Displaying publications 1 - 20 of 88 in total

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  1. Zulkiply SH, Rosliza AM
    Med J Malaysia, 2022 Nov;77(6):755-763.
    PMID: 36448396
    INTRODUCTION: Suicide is recognized as an important public health concern, as it is the second leading cause of death among young people. About 80% of all suicide cases occur in low- and middle-income countries (LMICs). Understanding the risk factors for suicidal behaviours among young people in LMIC is important in developing preventive strategies; however, evidence on this is still lacking. Socio-ecological model (SEM) is a suitable framework in explaining the factors of suicidal behaviour. The aim of this review is to identify the factors associated with suicidal ideation and suicidal attempt among young people in LMIC, guided by the SEM model, and eventually develop its preventive strategies.

    MATERIALS AND METHODS: This review has two parts. The first part is a scoping review of the factors associated with suicidal ideation and attempt among young people. The search was conducted in Pubmed, Scopus, and PsycInfo. The second part is the development of preventive strategies according to the identified factors. Both parts will be guided by the SEM model.

    RESULTS: A total of ten studies with 45,278 participants that matched the criteria are included in this review. The review found that the risk factors for suicidal ideation among young people in LMIC are being female, psychiatric illness, psychology problem, smoking, alcohol intake, victim of abuse, bullied, and food insecurity. The preventive strategies include policy, mental healthcare services, awareness programme, and coping strategies.

    CONCLUSION: More epidemiological studies are needed to evaluate the risk factors of suicide that are unique in LMIC, such as help-seeking behaviour and available mental healthcare services. Suicide prevention requires concerted effort of policymakers, healthcare services, community and individual; thus, SEM framework is suitable as a guidance for suicide prevention.

    Matched MeSH terms: Suicidal Ideation
  2. Zhong Q, Gelaye B, Rondon M, Sánchez SE, García PJ, Sánchez E, et al.
    J Affect Disord, 2014 Jun;162:1-7.
    PMID: 24766996 DOI: 10.1016/j.jad.2014.03.028
    OBJECTIVE: We sought to evaluate the psychometric properties of two widely used screening scales: the Patient Health Questionnaire (PHQ-9) and Edinburgh Postnatal Depression Scale (EPDS) among pregnant Peruvian women.
    METHODS: This cross-sectional study included 1517 women receiving prenatal care from February 2012 to March 2013. A structured interview was used to collect data using PHQ-9 and EPDS. We examined reliability, construct and concurrent validity between two scales using internal consistency indices, factor structures, correlations, and Cohen׳s kappa.
    RESULTS: Both scales had good internal consistency (Cronbach׳s alpha>0.8). Correlation between PHQ-9 and EPDS scores was fair (rho=0.52). Based on exploratory factor analysis (EFA), both scales yielded a two-factor structure. EFA including all items from PHQ-9 and EPDS yielded four factors, namely, "somatization", "depression and suicidal ideation", "anxiety and depression", and "anhedonia". The agreement between the two scales was generally fair at different cutoff scores with the highest Cohen׳s kappa being 0.46.
    CONCLUSIONS: Both the PHQ-9 and EPDS are reliable and valid scales for antepartum depression assessment. The PHQ-9 captures somatic symptoms, while EPDS detects depressive symptoms comorbid with anxiety during early pregnancy. Our findings suggest simultaneous administration of both scales may improve identification of antepartum depressive disorders in clinical settings.
    Matched MeSH terms: Suicidal Ideation
  3. Zhang J, Huen JMY, Lew B, Chistopolskaya K, Talib MA, Siau CS, et al.
    J Affect Disord, 2020 06 15;271:279-285.
    PMID: 32479327 DOI: 10.1016/j.jad.2020.03.076
    BACKGROUND: The etiological factors of mood disorders and psychopathologies are understudied. In this paper, we explored whether social psychological strains are related to depression, anxiety, and stress in non-clinical populations.

    METHODS: 6,305 college students (39.3% men; 60.7% women) from six Chinese provincial-level jurisdictions completed a paper-and-pencil survey with Psychological Strain Scales (PSS-40) and Depression, Anxiety, and Stress Scales-21 (DASS-21), both validated in Chinese populations.

