Search

Background: Previous studies of pubertal timing and self-harm are limited by subjective measures of pubertal timing or by the conflation of self-harm with suicide attempts and ideation. The current study investigates the association between an objective measure of pubertal timing – age at menarche – and self-harm with and without suicidal intent in adolescence and adulthood in females. Method: Birth cohort study based on 4042 females from the Avon Longitudinal Study of Parents and Children (ALSPAC). Age at menarche was assessed prospectively between ages 8 and 17 years. Lifetime history of self-harm was self-reported at ages 16 and 21 years. Associations between age at menarche and self-harm, both with and without suicidal intent, were examined using multivariable logistic regression. Results: Later age at menarche was associated with a lower risk of lifetime self-harm at age 16 years (OR per-year increase in age at menarche 0.87; 95% CI 0.80–0.95). Compared with normative timing, early menarche (<11.5 years) was associated with an increased risk of self-harm (OR 1.31, 95% CI 1.04–1.64) and later menarche (>13.8 years) with a reduced risk (OR 0.74, 95% CI 0.58–0.93). The pattern of association was similar at age 21 years (OR per-year increase in age at menarche 0.92, 95% CI 0.85–1.00). There was no strong evidence for a difference in associations with suicidal v. non-suicidal self-harm. Conclusions: Risk of self-harm is higher in females with early menarche onset. Future research is needed to establish whether this association is causal and to identify potential mechanisms. [ABSTRACT FROM AUTHOR]

Background: Mental illness is a worldwide public health concern. In the UK, there is a high prevalence of mental illness and poor mental wellbeing among young people. The aim of this study was to investigate whether physical activity is associated with better mental wellbeing and reduced symptoms of mental health disorder in adolescents. Methods: A cohort of 928 12–13 year olds (Year 8) from six secondary schools in England, who had participated in the AHEAD trial, 'Activity and Healthy Eating in Adolescence', were followed up three years later (when 15–16 years old, Year 11). At baseline, physical activity was measured using accelerometers. At follow-up, mental wellbeing was measured using the 'Warwick Edinburgh Mental Wellbeing Scale' (WEMWBS) and symptoms of mental health disorder using the 'Strengths and Difficulties Questionnaire' (SDQ). Multivariable linear regression analyses were used to investigate associations between physical activity and both mental wellbeing and symptoms of mental health disorder. Results: 794 (86%) of the eligible 928 young people provided valid accelerometer data at baseline. 668 (72%) provided complete mental wellbeing data and 673 (73%) provided complete symptoms of mental health disorder data at follow-up. The multivariable analyses showed no evidence of an association between physical activity volume (counts per minute (cpm)) or intensity (Moderate to Vigorous Physical Activity (MVPA)) and mental wellbeing (WEMWBS overall score) or overall symptoms of mental health disorder (SDQ Total Difficulties Score). However, higher levels of physical activity volume at age 12–13 years were associated with lower scores on the emotional problems subscale of the SDQ at age 15–16 years. Conclusions: This cohort study found no strong evidence that physical activity is associated with better mental wellbeing or reduced symptoms of mental health disorder in adolescents. However, a protective association between physical activity and the emotional problems subscale of the SDQ was found. This suggests that physical activity has the potential to reduce symptoms of depression and anxiety in adolescents. Future cohort study designs should allow for repeated measures to fully explore the temporal nature of any relationship. [ABSTRACT FROM AUTHOR]

Background: Adverse childhood experiences (ACEs) such as physical and emotional abuse are strongly associated with self‐harm, but mechanisms underlying this relationship are unclear. Inflammation has been linked to both the experience of ACEs and self‐harm or suicide in prior research. This is the first study to examine whether inflammatory markers mediate the association between exposure to ACEs and self‐harm. Methods: Participants were 4,308 young people from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population‐based birth cohort in the United Kingdom. A structural equation modelling approach was used to fit a mediation model with the number of ACEs experienced between ages 0 and 9 years old (yo), levels of the inflammatory markers interleukin‐6 and C‐reactive protein measured at 9.5 yo, and self‐harm reported at 16 yo. Results: The mean number of ACEs young people experienced was 1.41 (SE 0.03). Higher ACE scores were associated with an increased risk of self‐harm at 16 yo (direct effect relative risk (RR) per additional ACE 1.11, 95% CI 1.05, 1.18, p < 0.001). We did not find evidence of an indirect effect of ACEs on self‐harm via inflammation (RR 1.00, 95% CI 1.00, 1.01, p = 0.38). Conclusions: Young people who have been exposed to ACEs are a group at high risk of self‐harm. The association between ACEs and self‐harm does not appear to be mediated by an inflammatory process in childhood, as indexed by peripheral levels of circulating inflammatory markers measured in childhood. Further research is needed to identify alternative psychological and biological mechanisms underlying this relationship. [ABSTRACT FROM AUTHOR]

