BACKGROUND: Most studies have reported that suicide mortality rates are negatively associated with lithium levels in tap water; however, a few studies showed either no association or a positive association. Thus, the association between suicide mortality and lithium levels in tap water remains controversial. To clarify the association, our study evaluated the association between lithium levels in tap water and suicide mortality rates in Miyazaki Prefecture of Japan, after adjusting for confounding factors. METHODS: We measured lithium levels in tap water across the 26 municipalities of Miyazaki Prefecture in Japan. We examined the standardized mortality ratio (SMR) for suicide in each municipality and used the data as the average suicide SMRs over 5 years (2009-2013). Weighted least-squares regression analysis, adjusted for the size of each municipality's population, was used to investigate the association between lithium levels in tap water and suicide SMRs. In addition to a crude model, in an adjusted model, potential confounding factors (proportion of elderly people, proportion of one-person households, annual marriage rate, annual mean income, unemployment rate, the density of medical doctors per 100,000 people, annual total rainfall, and proportion of people with a college education or higher) were added as covariates. RESULTS: We showed that male and female suicide SMRs were not associated with lithium levels in tap water in Miyazaki Prefecture. After adjusting for confounders, male suicide SMRs were significantly and positively associated with the proportion of elderly people in the population and annual total rainfall, and female suicide SMRs were associated with the proportion of elderly people in the population. CONCLUSIONS No association between lithium levels in tap water and suicide mortality rates was found in Miyazaki Prefecture.
Drinking Water ; analysis ; Female ; Humans ; Japan ; Lithium ; analysis ; Male ; Suicide ; statistics & numerical data

BACKGROUND: Individual attitudes toward suicide are known to markedly influence suicidal ideation and suicidal behavior. Therefore, this study aimed to determine the factors associated with attitudes toward suicide.METHODS: This study was conducted on 3,213 adult men and women living in a province of Korea. After excluding 281 participants because of unreliable responses, the remaining 2,932 were included in the data analysis. Demographic factors were investigated, and psychological factors were evaluated. Attitudes toward suicide were evaluated using the Attitudes Towards Suicide-20, physical symptoms were evaluated using the Patient Health Questionnaire-15 (PHQ-15), self-compassion was evaluated using the Korean Self-Compassion Scale, and stress was evaluated using the Global Assessment of Recent Stress (GARS) scale. One-way analysis of variance was used to examine the psychological characteristics of attitudes toward suicide.RESULTS: Differences in various factors based on demographic characteristics were observed regarding attitudes toward suicide. Significant differences in attitudes toward suicide were observed based on severity of suicide, acceptability (F=20.332, p<0.001), prevention of suicide (F=7.700, p<0.001), and universality (F=13.741, p<0.001). The duration of suicidal ideation, self-kindness, self-judgment, common humanity, isolation, and over-identification showed differences, as did the GARS and PHQ-15 scores.CONCLUSION: This study explored the demographic and psychological factors affecting attitudes toward suicide. Adequate mediation of these factors is needed to prevent suicidal ideation and behavior.
Adult ; Demography ; Empathy ; Female ; Humans ; Korea ; Male ; Negotiating ; Psychology ; Statistics as Topic ; Stress, Psychological ; Suicidal Ideation ; Suicide

PURPOSE: The purpose of this study is to investigate how sexual experience associate with the suicide ideation, suicide plan and suicide attempt among culturally diverse adolescents compared with Korean adolescents. METHODS: This study used a secondary data analysis study with the data derived from the 10~12th (2014~2016) Korean Youth Risk Behavior Web-based Survey. Data of 2,201 culturally diverse adolescents and 189,278 Korean adolescents were analyzed. Descriptive statistics, χ² test, and hierarchical logistic regression were used for data analysis. RESULTS: After controlled for individual, family and social factors as compounding variables, the suicide ideation of culturally diverse adolescents with sexual experience was higher for 1.72 (95% CI: 1.24~2.38), suicide plan for 2.24 (95% CI: 1.58~3.17) and suicide attempt for 2.71 (95% CI: 1.87~3.93) compared to Korean adolescents without sexual experience. Regardless of cultural diversity, the risk of suicide ideation, suicide plan and suicide attempt of adolescents with sexual experience was higher than adolescents without sexual experience. CONCLUSION: Our study findings indicate the highest need to prevent suicide ideation, suicide plan and suicide attempt among culturally diversity adolescents with sexual experience among all the other adolescents' group.
Adolescent ; Cultural Diversity ; Humans ; Logistic Models ; Risk-Taking ; Sexual Behavior ; Statistics as Topic ; Suicide