    RESULTS: Both PSS-40 and DASS-21 have high internal consistency reliabilities, and are highly correlated with each other. Hence, Chinese college students with greater psychological strains (value, aspiration, deprivation, or coping) have greater depression, anxiety, and stress. These results still held after controlling for relevant socio-demographic variables in the multiple regression models.

    LIMITATIONS: This was a cross-sectional study, and the sample only included several provinces in mainland China, not a representative sample of all of them.

    CONCLUSIONS: Mood disorders and psychopathologies are linked to suicidal thoughts and behaviors. The results of this study extend the Strain Theory of Suicide from explaining the risk factors of suicidality to mood disorders and psychopathologies. Hence, these findings can inform prevention measures among college students, and possibly the general population.

    Matched MeSH terms: Suicidal Ideation
  4. Wu O, Lu X, Yeo KJ, Xiao Y, Yip P
    Int J Environ Res Public Health, 2022 Aug 30;19(17).
    PMID: 36078501 DOI: 10.3390/ijerph191710786
    BACKGROUND: University students with suicidal ideation are at high risk of suicide, which constitutes a significant social and public health problem in China. However, little is known about the prevalence and associated risk factors of suicidal ideation among first-year university students in China, especially during the COVID-19 pandemic.

    OBJECTIVES: To investigate the prevalence of suicidal ideation and its factors in first-year Chinese university students from a vocational college in Zhejiang during the COVID-19 pandemic.

    METHODS: Using a cluster sampling technique, a university-wide survey was conducted of 686 first-year university students from Hangzhou in March 2020 using University Personality Inventory (UPI). UPI includes an assessment for suicidal ideation and possible risk factors. Suicidal ideation prevalence was calculated for males and females. Univariate analysis and multivariable logistic regression models were conducted, adjusting for age and sex. Analyses were carried out using the SPSS version 22.0 software.

    RESULTS: The prevalence of 12-month suicidal ideation among first-year university students during March 2020 was 5.2%, and there was no significant difference between males and females (4.8% vs. 6.0%, x2 = 0.28, p = 0.597). Multivariable logistic regression analysis identified social avoidance (B = 0.78, OR = 2.17, p < 0.001) and emotional vulnerability (B = 0.71, OR = 2.02, p < 0.001) as positively associated with suicidal ideation.

    CONCLUSIONS: Social avoidance and emotional vulnerabilities are unique factors associated with greater suicidal ideation among first-year university students during the COVID-19 pandemic. UPI serves as a validated tool to screen suicide risks among Chinese university students. Encouraging social engagement and improving emotional regulation skills are promising targets to reduce suicidal ideation among first-year university students.

