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12 results

  • Prevalence and correlates of suicidal behaviours in a representative epidemiological youth sample in Hong Kong: the significance of suicide-related rumination, family functioning, and ongoing population-level stressors
  • Stephanie M. Y. Wong, Charlie H. Ip, Christy L. M. Hui, Y. N. Suen, Corine S. M. Wong, W. C. Chang, Sherry K. W. Chan, Edwin H. M. Lee, Simon S. Y. Lui, K. T. Chan, Michael T. H. Wong, Eric Y. H. Chen
  • Journal: Psychological Medicine , First View
  • Published online by Cambridge University Press: 02 June 2022, pp. 1-11
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  • View abstract
    Background

    Young people are most vulnerable to suicidal behaviours but least likely to seek help. A more elaborate study of the intrinsic and extrinsic correlates of suicidal ideation and behaviours particularly amid ongoing population-level stressors and the identification of less stigmatising markers in representative youth populations is essential.

    Methods

    Participants (n = 2540, aged 15–25) were consecutively recruited from an ongoing large-scale household-based epidemiological youth mental health study in Hong Kong between September 2019 and 2021. Lifetime and 12-month prevalence of suicidal ideation, plan, and attempt were assessed, alongside suicide-related rumination, hopelessness and neuroticism, personal and population-level stressors, family functioning, cognitive ability, lifetime non-suicidal self-harm, 12-month major depressive disorder (MDD), and alcohol use.

    Results

    The 12-month prevalence of suicidal ideation, ideation-only (no plan or attempt), plan, and attempt was 20.0, 15.4, 4.6, and 1.3%, respectively. Importantly, multivariable logistic regression findings revealed that suicide-related rumination was the only factor associated with all four suicidal outcomes (all p < 0.01). Among those with suicidal ideation (two-stage approach), intrinsic factors, including suicide-related rumination, poorer cognitive ability, and 12-month MDE, were specifically associated with suicide plan, while extrinsic factors, including coronavirus disease 2019 (COVID-19) stressors, poorer family functioning, and personal life stressors, as well as non-suicidal self-harm, were specifically associated with suicide attempt.

    Conclusions

    Suicide-related rumination, population-level COVID-19 stressors, and poorer family functioning may be important less-stigmatising markers for youth suicidal risks. The respective roles played by not only intrinsic but also extrinsic factors in suicide plan and attempt using a two-stage approach should be considered in future preventative intervention work.

  • Socio-economic and psychological correlates of suicidality among Hong Kong working-age adults: results from a population-based survey
  • KA Y. LIU, ERIC Y. H. CHEN, CECILIA L. W. CHAN, DOMINIC T. S. LEE, Y. W. LAW, YEATES CONWELL, PAUL S. F. YIP
  • Journal: Psychological Medicine / Volume 36 / Issue 12 / December 2006
  • Published online by Cambridge University Press: 28 November 2006, pp. 1759-1767
  • Print publication: December 2006
  • View abstract

    Background. The global toll of suicide is estimated to be one million lives per year, which exceeded the number of deaths by homicide and war combined. A key step to suicide prevention is to prevent less serious suicidal behaviour to preclude more lethal outcomes. Although 61% of the world's suicides take place in Asia and the suicide rates among middle age groups have been increasing since the economic crisis in many Asian countries, population-based studies of suicidal behaviour among working-age adults in non-western communities are scarce.

    Method. Data from a population-based survey with 2015 participants were used to estimate the prevalence of suicidal ideation and behaviour among the working-age population in Hong Kong, and to study the associated socio-economic and psychological correlates. We focused particularly on potential modulating factors between life-event-related factors and suicidal ideation.

    Results. Six per cent of the Hong Kong population aged 20–59 years considered suicide in the past year, while 1·4% attempted suicide. Hopelessness, reasons for living, and reluctance to seek help from family and friends had direct association with past-year suicidal ideation. Reasons for living were found to moderate the effect of perceived stress on suicidal ideation.

    Conclusions. Suicidality is a multi-faceted problem that calls for a multi-sectored, multi-layered approach to prevention. Prevention programmes can work on modulating factors such as reasons for living to reduce suicidal risk in working-age adults.

  • Suicide in Hong Kong: a case-control psychological autopsy study
  • ERIC Y. H. CHEN, WINCY S. C. CHAN, PAUL W. C. WONG, SANDRA S. M. CHAN, CECILIA L. W. CHAN, Y. W. LAW, PHILIP S. L. BEH, K. K. CHAN, JOANNE W. Y. CHENG, KA Y. LIU, PAUL S. F. YIP
  • Journal: Psychological Medicine / Volume 36 / Issue 6 / June 2006
  • Published online by Cambridge University Press: 30 March 2006, pp. 815-825
  • Print publication: June 2006
  • View abstract

    Background. The relative contribution of psychosocial and clinical risk factors to suicide among Chinese populations is an important issue. In Hong Kong, this issue requires vigorous examination in light of a 50% increase in suicide rate between 1997 and 2003.

