The impact of social context on socio-demographic risk factors for suicide: a synthesis of data from case-control studies

Crawford, Mike; Kuforiji, Bidemi; Ghosh, Pradip

doi:10.1136/jech.2008.084145

Cited by 23 publications

(17 citation statements)

References 49 publications

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“…Accidental and intentional subgroups presented with different demographic characteristics. Typical accidental victims were White males in their thirties and two‐thirds of them were in receipt of state benefits, reflecting these clients' levels of social vulnerability [28].Those of non‐White ethnicity were more represented in suicidal victims, in line with previous studies which show that being part of a minority community could be a risk factor for suicide [29]. In contrast with the rest of the sample, typical suicidal victims were females and older.…”

Section: Discussionsupporting

confidence: 81%

Deaths of opiate/opioid misusers involving dihydrocodeine, UK, 1997–2007

Zamparutti

Schifano

Corkery

et al. 2011

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Dihydrocodeine (DHC) is an opioid analgesic sometimes prescribed as an alternative to other medications (e.g. methadone and buprenorphine) for opioid misuse. Its effectiveness is, however, still controversial. • DHC prescription rates seem to be related to levels of DHC fatalities, possibly in relation to levels of disregard of the availability of supervised or interval dispensing of opioids, but no large‐scale analysis of DHC fatalities has been carried out. • We analysed here involvement of DHC in fatalities that occurred between 1997 and 2007 among individuals with a history of opiate/opioid misuse reported to the National Programme on Substance Abuse Deaths (np‐SAD). WHAT THIS STUDY ADDS • DHC, either alone or in combination, was identified in 584 fatalities. Typical cases identified were males in their early thirties. In accidental overdoses, DHC, which had been prescribed to 45% of the victims, was typically identified in combination with other drugs, such as heroin/morphine, methadone and hypnotics/sedatives. Both paracetamol and antidepressants were more typically identified in combination with DHC in suicides. • Opiate/opioid misusers should be educated about risks associated with polydrug intake and prescribers should carefully consider a pharmacological intervention alternative to DHC (e.g. methadone, buprenorphine) when managing and treating opiate addiction. AIMS Although its effectiveness is somewhat controversial, it appears that dihydrocodeine (DHC) is still prescribed in the UK as an alternative to both methadone and buprenorphine for the treatment of opiate addiction. METHODS Data covering the period 1997–2007 voluntarily supplied by coroners were analysed. All cases pertaining to victims with a clear history of opiate/opioid misuse and in which DHC, either on its own or in combination, was identified at post‐mortem toxicology and/or implicated in death, were extracted from the database. RESULTS Dihydrocodeine, either alone or in combination, was identified in 584 fatalities meeting the selection criteria. In 44% of cases it was directly implicated in the cause of death. These cases represented about 6.8% of all opiate/opioid‐related deaths during this period. Typical DHC cases identified were White males in their early thirties. Accidental deaths (96%) were likely to involve DHC in combination with other psychoactives, mainly heroin/morphine, hypnotics/sedatives and methadone. Both paracetamol and antidepressants were found in proportionately more suicide cases than in accidental overdoses. DHC had been prescribed to the decedent in at least 45% of cases. CONCLUSIONS Opiate/opioid misusers should be educated about risks associated with polydrug intake. More in particular, co‐administration of DHC with heroin, methadone and benzodiazepines may increase the risk of accidental fatal overdose. Prescribers should carefully consider pharmacological intervention alternative to DHC (e.g. methadone, buprenorphine) when managing and treating opiate addiction. Mo...

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Section: Discussionsupporting

confidence: 81%

Deaths of opiate/opioid misusers involving dihydrocodeine, UK, 1997–2007

Zamparutti

Schifano

Corkery

et al. 2011

Brit J Clinical Pharma

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“…Similarly, Kunst et al 193 demonstrated that the effect of social capital on suicide mortality was more pronounced for certain population groups, including young people, unmarried individuals, and men. Finally, a systematic review conducted by Crawford, Kuforiji, Ghosh, 250 synthesizing data from 54 studies, found that established risk factors including unemployment, living alone, and ethnic minority status had less on suicide risk for individuals living in areas where these factors were more common. 250…”

Section: Neighbourhoodsmentioning

confidence: 99%

“…Finally, a systematic review conducted by Crawford, Kuforiji, Ghosh, 250 synthesizing data from 54 studies, found that established risk factors including unemployment, living alone, and ethnic minority status had less on suicide risk for individuals living in areas where these factors were more common. 250…”

Section: Neighbourhoodsmentioning

confidence: 99%

Urban-Rural Differences in Major Mental Health Conditions

Solmi¹,

Dykxhoorn²,

Kirkbride³

2017

Mental Health and Illness in the City

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is a Research Associate in psychiatric epidemiology in the PsyLife group, Division of Psychiatry, UCL. She is interested in researching life course risk factors of various mental health problems in childhood, adolescence and young adulthood as well as ways to improve access to mental health services. Jennifer Dykxhoorn is a PhD student in the PsyLife Lab, Division of Psychiatry, UCL. Her research focuses on social and spatial determinants of psychotic disorders. She has a background in public mental health policy, having previously worked for the Public Health Agency of Canada and Mental Health Commission of Canada. Dr James Kirkbride is a Reader in Epidemiology in the Division of Psychiatry, UCL. He specialises in investigating the determinants of excess risk of schizophrenia and other psychotic disorders experienced by urban populations and ethnic minority groups. He runs the PsyLife group (www.PsyLife.eu) in the Division of Psychiatry, UCL.

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“…Research on the benefits of family coresidency in adulthood has heavily focused on the older population, as family is the main source of support in old age (Li 2013). Older adults living alone are more likely to experience loneliness (Greenfield and Russell 2011) and suicidal ideation or attempts (Crawford, Kuforiji, and Ghosh 2009;Lee and Oh 2008).…”

Section: Living Arrangements and Psychological Wellbeingmentioning

confidence: 99%

The problem group? Psychological wellbeing of unmarried people living alone in the Republic of Korea

Ho¹

2015

DemRes

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The impact of social context on socio-demographic risk factors for suicide: a synthesis of data from case-control studies

Cited by 23 publications

References 49 publications

Deaths of opiate/opioid misusers involving dihydrocodeine, UK, 1997–2007

Deaths of opiate/opioid misusers involving dihydrocodeine, UK, 1997–2007

Urban-Rural Differences in Major Mental Health Conditions

The problem group? Psychological wellbeing of unmarried people living alone in the Republic of Korea

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