    Matched MeSH terms: Suicidal Ideation
  5. Wee LH, Ibrahim N, Wahab S, Visvalingam U, Yeoh SH, Siau CS
    Omega (Westport), 2020 Dec;82(2):323-345.
    PMID: 30482086 DOI: 10.1177/0030222818814331
    This study explored health-care workers' perception of patients' suicide intention and their understanding of factors leading to particular interpretations. Semistructured face-to-face in-depth interviews were conducted with 32 health-care workers from a general hospital in Klang Valley, Malaysia. Interview data were transcribed verbatim and analyzed using the interpretative phenomenological analysis. The health-care workers were found to have four types of perceptions: to end life, not to end life, ambivalence about intention, and an evolving understanding of intention. Factors leading to their perceptions of patients' suicide intention were patient demographics, health status, severity of ideation/attempt, suicide method, history of treatment, moral character, communication of suicide intention, affective/cognitive status, availability of social support, and health-care workers' limited knowledge of patients' condition/situation. Insufficient knowledge and negative attitudes toward suicidal patients led to risk minimization and empathic failure, although most health-care workers used the correct parameters in determining suicide intention.
    Matched MeSH terms: Suicidal Ideation
  6. Wang W, Zhang J, Lew B
    J Relig Health, 2021 Dec;60(6):4537-4555.
    PMID: 34245434 DOI: 10.1007/s10943-021-01329-z
    This study examined the mediating effects of psychological strain (Strain Theory) as a possible explanation for the relationship between religiosity and suicidality among Chinese young adults. A questionnaire was administered that included the Religious Orientation-Revised Scale (RO-RS), Suicidal Behaviors Questionnaire-Revised (SBQ-R), and Psychological Strains Scale (PSS). Using cluster sampling, we recruited 13,250 college students across seven provinces in China. Both univariate and multivariate analyses were used to identify the main determinants of suicidality. We further explored the mediation effect of psychological strains on the relationship between religion and suicidality. We found that non-believers obtained the lowest PSS. Believers of Islam and other religions obtained higher RO-RS scores compared to non-religious participants. Psychological strain imposed a complete effect between religiosity and suicidality. A positive relationship between religion and suicidality was present among the participants of the study. Individuals who are affiliated with a religion are considered as a marginalized population in China, which may lead to psychological strains, further increasing the risk of suicidality.
    Matched MeSH terms: Suicidal Ideation
  7. Thompson, Holly Knox, Hasking, Penelope A.
    MyJurnal
    Self-injury is a significant predictor of future self-harm and suicide, and is associated with significant psychological morbidity. However, despite an
    apparent increase in prevalence, very little research on this behaviour has been conducted within Malaysia. This paper reviews the definitional issues
    pertinent to the study of self-injury including the need to adopt a consistent nomenclature for the behaviour, separate self-injury which occurs with and
    without suicidal intent, and to address role of culture in defining self-injurious behaviour. A review and critique of research exploring the prevalence, function, aetiology, and correlates of self-injury across both clinical and community samples is provided. Finally, in light of the current international knowledge regarding self-injurious behaviour, recommendations to guide future research in Malaysia are proposed.
    Matched MeSH terms: Suicidal Ideation
  8. Teng CL, Zuhanariah MN, Ng CS, Goh CC
    Med J Malaysia, 2014 Aug;69 Suppl A:4-7.
    PMID: 25417946
    This article describes the methodology of this bibliography. A search was conducted on the following: (1) bibliographic databases (PubMed, Scopus, and other databases) using search terms that maximize the retrieval of Malaysian publications; (2) Individual journal search of Malaysian healthrelated journals; (3) A targeted search of Google and Google Scholar; (4) Searching of Malaysian institutional repositories; (5) Searching of Ministry of Health and Clinical Research Centre website. The publication years were limited to 2000- 2013. The citations were imported or manually entered into bibliographic software Refworks. After removing duplicates, and correcting data entry errors, PubMed's Medical Subject Headings (MeSH terms) were added. Clinical research is coded using the definition "patient-oriented-research or research conducted with human subjects (or on material of human origin) for which the investigator directly interacts with the human subjects at some point during the study." A bibliography of citations [n=2056] that fit the criteria of clinical research in Malaysia in selected topics within five domains was generated: Cancers [589], Cardiovascular diseases [432], Infections [795], Injuries [142], and Mental Health [582]. This is done by retrieving citations with the appropriate MESH terms, as follow: For cancers (Breast Neoplasms; Colorectal Neoplasms; Uterine Cervical Neoplasms), for cardiovascular diseases (Coronary Disease; Hypertension; Stroke), for infections (Dengue; Enterovirus Infections, HIV Infections; Malaria; Nipah Virus; Tuberculosis), for injuries (Accidents, Occupational; Accidents, Traffic; Child Abuse; Occupational Injuries), for mental health (Depression; Depressive Disorder; Depressive Disorder, Major; Drug Users; Psychotic Disorders; Suicide; Suicide, Attempted; Suicidal Ideation; Substance- Related Disorders).
    Matched MeSH terms: Suicidal Ideation
  9. Tan ST, Sherina MS, Rampal L, Normala I
    Med J Malaysia, 2015 Feb;70(1):1-5.
    PMID: 26032521 MyJurnal
    BACKGROUND: Undergraduate medical students have been the most distressed group among the student population. Depression and anxiety have been found to be more prevalent in this group of students compared to others.

    OBJECTIVE: This study was conducted to determine the prevalence and predictors of suicidality among undergraduate medical students in a public university.

    METHODS: This was an analytical cross-sectional study, conducted in a public university in Selangor, Malaysia. Data were collected using self-administered questionnaires from January to February 2013, and analysed using the Statistical Package for Social Sciences Software (version 21).

