A London court on Wednesday rejected an appeal from Indian billionaire Nirav Modi against his extradition from the United Kingdom to India to face charges of fraud and money laundering.
British police arrested the diamond dealer in 2019 in London over his alleged involvement in a bank fraud that could be worth $2 billion.
Modi’s lawyers last year challenged a court order allowing the British government to extradite the fugitive businessman, citing his mental health and risk of suicide.
London’s High Court dismissed the appeal on Wednesday, saying Modi’s risk of suicide does not rule out his extradition.
Justice Jeremy Stuart-Smith, one of the two judges, said that they were “far from satisfied that Mr Modi’s mental condition and the risk of suicide are such that it would be either unjust or oppressive to extradite him,” according to the court ruling.
“On the basis of the assurances that the (Indian government) has given, we accept that there will be suitable medical provision and an appropriate plan in place for the management and medical care of Mr Modi, which will be provided in the knowledge that he is a suicide risk,” the judges said.
Modi’s alleged fraud first came to light in 2018 when Punjab National Bank, one of India’s largest banks, reported fraudulent activity at one of its branches.
India then issued an Interpol Red Notice for Modi’s arrest and London authorities were asked to execute it. The Indian foreign ministry said in a statement at the time that it welcomed the arrest, and would seek to extradite Modi as soon as possible.
Modi and officials at the bank allegedly issued fraudulent Letters of Undertakings to overseas banks to obtain buyer’s credit, according to India’s Central Bureau of Investigation (CBI).
Forbes once ranked Modi as India’s 85th richest man, with a net worth of $1.8 billion.
CNN has reached out to his lawyer after the court’s decision on Wednesday but is yet to hear back.
Modi, who remains at Wandsworth Prison in London, can challenge Wednesday’s court ruling at the UK Supreme Court.
A London court on Wednesday rejected an appeal from Indian billionaire Nirav Modi against his extradition from the United Kingdom to India to face charges of fraud and money laundering.
British police arrested the diamond dealer in 2019 in London over his alleged involvement in a bank fraud that could be worth $2 billion.
Modi’s lawyers last year challenged a court order allowing the British government to extradite the fugitive businessman, citing his mental health and risk of suicide.
London’s High Court dismissed the appeal on Wednesday, saying Modi’s risk of suicide does not rule out his extradition.
Justice Jeremy Stuart-Smith, one of the two judges, said that they were “far from satisfied that Mr Modi’s mental condition and the risk of suicide are such that it would be either unjust or oppressive to extradite him,” according to the court ruling.
“On the basis of the assurances that the (Indian government) has given, we accept that there will be suitable medical provision and an appropriate plan in place for the management and medical care of Mr Modi, which will be provided in the knowledge that he is a suicide risk,” the judges said.
Modi’s alleged fraud first came to light in 2018 when Punjab National Bank, one of India’s largest banks, reported fraudulent activity at one of its branches.
India then issued an Interpol Red Notice for Modi’s arrest and London authorities were asked to execute it. The Indian foreign ministry said in a statement at the time that it welcomed the arrest, and would seek to extradite Modi as soon as possible.
Modi and officials at the bank allegedly issued fraudulent Letters of Undertakings to overseas banks to obtain buyer’s credit, according to India’s Central Bureau of Investigation (CBI).
Forbes once ranked Modi as India’s 85th richest man, with a net worth of $1.8 billion.
CNN has reached out to his lawyer after the court’s decision on Wednesday but is yet to hear back.
Modi, who remains at Wandsworth Prison in London, can challenge Wednesday’s court ruling at the UK Supreme Court.
Five people were found dead in a southern Maryland home Friday in a murder-suicide incident, according to a Charles County Sheriff’s Office statement on Saturday.
The bodies were found in a house in La Plata, roughly a 35-mile drive south of Washington, DC, by law enforcement officers around 4 p.m. on Friday after a witness called 911 to report a shooting, Charles County sheriff’s spokesperson Diane Richardson said on Friday.
When police arrived at the house they found the homeowner at the front door who said he had returned home from work and discovered five people deceased inside.
Police said initial investigations showed that a suspect identified as Andre Sales, 28, came into the house and killed four people before shooting himself with a gun which was recovered at the scene.