Background: Emotional dysregulation may be a risk factor for disordered eating and self‐harm in young people, but few prospective studies have assessed these associations long‐term, or considered potential mediators. We examined prospective relationships between childhood emotional dysregulation and disordered eating and self‐harm in adolescence; and social cognition, emotional recognition, and being bullied as mediators. Methods: We analysed Avon Longitudinal Study of Parents and Children data on 3,453 males and 3,481 females. We examined associations between emotional dysregulation at 7 years and any disordered eating and any self‐harm at 16 years with probit regression models. We also assessed whether social cognition (7 years), emotional recognition (8 years) and bullying victimisation (11 years) mediated these relationships. Results: Emotional dysregulation at age 7 years was associated with disordered eating [fully adjusted probit B (95% CI) = 0.082 (0.029, 0.134)] and self‐harm [fully adjusted probit B (95% CI) = 0.093 (0.036, 0.150)] at age 16 years. There was no evidence of sex interactions or difference in effects between self‐harm and disordered eating. Mediation models found social cognition was a key pathway to disordered eating (females 51.2%; males 27.0% of total effect) and self‐harm (females 15.7%; males 10.8% of total effect). Bullying victimisation was an important pathway to disordered eating (females 17.1%; males 10.0% of total effect), but only to self‐harm in females (15.7% of total effect). Indirect effects were stronger for disordered eating than self‐harm. Conclusions: In males and females, emotional dysregulation in early childhood is associated with disordered eating and self‐harm in adolescence and may be a useful target for prevention and treatment. Mediating pathways appeared to differ by sex and outcome, but social cognition was a key mediating pathway for both disordered eating and self‐harm. [ABSTRACT FROM AUTHOR]

Objective: Non-response to antidepressant treatment is a substantial problem in primary care, and many patients with depression require additional second-line treatments. This study aimed to examine the prevalence and patterns of antidepressant switching in the UK, and identify associated demographic and clinical factors.Method: Cohort analysis of antidepressant prescribing data from the Clinical Practice Research Datalink, a large, anonymised UK primary care database. The sample included 262,844 patients who initiated antidepressant therapy between 1 January 2005 and 31 June 2011.Results: 9.3% of patients switched to a different antidepressant product, with most switches (60%) occurring within 8 weeks of the index date. The proportion switching was similar for selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants and other antidepressants (9.3%, 9.8% and 9.2%, respectively). Most switches were to an SSRI (64.5%), and this was the preferred option regardless of initial antidepressant class. Factors predictive of switching included male gender, age, and history of self-harm and psychiatric illness.Conclusion: Over one in every 11 patients who initiates antidepressant therapy will switch medication, suggesting that initial antidepressant treatment has been unsatisfactory. Evidence to guide choice of second-line treatment for individual patients is currently limited. Additional research comparing different pharmacological and psychological second-line treatment strategies is required in order to inform guidelines and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite recent declines, suicide remains a priority for China. Ease of availability of high-lethality suicide methods, such as pesticides and firearms, contributes to the overall incidence and is an important target for suicide prevention. This study investigates whether changes in the distribution of methods of suicide have contributed to the recent reduction in suicide in China.Method: Suicide rates (2006-2013) were calculated using the Chinese Disease Surveillance Points system, stratified by gender, age group, and urban-rural residence, to investigate trends in suicide over the study period. Multilevel negative binomial regression models were used to investigate associations between socio-demographic factors and method-specific suicide.Results: The most common method of suicide in China for both males and females was pesticide poisoning, followed by hanging. All methods declined over the study period, with the exception of suicide by jumping in males. Suicide rates for pesticide poisoning and for hanging increased exponentially with age in those aged over ≥45 years in both sexes. Pesticide poisoning declined from 55% to 49% of all suicides, while hanging increased from 27% to 31%.Limitations: This was an ecological study of a time series of suicide rates, with risk factor adjustment being limited to population-level point estimates derived from a single census.Conclusions: Suicide by pesticide poisoning and hanging remain the leading methods of suicide in China. Changes to the safe use of pesticides and targeted prevention initiatives to restrict access, along with socio-economic development and urbanisation, are likely contributors to declines in suicide by pesticide poisoning. [ABSTRACT FROM AUTHOR]