    RESULTS: Out of 625 undergraduate medical students, 537 (85.9%) participated in the study. The prevalence of the suicidality among undergraduate medical students was 7.0%. The significant predictors of suicidality based on multiple logistic regression were the respondent's lifetime suicide attempts (Adjusted Odds Ratio, AOR 10.4, 95% CI 2.7 to 40.9); depression (AOR 5.9, 95% CI 1.5 to 23.0); breaking off a steady love relationship (AOR 5.4, 95% CI 1.3 to 22.4); hopelessness (AOR 4.9, 95% CI 1.1 to 21.6); and something valued being lost or stolen (AOR 4.4, 95% CI 1.2 to 15.9).

    CONCLUSION: These findings indicate that mental health care services should be strengthened at university level. The results show a need for an intervention programme to reduce suicidality among the undergraduate medical students.
    Matched MeSH terms: Suicidal Ideation*
  10. Syed Elias SM, Makhtar A, Ahmad Tarmidi NH
    Enferm Clin, 2021 04;31 Suppl 2:S356-S360.
    PMID: 33849199 DOI: 10.1016/j.enfcli.2020.09.026
    This study aimed to determine the prevalence of suicidal ideation and the associated factors with suicidal ideation among older people. This was a cross-sectional study. The present study was carried out from March 2018 to May 2018. In total, 200 older people aged 60 years and over were recruited from a medical outpatient clinic in Malaysia. The older people completed a self-administered questionnaire on sociodemographic background, depression, and suicidal ideation. The data analysis involved descriptive and inferential analysis using IBM SPSS Statistics version 23.0. The prevalence rate of suicidal ideation was 3%. There were significant associations between ethnicity (p<0.00), marital status (p=0.008), depression (p<0.00) and suicidal ideation. Risk factors for suicidal ideation in older people are ethnicity, marital status, and depression. Future studies should focus on these factors in any intervention aimed to reduce suicidal ideation among older people in Malaysia.
    Matched MeSH terms: Suicidal Ideation*
  11. Song Y, Bai W, Wang M, Liu X, Zhang L, Yu W, et al.
    J Affect Disord, 2019 12 01;259:195-200.
    PMID: 31446380 DOI: 10.1016/j.jad.2019.08.042
    BACKGROUND: Suicide is a major global mental health problem among college students. The aim of the current study was to explore the association between the psychological strains of the strain theory of suicide and suicidal behaviors among college students.

    METHODS: Participants comprised 1912 college students (16-28 years old, 47.2% female) from three universities in Jilin Province, China, who completed the self-report assessments of psychological strains (40 items Psychological Strains Scale) and suicidal behaviors (Suicidal Behaviors Questionnaire-Revised). The demographic characteristics included four variables: health status, psychological status, academic status and economic status.

    RESULTS: Approximately 15.0% (286/1912) of participants were classified as having suicide risk, based on the cut-off scores of the SBQ-R. The prevalence of suicidal behaviors among males and females was 11.9% (120/1009) and 18.4% (166/903), respectively. Value strain (OR = 1.075, 95%CI: 1.057-1.094), aspiration strain (OR = 1.082, 95%CI: 1.064-1.101), deprivation strain (OR = 1.073, 95%CI: 1.052-1.093), and coping strain (OR = 1.095, 95%CI: 1.075-1.116) were risk factors for suicidality in college students. Coping strain (OR = 1.050, 95%CI: 1.023-1.077) was still positively associated with suicide risk in multivariate logistic regression. Logistic regression analysis indicated that coping strain had the highest correlation with suicidal behaviors.

    LIMITATIONS: The directionality of the relationships cannot be deduced because this study is cross-sectional.

    CONCLUSION: This study confirms a strong association between psychological strains and suicidal behaviors in college students. Some measures can be taken to reduce psychological strains to mitigate suicide risk among college students. More studies investigating coping strain among college students are warranted.