This study provides a statistical analysis of 1,226 cases of death occurring in Area 8, Seoul Metropolitan Police Agency (Gangseo, Yangcheon, and Guro Police Stations) from January 1 to December 31, 2017. There were 427 postmortem inspection cases in Gangseo, 393 in Yangcheon, 377 in Guro, and 29 in other areas. The number of autopsy cases was 69 in Gangseo, 70 in Yangcheon, 86 in Guro, and seven in other areas. According to the postmortem inspection reports, there were 593 cases of natural death and 336 cases of unnatural death, while in 297 cases the cause of death was unknown. Of the 297 unknown cases, autopsy rates from each police station were as follows: 54 of 99 cases (54.5%) in Gangseo, 60 of 101 cases (59.4%) in Yangcheon, 67 of 93 cases (72.0%) in Guro, and in all four cases (100%) from other areas. Unnatural deaths included 215 cases of suicide, nine cases of homicide, and 64 accidental death, while 48 cases were undetermined. Among the unnatural deaths, the cause of death included 138 cases of hanging, 72 cases of falls from a height, and 32 cases of poisoning. Since this statistical study is based on actual postmortem inspection data for 1,226 cases of death in the eight areas of Seoul (excluding deaths from traffic accidents), it raises issues relating to the current postmortem inspection system, and can be used as reference material for a comprehensive overview of causes of death.
Accidental Falls ; Autopsy ; Cause of Death ; Homicide ; Humans ; Poisoning ; Police ; Seoul ; Statistics as Topic ; Suicide

A case-control study was conducted to investigate associations between organophosphate pesticide (OP) exposure, aggression, impulsivity, and attempted suicide. Questionnaires were used to collect information; impulsivity and aggression were measured by the Barratt Impulsivity Scale (BIS) and the Aggression Inventory (AI). A greater number of OP symptoms was associated with an increased odds of a suicide attempt after adjusting for marital status and income (OR = 1.45; CI 1.14-1.86). Attempted suicide was significantly associated with high impulsivity scores (means: 72.4 vs. 60.6, P < 0.0001) and high aggression scores (means: 38.5 vs. 26.1, P < 0.0001). Suicide attempters had a higher number of OP exposure symptoms than controls and scored higher on scales of impulsivity and aggression.
Adult ; Aggression ; Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Impulsive Behavior ; Male ; Middle Aged ; Occupational Exposure ; Organophosphate Poisoning ; complications ; Organophosphates ; adverse effects ; Pesticides ; adverse effects ; Risk Factors ; Suicide, Attempted ; statistics & numerical data

BackgroundPatients with major depressive disorder (MDD) usually have high risk of suicidality. Few studies have investigated the effects of stressful life events (SLEs) on the risk of suicide in Chinese patients who have developed MDD. This study aimed to investigate the impact of SLEs on suicidal risk in Chinese patients with MDD.

MethodsIn total, 1029 patients with MDD were included from nine psychiatric hospitals to evaluate the impact of SLEs on suicidal risk. Patients fulfilling the Mini-International Neuropsychiatric Interview (MINI) criteria for MDD were included in the study. Patients were excluded if they had lifetime or current diagnoses of psychotic disorder, bipolar disorder, and alcohol or substance dependence. Depressive symptoms were assessed by the 17-item Hamilton Depression Scale (HAMD-17). The suicidal risk of MDD patients was determined by the suicide risk module of MINI. SLEs were assessed by the Life Events Scale.

ResultsNo gender difference was found for suicidal risk in MDD patients. Patients with suicidal risk had younger ages, lower education levels, more drinking behavior, and lower marriage rate, and fewer people had child and more severe depressive symptoms than nonsuicidal risk group. High-level perceived stressfulness (HPS) and number of SLEs that patients were exposed to were significantly greater in patients with suicidal risk than patients without. In multivariate logistic analysis, HPS of SLEs (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16-2.05, P = 0.003) and depressive symptoms (OR = 1.08, 95% CI: 1.05-1.11, P < 0.001) were associated with suicidal risk even after adjustment of gender, age, marriage, drinking behavior, and childless.

ConclusionsHPS of SLEs is associated with suicide risk in Chinese patients with MDD. Further suicide prevention programs targeting this risk factor are needed.

Trial RegistrationClinicalTrials.gov: NCT02023567; https://clinicaltrials.gov/ct2/show/NCT02023567?term=NCT02023567&rank=1.

Adolescent ; Adult ; Asian Continental Ancestry Group ; Bipolar Disorder ; epidemiology ; psychology ; Depressive Disorder, Major ; epidemiology ; psychology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; Psychiatric Status Rating Scales ; Risk Factors ; Suicide ; psychology ; statistics & numerical data ; Young Adult

PURPOSE: The purpose of this study was to construct and test a hypothetical model about impact of parents' problem drinking on suicidal ideation of their children who are university students and the multiple mediating effects of childhood trauma, experiential avoidance, and depression based on stress-vulnerability model. METHODS: A purposive sample of 400 university students was recruited from three universities in provincial areas and the data were collected between October and November 2016. The collected data were then analyzed using SPSS 20.0 and AMOS 20.0 programs. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Multiple mediating effects analysis using phantom variable and bootstrapping were implemented to verify the mediating effect of the research model. RESULTS: We found no significant direct effect on depression and suicidal ideation of parents' problem drinking, but multiple mediating effects of childhood trauma and experiential avoidance between parents' problem drinking and depression (B=.38, p=.001). The path from parents' problem drinking to suicidal ideation was significantly mediated by childhood trauma and depression (B=.02, p=.016) and by childhood trauma, experiential avoidance, and depression (B=.05, p=.011), but experiential avoidance did not have a significant direct effect on suicidal ideation (B=.02, p=.616). CONCLUSION: Based on the results of this study, it can be suggested that in order to decrease depression and prevent suicide of university students, considering of parents' problem drinking and childhood trauma, intervention methods that decreased chronic use of experiential avoidance and strengthen acceptance should be developed and made available to them.
Child* ; Depression* ; Drinking* ; Humans ; Negotiating* ; Parents ; Psychological Trauma ; Statistics as Topic ; Suicidal Ideation* ; Suicide