Background: The occurrence of early childhood adversity is strongly linked to later self-harm, but there is poor understanding of how this distal risk factor might influence later behaviours. One possible mechanism is through an earlier onset of puberty in children exposed to adversity, since early puberty is associated with an increased risk of adolescent self-harm. We investigated whether early pubertal timing mediates the association between childhood adversity and later self-harm. Methods: Participants were 6698 young people from a UK population-based birth cohort (ALSPAC). We measured exposure to nine types of adversity from 0 to 9 years old, and self-harm when participants were aged 16 and 21 years. Pubertal timing measures were age at peak height velocity (aPHV – males and females) and age at menarche (AAM). We used generalised structural equation modelling for analyses. Results: For every additional type of adversity; participants had an average 12–14% increased risk of self-harm by 16. Relative risk (RR) estimates were stronger for direct effects when outcomes were self-harm with suicidal intent. There was no evidence that earlier pubertal timing mediated the association between adversity and self-harm [indirect effect RR 1.00, 95% confidence interval (CI) 1.00–1.00 for aPHV and RR 1.00, 95% CI 1.00–1.01 for AAM]. Conclusions: A cumulative measure of exposure to multiple types of adversity does not confer an increased risk of self-harm via early pubertal timing, however both childhood adversity and early puberty are risk factors for later self-harm. Research identifying mechanisms underlying the link between childhood adversity and later self-harm is needed to inform interventions. [ABSTRACT FROM AUTHOR]

Purpose: Whilst psychotic experiences are associated with suicidal behaviour in a number of studies the value of psychotic experiences for the prediction of suicidal behaviour and the role of depressive symptoms in this relationship is not clear. We examined the association between psychotic experiences and subsequent suicidal behaviour and examine the role of depressive symptoms in this relationship.Methods: Psychotic experiences and depressive symptoms at age 12 and 16 years, and suicidal behaviour at age 16 years were assessed in participants (prospective analysis n = 3171; cross-sectional analysis n = 3952) from a population-based cohort.Results: Psychotic experiences (OR 1.75 95 % CI 1.20, 2.54) and depression (OR 3.97 95 % CI 2.56, 6.15) at 12 years were independently associated with suicidal behaviour at 16 years after adjustment for confounding. There was no evidence that the relationship between psychotic experiences and suicidal behaviour was stronger in participants who were also depressive. A ROC analysis showed that adding information on psychotic experiences to measures of depressive symptoms had hardly any effect on improving prediction of suicidal behaviour (AUC increased from 0.64 to 0.65). Whereas adding a measure of depressive symptoms to the measure of psychotic experiences improved prediction substantially (AUC 0.56-0.65).Conclusions: Psychotic experiences and depression are independently associated with suicidal behaviour although the association with depression is substantially stronger. Psychotic experiences alone are not a strong predictor of later suicidal behaviour and add little to predicting the risk of suicidal behaviour over and above the information provided by depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: We aimed to identify groups of children presenting distinct perinatal adversity profiles and test the association between profiles and later risk of suicide attempt. Methods: Data were from the Québec Longitudinal Study of Child Development (QLSCD, N = 1623), and the Avon Longitudinal Study of Parents and Children (ALSPAC, N = 5734). Exposures to 32 perinatal adversities (e.g. fetal, obstetric, psychosocial, and parental psychopathology) were modeled using latent class analysis, and associations with a self-reported suicide attempt by age 20 were investigated with logistic regression. We investigated to what extent childhood emotional and behavioral problems, victimization, and cognition explained the associations. Results: In both cohorts, we identified five profiles: No perinatal risk, Poor fetal growth, Socioeconomic adversity, Delivery complications, Parental mental health problems (ALSPAC only). Compared to children with No perinatal risk, children in the Poor fetal growth (pooled estimate QLSCD-ALSPAC, OR 1.89, 95% CI 1.04–3.44), Socioeconomic adversity (pooled-OR 1.42, 95% CI 1.08–1.85), and Parental mental health problems (OR 1.74, 95% CI 1.27–2.40), but not Delivery complications, profiles were more likely to attempt suicide. The proportion of this effect mediated by the putative mediators was larger for the Socioeconomic adversity profile compared to the others. Conclusions: Perinatal adversities associated with suicide attempt cluster in distinct profiles. Suicide prevention may begin early in life and requires a multidisciplinary approach targeting a constellation of factors from different domains (psychiatric, obstetric, socioeconomic), rather than a single factor, to effectively reduce suicide vulnerability. The way these factors cluster together also determined the pathways leading to a suicide attempt, which can guide decision-making on personalized suicide prevention strategies. [ABSTRACT FROM AUTHOR]

