To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Previous research has identified a vulnerability paradox in global mental health: contrary to positive associations at the individual level, lower vulnerability at the country level is accompanied by a higher prevalence in a variety of mental health problems in national populations. However, the validity of the paradox has been challenged, specifically for bias from modest sample sizes and reliance on a survey methodology not designed for cross-national comparisons.
To verify whether the paradox applies to suicide, using data from a sizable country sample and an entirely different data source.
We combined data from the World Health Organization 2014 suicide report and the country vulnerability index from the 2016 World Risk Report. Suicide was predicted in different steps based on gender, vulnerability and their interaction, World Bank income categories, and suicide data quality.
A negative association between country vulnerability and suicide prevalence in both women and men was found. Suicide rates were higher for men, regardless of country vulnerability. The model predicting suicide in 96 countries based on gender, vulnerability, income and data quality had the best goodness-of-fit compared with other models. The vulnerability paradox is not accounted for by income or data quality, and exists across and within income categories.
The study underscores the relevance of country-level factors in the study of mental health problems. The lower mental disorder prevalence in more vulnerable countries implies that living in such countries fosters protective factors that more than compensate for the limitations in professional healthcare capacity.
Suicidal behaviour is the end result of the complex relation between many factors which are biological, psychological and environmental in nature. Network analysis is a novel method that may help us better understand the complex association between different factors.
To examine the relationship between suicidal symptoms as assessed by the Beck Scale for Suicide Ideation and future suicidal behaviour in patients admitted to hospital following a suicide attempt, using network analysis.
Secondary analysis was conducted on previously collected data from a sample of 366 patients who were admitted to a Scottish hospital following a suicide attempt. Network models were estimated to visualise and test the association between baseline symptom network structure and suicidal behaviour at 15-month follow-up.
Network analysis showed that the desire for an active attempt was found to be the most central, strongly related suicide symptom. Of the 19 suicide symptoms that were assessed at baseline, 10 symptoms were directly related to repeat suicidal behaviour. When comparing baseline network structure of repeaters (n=94) with the network of non-repeaters (n=272), no significant differences were found.
Network analysis can help us better understand suicidal behaviour by visualising the complex relation between relevant symptoms and by indicating which symptoms are most central within the network. These insights have theoretical implications as well as informing the assessment and treatment of suicidal behaviour.
Randomised studies examining the effect on patients of training
professionals in adherence to suicide guidelines are scarce.
To assess whether patients benefited from the training of professionals
in adherence to suicide guidelines.
In total 45 psychiatric departments were randomised (Dutch trial
register: NTR3092). In the intervention condition, all staff in the
departments were trained with an e-learning supported train-the-trainer
programme. After the intervention, patients were assessed at admission
and at 3-month follow-up. Primary outcome was change in suicide ideation,
assessed with the Beck Scale for Suicide Ideation.
For the total group of 566 patients with a positive score on the Beck
Scale for Suicide Ideation at baseline, intention-to-treat analysis
showed no effects of the intervention on patient outcomes at 3-month
follow-up. Patients who were suicidal with a DSM-IV diagnosis of
depression (n = 154) showed a significant decrease in
suicide ideation when treated in the intervention group. Patients in the
intervention group more often reported that suicidality was discussed
Overall, no effect of our intervention on patients was found. However, we
did find a beneficial effect of the training of professionals on patients
Email your librarian or administrator to recommend adding this to your organisation's collection.