Article

The Impact of Suicidality-Related Internet Use: A Prospective Large Cohort Study with Young and Middle-Aged Internet Users

National Institute of Mental Health, Japan
PLoS ONE (Impact Factor: 3.23). 04/2014; 9(4):e94841. DOI: 10.1371/journal.pone.0094841
Source: PubMed

ABSTRACT

There has been no study that has allowed clear conclusions about the impact of suicide-related or mental health consultation-related internet use.
To investigate the impacts of suicide-related or mental health consultation-related internet use.
We conducted prospective observational longitudinal study with data collection at baseline screening (T0), 1 week after T0 (T1) and 7 weeks after T0 (T2). Participants with a stratified random sampling from 744,806 internet users were 20-49 years of age who employed the internet for suicide-related or mental health consultation-related reasons and internet users who did not. The main outcome was suicidal ideation. Secondary outcome measures comprised hopelessness, depression/anxiety, and loneliness.
The internet users who had employed the internet for suicide-related or mental health consultation-related reasons at T0 (n = 2813), compared with those who had not (n = 2682), showed a significant increase in suicidal ideation (β = 0.38, 95%CI: 0.20-0.55) and depression/anxiety (β = 0.37, 95%CI: 0.12-0.61) from T1 to T2. Those who disclosed their own suicidal ideation and browsed for information about suicide methods on the web showed increased suicidal ideation (β = 0.55, 95%CI: 0.23-0.88; β = 0.45, 95% CI: 0.26-0.63, respectively). Although mental health consultation with an anonymous other online did not increase suicidal ideation, increased depression/anxiety was observed (β = 0.34, 95%CI: -0.03-0.71).
An increased suicidal ideation was observed in the young and middle-aged who employed the internet for suicide-related or mental health consultation-related reasons. Mental health consultation via the internet was not useful, but those who did so showed worsened depression/anxiety.

Download full-text

Full-text

Available from: Naohiro Yonemoto, Jul 21, 2014
  • Source
    • "A cross-sectional study based on a detailed review of the inquest reports from suicides showed that the individuals had used the Internet to research the methods of suicide they used in some cases (Gunnell et al., 2012). A large online cohort study by Sueki et al. (2014) showed that the rate of suicide planning over the lifetime was significantly higher in suicide-related Internet users (44.3%) than in a control group (8.3%). In other words, those who search for information using suicide-related keywords are likely to be at high risk of suicide. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Nurturing gatekeepers is an effective suicide prevention strategy. Internet-based methods to screen those at high risk of suicide have been developed in recent years but have not been used for online gatekeeping. Aims: A preliminary study was conducted to examine the feasibility and effects of online gatekeeping. Method: Advertisements to promote e-mail psychological consultation service use among Internet users were placed on web pages identified by searches using suicide-related keywords. We replied to all emails received between July and December 2013 and analyzed their contents. Results: A total of 139 consultation service users were analyzed. The mean age was 23.8 years (SD = 9.7), and female users accounted for 80% of the sample. Suicidal ideation was present in 74.1%, and 12.2% had a history of suicide attempts. After consultation, positive changes in mood were observed in 10.8%, 16.5% showed intentions to seek help from new supporters, and 10.1% of all 139 users actually took help-seeking actions. Conclusion: Online gatekeeping to prevent suicide by placing advertisements on web search pages to promote consultation service use among Internet users with suicidal ideation may be feasible.
    Full-text · Article · Oct 2015 · Crisis The Journal of Crisis Intervention and Suicide Prevention
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Infodemiology studies for suicide prevention have become increasingly common in recent years. However, the association between Twitter use and suicide has only been partially clarified. This study examined the association between suicide-related tweets and suicidal behaviour to identify suicidal young people on the Internet. Methods: A cross-sectional survey was conducted using Internet survey panels (n=220,848) comprising users in their 20s, through a major Japanese Internet survey company. Final analyses included the data of 1000 participants. Results: Of the participants (n=1000) used in the final analysis, 61.3% were women and the mean age was 24.9 years (SD=2.9, range=20-29). Logistic regression analyses showed that tweeting "want to die" and "want to commit suicide" was significantly related to suicidal ideation and behaviour. Lifetime suicide attempts, the most powerful predictor of future suicide out of all suicidal behaviours, were more strongly associated with tweeting "want to commit suicide" than tweeting "want to die". Having a Twitter account and tweeting daily were not associated with suicidal behaviour. Limitations: An online panel survey has some inherent biases, such as coverage bias. Respondents were already registered as members of a particular Internet survey company in Japan, which limits the possibility of generalization. Conclusions: Twitter logs may be used to identify suicidal young Internet users. This study provides a basis for the early identification of individuals at high risk for suicide.
    Full-text · Article · Sep 2014 · Journal of Affective Disorders
  • [Show abstract] [Hide abstract]
    ABSTRACT: To systematically review research on how people use the Internet for suicide-related reasons and its influence on users. This review summarises the main findings and conclusions of existing work, the nature of studies that have been conducted, their strengths and limitations, and directions for future research. An online search was conducted through PsycINFO, PubMed, Ovid MEDLINE and CINAHL databases for papers published between 1991 and 2014. Papers were included if they examined how the Internet was used for suicide-related reasons, the influence of suicide-related Internet use, and if they presented primary data, including case studies of Internet-related suicide attempts and completions. Findings of significant relationships between suicide-related search trends and rates of suicide suggest that search trends may be useful in monitoring suicide risk in a population. Studies that examine online communications between people who are suicidal can further our understanding of individuals' suicidal experiences. While engaging in suicide-related Internet use was associated with higher levels of suicidal ideation, evidence of its influence on suicidal ideation over time was mixed. There is a lack of studies directly recruiting suicidal Internet users. Only case studies examined the influence of suicide-related Internet use on suicidal behaviours, while no studies assessed the influence of pro-suicide or suicide prevention websites. Online professional services can be useful to suicide prevention and intervention efforts, but require more work in order to demonstrate their efficacy. Research has shown that individuals use the Internet to search for suicide-related information and to discuss suicide-related problems with one another. However, the causal link between suicide-related Internet use and suicidal thoughts and behaviours is still unclear. More research is needed, particularly involving direct contact with Internet users, in order to understand the impact of both informal and professionally moderated suicide-related Internet use. © The Royal Australian and New Zealand College of Psychiatrists 2015.
    No preview · Article · Feb 2015 · Australian and New Zealand Journal of Psychiatry
Show more