Resource profiles and suicide attempts in youth with disabilities.

PurposeUric acid (UA) is thought to exert neuroprotective roles. The purpose of this study was to examine the association of serum UA with suicide attempts (SA) in adolescents and young adults with major depressive disorder (MDD).Patients and MethodsWe retrospectively recruited 533 participants with MDD aged 13 to 25 years, of which 168 had a history of SA in the past three months and 365 did not have a history of SA. Serum UA levels were measured using the uricase-peroxidase coupling method. In addition to overall serum UA level comparison in MDD individuals with and without SA, a stratified analysis by biological sex was carried out.ResultsCompared to MDD individuals without a history of SA, serum UA levels were significantly lower in MDD individuals with SA (P < 0.001). Female MDD, but not male MDD individuals, with SA exhibited lower levels of UA than those without SA (P < 0.01). Importantly, serum UA remained significantly associated with SA in MDD individuals (OR = 0.996, 95% CI: 0.993~0.999, P < 0.01) when controlling for possible confounding variables.ConclusionThis research identifies a relationship between serum UA levels and SA in adolescents and young adults with MDD. UA may represent a biological risk marker for SA, in particular for female MDD individuals.

The study aimed to assess factors associated with multiple suicide attempts (MSA) in adolescents with a history of suicide attempts in Morocco. National cross-sectional data from the Global School-Based Student Health Survey (GSHS) in Morocco in 2016 were analysed. Students who reported to have a history of past 12-month suicide attempts were included in the final sample (n = 931). In multiple logistic regression, students with MSA were compared with students with a single suicide attempt (SSA). Results indicated that among the subsample of school adolescents (median age = 15 years), 55.8% had attempted suicide once, and 44.2% multiple times in the past 12 months. Compared to students who attempted suicide once, students with MSA more often had anxiety-induced sleep disturbance and were more frequently bullied. Compared to participants without psychosocial distress, students with three or more psychosocial distress factors had higher odds of MSA. Further, compared to students without health risk behaviours, students with three or more health risk behaviours had a higher odd of MSA. Psychosocial distress (anxiety-induced sleep disturbance and frequently being bullied) and multiple health risk behaviours increased the odds of MSA, suggesting the potential relevance of these variables in identifying multiple suicide attempters among adolescents in Morocco.

Progress in research on the neurobiology of suicide behavior in adolescents has notably lagged compared to that of adults. This study aimed to investigate the associations between serum indicators, including oxidative stress (OS) and inflammatory indicators, and psychological factors with suicide attempts (SA) in adolescents with major depressive disorder (MDD) while also exploring potential markers. This study involved the psychological assessment of 106 first-time hospitalized adolescents aged 12 to 18 with MDD and the measurement of serum indicators. Participants were categorized into two groups according to their history of SA within the preceding six months. Screening the best markers for suicide by machine learning algorithms. Multivariable logistic regression was used to assess the correlation between these indicators and suicide. Secondly, Mendelian randomization (MR) was used to initially explore the causal relationship between these serum indicators and suicide. In adolescents diagnosed with MDD, those who had attempted suicide exhibited elevated serum superoxide dismutase (SOD) activity, reduced nitric oxide (NO) levels, more severe anxiety and depressive symptoms, worse sleep quality, increased exposure to adverse life events, less effective coping strategies, worse parental attachment, more severe alexithymia, and more impulsivity when compared to their counterparts without a history of SA (all p<0.05). The multivariable analyses showed a significant association between serum SOD activity (OR 1.254, 95% CI 1.043-1.534) and anxiety symptoms (OR 1.056, 95% CI 1.020-1.097) with SA in adolescents diagnosed with MDD. The MR analyses showed a causal association between genetically determined low uric acid (UA) levels and a higher risk of SA (OR 0.942 95%CI 0.896-0.991). Serum SOD activity, anxiety symptoms, and UA levels may be potential markers of SA and suicide intent in adolescents with MDD.

