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      Predicting risk along the suicidality continuum: A longitudinal, nationally representative study of the Irish population during the COVID‐19 pandemic

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          Abstract

          Introduction

          Little is known about the lifetime prevalence of different indicators of suicidality in the Irish general population; whether suicidality has increased during the COVID‐19 pandemic; and what factors associated with belonging to different points on a continuum of suicidality risk.

          Methods

          A nationally representative sample of Irish adults ( N = 1,032) completed self‐report measures in May 2020 and a follow‐up in August 2020 ( n = 715).

          Results

          Lifetime prevalence rates were 29.5% for suicidal ideation, 12.9% for non‐suicidal self‐injury (NSSI), and 11.2% for attempted suicide. There were no changes in past two‐week rates of NSSI and attempted suicide during the pandemic. Correlations between the indicators of suicidality supported a progression from ideation to NSSI to attempted suicide. Suicidal ideation alone was associated with being male, unemployed, higher loneliness, and lower religiosity. NSSI (with no co‐occurring attempted suicide) was associated with a history of mental health treatment. Attempted suicide was associated with ethnic minority status, lower education, lower income, PTSD, depression, and history of mental health treatment.

          Conclusion

          Suicidal ideation, NSSI, and attempted suicide are relatively common phenomena in the general adult Irish population, and each has unique psychosocial correlates. These findings highlight important targets for prevention and intervention efforts.

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          Most cited references80

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The PHQ-9: validity of a brief depression severity measure.

            While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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              The PHQ-9

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                Author and article information

                Contributors
                philip.hyland@mu.ie
                Journal
                Suicide Life Threat Behav
                Suicide Life Threat Behav
                10.1111/(ISSN)1943-278X
                SLTB
                Suicide & Life-Threatening Behavior
                John Wiley and Sons Inc. (Hoboken )
                0363-0234
                1943-278X
                29 June 2021
                29 June 2021
                : 10.1111/sltb.12783
                Affiliations
                [ 1 ] Department of Psychology Maynooth University Maynooth Ireland
                [ 2 ] Trinity Centre for Global Health Trinity College Dublin Dublin Ireland
                [ 3 ] National Office for Suicide Prevention Health Service Executive Dublin Ireland
                [ 4 ] School of Nursing, Midwifery and Health Systems University College Dublin Dublin Ireland
                [ 5 ] School of Psychology Ulster University Coleraine Northern Ireland
                [ 6 ] School of Psychology University of Sheffield Sheffield England
                [ 7 ] School of Health & Social Care Edinburgh Napier University Edinburgh Scotland
                Author notes
                [*] [* ] Correspondence

                Dr Philip Hyland, Room 1.1.4 Education House, Department of Psychology, Maynooth University, Kildare, Ireland.

                Email: philip.hyland@ 123456mu.ie

                Author information
                https://orcid.org/0000-0002-9574-7128
                Article
                SLTB12783
                10.1111/sltb.12783
                8420335
                34184787
                6b4ae6b3-63bd-4dc1-9dba-112f45eea246
                © 2021 The Authors. Suicide and Life‐Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 07 April 2021
                : 21 December 2020
                : 04 May 2021
                Page count
                Figures: 1, Tables: 4, Pages: 16, Words: 33139
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.7 mode:remove_FC converted:06.09.2021

                attempted suicide,non‐suicidal self‐injury (nssi),risk factors,self‐harm,suicidal ideation,suicide

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