Background: studies have shown that milk and dairy consumption in adulthood have beneficial effects on health.Methods: we examined the impact of childhood and adult diet on physical performance at age 63–86 years. The Boyd Orr cohort (n = 405) is a 65-year prospective study of children who took part in a 1930's survey; the Caerphilly Prospective Study (CaPS; n = 1,195) provides data from mid-life to old age. We hypothesised that higher intakes of childhood and adult milk, calcium, protein, fat and energy would be associated with a better performance.Results: in fully adjusted models, a standard deviation (SD) increase in natural log-transformed childhood milk intake was associated with 5% faster walking times from the get-up and go test in Boyd Orr (95% CI: 1 to 9) and 25% lower odds of poor balance (OR: 0.75; 0.55 to 1.02). Childhood calcium intake was positively associated with walking times (4% faster per SD; 0 to 8) and a higher protein intake was associated with lower odds of poor balance (OR: 0.71; 0.54 to 0.92). In adulthood, protein intake was positively associated with walking times (2% faster per SD; 1 to 3; Boyd Orr and CaPS pooled data).Conclusion: this is the first study to show positive associations of childhood milk intake with physical performance in old age. [ABSTRACT FROM PUBLISHER]

Background Although several plausible biological mechanisms have been advanced for the associationbetween greater physical stature and lower coronary heart disease (CHD) risk in prospective cohort studies, the importance of one of the principal artefactual explanations dreverse causality due to shrinkaged remains unresolved. To explore this issue, studies with repeat measurements of height arerequired, but, to date, such data have been lacking. Objective To examine the possible relationship between height loss and future CHD. Methods Data were analysed from the Whitehall II prospective cohort study of 3802 men and 1615 women who participated in a physical examination in 1985e8, had their height re-measured in 1997e9, and were then followed up for fatal and non-fatal CHD. Results A mean follow-up of 7.4 years after the second height measurement gave rise to 69 CHD events in men and 18 in women. After adjustment for baseline CHD risk factors, greater loss of physical stature between survey and resurvey was associated with an increased risk of CHD in men (HR; 95% CI for a one SD increase: 1.24; 1.00 to 1.53) but not women (0.93; 0.58 to 1.50). Conclusions Reverse causality due to shrinkage may contribute to the inverse association between a single measurement of height and later CHD in other studies. [ABSTRACT FROM AUTHOR]

Introduction: The impact of long-term smoking abstinence upon symptoms of depression and anxiety has not been adequately studied. The ATTEMPT cohort is the largest longitudinal study of smoking cessation currently available with sufficiently frequent follow-up to be able to address this question. Methods: A cohort of quitters free from symptoms of depression (n = 1,027) and anxiety (n = 936) at baseline were followed up over 9 months using an established Internet panel. Results: The age- and sex-adjusted odds ratios for incident symptoms of depression or anxiety associated with 6- to 9-month smoking abstinence compared with continued smoking were 1.03 (95% CI 0.41 to 2.56) and 1.05 (95% CI 0.39 to 2.82), respectively. Conclusions: Stopping smoking does not appear to increase the risk of symptoms of depression and anxiety in those free from symptoms when they quit. [ABSTRACT FROM AUTHOR]

Background: Self-harm and eating disorders are often comorbid in clinical samples but their co-occurrence in the general population is unclear. Given that only a small proportion of individuals who self-harm or have disordered eating present to clinical services, and that both self-harm and eating disorders are associated with substantial morbidity and mortality, it is important to study these behaviours at a population level.Methods: We assessed the co-occurrence of self-harm and disordered eating behaviours in 3384 females and 2326 males from a UK population-based cohort: the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants reported on their self-harm and disordered eating behaviours (fasting, purging, binge-eating and excessive exercise) in the last year via questionnaire at 16 and 24 years. At each age we assessed how many individuals who self-harm also reported disordered eating, and how many individuals with disordered eating also reported self-harm.Results: We found high comorbidity of self-harm and disordered eating. Almost two-thirds of 16-year-old females, and two-in-five 24-year old males who self-harmed also reported some form of disordered eating. Young people with disordered eating reported higher levels of self-harm at both ages compared to those without disordered eating.Limitations: We were not able to measure whether participants identified their disordered eating as a method of self-harm.Conclusions: Self-harm and disordered eating commonly co-occur in young people in the general population. It is important to screen for both sets of difficulties to provide appropriate treatment. [ABSTRACT FROM AUTHOR]

Background: Biological markers of suicide risk have the potential to inform prevention and treatment efforts. It has recently been hypothesised that inflammation may influence mood and in turn suicide risk. We investigated the association between indicators of systemic inflammation and suicide in a large cohort of Taiwanese adults.Methods: White blood cell (WBC) count and levels of C-reactive protein (CRP) were measured in 462,747 and 359,849 adults in the Taiwan MJ cohort, respectively. The associations between WBC, CRP and suicide risk were investigated using Cox proportional hazards models adjusting for a range of potential confounding factors.Results: During a mean 15.1 and 15.8 years of follow-up, 687 and 605 suicides were identified in participants who had information on WBC and CRP respectively. There was an association of suicide with WBC count (adjusted hazard ratio [aHR] = 1.13 per 1 standard deviation increase of log-transformed WBC, 95% confidence interval [CI] 1.05, 1.22). The association was driven by the highest quintile of WBC count (aHR = 1.39, 95% CI 1.09, 1.77; reference: the lowest quintile). No association between CRP and suicide was found.Limitations: Our cohort was from a privately-run health check-up programme and had a lower suicide rate than that in the general population.Conclusions: Individuals with the highest WBC counts may have increased risk of suicide. Peripheral markers of inflammation are potential biomarkers of suicide risk; however, this seems to vary by population and the marker investigated and could be influenced by a range of confounding factors. [ABSTRACT FROM AUTHOR]