PURPOSE: This study investigated the sexual behaviors, emotional state, and suicide-related characteristics of female adolescents with sexual experience. METHODS: This is a secondary data analysis study using the data of the 11th (2015) Youth Health Behavior Online Survey. The subjects were 889 female students who had sexual intercourse experience in middle and high schools in the Republic of Korea. For data analysis, descriptive statistics, χ² test, and hierarchical logistic regression were used. RESULTS: Among the subjects, 22.2% reported having experienced homosexual or bisexual relations. The sexual debut time of 31.9% of the subjects was in elementary school or earlier, while 8.1% and 10.7% experienced pregnancy and sexually transmitted diseases, respectively. They reported negative emotional states (high stress 51.7%, unhappiness 17.8%, depressive mood 9.8%) and substantial suicide experiences (suicidal ideation 33.6%, suicidal plan 16.6%, suicidal attempt 13.2%). Through hierarchical logistic regression (Cox & Snell R²=.31), the influencing factors for suicide ideation identified included being subjected to sexual relations, experience of pregnancy, perceived stress and happiness, and depressive mood. CONCLUSION: It is important to prevent negative mental health consequences among female students with early sexual experience. Sexual education should strengthen their physical and mental safety through psychological care strategies.
Adolescent ; Bisexuality ; Coitus ; Education ; Female ; Happiness ; Health Behavior ; Homosexuality ; Humans ; Logistic Models ; Mental Health ; Pregnancy ; Republic of Korea ; Sexual Behavior ; Sexually Transmitted Diseases ; Statistics as Topic ; Suicidal Ideation ; Suicide

PURPOSE: The aim of this study was to examine factors influencing depression and suicide attempts among South Korean adolescent victims of violence. METHODS: This secondary data analysis was based on the 11th (2015) Korea Youth Risk Behavior Web-based survey. The study sample comprised of 1,565 students who were victims of violence and subsequently required medical treatment during the past 12 months. Descriptive statistics and logistic regression analyses were completed. RESULTS: Factors associated with adolescent depression due to violence were residence type, perceived happiness, sleep satisfaction, perceived stress, perceived health, gender, lifetime smoking habits, number of violent experiences, and lifetime alcohol consumption habits. Factors associated with adolescent suicide attempts were perceived health, residence type, number of violent experiences, lifetime smoking habits, and gender. CONCLUSION: Our study findings show that different factors affect depression and suicide attempts among Korean juvenile victims of violence. Therefore, considering these factors, it is necessary to prepare intervention strategies that include family-centered support systems, improvement in coping ability of the individual and counselors who have experience with juvenile victims of violence.
Adolescent ; Alcohol Drinking ; Counseling ; Depression ; Exposure to Violence ; Happiness ; Humans ; Korea ; Logistic Models ; Risk-Taking ; Smoke ; Smoking ; Statistics as Topic ; Suicide ; Suicide, Attempted ; Violence

BACKGROUND: Suicide is the number one cause of youth death in Korea. Suicide rate differ by age groups. Suicide ideation provides useful information to understand and predict suicide. It is unclear whether the prevalence and risk factors of suicidal ideation of adolescents differ among age groups. This study aimed to compare the prevalence and risk factors of suicidal ideation by age groups among the adolescents in Korea. METHODS: This cross-sectional study used Fifth Korean National Health and Nutrition Examination Survey (KNHANES V-3, 2012). The participants were divided into three age groups: the first adolescents (9–14 years, n=628), middle adolescents (15–19 years, n=361), and latter adolescents (20–24 years, n=276) groups. Multiple logistic regression was used for data analysis. RESULTS: The prevalence of suicidal ideation was 15.1% of first adolescents, 16.4% of middle adolescents, and 15.6% of latter adolescents, respectively. There was no difference on prevalence of suicidal ideation by age groups. Among risk factors of suicidal ideation, sex (female) was risk factor in the first and latter adolescents, depression and stress were risk factors in all age adolescents. CONCLUSIONS: Suicide prevention in adolescents should be done from the upper grades of elementary school and focus on strategies to reduce depression and stress according to adolescents characteristics. Also, female adolescents should not overlook the high risk of suicidal ideation.
Adolescent ; Cross-Sectional Studies ; Depression ; Humans ; Korea ; Logistic Models ; Nutrition Surveys ; Prevalence ; Risk Factors ; Statistics as Topic ; Suicidal Ideation ; Suicide