LGBT youth at higher risk for suicide attempts

LGBT adolescents are more likely than other kids their age to try to kill themselves, a new analysis confirms. Data pooled from 35 earlier studies show that sexual minority...

LGBT adolescents are more likely than other kids their age to try to kill themselves, a new analysis confirms.

Data pooled from 35 earlier studies show that sexual minority youth were more than three times as likely to attempt suicide as heterosexual peers, researchers report in JAMA Pediatrics.

Transsexual youth were at highest risk, nearly six times as likely to attempt suicide as heterosexual peers, researchers reported.

“Adolescents facing ‘non-conventional’ sexual identity are at risk of higher self-threatening behaviors, independent of bullying and other risk factors,” said the study’s lead author, Dr. Ester di Giacomo, a researcher in psychiatry at the University of Milano-Bicocca, in Italy. “I think that a difficulty in self-acceptance and social stigmatization might be keys for understanding such elevation in the risk of self-threatening behaviors.”

Many LGBT youth have trouble accepting who they are because of the way they are seen by others, di Giacomo explained in an email.

Suicide is the second leading cause of death in adolescents, di Giacomo and her colleagues noted. A host of factors can raise the risk that teens will try to kill themselves, including psychiatric illness, bullying, and childhood abuse and trauma. Added to that can be sexual orientation.

The 35 studies in the analysis involved a total of nearly 2.4 million heterosexual youth and 113,468 sexual minority youth, ages 12 to 20, from 10 countries.

Overall, sexual minority youth were 3.5 times as likely to attempt suicide as heterosexual peers. Transgender adolescents were 5.87 times more likely, gay and lesbian adolescents were 3.71 times more likely and bisexual youth were 3.69 times more likely than heterosexual peers to attempt suicide.

The big advantage of this kind of study is that “in combining information across so many prior studies you’re really getting at one of the best estimates of the disparity of suicide risk due to sexual orientation,” said Brian Mustanski, director of the Institute for Sexual and Gender Health and Well Being at Northwestern University’s Feinberg School of Medicine in Chicago. “We already knew (LGBT) teens were at risk, but this study gives a more precise estimate of that risk.”

Mustanski has followed a group of young people for over a decade. He has found that the accumulation of experiences with victimization and bullying can lead to depression and feelings of hopelessness. “And those increase the risk for suicide,” said Mustanski who was not affiliated with the new study.

In a recent study, Mustanski and his colleagues found that having a romantic relationship can be protective against the negative effects of bullying. “If (teens) were bullied but they had a romantic partner, they didn’t have depression like those who didn’t have a romantic partner,” he said. “Having positive family relationships and parental support promotes positive mental health, but it doesn’t take away the effects of bullying like a romantic relationship does.”

While the outside world can have a negative impact, there are factors that can ameliorate it, said Dana Rofey, an associate professor of psychiatry and pediatrics at the Children’s Hospital of Pittsburgh at the University of Pittsburgh Medical Center. “There are protective factors, such as having support from the family, a safe school environment, and a safe and supportive work environment as well as access to psychological and medical care,” Rofey said.

Rofey points to an article published in Pediatrics that looked at measures of anxiety and depression in transgender children. Researchers in that study found that children who were supported and allowed to live openly in their “opposite” gender weren’t more anxious or depressed than other children.

While the new study underscores the increased risk of suicide attempts in sexual minority youth, “it’s important to understand not all LGBT teens are suicidal,” Mustanski said. “We read about this community being at risk, but there are plenty of LGBT teens who are happy and thriving and doing great.”

SOURCE: JAMA Pediatrics, online October 8, 2018.

OCTOBER 8, 2018 / 8:27 AM / UPDATED 15 HOURS AGO

Sleep deprivation could be as risky for drivers as alcohol

(Reuters Health) – Drivers who hit the road on less than four hours of sleep are at least as likely to be involved in a crash as drivers who had too much to drink, a U.S. study suggests.

Brian Tefft, senior researcher at the AAA Foundation for Traffic Safety in Washington, D.C., reviewed data on more than 6,800 road accidents between 2005 and 2007 to study the effects of sleep deprivation on driving.

“We really wanted to quantify” the relationship between how sleep-deprived a driver is, and “how much it affects their crash risk,” Tefft told Reuters Health by phone.

As part of an earlier study, the drivers in these accidents had all been interviewed in depth by investigators from the U.S. Department of Transportation. Tefft classified the drivers into those who were “culpable” for a crash and those who weren’t.

Drivers whose errors, actions, or lack of actions, led to a crash were deemed culpable, whereas those involved in crashes caused by external factors, such as brake failure or poor infrastructure, were not.

His findings showed that people who drove after getting less than seven hours of sleep were at higher risk for being culpable for the crash. That risk was greatest for drivers who slept less than four hours.

“The sharp increase in risk below four hours stands out,” the University of Pittsburgh’s Dr. Sanjay Patel, who was not involved in the study, told Reuters Health in an email.

“The odds of being responsible for a crash go up from 2.9-fold to 15.1-fold as sleep drops from four to five hours to less than 4 hours. But that . . . is not surprising given what we know about how decreasing sleep affects other aspects of brain function,” Patel said.

Drivers who reported having slept for less than four hours had “crash risks” similar to what’s been documented in drivers with blood alcohol concentrations (BAC) of 0.12 g/dL, Tefft notes in his report. In the U.S., driving with a BAC of 0.08 g/dL or higher is illegal, with lower limits for commercial drivers. Most of Western Europe and Japan have stricter limits.

One weakness of the study is that it relied on drivers themselves to report how much they had slept. Another potential weakness is that other factors, like the presence of a sleep disorder, could contribute to crash risk.

Also, Patel pointed out, “Drivers deemed non-culpable may still have been partially responsible for the crash – they (may have been) slow in veering out of the way of the culpable driver, for example.”

Overall, 78 percent of non-culpable drivers and 70 percent of culpable drivers reported having slept for seven to nine hours in the 24 hours before crashing, Tefft reported in the journal Sleep.

The study also found that drivers who had recently changed their sleep or work schedule had about a 30 percent increase in their risk of causing a crash.

“(This shows that) independently of the effect of sleep deprivation, disruption in the body’s internal clock can also increase one’s risk of causing a crash,” Tefft said.

Drivers who spent less than four hours asleep in a 24-hour period are also at a significantly greater risk of being culpable in a single-vehicle crash than in one that involves another vehicle, the study showed.

Single-vehicle crashes are more than three times as likely as multiple-vehicle crashes to result in fatalities, Tefft said.

Data from the National Sleep Foundation show 60 percent of U.S. adults have driven while feeling drowsy and around 33 percent have actually fallen asleep at the wheel.

Benjamin McManus, a researcher in the Translational Research and Injury Prevention Laboratory at The University of Alabama at Birmingham, says Tefft’s study indicates sleep-deprived crashes aren’t all cases of “nodding off” or being “asleep-at-the-wheel.”

“Judgment and decision making are highly impacted by poor sleep quantity and quality,” McManus said in an email.

“With changes in the work economy and growth of ridesharing, we’re seeing a growth of a “gig” economy where many work from home, work irregular hours, or work multiple jobs. (Data like this) may make the difference between recommendations of ‘you need a cup of coffee’ versus ‘you need a nap.’”

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