Background: Poor cognitive abilities and low intellectual quotient (IQ) are associated with an increased risk of suicide attempts and suicide mortality. However, knowledge of how this association develops across the life-course is limited. Our study aims to establish whether individuals who died by suicide by mid-adulthood are distinguishable by their child-to-adolescence cognitive trajectories. Methods: Participants were from the 1958 British Birth Cohort and were assessed for academic performance at ages 7, 11, and 16 and intelligence at 11 years. Suicides occurring by September 2012 were identified from linked national death certificates. We compared mean mathematics and reading abilities and rate of change across 7–16 years for individuals who died by suicide v. those still alive, with and without adjustment for potential early-life confounding factors. Analyses were based on 14 505 participants. Results: Fifty-five participants (48 males) had died by suicide by age 54 years. While males who died by suicide did not differ from participants still alive in reading scores at age 7 [effect size (g) = −0.04, p = 0.759], their reading scores had a less steep improvement up to age 16 compared to other participants. Adjustments for early-life confounding factors explained these differences. A similar pattern was observed for mathematics scores. There was no difference between individuals who died by suicide v. participants still alive on intelligence at 11 years. Conclusions: While no differences in tests of academic performance and IQ were observed, individuals who died by suicide had a less steep improvement in reading abilities over time compared to same-age peers. [ABSTRACT FROM AUTHOR]

Previous cohort studies have observed higher birth order to be associated with increased risk of suicidal behaviour. However, the mechanisms underlying this association are unclear. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we used multivariable logistic regression models and mediation analysis to investigate the associations of birth order with adolescent suicide attempts and psychiatric disorder. We investigated whether the number of maternal depressive episodes and father absence mediated the associations found. In fully adjusted models (n = 2571), higher birth order was associated with an increased risk of both suicide attempts (OR = 1.42, CI = 1.10–1.84) and psychiatric disorder (OR = 1.29, CI = 0.99–1.69). Maternal depression and father absence only partially mediated (8%; 12%) these associations. Whilst maternal depression and paternal absence partially mediated the associations between birth order, and suicidal behaviour and psychiatric disorder, other pathways may account for much of these associations. Future studies should investigate alternative mediating pathways. [ABSTRACT FROM AUTHOR]

Background: Only one‐third of young people who experience suicidal ideation attempt suicide. It is important to identify factors which differentiate those who attempt suicide from those who experience suicidal ideation but do not act on these thoughts. Methods: Participants were 4,772 members of the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population‐based birth cohort. Suicide ideation and attempts were assessed at age 16 years via self‐report questionnaire. Multinomial regression was used to examine associations between factors that differentiated adolescents in three groups: no suicidal ideation or attempts, suicidal ideation only and suicide attempts. Analyses were conducted on an imputed data set based on those with complete outcome data (suicidal thoughts and attempts) at age 16 years (N = 4,772). Results: The lifetime prevalence of suicidal ideation and attempts in the sample was 9.6% and 6.8% respectively. Compared to adolescents who had experienced suicidal ideation, those who attempted suicide were more likely to report exposure to self‐harm in others (adjusted OR for family member self‐harm: 1.95, for friend self‐harm: 2.61 and for both family and friend self‐harm: 5.26). They were also more likely to have a psychiatric disorder (adjusted OR for depression: 3.63; adjusted OR for anxiety disorder: 2.20; adjusted OR for behavioural disorder: 2.90). Other risk factors included female gender, lower IQ, higher impulsivity, higher intensity seeking, lower conscientiousness, a greater number of life events, body dissatisfaction, hopelessness, smoking and illicit drug use (excluding cannabis). Conclusions: The extent of exposure to self‐harm in others and the presence of psychiatric disorder most clearly differentiate adolescents who attempt suicide from those who only experience suicidal ideation. Further longitudinal research is needed to explore whether these risk factors predict progression from suicidal ideation to attempts over time. Read the Commentary on this article at doi: 10.1111/jcpp.12982 [ABSTRACT FROM AUTHOR]

