service, discharge between the ages of 16 and 34 years, being untrained on discharge, and length of service under 10 years were associated with higher suicide risk. Factors associated with reduced risk included being married, a higher rank, and deployment on combat operations. The rate of contact with specialist NHS mental health services (273/1,086, 25%) was lowest in the youngest age groups (10% for 16- to 19-year-olds; 23% for 20- to 24-year-olds). Study limitations include the fact that information on veterans was obtained from administrative databases and the role of pre-service vulnerabilities and other factors that may have influenced later suicide risk could not be explored. In addition, information on contact with support services was only available for veterans in contact with specialist NHS mental health services and not for those in contact with other health and social care services.
In this study, we found suicide risk in personnel leaving the UKAF was not high but there are important differences according to age, with higher risk in young men and women. We found a number of factors which elevated the risk of suicide but deployment was associated with lower risk. The focus should be on improving and maintaining access to mental health care and social support for young service leavers, as well as implementing general suicide prevention measures for all veterans regardless of age.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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