Posts Tagged ‘Suicide’

Singing the Birthday Blues

Wednesday, June 27th, 2012

People aged 60 and over are 14 percent more likely to die on their birthdays A recent study of more than two million people found that the birthday blues bring a rise in deaths from heart attacks, strokes, falls, suicides and even cancer.  The findings – based on a study over 40 years in Switzerland – back up the idea that birthday stress has a major impact on lifespans.  The majority of the increase was attributed to heart attacks, which rose 18.6 percent on birthdays and were significantly higher for men and women.  Levels of strokes were up 21.5 per cent – primarily in women – and there was a surprisingly large increase in cancer deaths in both sexes of 10.5 per cent.

Dr Vladeta Ajdacic-Gross, a senior researcher in psychiatry at the University of Zurich, said: Birthdays end lethally more frequently than might be expected.”  One notable person who died on his birthday is William Shakespeare, who passed away in 1616 of causes unknown.

The Swiss research is confirmed by data on Canadian hospital admissions showing that strokes are more likely to occur on birthdays than other days, especially among patients with a history of high blood pressure.  A substantial rise in suicides and accidental deaths for the over-60s on birthdays was found only in men.  There was a 34.9 percent rise in suicides; 28.5 percent rise in accidental deaths not related to cars; and a 44 percent rise in deaths from falls on birthdays.  The risk increases for about four days before the big day.

It was previously thought that people are more likely to die after their birthday as the thought of reaching a milestone would help them hold on for more time.  The researchers said this theory was disproved by their findings, and they support the anniversary reaction theory – also known as the birthday blues.

Dr Lewis Halsey, a senior lecturer in environmental physiology at the University of Roehampton, said: “One interesting finding is that more suicides happen on birthdays, though only in men.  The authors suggest that this increase could be related to them drinking more alcohol on birthdays.  But perhaps men are more likely to make a statement about their unhappiness when they think people will be taking more notice of them.  Or perhaps women feel that it is unfair on others who might be celebrating with them to put them through dealing with suicide.”

American researchers have found similar increases in heart deaths on Christmas and New Year’s Day.  They list stress among possible causes — and say people having chest pain or other symptoms might wait too long to get medical help on days when they are thinking about celebrating.

Foreclosure Is Hazardous to Your Health

Monday, November 14th, 2011

Falling behind on mortgage payments harms more than just finances; the stress and strain can negatively impact physical and psychological health.  In 2009, 2.2 percent of all American homes — more than 2.8 million — were in some stage of delinquency.  Researchers examined data collected in 2006 and 2008 on nearly 2,500 Americans who took part in the Health and Retirement Study, a nationally representative sample of Americans aged 50 and older.  The data included information about general health, psychological health, income and whether the person had fallen behind on paying their mortgage.  People who were behind between 2006 and 2008 reported more depressive symptoms, increased food insecurity and were more likely to not take prescription medications as prescribed because of the cost.

“People are making unhealthy trade-offs when they’re trying to make their mortgage,” said Dawn Alley, an assistant professor of epidemiology and public health at the University of Maryland School of Medicine.  “We think it’s a very serious issue.”  The study was published in the American Journal of Public Health.

Nearly 32 percent of people who were having difficulty paying their mortgages didn’t take medications as prescribed because of costs, compared to the five percent who were able to make their mortgage payments.  “Depression, not taking medications and not spending enough money on nutritious food can exacerbate conditions you already have,” Alley said.

Nearly one-third of the people who were mortgage-delinquent reported fair or poor health compared to 19 percent who were able to pay their mortgages on time.  “The rise in mortgage defaults may have important public health implications that could ultimately prove costly to affected individuals, employers, the healthcare system, and society,” according to the study’s authors.

More than a quarter of people in mortgage default or foreclosure are over 50,” Alley said. For an older person with chronic conditions like diabetes or hypertension, the types of health problems we saw are short-term consequences of falling behind on a mortgage that could have long-run implications for that person’s health,” Alley said.

“This study has pinpointed an issue that until now has been somewhat under the radar, but which threatens to become a major public health crisis if not addressed,” said E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine.  “Through research such as this, faculty epidemiologists and public health specialists provide valuable information and perspectives that are useful for government and private policy makers as they work to meet the health and economic needs of Americans.”

This study was co-sponsored by the National Institutes of Health and was conducted with support, resources and use of facilities from the Philadelphia Veterans Affairs Medical Center.