The objective of this study was to examine agreement between self-reported and medically recorded self-harm, and investigate whether the prevalence of self-harm differs in questionnaire responders vs. non-responders. A total of 4,810 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) completed a self-harm questionnaire at age 16 years. Data from consenting participants were linked to medical records (number available for analyses ranges from 205–3,027). The prevalence of self-harm leading to hospital admission was somewhat higher in questionnaire non-responders than responders (2.0 vs. 1.2%). Hospital attendance with self-harm was under-reported on the questionnaire. One third reported self-harm inconsistently over time; inconsistent reporters were less likely to have depression and fewer had self-harmed with suicidal intent. Self-harm prevalence estimates derived from self-report may be underestimated; more accurate figures may come from combining data from multiple sources. [ABSTRACT FROM PUBLISHER]

Background Several aspects of school life are thought to be associated with increased risk of self-harm in adolescence, but these have rarely been investigated in prospective studies. Methods Members of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort completed postal surveys of school experiences aged 14, and self-harm behaviour aged 16 ( n =3939). Associations between school experiences (feeling connected to school, enjoyment of school and perception of teachers as fair) and subsequent self-harm were examined using multivariable logistic regression models. Results Self-harm aged 16 was associated with earlier perceptions of school, specifically not getting on well with or feeling accepted by others (OR=2.43 [1.76, 3.35] and OR=2.69 [2.16, 3.35] respectively), not liking school or the work done in class (OR=1.40 [1.17, 1.69] and OR=1.36 [1.10, 1.67]), and feeling that teachers are not clear about behaviour or fail to address misbehaviour consistently (OR=1.59 [1.20, 2.12] OR=1.89 [1.51, 2.37]). These associations were partially attenuated in models controlling for mental health concurrent with the outcome. Poor school experiences were related to both suicidal and non-suicidal self-harm, with slightly stronger associations visible for the former. Limitations (i) There was some loss to follow up, (ii) experience of bullying was not measured, and (iii) exposure and outcome measures were self-report. Conclusions Students who feel unconnected to school, unhappy at school, or feel that teachers are unfair are more likely to self-harm in the future. Assessing students׳ perceptions of school may serve to identify those at risk of self-harm who would benefit from preventative interventions. [ABSTRACT FROM AUTHOR]

Background: Older adults worldwide are at a greater risk of suicide than other age groups. There is a scarcity of prospective studies exploring risk factors for suicide in older people and their discriminative ability to identify future suicide.Methods: We examined a prospective cohort of senior Taipei City residents between 2005 and 2009 (N=101,764). Cox proportional hazards regression analysis was used to determine significant risk factors and to construct a predictive score. The accuracy of the derived score in the prediction was tested by Receiver Operating Characteristic analysis.Results: Male sex (Hazard Ratio [HR]=3.41, p<0.001), lower education (HR=3.31, p<0.001) and lower income (HR=2.52, p=0.01) were associated with an increased risk of suicide, as well as depressed mood (HR=1.44, p=0.02; per unit increase in a 4-point scale) and insomnia (HR=1.30, p=0.03; per unit increase in a 4-point scale). The derived prediction score yielded a sensitivity of 0.63 a specificity of 0.73 and an area under curve of 0.73. Removing depressed mood from the prediction model did not significantly alter suicide predictability (P=0.11).Limitations: The dataset examined did not contain information regarding to important risk factors such as substance misuse and prescribed medications and the measures of mental health were relatively limited.Conclusion: Prediction of suicide based on factors recorded in a routine health screen of elderly people was unsatisfactory; the strongest predictors were factors that cannot be easily altered. Further understanding of how the socioeconomic condition of seniors contributes to suicide may provide valuable insights for intervention targeting this growing population-at-risk. [ABSTRACT FROM AUTHOR]

Objective: Parental suicidal behavior is associated with offspring's risk of suicidal behavior. However, much of the available evidence is from population registers or clinical samples. We investigated the associations of self-reported parental suicide attempt (SA) with offspring self-harm and suicidal thoughts in the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort. Method: Parental SA was self-reported on 10 occasions from pregnancy until their child was 11 years of age. Offspring self-reported lifetime self-harm, with and without suicidal intent, suicidal thoughts, and suicide plans, at age 16 to 17 years. Multivariable regression models quantified the association between parental SA and offspring outcomes controlling for confounders. Results: Data were available for 4,396 mother-child and 2,541 father-child pairs. Adjusting for confounders including parental depression, maternal SA was associated with a 3-fold increased risk of self-harm with suicidal intent in their children (adjusted odds ratio [aOR] = 2.94, 95% confidence interval [CI] = 1.43-6.07) but not with self-harm without suicidal intent (aOR = 0.83, 95% CI = 0.35-1.99). Children whose mother attempted suicide were more likely to report suicidal thoughts and plans (aOR = 5.04, 95% CI = 2.24-11.36; aOR = 2.17, 95% CI = 1.07-4.38, respectively). Findings in relation to paternal SA were somewhat weaker and not significant. Conclusions: Maternal SA increased their offspring's risk of self-harm with suicidal intent and of suicidal thoughts, but was unrelated to self-harm without intent; findings for paternal suicide attempt were weaker and not significant. Maternal SA, which may not come to the attention of health care professionals, represents a major risk for psychiatric morbidity in their offspring. [ABSTRACT FROM AUTHOR]