    Method. Using a case-control psychological autopsy method, 150 suicide deceased were compared with 150 living controls matched by age and gender. Semi-structured interviews were conducted with the next-of-kin of the subjects. Data were collected on a wide range of potential risk and protective factors, including demographic, life event, clinical and psychological variables. The relative contribution of these factors towards suicide was examined in a multiple logistic regression model.

    Results. Six factors were found to significantly and independently contribute to suicide: unemployment, indebtedness, being single, social support, psychiatric illness, and history of past attempts.

    Conclusions. Both psychosocial and clinical factors are important in suicides in Hong Kong. They seem to have mediated suicide risk independently. In addition, socio-economic adversities seem to have played a relatively important role in the increasing suicide rate in Hong Kong.

  • 7 - The nature of delusions: a hierarchical neural network approach
  • from Part two - Clinical disorders
  • Edited by Dan J. Stein, University of Stellenbosch, South Africa, Jacques Ludik, University of Stellenbosch, South Africa
  • Book: Neural Networks and Psychopathology
  • Published online: 12 January 2010
  • Print publication: 03 December 1998, pp 167-188
  • View extract

    Summary

    For more than 300 years, delusions have been defined as ‘pathological beliefs’ (Berrios, 1996; Spitzer, 1990; see Table 7.1 for clinical examples). During the first half of the nineteenth century, Baillarger reinforced this view by suggesting that ‘form’ be distinguished from ‘content’ (Berrios, 1994). Analysis of content (i.e. of the semantics of ‘belief’) has since then generated clinical subtypes (e.g. depressive versus schizophrenic delusions) (Sérieux and Capgras, 1909; Jaspers, 1963; Moor and Tucker, 1979; Sims, 1988), supported psychoanalytical interest in symbols, and (more recently) encouraged correlational research, for example with biographical data, particularly amongst those interested in attribution theory (Bentall, 1994). The ‘pathological belief’ view has, in general, been less useful to the neurobiological study of delusions (Berrios, 1991; Fuentenebro and Berrios, 1995). Analysis of the form of delusions has also been useful in some cases. For example, it has led to stable diagnostic categories (Schneider, 1959; Jaspers, 1963), and to multidimensional approaches, whose main consequence has been the erosion of the old, categorical, ‘all-or-none’ view. Whether from the perspective of content or of form, most research has been cross-sectional and hence uninformative on how delusions actually change with time. Notable exceptions to this approach have been the work of Kendler, Glazer and Morgenstern (1983) and Garety and Hemsley (1994).

    The multidimensional approach is not free from problems. For example, some dimensions of delusions such as ‘bizarreness’ remain ambiguous (Monti and Stanghellini, 1993). Borrowed from Kurt Schneider (Goldman et al., 1992), the term originally meant ‘ absurd ’, ‘ impossible ’ or ‘ contrary to common knowledge ’ (e.g. as in DSM-III-R: APA, 1987).

  • 3 - Neural network models in psychiatric diagnosis and symptom recognition
  • from Part one - General Concepts
  • Edited by Dan J. Stein, University of Stellenbosch, South Africa, Jacques Ludik, University of Stellenbosch, South Africa
  • Book: Neural Networks and Psychopathology
  • Published online: 12 January 2010
  • Print publication: 03 December 1998, pp 34-56
  • View extract

    Summary

    Matters historical

    Psychiatric diagnosis has been conceptualized as either a ‘one-off’ (‘recognition’) type of cognitive act or as a ‘recursive (constructional) process’. History teaches us that scientists choose their models not on the basis of some ‘crucial empirical test’ (such tests do not exist at this level of abstraction) but on the more humdrum (but rarely owned up to) dictate of fashion. For example, during the eighteenth century, when the so-called ‘ontological’ notions of disease (as it was then based on the more botanico tradition) (Berg, 1956; López-Piñero, 1983), reigned supreme, there was little problem in accepting the view that the diagnosis (recognition) of disease happened at one fell (cognitive) swoop. This was because the Platonic (ontological) assumption lurking behind such a notion amply justified the belief that disease was ‘fully bounded and out there’ and, furthermore, that inklings of its existence had been planted at birth (like everything else) in the mind of the diagnostician. The a priori privileging of some features of a disease (the successful strategy that Linné had already tried on plants), and the view that such features actually ‘signified’ the disease, was just one version of the ontological approach. Indeed, a century earlier, a similar view had governed the study of linguistics (Aarsleff, 1982). That it was fashion and Zeitgeist that sustained the popularity of the ontological view is illustrated by the fact that a rival approach put forward at the time by Adanson was given short shrift (Stevens, 1984).

  • Neural network model of amnesia
  • Eric Y. H. Chen
  • Journal: The British Journal of Psychiatry / Volume 164 / Issue 1 / January 1994
  • Published online by Cambridge University Press: 02 January 2018, pp. 125-126
  • Print publication: January 1994
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  • Ordering thoughts in thought disorder
  • Eric Y. H. Chen
  • Journal: The British Journal of Psychiatry / Volume 159 / Issue 1 / July 1991
  • Published online by Cambridge University Press: 02 January 2018, p. 160
  • Print publication: July 1991
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