    Matched MeSH terms: Suicidal Ideation*
  12. Sinniah A, Oei TP, Chinna K, Shah SA, Maniam T, Subramaniam P
    Front Psychol, 2015;6:1934.
    PMID: 26733920 DOI: 10.3389/fpsyg.2015.01934
    The PANSI is a measure designed to assess the risk and protective factors related to suicidal behaviors. The present study evaluated the psychometric properties and factor structure of the Positive and Negative Suicide Ideation (PANSI) Inventory in a sample of clinical outpatients at a major hospital in Malaysia. In this study, 283 psychiatric patients and 200 medical (non-psychiatric) patients participated. All the patients completed the PANSI and seven other self-report instruments. Confirmative factor analysis supported the 2-factor oblique model. The internal consistency of the two subscales of PANSI-Negative and the PANSI-Positive were 0.93 and 0.84, respectively. In testing construct validity, PANSI showed sizable correlation with the other seven scales. Criterion validity was supported by scores on PANSI which differentiated psychiatric patients from medical patients. Logistic regression analyses showed PANSI can be used to classify the patients into suicidal or non-suicidal. The PANSI is a reliable and valid instrument to measure the severity of suicidal ideation among clinical outpatients in Malaysia.
    Study site: Psychiatric clinic, Medical clinic, Ear, Nose and Throat (ENT) clinic, Ophthalmology clinic and orthopedic clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Scale, Questionnaire and Device: Positive and Negative Suicide Ideation Inventory (PANSI), Depression Anxiety Stress Scale (DASS-21), Reasons for Living Inventory (RFL), Beck Hopelessness Scale (BHS), Provision of Social Relations (PSR), Satisfaction with Life Scale (SWLS), Rosenberg Self Esteem Scale (RSE), The Adult Trait Hope Scale (ATHS)
    Matched MeSH terms: Suicidal Ideation
  13. Sinniah A, Oei TPS, Maniam T, Subramaniam P
    Psychiatry Res, 2017 08;254:179-189.
    PMID: 28463716 DOI: 10.1016/j.psychres.2017.04.026
    The aim of this study was to investigate the effectiveness of Individual Cognitive Behavior Therapy (ICBT) in treating patients with mood disorders with suicidal ideation. A total of 69 patients (48 females, 21 males) with the diagnoses above were randomly allocated to either the group of Treatment As Usual (TAU)+ICBT (n=33) or the TAU group (n=36). All participants completed the Beck Depression Inventory (BDI), Beck Scale for Suicide Ideation (BSS), Positive and Negative Suicide Ideation Inventory (PANSI), Beck Hopelessness Scale (BHS), and Depression Anxiety Stress Scale-21 (DASS-21). These questionnaires were administered at pre-treatment, midway through treatment (week 4), post-treatment (week 8), and at follow-ups after three months (week 20) and six months (week 32). Factorial ANOVA results showed that the TAU+ICBT patients improved significantly and at faster rate as compared to the TAU group, which showed improvement only from pre to mid treatment on DASS-D and BHS-T measures. The effect size (Cohen's d), for the TAU+ICBT group showed large effect (1.47) for depressive symptoms and suicidal ideation (1.00). These findings suggest that ICBT used in addition to the TAU, was effective in enhancing treatment outcome of patients with unipolar mood disorders as well as, reducing risk for suicide behavior.
    Matched MeSH terms: Suicidal Ideation*
  14. Siau CS, Wee LH, Adnan TH, Yeoh SH, Perialathan K, Wahab S
    J Nurses Prof Dev, 2019 2 12;35(2):98-103.
    PMID: 30741918 DOI: 10.1097/NND.0000000000000520
    The aim of this study was to examine Malaysian nurses' attitudes toward suicide. Nurses from five hospitals participated in this study. Studying the attitudes of nurses toward suicidal patients and its application to nursing professional development practitioners is an important topic. Most nurses were agreeable to assuming responsibility and to be trained in suicide prevention. Suicide-related training should focus on improving the attitudes of nonpsychiatric nurses, those with no experience in caring for suicidal patients, and those with less nursing experience, all of whom reported more negative attitudes toward suicidal patients.
    Matched MeSH terms: Suicidal Ideation
  15. Siau CS, Chan CMH, Wee LH, Wahab S, Visvalingam U, Chen WS, et al.
    Omega (Westport), 2023 Jun;87(2):469-484.
    PMID: 34096373 DOI: 10.1177/00302228211021746
    We examined whether burnout, depression, anxiety, stress, lifetime suicidal ideation, self-efficacy in preventing suicide and demographic factors predicted the understanding of and willingness to help suicidal patients among hospital healthcare workers. A total of 368 healthcare workers from the major surgical and medical departments in a general hospital setting were recruited. Participants responded to the Depression Anxiety and Stress Scale-21, Self-efficacy in Suicide Prevention, and Understanding Suicide Attempt Patient Scale. Those from the psychiatric department, with higher suicide prevention self-efficacy, and lower personal accomplishment indicated more understanding and helpful attitudes; doctors, depressed and anxious healthcare workers reported less understanding and helpful attitudes. Suicide prevention efforts must be conducted in tandem with equipping and supporting the healthcare workers who manage suicidal patients.
    Matched MeSH terms: Suicidal Ideation
  16. Sharif Nia H, Heidari M, Naghavi N, Lehto RH, Haghdoost AA, Jafari-Koulaee A, et al.
    Omega (Westport), 2020 Oct 26.
    PMID: 33106088 DOI: 10.1177/0030222820966934
    This review study fills an important gap by aiming to determine the age changes in attempted and completed suicide in Iran during the past decade. A systematic review of related articles in international and Iranian databases from January 2008 to January 2020 was first conducted and relevant studies were extracted based on established criteria. Results showed that the mean age of suicide in Iran is 29.8 (range 27.7 - 31.8) years old for men and 27.4 (range 25.8 - 28.9) for women (P 
    Matched MeSH terms: Suicidal Ideation
  17. Sathian B, Menezes RG, Asim M, Mekkodathil A, Sreedharan J, Banerjee I, et al.
    Nepal J Epidemiol, 2020 Mar;10(1):821-829.
    PMID: 32257512 DOI: 10.3126/nje.v10i1.28277
    Background: Worldwide, tobacco smoking is a major risk factor for morbidity and early mortality among adult population. The present study aimed to find out the association between current smoking and suicidal ideation among young people in Nepal.