Abstract: Background: Low IQ is associated with an increased risk of suicide and suicide attempt in adults, but less is known about the relationship between IQ and aspects of suicidal/self-harm behaviours in adolescence. Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based prospective UK cohort. Binomial and multinomial logistic regression models were used to examine the association of IQ measured at age 8 with suicide-related outcomes amongst 4810 adolescents aged 16–17 years. Results: There was some evidence that associations differed in boys and girls (p values for interaction ranged between 0.06 and 0.25). In boys higher IQ was associated with increased risk of suicidal thoughts (adjusted odds ratio per 10 point increase in IQ score=1.14, 95% Confidence Interval [CI] 1.01–1.28) and suicidal plans (1.15, 95% CI 0.93–1.43), although statistical evidence for the latter association was limited. There was also evidence for an association with non-suicidal self-harm (1.24, 95% CI 1.08–1.45) but not suicidal self-harm (1.04, 95% CI 0.86–1.25). In girls higher IQ was associated with increased risk of non-suicidal self-harm (1.11, 95% CI 1.02–1.22) but not suicidal thoughts, suicidal plans or suicidal self-harm. Limitations: Loss to follow up and questionnaire non-response may have led to selection bias. Conclusion: In contrast to previous studies of IQ–suicide associations in adults, we found that higher IQ was associated with an increased risk of non-suicidal self-harm in male and female adolescents and suicidal thoughts in males. Associations of IQ with self-harm differed for self-harm with and without suicidal intent, suggesting that the aetiology of these behaviours may differ. [Copyright &y& Elsevier]

Recent studies in Western nations have shown inverse associations between body mass index (BMI, measured as weight (kg)/height (m)2) and suicide. However, it is uncertain whether the association is similar in non-Western settings, and the biologic pathways underlying the association are unclear. The authors investigated these issues in a cohort of 542,088 Taiwanese people 20 years of age or older who participated in a health check-up program (1994–2008); there were 573 suicides over a mean 8.1 years of follow up. There was a J-shaped association between BMI and suicide risk (P for the quadratic term = 0.033) but limited evidence of a linear association (adjusted hazard ratio per 1-standard-deviation increase = 0.95 (95% confidence interval: 0.85, 1.06)); compared with individuals whose BMI was 18.5–22.9, adjusted hazard ratios for those with a BMI <18.5 or ≥35 were 1.56 (95% confidence interval: 1.07, 2.28) and 3.62 (95% confidence interval: 1.59, 8.22), respectively. A high waist-to-hip ratio was associated with an increased risk of suicide. There was some evidence for a reverse J-shaped association of systolic blood pressure and high density lipoprotein cholesterol with suicide and an association of higher triglyceride level with increased suicide risk; these associations did not appear to mediate the associations of BMI and waist-to-hip ratio with suicide. [ABSTRACT FROM PUBLISHER]

Background Socioeconomic differentials in adult height are frequently observed, but the age at which these inequalities emerge and the patterns they follow through childhood are unknown. Subjects and Methods Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), height trajectories from birth to 10 years (N=12366) were modelled. Individual trajectories were estimated using mixed-effects models. Differences in trajectories by socioeconomic position (SEP) were investigated. Results There was a clear gradient in birth length across categories of maternal education; average birth length in boys was 0.41 cm lower in the lowest maternal education category compared with the highest, which is 0.9% of the average birth length for the highest SEP category (equivalent results for girls 0.65 cm, 1.3%). Socioeconomic differences in childhood growth were small, and only resulted in minimal widening of the height inequality with increasing age. By the age of 10 years, the mean difference between children in the lowest and highest maternal education categories was 1.4 cm for boys and 1.7 cm for girls; similar proportionate differences to those seen at birth (1.0% for boys and 1.2% for girls). Patterns were the same when father's education or household occupational social class were used to measure SEP. Conclusions The socioeconomic differential in height during childhood in this cohort of children born in the UK in the 1990s arises largely through inequalities in birth length, with small increases in the inequality from differences in growth in later childhood. [ABSTRACT FROM AUTHOR]

