This study was designed to provide a representative description of the mental health of youth accessing homelessness services in Canada. It is the most extensive survey in this area to date and is intended to inform the development of mental health and addiction service and policy for this marginalized population.
This study reports mental health-related data from the 2015 "Leaving Home" national youth homelessness survey, which was administered through 57 agencies serving homeless youth in 42 communities across the country. This self-reported, point-in-time survey assessed a broad range of demographic information, pre-homelessness and homelessness variables, and mental health indicators.
Survey data were obtained from 1103 youth accessing Canadian homelessness services in the Nunavut territory and all Canadian provinces except for Prince Edward Island. Forty-two per cent of participants reported 1 or more suicide attempts, 85.4% fell in a high range of psychological distress, and key indicators of risk included an earlier age of the first episode of homelessness, female gender, and identifying as a sexual and/or gender minority (lesbian, gay, bisexual, transgender, queer, and 2 spirit [LGBTQ2S]).
This study provides clear and compelling evidence of a need for mental health support for these youth, particularly LGBTQ2S youth and female youth. The mental health concerns observed here, however, must be considered in the light of the tremendous adversity in all social determinants faced by these youth, with population-level interventions best leveraged in prevention and rapid response.
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Cites: Lancet. 1998 Aug 29;352(9129):743 PMID 9729028
The 15-year follow-up of mortality and the factors associated with death from various causes were studied in an unselected group of patients surviving deliberate self-poisoning in 1978. The cohort included 152 females and 101 males. By the end of 1993 a total of 37 (24%) of the females and 33 (33%) of the males admitted in 1978 had died. The total follow-up mortality was 4.5 times greater than expected for the female group (95% confidence interval: 3.1-6.1) and 3.6 times greater than expected (2.5-5.1) for the male group. It was highest in the first 5-year period. With regard to specific causes the mortality ratio was highest for deaths from suicide. For females it was 61.1 (30.5-109.4) and for males: 38.8 (20.4-65.4) times the expected ratio. It was also significantly raised for deaths from cardiovascular diseases in females: SMR = 3.7 (2.0-6.4) and from respiratory diseases in males: SMR = 3.3 (1.2-7.1). Significant predictors for death from all causes were age > or = 30 years: RR = 4.4 (2.3-8.5) and male sex: RR = 2.1 (1.2-3.5). Imprisonment was found to be a protective factor: RR = 0.2 (0.1-0.5). Predictors for death from suicide were age > or = 30: RR = 3.1 (1.2-8.1), male sex: RR = 3.3 (1.4-7.9) and a serious suicidal attempt, as evaluated by a psychiatrist: RR = 3.4 (1.4-7.9). It is concluded that patients who survive parasuicide by deliberate self-poisoning are at increased risk of death. The predictors for death are not very specific and are difficult to apply in clinical work with these patients.
BACKGROUND: Deliberate self-poisoning is a big health problem. We wanted to study if there had been changes in drug use, morbidity and mortality in this group over the last 25 years in our hospital's catchment area. MATERIAL AND METHODS: In this study, 924 patients admitted to our hospital after deliberate self-poisoning in 1978, 1987 and 2002 were studied prospectively. RESULTS: From 1978 to 1987, there was a significant increase in the incidence of self-poisoning followed by a decline from 1987 to 2002 among both men and women. The age distribution remained the same. Benzodiazepines were the most commonly used drugs during the whole period (20% of patients in 1978, 39% in 1987, and 30% in 2002). There has been a significant reduction in the use of acetylsalicylic acid, tricyclic antidepressants and a significant increase in paracetamol and selective serotonin reuptake inhibitor poisonings. The use of gastric lavage and activated charcoal declined. The main antidote in 1978 was physostigmine, in 1987 and 2002 n-acetyl cysteine. During the whole period, complications (usually minor) were recorded in approximately 10% of cases. In 1978, mortality was 1.3%, in 1987 0.9%; no patient died in 2002. INTERPRETATION: The incidence of deliberate self-poisoning has fallen over the last 25 years. Selective serotonin reuptake inhibitors have to a large extent replaced tricyclic antidepressants and paracetamol has replaced acetylsalicylic acid.
Acute non-lethal poisonings with drugs within the period of 10 years according to archives data of Toxicological center and medicolegal department of victims' examination in Leningrad medicolegal expert Bureau were analysed. Number of drug poisoning cases increased two-fold and formed 76% of all poisoning cases. Tranquilizers, then antihistaminic, neuroleptic and hypotensive (clofelin) agents were used most often. Drugs were taken with suicidal attempt or with the aim of getting "alcoholic" effect. Poisonings among women were registered three times more often than among men.