The victims have been identified as his ex-girlfriend Sara Mann, 21, her mother Sommaly Mann, 48, and her younger brother Kai Mann, 18, authorities said. The fourth victim has been identified as Javon Watson, 23, but his relation to the other victims is not clear.
Authorities say autopsies will be conducted to determine the cause of death for each victim and investigators are interviewing family and friends to establish a motive for the killings.
Two children, who the sheriff’s office did not identify, were initially unaccounted for, but were later found safe at another location.
The sheriff’s office said the investigation is ongoing.
Disturbing new details have emerged in the attack on House Speaker Nancy Pelosi’s husband, Paul Pelosi, including that the alleged assailant told police he was on a “suicide mission” and had a list of other prominent targets.
“This was not a random act of violence. This was not a random residential burglary. This is something that was specifically targeted,” San Francisco District Attorney Brooke Jenkins said Tuesday.
Here’s what we presently know about the attack.
The alleged suspect, David DePape, 42, told officers and medics at the scene that he was sick of the “level of lies” coming from Washington, DC, and “came here to have a little chat with [Pelosi’s] wife,” according to a Tuesday court filing.
“I didn’t really want to hurt him, but you know this was a suicide mission. I’m not going to stand here and do nothing even if it cost me my life,” DePape allegedly said.
DePape named several targets, according to the filing, including prominent state and federal politicians and their relatives.
Jenkins confirmed to CNN earlier Tuesday that authorities believe DePape had other “targets” besides the House speaker.
Asked by CNN’s Erin Burnett about the suspect’s alleged plans, Jenkins said that “there were other public officials that were apparently targets of his, and obviously he showed up at the speaker’s house first.” The case, Jenkins said, is still “very fresh” and she declined to give specific details of who had been a potential target.
DePape has been “cooperative” with police and “submitted to a lengthy interview” before obtaining representation through counsel, according to the district attorney.
US Capitol Police first learned of the break-in at the San Francisco home of House Speaker Nancy Pelosi about 10 minutes after the incident when an officer noticed police lights and sirens on a live camera feed in the Capitol Police’s Washington, DC, command center, according to a source briefed on the attack.
CNN previously reported there may be video of the break-in that US Capitol Police and law enforcement could review as there are security cameras at the home, according to two law enforcement sources.
The San Francisco Police Department had stopped regularly posting a patrol car outside Pelosi’s house last year, according to two additional sources.
DePape entered a not guilty plea Tuesday to all state charges during his initial appearance in court.
He also waived his right to a hearing within 10 days at his arraignment in a San Francisco court room. Judge Diane Northway set a hearing for November 4 in San Francisco Superior Court to set a date for the preliminary hearing and bail setting.
DePape has been charged with a litany of crimes, including assault, attempted murder and attempted kidnapping, following last week’s break-in.
The attempted kidnapping charge carries a maximum of 20 years in prison. He has not yet entered a plea in federal court.
DePape’s attorney, Adam Lipson, said outside the courtroom, “There’s been a lot of speculation, a lot of rumor, simply based on the nature of this case. So I’m not going to add to all the speculation by talking about the facts of this case right now.”
“What I will say is that there’s been a lot of speculation regarding Mr. DePape’s vulnerability to misinformation and that’s certainly something we are going to look into, that we are going to delve into, as his defense team, but again it would be premature to talk about that at this time,” Lipson said.
US Capitol Police Chief Tom Manger said Tuesday the agency has “engaged in a review” of the incident and said the current political climate calls for more resources for the physical safety of members of Congress.
“We believe today’s political climate calls for more resources to provide additional layers of physical security for Members of Congress,” Manger said in a written statement.
“This plan would include an emphasis on adding redundancies to the measures that are already in place for Congressional leadership. Hopefully you can understand that we cannot disclose the details about these improvements because our country cannot afford to make it easier for any potential bad actors,” he added.
Manger also said the Capitol Police has “worked diligently to investigate reported threats, improve intelligence collection and analysis, and strengthen our partnerships with law enforcement agencies across the country to provide security for Members when they are traveling outside Washington, DC.”
California Democratic Rep. Zoe Lofgren told CNN’s Brianna Keilar on Tuesday that lawmakers won’t be any safer “until we call out what is the root cause of this political violence.”