    Materials and Methods: A cross-sectional questionnaire-based survey was carried out among 452 youths from Pokhara, Nepal. The present study included both genders (age 18-24 years) who were smokers as well as non-smokers.

    Results: Across the study period, 452 participants were identified after matching for age, and sex (226 in the smoking group and 226 in the non-smoking group). The mean age of participants was 21.6±1.2 years and 58.8% were males. The overall rate of suicidal ideation in our cohort was 8.9%. Smokers were slightly more likely to report suicidal ideation than non-smokers (aOR 1.12). The risk of developing suicidal ideation was 3.56 (95% CI 1.26-10.09) times more in individuals who smoked greater than 3.5 cigarettes per week (p=0.01).

    Conclusion: The rate of suicidal ideation was slightly higher among smokers and a dose-response relationship was identified with the number of cigarettes smoked per week. Being aware of the link between smoking and suicidal ideation may help health care professionals working with young people to address more effectively the issues of mental well-being and thoughts about suicide.

    Matched MeSH terms: Suicidal Ideation
  18. Sajadi SF, Hajjari Z, Zargar Y, Mehrabizade Honarmand M, Arshadi N
    Int J High Risk Behav Addict, 2014 Dec;3(4):e20995.
    PMID: 25741480 DOI: 10.5812/ijhrba.20995
    BACKGROUND: There is a great deal of medical literature suggesting that substance use disorder is a serious clinical concern, affecting general population and associated with considerable economic, societal, and personal costs.

    OBJECTIVES: This study sought to clarify the relationship between early trauma, dissociative experience, and suicide ideation as predictive factors of active and passive addiction potential (A/PAP) in high-school students.

    PATIENTS AND METHODS: Three hundred students with the mean age of 15.72 y were selected via multistage random sampling. All participants were asked to complete Iranian addiction potential scale, early trauma inventory, dissociative experiences scale, and Beck's suicide ideation scale. Analyzing data was done using canonical correlation.

    RESULTS: Structural coefficients showed that the pattern of high scores in A/PAP correlates with the pattern of high scores in early trauma, dissociative experience and suicide ideation. The findings of the study showed that the combination of low A/PAP can probably decrease the likelihood of early trauma, dissociative experience and suicide ideation.