Background Socio-economic influences over a lifetime impact on health and may contribute to poor physical functioning in old age. Methods The authors examined the impact of both childhood and adulthood socio-economic factors on locomotor function at 63-86 years (measured with the get up and go timed walk and flamingo balance test) in the UK-based Boyd Orr (n=405) and Caerphilly (n=1196) prospective cohorts. Results There was a marked reduction in walking speed and balance time with increasing age. Each year of age was associated with a 1.7% slower walk time and a 14% increased odds of poor balance. Participants who moved from a low socio-economic position in childhood to a high socio-economic position in adulthood had 3% slower walking times (95% CI -- 2% to 8%) than people with a high socio-economic position in both periods. Participants who moved from a high socio-economic position in childhood to a low adulthood socio-economic position had 5% slower walking times (95% CI --2% to 12%). Participants with a low socio-economic position in both periods had 10% slower walking times (95% CI 5% to 16%; p for trend<0.001). In Boyd Orr, low socio-economic position in childhood was associated with poor balance in old age (OR per worsening category=1.26; 95% CI 1.01 to 1.57; p=0.043), as was socio-economic position in adulthood (OR=1.71; 95% CI 1.20 to 2.45; p=0.003). Similar associations were not observed in Caerphilly. Conclusion Accumulating socio-economic disadvantage from childhood to adulthood is associated with slower walking time in old age, with mixed results for balance ability. [ABSTRACT FROM AUTHOR]

Abstract: Background: Children and adolescents who report psychotic symptoms in non-clinical samples are at an increased risk of developing schizophrenia. Study of such ‘high risk’ groups may increase our understanding of early risk factors for psychotic illnesses. Maternal infection during pregnancy is associated with an increased risk of schizophrenia in the offspring, and it has been hypothesised that exposure to maternal intake of analgesics during pregnancy, taken to alleviate the symptoms of viral infections, may partly explain this association. The aim of this study was to examine the relationship between maternal use of aspirin and other analgesics during pregnancy and the occurrence of psychotic symptoms in the offspring. Methods: This was a longitudinal study of 6437 children belonging to the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort who participated in the psychosis-like-symptoms semi-structured interview (PLIKSi) at 12years of age. Data on in-utero exposure to analgesics were obtained from self-report questionnaires completed by the mothers during pregnancy. Results: Increasing frequency of aspirin use during pregnancy was associated with an increased risk of psychotic experiences (adjusted OR 1.44, 95% CI 1.08–1.92). Risk was highest in those whose mothers used aspirin most days or daily (adjusted OR 2.79, 95% CI 1.27–6.07). Paracetamol and other analgesic use during pregnancy were not associated with the risk of offspring psychotic symptoms. Conclusions: Medications such as aspirin that interfere with the prostaglandin pathway, taken during pregnancy, may influence the risk of schizophrenia in the offspring. Other epidemiological studies are needed to examine this association further. [Copyright &y& Elsevier]

Background: In South Asia, up to 20% of people ingesting pesticides for self-poisoning purchase the pesticide from a shop with the sole intention of self-harm. Individuals who are intoxicated with alcohol and/or non-farmers represent 72% of such high-risk individuals. We aimed to test the feasibility and acceptability of vendor-based restrictions on pesticide sales for such high-risk individuals.Methods: We conducted a pilot study in 14 (rural = 7, urban = 7) pesticide shops in Anuradhapura District of Sri Lanka. A two-hour training program was delivered to 28 pesticide vendors; the aim of the training was to help vendors recognize and respond to customers at high risk of pesticide self-poisoning. Knowledge and attitudes of vendors towards preventing access to pesticides for self-poisoning at baseline and in a three month follow-up was evaluated by questionnaire. Vendors were interviewed to explore the practice skills taught in the training and their assessment of the program.Results: The scores of knowledge and attitudes of the vendors significantly increased by 23% (95% CI 15%-32%, p < 0.001) and by 16% (95% CI 9%-23%, p < 0.001) respectively in the follow-up. Fifteen (60%) vendors reported refusing sell pesticides to a high-risk person (non-farmer or intoxicated person) in the follow-up compared to three (12%) at baseline. Vendors reported that they were aware from community feedback that they had prevented at least seven suicide attempts. On four identified occasions, vendors in urban shops had been unable to recognize the self-harming intention of customers who then ingested the pesticide. Only 2 (8%) vendors were dissatisfied with the training and 23 (92%) said they would recommend it to other vendors.Conclusions: Our study suggests that vendor-based sales restriction in regions with high rates of self-poisoning has the potential to reduce access to pesticides for self-poisoning. A large-scale study of the effectiveness and sustainability of this approach is needed. [ABSTRACT FROM AUTHOR]

The article discusses smoking cessation treatment and the related risk of depression, suicide and self harm by using linked data from Great Britain's Office for National Statistics (ONS) and Hospital Episode Statistics (HES) as of October 26, 2013. The authors say the data show there is no evidence of higher risk of suicidal behavior with prescribed varenicline or bupropion compared with prescribed nicotine replacement therapy (NRT).