“The head of the RNC, Ronna McDaniel and also Kevin McCarthy, the minority leader, expressed sadness for Paul Pelosi. But then went onto say ‘it’s really a product of crime – that’s the Democrats fault.’”
“That’s like saying Lee Harvey Oswald was connected with crime in Dallas or John Wilkes Booth was the result of a crime problem at Ford’s Theater. Not only is it ridiculous, it is part of the problem of dismissing what is causing this violence,” Lofgren said.
Just one day after releasing a tepid but grounded statement on the incident, former President Donald Trump fanned the flames of an unfounded conspiracy about the attack.
“It’s weird things going on in that household in the last couple of weeks,” Trump said. “You know, probably, you and I are better off not talking about it. The glass, it seems, was broken from the inside to the out and, you know, so, it wasn’t a break in, it was a break out,” the former President told conservative radio host Chris Stigall.
Trump went on to say that he’s “not a fan of Nancy Pelosi,” but that what happened was “very sad.” He added: “The whole thing is crazy. I mean, if there’s even a little bit of truth to what’s being said, it’s crazy. But the window was broken in and it was strange the cops were standing there practically from the moment it all took place.”
In the days following the attack, several prominent right-wing figures have floated conspiracy theories about the attack – including that Paul Pelosi and the intruder were gay lovers who had gotten into a fight.
The spurious theory traces back to an incorrect early news report and a handful of pieces of evidence that its proponents have spun wildly out of context. It runs entirely contrary to the explanation police and federal law enforcement have outlined.
“There is absolutely no evidence that Mr. Pelosi knew this man,” San Francisco Police Chief William Scott told CNN in an interview. “As a matter of fact, the evidence indicates the exact opposite.”
WB Games president David Haddad announced on Rocksteady’s website today that the video game developer’s co-founders, Sefton Hill and Jamie Walker, are leaving the studio at the end of 2022. Rocksteady, which created the Batman: Arkham series, is set to release its anticipated pseudo-spin-off, Suicide Squad: Kill the Justice League, in 2023.
“With Suicide Squad: Kill the Justice League nearly finished, they have both decided to leave Rocksteady at the end of 2022 and will begin a new adventure in gaming,” Haddad writes in the announcement. “We have the utmost respect and gratitude for Jamie and Sefton and wish them all the best in their new endeavor, and like many fans, we look forward to what they do next.”
Haddad did not share details of “what they do next,” but Hill and Walker—who founded Rocksteady in 2004—could well be looking to do it all over again. They were still an active part of the studio, with Hill most recently acted as Suicide Squad’s game director. Stepping up in their place are director of production Nathan Burlow, who Haddad calls an “original founding member,” promoted to studio director, and Darius Sadeghian, who will become studio product director.
“Nathan and Darius are extremely talented executives and they are passionate about continuing the high-quality game development of Rocksteady for Suicide Squad: Kill the Justice League and all future games,” Haddad wrote.
Read More:Gotham Knights Sounds Like A Big Disappointment
About their sudden departure, Hill and Walker wrote in the announcement that, “From the day we founded the company in 2004 all the way to today, Rocksteady has been our life and soul. It has given us the opportunity to do what we love most: make great games with exceptionally talented people.”
G/O Media may get a commission
Hill and Walker emphasized the community at Rocksteady, saying that “there is something extra special about Rocksteady that goes beyond the games we make, and everyone who works here feels it.”
“We want to thank the team for their hard work and everything they bring to make this such a great place to be,” the pair continued. “Now with Suicide Squad in safe hands, and the team here stronger than ever, it’s time to hand over the reins, and for us to start a new adventure together in games.”
Earlier this fall, Suicide Squad writer Kim MacAskill passed on a lifetime achievement award from from nonprofit Women in Games, saying that event sponsors Rocksteady and Warner Bros. Interactive need to “take accountability.”
“You can throw your name on every diversity event going,” she said, “but unless you take accountability, it means nothing and I see you.”
In 2020, Rocksteady responded to a report by The Guardian detailing sexual harassment in its workplace, saying, “All formal complaints were thoroughly investigated, addressed appropriately and a number of serious measures were taken in response to the issues that were surfaced, including discipline or termination of staff.”