Another study by Janet Currie of Princeton University and Erdal Tekin of Georgia State University shows a direct relation between foreclosure rates and the health of residents in Arizona, California, Florida and New Jersey.  The researchers concluded in a paper published by the National Bureau of Economic Research that an increase of 100 foreclosures related to a 7.2 percent increase in emergency room visits and hospitalizations for hypertension, and an 8.1 percent increase for diabetes, among people in the 20 to 49 age group.

Writing in the Wall Street Journal, S. Mitra Kalita says that “Each rise of 100 foreclosures was also associated with 12 percent more visits related to anxiety in the same age category.  And the same rise in foreclosures was associated with 39 percent more visits for suicide attempts among the same group, though this still represents a small number of patients, the researchers say.  Teasing out cause and effect can be delicate, and correlation doesn’t necessarily mean foreclosures directly cause health problems.  Financial duress, among other issues, could lead to health problems — and cause foreclosures, too.  The economists didn’t find similar patterns with diseases such as cancer or elective surgeries such as hip replacement, leading them to conclude that areas with high foreclosures are seeing mostly an increase of stress-related ailments.”

Why Are More Middle-Aged Women Killing Themselves?

Tuesday, August 9th, 2011

A recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA) found a 49 percent increase in emergency department visits for drug-related suicide attempts for women 50 years and older.  Women in the 40-69 age bracket are at greater risk of killing themselves than other women, according to research on age-specific suicide rates between 1998 and 2007.  In 2007, this age group comprised 60 percent of the 7,328 suicides reported among women.  The question is:  Why is this happening to middle-aged women?

There is a possibility that it is a question of numbers: One in four American adults has a treatable mental health condition; women in the 40-69-year-old age group represent one of the nation’s fastest-growing populations.  Alternatively, it could be a function of baby boomers’ elevated rates of substance abuse, a critical risk factor in suicide, said Julie Phillips, Ph.D., a social demographer and associate professor at Rutgers University.  According to Phillips, the age-specific rates were derived from data from the National Center for Health Statistics and the Census Bureau.

During the nine-year time period studied, suicide rates remained fairly stable for women younger than 40; for women older than 70, suicide rates declined.  Women 50 and older may be in crisis because pain and sleep disorders — widespread problems related to aging — often lead to increased use of prescription drugs, said Albert Woodward, Ph.D., the project director of SAMHSA’s Drug Abuse Warning Network.  According to the SAMHSA report, suicide attempts involving drugs to treat anxiety and insomnia rose 56 percent.  Woodward said that middle-aged women may experience depression because of declining health and other negative life events.   Loneliness and depression also are risk factors for suicide.  “Older women, especially in the U.S., are more isolated and separated from daily human contact outside of work and the internet,” said Ellyn Kaschak, Ph.D., emeritus professor of psychology at San Jose State University and the editor of the journal Women & Therapy.

Dr. LeslieBeth Wish, a psychologist and licensed clinical social worker in Sarasota, FL, has found  a surprising increase in suicide attempts by women aged between 45 and 54.  Women are susceptible to depression but older women may also be suffering from pre-menopause hormone fluctuations that can affect mood changes and depression.  According to Dr. Wish, women in their middle years are more aware of their mortality and may be disenchanted that they will never be happy.  Becoming an empty nester also is stressful.

Of greater concern is the 67 percent increase of women taking hydrocodone, and an astonishing 210 percent increase for women taking oxycodone.  According to SAMHSA administrator Pamela S. Hyde, J.D., “The steep rise in the abuse of narcotic pain relievers by women is extremely dangerous and we are now seeing the results of this public health crisis in our emergency rooms.  Emergency rooms should not be the frontline in our efforts to intervene.  Friends, family, and all members of the community must do everything possible to help identify women who may be in crisis and do everything possible to reach out and get them needed help.”

Because they are often members of the so-called “Sandwich Generation,” middle-aged women frequently discount their own needs as they organize commitments to jobs, marriages, kids, and aging parents.  Many say they don’t get enough sleep and eat too much junk-food.  According to medical experts, these habits — combined with soaring cortisol (a steroid hormone, or glucocorticoid, produced by the adrenal gland) levels — from stress — could mean this will be the first generation of women who don’t live five to seven years longer than males.

Nurse Burn-Out, Depression Can Be Fatal to Patients

Tuesday, July 26th, 2011

The horror began last September 14 when an experienced Seattle nurse realized she’d overdosed a fragile baby with 10 times too much medication. The stunned nurse told nearby staff at the Cardiac Intensive Care Unit at Seattle Children’s Hospital what had transpired.  “It was in the line of, ‘Oh my God, I have given too much calcium,’” recalled a fellow nurse.  In the nurse’s 24-year career, all of it spent at Seattle Children’s, dispensing 1.4 grams of calcium chloride — instead of the correct dose of 140 milligrams — was the sole serious medical mistake she’d ever made, according to the public investigation.  “She was devastated, just devastated,” said her partner and co-parent of their two children.  That mistake turned out to be the start of a life that unraveled, contributing not only to the child’s death, an eight-month-old girl, but also to Hiatt’s firing, a state nursing commission investigation — and Hiatt’s suicide at age 50.