INTRODUCTION: Poisoning is a common cause of emergency visits and hospital admission in Western countries. The purpose of this study was to assess the incidence and type of toxic exposures presenting to emergency medical facilities in Iceland. MATERIALS AND METHODS: The study was prospective and included all patients with confirmed or suspected poisoning presenting to hospitals and rural medical centers providing emergency services in Iceland during the twelve-month period from April 2001 until March 2002. RESULTS: A total of 1,121 toxic exposures were documented representing an incidence of 3.91 cases per 1,000 inhabitants per year. The female to male ratio was 1.23. The majority of exposures (56.7%) occurred in the patient's home, 60% were deliberate, 72% had drugs and/or alcohol as their main cause, and 11% involved illicit drugs. Exposures to chemicals other than drugs were usually unintentional. CONCLUSION: Toxic exposures requiring emergency medical care are common in Iceland. Self-poisonings by ingestion of prescription drugs and/or alcohol accounted for the majority of cases.
OBJECTIVES. Prospective design is mandatory to study pattern of poisoning and suicidal intention of patients. MATERIAL AND METHODS. Prospective cross-sectional multi-center study of all patients contacting health care services because of acute poisoning during one year in Oslo, irrespective of intention. Data on the adult hospitalized patients (> or = 16 years) are presented here. RESULTS. Of a total of 3,775 such adult contacts (3,025 episodes), there were 947 (31 %) hospitalizations; annual incidence 1.9 (per 1,000) in males and 2.1 in females. Median age was 36 years (range 16-89); 54% females. Benzodiazepines (18%), ethanol (17%), paracetamol (12%), opioids (7%), and gamma hydroxybutyric acid (GHB) (7%) were most frequently taken. Patients stated suicidal intention in 29% of the admissions; physicians in 10%. CONCLUSION. Benzodiazepines and ethanol were the most common agents, but newer illicit drugs were frequent, especially GHB. Males often took ethanol and drugs of abuse; females often used prescription drugs with suicidal intention.
Previous studies of bipolar disorders indicate that childhood abuse and substance abuse are associated with the disorder. Whether both influence the clinical picture, or if one is mediating the association of the other, has not previously been investigated.
A total of 587 patients with bipolar disorders were recruited from Norway and France. A history of childhood abuse was obtained using the Childhood Trauma Questionnaire. Diagnosis and clinical variables, including substance abuse, were based on structured clinical interviews (Structured Clinical Interview for DSM-IV Axis I disorders or French version of the Diagnostic Interview for Genetic Studies).
Cannabis abuse was significantly associated with childhood abuse, specifically emotional and sexual abuse (? 2 = 8.63, p = 0.003 and ? 2 = 7.55, p = 0.006, respectively). Cannabis abuse was significantly associated with earlier onset of the illness (z = -4.17, p
The study comprises 541 patients admitted to the Poisoning Treatment Centre at Bispebjerg Hospital, Copenhagen; 440 of the patients were psychiatrically evaluated prospectively. The sex distribution was almost equal. In comparison with the normal population there was an overrepresentation of the age groups of 30-49 years old and of 18-19 years old. Only 20% were employed. Sixty-nine percent of the males and 40% of the females were living alone. Forty-six percent of the patients had some sort of abuse. Twenty-one percent suffered from psychotic disorder. Forty-eight percent had at least once before attempted suicide. The group was found to be at high risk of repeating suicide attempt according to a scale developed in the poisoning treatment centre in Edinburgh. The treatment of suicidal patients is discussed.
To investigate the impact of adolescent violent and non-violent criminality and subsequent risk of morbidity and mortality in adulthood in a large Swedish cohort of young men conscripted for military service in 1969/70.
The cohort consisted of 49,398 18-year-old Swedish conscripts followed up for morbidity and mortality up to the age of 55?years in Swedish national registers. Information about convictions for crime before conscription was obtained from national crime registers. Data from a survey at conscription were scrutinized to get information on potential confounders.
Hospitalization due to alcohol and drug related diagnoses and attempted suicide were significantly more evident in the violent group compared to non-violent criminals and non-criminals. More than one fifth (21.13%) of the young violent offenders, 12.90% of the non-violent offenders and 4.96% of the non-criminals had died during the follow-up period. In Cox proportional multivariate analyses, young violent offenders had twice the hazard (HR?=?4.29) of all-cause mortality than the non-violent offenders (HR?=?2.16) during the follow-up period. Alcohol and drug related mortality, suicide and fatal accidents were most evident in both violent and non-violent offenders.
Men with adolescent criminality received more inpatient care due to alcohol and drug related diagnoses and attempted suicide as adults. Mortality due to unnatural causes, alcohol, and drug related diagnoses, suicide and accidents was most evident in violent offenders, while these causes of death were much lower in non-criminals. Men with adolescent criminality are a high-risk group for multiple adverse health outcomes and for early death. Efforts for detection of substance use and psychiatric disorders in this group is important for the prevention work in both local- and community levels as well as national prevention programs.