Prescription folic acid may help lower the risk of suicide attempts. (Photo: Getty Images)
Taking prescription folic acid is associated with a significantly lower risk of suicide attempts, according to a recent study published in JAMA Psychiatry. Experts say this could potentially offer a “major breakthrough” in suicide prevention.
The large-scale study, which looked at the data of 867,000 American adults over two years, showed a beneficial association between taking prescription folic acid — a B vitamin that helps the body make healthy new cells — and a 44% lower rate of suicide attempts and intentional self-harm. The research also found that every additional month of folic acid treatment was associated with a 5% reduction in suicidal event rates.
That’s significant, given that suicide is a leading cause of death in the U.S., according to the Centers for Disease Control and Prevention (CDC). In 2020, an estimated 12.2 million American adults seriously contemplated suicide, 3.2 million planned a suicide attempt and 1.2 million attempted suicide.
What do experts think about the study?
Dr. Tatiana Falcone, a psychiatrist with Cleveland Clinic who was not involved in the study, tells Yahoo Life that the results are “really interesting.” She points out that the researchers ruled out possible factors that could “potentially confound the results” and still found that prescription folic acid made a difference. The researchers also compared two groups — one taking prescription folic acid and another taking cyanocobalamin (vitamin B12) as a control group — and found that the folic acid group experienced fewer suicide attempts.
Sanam Hafeez, a neuropsychologist and director of Comprehend the Mind, who was not involved in the study, tells Yahoo Life that results are “impressive.” However, she agrees with Falcone that more research is needed. Hafeez also says it’s important to point out that the folic acid used for the purpose of this study was in a prescription form — “not the OTC supplemental kind,” she says.
But if further studies confirm folic acid — which is inexpensive and widely available — as a suicide prevention tool, “it will be significant for the patients that have low folate levels associated with depression or suicidal thoughts,” says Falcone.
Hafeez agrees, saying: “It would not only be a major breakthrough in the treatment of depression but also medication-resistant depression.”
So how does folic acid help?
Some studies suggest there’s a link between low levels of folate — the natural form of the B vitamin — and depression. That may be because folate plays a role in forming serotonin, a neurotransmitter that helps regulate mood. Medications such as selective serotonin reuptake inhibitors (SSRIs) help treat depression and other mood disorders by increasing levels of serotonin in the brain.
But, says Falcone, “Some percentage of patients with depression have abnormalities in the folate acid metabolism,” which will impact their response to SSRI antidepressants.
“Treatment with folinic acid has been reported beneficial in patients with treatment-resistant depression who have decreased levels of folate … in their cerebrospinal fluid,” she adds.
Falcone adds that not waiting to get treatment for depression is crucial. “The longer that the depressive symptoms persist, the longer that the suicidal thoughts persist, the more likely that the patient will continue to worsen,” she says, explaining that this is why it’s “important to work collaboratively with your doctor to find the appropriate combination of treatments that is right for the patient.” She adds: “A combination of medication and therapy is the best.”
If you or someone you know is experiencing suicidal thoughts, call 911 or the National Suicide Prevention Lifeline at 988 or 1-800-273-8255, or text HOME to the Crisis Text Line at 741741.
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A diagnosis of dementia more than doubles the risk of suicide in the first three months after a patient is told the news, according to the latest research.
The study, which followed nearly 600,000 English people for 18 years, found patients who already had a psychiatric condition, or who were younger than age 65 at the time of diagnosis, were at a similar risk. The risk was highest during the first three months after learning the news for people younger than 65: They were 6.5 times more likely to die by suicide.
“A dementia diagnosis can be devastating, but the immediate period after diagnosis is often the period of greatest distress,” said lead study author Dr. Charles Marshall, clinical senior lecturer and honorary consultant neurologist at the Wolfson Institute of Population Health at Queen Mary University of London.
“Receiving a diagnosis of Alzheimer’s at an early age is rare, unexpected and overwhelming,making it very difficult to accept,” said Beth Kallmyer, vice president of care and support for the Alzheimer’s Association, who was not involved in the study.
