Depressive symptoms and suicide in 56,000 older Chinese: a Hong Kong cohort study

Objective: To examine dose-response associations between depressive symptoms and suicide and modification effects of sex, age and health status in older Chinese. Methods: We used the Chinese version of the 15-item Geriatric Depression Scale (GDS) to measure depressive symptoms (GDS score ≥ 8) and Cox regression to examine association with suicide mortality in a population-based cohort of 55,946 individuals, aged 65 years or above, enrolled from July 1998 to December 2000 at one of 18 Elderly Health Centres of Hong Kong Department of Health. The cohort was followed up for suicide mortality till 31 March 2009 (mean follow-up 8.7 years). Results: Depressive symptoms were associated with suicide in men [hazard ratio (HR) 2.03, 95% confidence interval (CI) 0.96-4.29] and women (HR = 2.36, 95% CI 1.31-4.24) after adjusting for age, education, monthly expenditure, smoking, alcohol drinking, physical activity, body mass index, health status, and self-rated health. There was no threshold for GDS score and suicide in either sex. Age, sex and health status did not modify the association. Conclusions: Depressive symptoms predict higher suicide risk in older Chinese in a dose-response pattern. These associations were not attenuated by adjustment for health status, suggesting that depressive symptoms in older people are likely to be an independent causal factor for suicide. The GDS score showed no threshold in predicting suicide risk, suggesting that older people with low GDS scores deserve further attention and those with very high scores need urgent intervention. © 2011 The Author(s).published_or_final_versionSpringer Open Choice, 21 Feb 201

Association of temporal factors and suicides in the United States, 2000–2004

The purpose of the study was to examine the association of temporal factors, in particular days of the week and seasons of the year and death from suicide in the United States. Data were pooled from the Multiple Cause of Death Files. Hierarchical logistic regression models were fitted to all deaths occurring in 2000 through 2004 by suicide. The incidence of suicide was significantly higher on Wednesdays, compared to Sunday. Specifically, individuals were 99% more likely to kill themselves on Wednesday than on Sunday. Suicides were more prevalent in the summer months, and they were less likely to occur in winter. The state suicide rate significantly elevated individual suicide risk. The results held even after controlling for the potentially confounding effects of socio-economic and demographic variables at both the individual and state levels. It was concluded that the observed association between seasonality and suicide cannot be discounted as a mere coincidence. Future research ought to focus on integrating individual level data and contextual variables when testing for seasonality effects

KPC-producing Klebsiella pneumoniae, finally targeting Turkey

We report here the first identification of the worldwide spread of Klebsiella pneumoniae carbapenemase-2-producing and carbapenem-resistant K. pneumoniae clone ST258 in Turkey, a country where the distantly-related carbapenemase OXA-48 is known to be endemic. Worryingly, this isolate was also resistant to colistin, now considered to be the last-resort antibiotic for carbapenem-resistant isolates

Light motor vehicle collisions with heavy vehicles:psychosocial and health related risk factors of drivers being at-fault for collisions

Abstract Background: Fatal head-on collisions between passenger cars and trucks are sometimes thought as self-inflicted death of the passenger car drivers. Methods: A total of 378 Finnish drivers of light motor vehicles (LMV) died in collisions with heavy vehicles between the years 2002–2011. These male and female drivers, who were considered as being at fault, and whose collisions with heavy vehicles occurred in the oncoming vehicle’s lane, were explored in relation to information on their socio-demographics, physical and mental health condition and driving-related factors. Results: Cause of death of at-fault LMV drivers, as defined in medico-legal examination, was most commonly accidental (51%), followed by suicide (32%), undetermined intent (17%) and acute illness (0.3%). Ten-year time trend in rates of LMV drivers has remained stable (Annual Percentage Change, APC = −0.03; p = 0.983), the annual proportion varying between 14%–21%. However, a statistically significantly increasing time trend was observed in fatal accidents due to suicides (APC = 5.31, p = 0.028). Generally, at-fault LMV drivers were characterized as having mental health problems susceptibility to risk (44%), personal relationship problems (33%), long-term physical illness (68%) or medication (35%) or driving under influence of alcohol (24%). Male LMV drivers, compared to women, were more commonly unmarried, farm/wood/industrial workers and drove alone and without a planned destination. Female LMV drivers were, more commonly than men, widowed, third degree students, skilled workers, had long term mental illnesses/disturbances, drove with family member(s) and their fatal accidents occurred in winter. Conclusion: The findings give support to the recommendation that suicidal ideation must be considered when assessing fitness-to-drive

Associations of adolescent psychosocial factors to later benzodiazepine use:a population-based follow-up study of adolescent psychiatric inpatients in Northern Finland

Abstract We investigated factors associated with benzodiazepine (BZD) use during late adolescence and early adulthood. The study population consisted of 508 adolescents admitted to psychiatric inpatient care between April 2001 and March 2006. Information on adolescents’ family- and school-related factors, suicidality and psychiatric disorders were obtained by semistructured interviews. Data on BZD prescriptions from 1999 to 2012 were collected from the Social Insurance Institution of Finland. In males heavy BZD use associated with adolescent substance-use disorder (OR, 3.5; P < 0.004) and parents’ psychiatric problems (OR, 3.5; P = 0.029). Among females, conduct disorder (OR, 3.3; P = 0.016), being a bully/bully-victim (OR, 3.3; P = 0.019) and parental substance-use problems (OR, 2.6; P = 0.024) were related to heavy BZD use. The mean (±SD) age of first BZD prescription was significantly lower in heavy, compared with mild users (men: 19.3 ± 2.5 vs. 21.0 ± 2.5 years, P = 0.027; women: 19.7 ± 2.6 vs. 21.5 ± 3.4 years, P = 0.027). Heavy, compared with mild, BZD use is associated with female suicide attempts (OR, 5.0; P = 0.049). Physicians should be cautious when prescribing BZDs to young adults and must allocate treatment to those with carefully evaluated clinical indications

Is Family Screening Necessary in Brucellosis?

Brucellosis is an endemic disease in Turkey. Simultaneous infections among family members consuming infected dairy products have been reported. The most frequent signs and symptoms are nonspecific, and most human cases remain unrecognized. We aimed to screen family members of index cases with brucellosis