This story highlights the twin casualties caused by serious medical errors: The patient is the first victim, the person hurt or killed by a preventable error.  The second victim is the healthcare professional who has to live with the aftermath of making it.

There is no question that patients are the primary concern in a nation where one in seven Medicare patients experience serious harm because of medical errors and hospital infections each year.  Another 180,000 patients die, according to a study by the Department of Health and Human Services’ Office of Inspector General.  That’s nearly twice the 98,000 deaths attributed to preventable errors in the important 1999 report “To Err is Human,” by the Institute of Medicine, which fired up the nation’s patient-safety movement.  In the real world, doctors, nurses and other medical workers who commit errors are often traumatized, with reactions ranging from anxiety and sleeping problems to doubt about their professional abilities – as well as thoughts of suicide, according to two recent studies.

This sad story raises the issue of healthcare provider depression and burnout.  Writing on the allnursing.com website, an anonymous nurse says “While visiting in the lounge one day, we discovered that every nurse there was on an anti-depressant.  I have had ‘Treatment Resistant Depression’ for about 20 years — as long as I’ve been a nurse.  Now I am totally burned out, on major meds, and am seeking disability due to depression/anxiety.  I believe years of long hours, high stress, high expectations and little appreciation (from management, not patients) has contributed to this.  How many other jobs consider you a traitor because you call in sick?  And trying to get off for a sick child is an unforgivable sin.  How many other jobs want you to work overtime on the days you are scheduled, call you at all hours of the night or day when you are off, first pleading with you to come in, then laying a guilt trip on you if you say “NO!”  And let’s not forget the mandatory in-services and CEUs (continuing education units) that take time away from your family.  If any profession should understand the importance of the individuals’ physical, mental, social and spiritual self it should be nursing — -after all we are taught in nursing school about treating the patient as a whole, not just a disease!  Why don’t we treat our staff the same way.”

According to Anthony Cirillo on the Hospital Impact website,“Two studies suggest that nurses working in hospitals are much more susceptible to depression than their counterparts in clinics, schools or other locations, especially if their hospital is high-volume.  A study in Journal of Clinical Psychiatry looked at the relationship between bed occupancy rates and absenteeism and found that those working in units that were 10 percent more crowded than the optimal rate had twice the rate of depressive illness than their counterparts in less crowded units.  The second study, appearing in Health Policy, is based on data from the 2005 National Survey of the Work and Health of Nurses in Canada. While looking at absenteeism in general, the report notes that depression is a “significant determinant” for missed work among RNs and LPNs, and that those who work in a hospital are more likely than those working in other settings to miss work.  One thing we might first observe is that with health reform, things will get much worse before they get better.  At some point, the estimated 35 million newly insured Americans will seek healthcare, potentially burdening the system.  And, of course this all impacts recruitment and retention and even further impacts whether folks choose to enter into the profession.”

According to the Nursing Center website, “Studies have also shown that nurses (the vast majority of whom are women) may be especially at risk.  This study surveyed 150 medical-surgical nurses from three hospitals to determine the prevalence and predictors of depression among female nurses.  All participants had at least a year of nursing experience and worked at least 20 hours per week.  Most (93 percent) were white; they averaged 38 years of age and 10 years’ hospital nursing experience.  Thirty-five percent of nurses had mild-to-moderate depressive symptoms; the most common included restless sleep, poor motivation, feeling bothered, and concentration problems; many reported feeling hopeful, happy, or joyful on only two days (or fewer) during the week before filling out the questionnaire.  Somatic symptoms, stressful major life events, greater occupational stress, and lower income were correlated with the presence of depressive symptoms.  Fatigue and low energy were bothersome to 43 percent of nurses; pain in extremities and joints, trouble sleeping, and back pain were also common.  Having a mortgage or loan of more than $10,000 within the previous year was the most commonly reported (43 percent) stressful major life event.  Others included changes in sleeping habits, vacation, and holidays.  The most highly ranked occupational stressors were having insufficient time to provide emotional support to a patient and to complete nursing tasks, being required to complete many non-nursing tasks (such as paperwork), and inadequate staffing.”