“One of the most important things you could tell someone facing an Alzheimer’s diagnosis is that they are not alone and support is available,” she said.
Prior research has established a distinct connection between dementia and suicide, including a 2021 studyby Yale University scientists. “Adults over the age of 65 who were diagnosed with Alzheimer’s disease were twice as likely to die from suicide than older adults who did not suffer from dementia,” Kallmyer said.
Most cases of dementia are in the elderly, but chronic conditions and behavioral choices can play a role, according to Kallmyer. “Obesity, diabetes and sedentary lifestyles in younger people are rising quickly, and these are risk factors for dementia,” shesaid.
In the new study, published Monday in the journal JAMA Neurology, the actual number of people —95 patients —who died by suicide after finding out they had dementia was small. However,that did not diminish the study’s value in identifying the most vulnerable subgroups and three-month timing, Marshall said.
Past studies have also found a relationship between a diagnosis of dementia and suicide in people diagnosed at an earlier age. While the new study was unable to determine why this would be so, Marshall pointed to the interpersonal theory of suicide as a possible answer.
“Perceived burdensomeness is a critical pillar for suicidal behavior,” Marshall said. “That perception of burdensomeness may be higher in younger patients with dementia who are more likely to be in their work-productive years as well as have family-caring responsibilities.”
Results from studies like these suggest that physicians should conduct a “robust risk assessment” for signs of suicide at the time of diagnosis, Marshall and his coauthors wrote in the latest study.
“We know that early Alzheimer’s disease can cause low mood, anxiety and social isolation. These symptoms might be both causes and signs of suicide risk,” Marshall said in an email.
Becoming educated about dementia “and in particular, younger onset Alzheimer’s disease, is an important first step in supporting someone who receives a younger onset diagnosis,” Kallmyer said.
Health and financial plans should be put in place early so that the person living with dementia can participate in those decisions, she suggested.
“If the person is still working, it’s critical that they investigate employment benefits that could help them — and it’s essential that they do this before they leave their jobs. Employer benefits might include short- and long-term disability insurance, which can be very helpful while they are applying for Social Security disability,” Kallmyer said.
Signs of depression and suicidal warning signs mimic those of dementia, making it extremely difficult for caregivers, according to the Alzheimer’s Association.
“Because of the complexities involved with diagnosing depression with dementia, it may be helpful to consult a geriatric psychiatrist who specializes in recognizing, diagnosing, and treating depression in older adults,” the association noted.
The US Substance Abuse and Mental Health Services Administration, or SAMHSA, has developed a series of resources for caregivers. If you or a loved one needs suicide or mental health-related crisis support, SAMHSA encourages calls or texts to the 988 suicide and crisis lifeline. There is also a tool to find providers of treatment and support.
A London coroner has ruled a 14-year-old girl’s 2017 death a suicide resulting from harmful social media posts.
The ruling came Friday at the conclusion of an inquest — or a judicial inquiry — into Molly Russell’s death five years ago, according to The Molly Rose Foundation (MRF) established in the 14-year-old’s memory to prevent suicide among people under 25.
Coroner Andrew Walker of the Northern District of Greater London said her death was “an act of self-harm while suffering from depression and the negative effects of online content.”
Walker said the online material Molly viewed on platforms including Instagram and Pinterest “was not safe” and “should not have been available for a child to see.”
The ruling was the first of its kind to place direct blame for a child’s official death on social media rather than simply correlating the two.
“The inquest has demonstrated very clearly the significant dangers social media platforms such as Instagram, Twitter and Pinterest present in the absence of any effective regulation,” MRF said in a statement Friday. “This shows that if government and tech platforms take action on the issues raised in the inquest, it will have a positive effect on the mental well-being of young people, which is the key aim of the Molly Rose Foundation.
Molly Russell’s father Ian Russel said “there is always hope.”Molly Rose Foundation
“For social media, the Wild West era is over.”
In response to the ruling, Molly’s father, Ian Russell, said Friday “there is always hope” no matter how “dark it seems.”
“[I]f you’re struggling, please speak to someone you trust or one of the many support organizations, rather than engage with online content that may be harmful,” he said, according to MRF.
“Thank you, Molly, for being my daughter. Thank you,” Russell added. “We should not be sitting here. This should not happen because it does not need to happen. We told this story in the hope that change would come about.”