    CONCLUSIONS: Early trauma, dissociative experience, and suicide ideation can predict A/PAP and explain the considerable variance of survival index.

    Matched MeSH terms: Suicidal Ideation
  19. Sahimi HMS, Mohd Daud TI, Chan LF, Shah SA, Rahman FHA, Nik Jaafar NR
    Front Psychiatry, 2021;12:658174.
    PMID: 34025479 DOI: 10.3389/fpsyt.2021.658174
    Objective: The burden of suicidal behavior is anticipated to increase as a sequela of the COVID-19 pandemic. However, there is limited evidence on suicidal behavior among healthcare workers, an at-risk population. Our study aimed to investigate suicidal ideation in terms of the rate and associated factors in a sample of Malaysian healthcare workers during the early-phase of the COVID-19 pandemic. Methods: A subpopulation analysis (N = 171) was conducted within a larger, nation-wide cross-sectional study of Malaysian healthcare worker psychological distress from March 18-21, 2020. Current suicidal ideation was measured with item 9 of the Patient Health Questionnaire-9 (PHQ-9). The following independent variables were assessed: socio-demographic profile, occupation and service-related factors, health-anxiety (Health Anxiety Inventory, HAI), lifetime anxiety disorder and severity of depression (PHQ-9). Results: The proportion of healthcare workers with current suicidal ideation (19/171) and clinical depression (17/171) were 11.1 and 9.9%, respectively. Multivariable analysis showed that clinical depression was the most significant factor associated with current suicidal ideation (p < 0.001, OR = 55.983, 95% CI = 9.015-347.671) followed by mild (subthreshold) depression (p = 0.001, OR = 115.984, 95% CI = 2.977-85.804). Service duration of more than 10 years was associated with significantly less suicidal ideation (p = 0.049, OR = 0.072, 95% CI = 0.005-0.993). Conclusions: Depression (subthreshold and especially within the clinical range) and early-career status (<10 years in service) may be target areas of early intervention for reduction of suicidal ideation amongst healthcare workers who have served during the COVID-19 pandemic. Further research is warranted to elucidate specific occupational stressors related to COVID-19 work conditions to tailor appropriate suicide preventive strategies in this population.
    Matched MeSH terms: Suicidal Ideation
  20. Rusdi Abdul Rashid, Muhammad Muhsin Ahmad Zahari, Mohammad Hussain Habil, Noor Zurani Md Haris Robson
    ASEAN Journal of Psychiatry, 2009;10(2):202-209.
    MyJurnal
    Objective: The smoking rate among patients with mental health problem is higher than in the general population. Effective pharmacotherapy to treat nicotine addiction is thus needed to reduce the morbidity and mortality associated with cigarette smoking among these patients. This article reviews the literature on the suitability of varenicline for smokers with mental health problems.
    Methods: A search of the literature was conducted using PubMed from year 2001 to July 2009 using key words varenicline alone and varenicline and mental health. Articles chosen were narrowed to those published in English. The type of articles chosen included clinical trials, metaanalyses, case reports, and review articles.
    Results: The search produced a total of 322 articles on varenicline and 14 articles on varenicline and mental health. Varenicline, a new drug for smoking cessation is an α4β2 partial agonist and partial antagonist at nicotinic acetylcholine receptor. As a partial agonist, varenicline relieves craving and withdrawal symptoms that occur during smoking abstinence and also reduce the rewarding effects of smoking in patients who relapse. However, at present, there is concern regarding the neuropsychiatric side effects such as aggressive behaviour, suicidal ideation, mania and depression associated with varenicline use in patients with mental health problems, but these reports did not show a causal-link or lack of link between these symptoms and varenicline.
    Conclusion: Current available data support the effectiveness of varenicline to treat nicotine dependence. However its safety among smokers with mental health problems remains to be elucidated. At present, further safety assessment is needed in this patient population. Until new data is available regarding the safety of varenicline in these populations, psychiatrists and physicians prescribing this medication should be extra cautious and monitor for possible psychiatric side effects when prescribing this medication to patients with pre-existing psychiatric disorders or have vulnerability to psychoses.
    Matched MeSH terms: Suicidal Ideation
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