A spokeswoman for Meta, the parent company for Facebook and Instagram, said in a statement following the conclusion that the company is “committed to ensuring that Instagram is a positive experience for everyone, particularly teenagers” and would “carefully consider the coroner’s full report.”
Pinterest has apologized for the content it promoted to Molly via email, including “10 depression pins you might like” and “depression recovery, depressed girl and more pins trending on Pinterest,” according to the BBC.
“At its heart, this is about online safety,” MRF said of the conclusion of the inquest into the 14-year-old’s death.
The ruling garnered national and international attention. Even Prince William issued a statement on the matter.
“No parent should ever have to endure what Ian Russell and his family have been through,” William tweeted from the official Prince and Princess of Wales account. “They have been so incredibly brave. Online safety for our children and young people needs to be a prerequisite, not an afterthought.”
Social media and video-sharing platforms contain content showing suicidal ideation, self-harm material and general reflections on depression, according to the U.K.’s National Society for the Prevention of Cruelty to Children (NSPCC). A teenager may view that kind of content on top of more mainstream material featuring videos and images of their peers, as well as influencers and models, which may prompt young users to make flawed comparisons between themselves and the material they view online.
“The ruling should send shockwaves through Silicon Valley – tech companies must expect to be held to account when they put the safety of children second to commercial decisions. The magnitude of this moment for children everywhere cannot be understated,” NSPCC Executive Director Sir Peter Wanless said in a statement. “Molly’s family will forever pay the price of Meta and Pinterest’s abject failure to protect her from content no child should see, but the Online Safety Bill is a once-in-a-generation opportunity to reverse this imbalance between families and big tech.”
If you are struggling with suicidal thoughts or are experiencing a mental health crisis and live in New York City, you can call 1-888-NYC-WELL for free and confidential crisis counseling. If you live outside the five boroughs, you can dial the 24/7 National Suicide Prevention hotline at 1-800-273-8255 or go to SuicidePreventionLifeline.org.
Summary: Study reveals a 44% reduction in suicidal events, including suicide attempts and self-harm, in depressed patients who took folic acid supplements.
Source: University of Chicago
Suicide is one of the leading causes of death in the US, with more than 45,000 people dying by suicide in 2020.
Experts recommend many strategies and treatments to decrease the risk of suicide, including psychotherapy, peer support, economic support, and medications like antidepressants.
Few if any would be likely to put folic acid supplements on that list, but a recent study done at the University of Chicago may change that.
The study, published in JAMA Psychiatry on September 28th, used data from the health insurance claims of 866,586 patients and looked at the relationship between folic acid treatment and suicide attempts over a two-year period.
They found that patients who filled prescriptions for folic acid, also known as vitamin B9, experienced a 44% reduction in suicidal events (suicide attempts and intentional self-harm).
Robert Gibbons, Ph.D., the Blum-Riese Professor of Biostatistics and Medicine at the University of Chicago, the lead author of the study, is hopeful that these findings could improve suicide prevention efforts, especially because of how accessible folic acid is.
“There are no real side effects, it doesn’t cost a lot of money, you can get it without a prescription,” Gibbons said. “This could potentially save tens of thousands of lives.”
Gibbons initially became interested in folic acid in the context of suicide because of a previous study in which his group looked for relationships between risk of attempting suicide and 922 different prescribed drugs.
The study simultaneously screened each drug for associations with increases and decreases in suicide attempts. Surprisingly, folic acid was associated with a decreased risk of suicide attempt, along with drugs expected to be associated with risk of suicide, like antidepressants, anxiolytics, and antipsychotics.
One of the challenges of this earlier study was to analyze the effects of many drugs in a large-scale data set, which is difficult. Many people take more than one drug, and drugs can have different effects when taken together than when taken alone.
It can also be difficult to get meaningful results from studies like these that look for relationships in large data sets because of confounding factors, which can cause two variables in a study, like suicide and a drug, to seem to have a direct causal relationship with each other.
Sometimes, these are actually both related to a confounding factor, such as socioeconomic status or health-conscious attitudes, or because they are prescribed for a condition that is associated with suicide (e.g. depression).
But Gibbons and his group were able to partially eliminate these complications by comparing subjects to themselves before and after being prescribed a drug, instead of comparing subjects who did and did not take the drug to one another.
In fact, they initially thought folic acid had only shown up in their study because of a simple explanation, but that turned out not to be the case.
“When we first saw this result, we thought it was pregnancy. Pregnant women take folic acid, and pregnant women tend to have a low suicide rate, so it’s just a false association. So, we just did a quick analysis to restrict it to men. But we saw exactly the same effect in men,” Gibbons said.
To investigate and further confirm the relationship between folic acid and suicide risk, Gibbons and his co-authors did this new study and focused specifically on folic acid, and accounted for many possible confounding factors, including age, sex, mental health diagnoses, other central nervous system drugs, conditions that affect folic acid metabolism, and more.
Even after adjusting for all these factors, filling a prescription for folic acid was still associated with a decreased risk of attempting suicide.
Surprisingly, folic acid was associated with a decreased risk of suicide attempt, along with drugs expected to be associated with risk of suicide, like antidepressants, anxiolytics, and antipsychotics. Image is in the public domain
They even found that the longer a person took folic acid, the lower their risk of suicide attempt tended to be. Each month of being prescribed folic acid was associated with an additional 5% decrease in risk of suicide attempt during the 24-month follow-up period of their study.
It also occurred to the authors that maybe people who take vitamin supplements in general want to improve their health and would thus be less likely to attempt suicide.
To address this possibility, they did a similar analysis with another supplement, vitamin B12, as a negative control. But unlike folic acid, there didn’t seem to be any relationship between vitamin B12 and risk of suicide.
Although Gibbons and his co-authors were careful to adjust for confounding factors, they cannot yet say for sure whether the relationship between folic acid and suicidal events is causal; that is, they don’t yet know if taking folic acid will directly cause a person’s risk of suicide to become lower.
To know for sure, the authors are following up this study with a large-scale randomized controlled trial (RCT) to test whether folic acid directly lowers the risk of suicidal events, including ideation, attempts and completion.
This will involve randomly splitting subjects into two groups, giving a placebo to one group and folic acid to the other and comparing the rate of suicidal events over time.
If their findings are confirmed in the new research, folic acid would be a safe, inexpensive, and widely available suicide prevention strategy, and potentially help save thousands of lives.
About this psychology research news
Author: Press Office Source: University of Chicago Contact: Press Office – University of Chicago Image: The image is in the public domain
Original Research: Closed access. “Association Between Folic Acid Prescription Fills and Suicide Attempts and Intentional Self-harm Among Privately Insured US Adults” by Robert D. Gibbons et al. JAMA Psychiatry
Abstract
Association Between Folic Acid Prescription Fills and Suicide Attempts and Intentional Self-harm Among Privately Insured US Adults
See also
Importance
Suicide is a leading cause of death in the United States, having increased more than 30% from 2000 to 2018. An inexpensive, safe, widely available treatment for preventing suicidal behavior could reverse this trend.
Objective
To confirm a previous signal for decreased risk of suicide attempt following prescription fills for folic acid in a national pharmacoepidemiologic study of patients treated with folic acid.
Design, Setting, and Participants
A within-person exposure-only cohort design was used to study the dynamic association between folic acid (vitamin B9) prescription fills over a 24-month period and suicide attempts and intentional self-harm. Data were collected from a pharmacoepidemiologic database of US medical claims (MarketScan) for patients with private health insurance who filled a folic acid prescription between 2012 and 2017. The same analysis was repeated with a control supplement (cyanocobalamin, vitamin B12). Data were analyzed from August 2021 to June 2022.
Exposure
Folic acid prescription fills.
Main Outcome and Measure
Suicide attempt or intentional self-harm resulting in an outpatient visit or inpatient admission as identified by codes from the International Statistical Classification of Diseases, Ninth and Tenth Revisions, Clinical Modification.
Results
Data on 866 586 patients were collected; 704 514 (81.30%) were female, and 90 296 (10.42%) were 60 years and older. Overall, there were 261 suicidal events during months covered by a folic acid prescription (5 521 597 person-months) for a rate of 4.73 per 100 000 person-months, compared with 895 suicidal events during months without folic acid (8 432 340) for a rate of 10.61 per 100 000 person-months. Adjusting for age and sex, diagnoses related to suicidal behavior, diagnoses related to folic acid deficiency, folate-reducing medications, history of folate-reducing medications, and history of suicidal events, the hazard ratio (HR) for folic acid for suicide events was 0.56 (95% CI, 0.48-0.65), with similar results for the modal dosage of 1 mg of folic acid per day (HR, 0.57; 95% CI, 0.48-0.69) and women of childbearing age (HR, 0.60; 95% CI, 0.50-0.73). A duration-response analysis (1-mg dosage) revealed a 5% decrease in suicidal events per month of additional treatment (HR, 0.95; 95% CI, 0.93-0.97). The same analysis for the negative control, cyanocobalamin, found no association with suicide attempt (HR, 1.01; 95% CI, 0.80-1.27).
Conclusions and Relevance
This large-scale pharmacoepidemiologic study of folic acid found a beneficial association in terms of lower rates of suicide attempts. The results warrant the conduct of a randomized clinical trial with suicidal ideation and behavior as outcomes of interest. If confirmed, folic acid may be a safe, inexpensive, and widely available treatment for suicidal ideation and behavior.
A 22-year-old Canadian woman struggling with a debilitating case of Lyme disease committed suicide “to free herself from the unbearable pain,” her grieving dad said.
“It is with the heaviest of hearts (and still in shock) that I share the tragic news that our sweetheart Amelie (22) took her own life this past Sunday,” Alain Champagne, CEO of Le Groupe Maurice in Canada, wrote on LinkedIn earlier this month.
“We were witnesses as to how challenging life had become for her in dealing with the evolving Lyme disease symptoms,” the grief-stricken father continued.
He explained that his daughter had suffered for years but only recently received the diagnosis in the US in June — after “years of medical errance” in their home city of Quebec.
Amelie Champagne, 22, took her own life after struggling for years with undiagnosed Lyme disease.Linkedin/alain-champagne
He wrote that “over time and despite the recent treatments, the disease had evolved way beyond the numerous physical symptoms and was now severely impacting her brain.”
He said Amelie was so wracked by the tick-borne bacterial infection that “she decided to free herself from the unbearable pain,” Champagne wrote.
“Amelie left a long-lasting impression through her engaging and empathetic personality,” her dad, Alain, wrote on LinkedIn.Linkedin/alain-champagne
But despite his daughter’s illness, the father gushed about the impact Amelie had on those she met.
“Amelie left a long-lasting impression through her engaging and empathetic personality. Despite the struggles of the past few years she persevered through university, kept working at a respite center for handicapped kids, was starting to volunteer at a homeless shelter near our place … and remained ever the vibrant/fun-loving friend and member of our family,” he said.
Alain Champagne, CEO of Le Groupe Maurice in Canada, shared his heartbreak in a viral post.Linkedin/alain-champagne
Lyme disease, the most common vector-borne disease in the US, is caused by the bacterium Borrelia burgdorferi, and sometimes Borrelia mayonii, according to the Centers for Disease Control and Prevention.
Common symptoms include fever, headache, fatigue and a characteristic skin rash. If left untreated, infection can spread to joints, the heart, and the nervous system.
Most cases can be treated successfully with antibiotics if diagnosed. However, diagnosis can bedifficult because early symptoms are common to many other illnesses.
Canadian pop-rock star Avril Lavigne also suffered a severe case of Lyme disease. Lavigne, 37, who was diagnosed in 2015, said it was so debilitating, she had “accepted death.”
“I had accepted death and could feel my body shutting down. I felt like I was drowning. Like I was going under water and I just needed to come up for air. Like I was in a river being pulled in a current. Unable to breathe,” she wrote in an open letter to fans in 2018.
The singer has launched a foundation, The Avril Lavigne Foundation, to help fight the disease.
If you are struggling with suicidal thoughts or are experiencing a mental health crisis and live in New York City, you can call 1-888-NYC-WELL for free and confidential crisis counseling. If you live outside the five boroughs, you can dial the 24/7 National Suicide Prevention hotline at 988 or go to SuicidePreventionLifeline.org.