Mood disorders (MD) are often associated with a higher incidence of suicidal behavior, especially in adolescent patients. However, the mechanisms by which depression affects suicide attempts in adolescents with MD remain poorly elucidated. Therefore, the purpose of this study was to determine the incidence, risk factors, and clinical correlates of suicide attempts in Chinese adolescent patients with MD, as well as the inter-relationship between depressive symptoms, rumination, and suicide attempts, and the role of rumination in mediating depression and suicide attempts. A total of 331 MD adolescent patients aged 11 ~ 18years were recruited from a psychiatric hospital. Suicide attempts were assessed with the MINI Suicide Scale. Depressed symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9). To assess rumination, we used the 21-item Chinese version of the Ruminative Responses Scale (RRS). Overall, the percentage of suicide attempts among MD adolescents was 51.96%, with a higher percentage of females (58.62%) than males (36.36%). Compared to non-suicide attempters, suicide attempters had higher scores on PHQ-9, RRS, depression-related, brooding, and reflective pondering. Gender and RRS were independently associated with suicide attempts. Rumination played a fully mediating role between depression and suicide attempts. In addition, the mediating effect of depression between rumination and suicide attempts was not significant. The incidence of suicide attempts was higher in MD adolescents than in general adolescents. Gender and rumination were associated with suicide attempts in MD adolescents. Moreover, rumination mediated the correlation between depressive symptoms and suicide attempts, suggesting that rumination may be an important intervention component for clinical staff to prevent suicidal behavior in adolescents with MD.

Objectives: Suicide is still one of the leading causes of youth mortality, and amongst others previous suicide attempts have been found to be one of the strongest risk factors for suicide. The objective of this study is to examine risk factors of suicide attempts in a total population of Faroese adolescents. It is expected that anxious attachment, high scores on negative affectivity and low scores on past and present social support were correlated to an increased risk of life-time suicide attempts in both female and male adolescents. Method: Analyses were conducted based on data from The Faroese Adolescent Trauma Study, a self-report questionnaire survey including a total population of Faroese eighth graders (N = 687; 85 % response rate, mean age 14.2 years, SD = 2.1). The questionnaire included The Revised Adult Attachment Scale (RAAS), The Trauma Symptom Checklist (TSC), and The Crisis Support Scale (CSS). Results: In the total population 9.9 % (N = 68) of the participants reported life-time suicide attempt; of those 28 % were boys and 72 % were girls. In line with the expectations, the initial comparison showed that adolescents reporting life-time suicide attempt had significantly higher scores on attachment anxiety and negative affectivity, and had significantly lower scores on attachment closeness, and both past and present social support. Further analyses stratified on gender, however, revealed unexpected results, as a high score on negative affectivity only was a significant risk factor for life-time suicide attempt among the girls, and high score on attachment closeness only was a significant protective factor of life-time suicide attempt among the boys. Conclusions: This study provides important data about the role of attachment, negative affectivity, and social support in suicide attempts in a total population of Faroese adolescents. Moreover the results show the necessity of taking gender into account in research of risk and protective factors of suicide attempts, and when establishing arrangements to prevent and treat suicide attempts in adolescents.

The prospective relationship between sleep problems and suicidal behavior in the National Longitudinal Study of Adolescent Health

The suicide rate among adolescents around the world has increased rapidly. There are many risk factors for attempting suicide, but not all have been clarified yet. Therefore, it is very important to identify risk factors. This study evaluated adolescents with a history of suicide attempts and their association with chronic diseases. Besides, to check whether they attempted suicide multiple times. Other clinical features related to multiple suicide attempts were investigated. This study used a multicentre, retrospective cross-sectional design; 253 adolescents admitted to emergency departments in 2019 for suicide attempts were evaluated. Adolescents with chronic disease were at greater risk for both single and multiple suicide attempts and patients had a 6.14 times higher risk of multiple attempts (p = .013). The likelihood of multiple attempts did not differ according to the presence of somatic or psychiatric disease. Multiple attempters were more likely to poison themselves with their therapeutic drugs (p = .002). When adolescents with a chronic disease present to the emergency services after a single suicide attempt using their therapeutic drugs, families should be informed regarding the potential for further attempts.

There is a lack of studies establishing the association between allergic rhinitis (AR) and despair, suicidal thinking, and suicide attempts in adolescents and children at a population level. This study aimed to investigate whether there are associations between allergic rhinitis and despair, suicidal thinking, and suicide attempts. The study utilized data from middle through high school adolescents from 2005-2021 who enrolled in the Korea Youth Risk Behavior Web-based Survey (KYRBS; 1,067,169). We assessed despair, suicidal thinking, and suicide attempts in the context of both non-atopic and atopic AR. Multivariable analysis was used to determine the association of variables. The prevalence of allergic rhinitis was 28.0%. 1,067,169 enrolled participants were included in the final analysis. There were 299,468 individuals with allergic rhinitis and 767,701 without. In the context of AR, adolescents were more likely to have despair [adjusted odds ratio (aOR), 1.16; 95% CI, 1.15-1.17], suicidal thoughts (aOR, 1.12; 95% CI, 1.11-1.13 for model 2), and suicide attempts (aOR, 1.13; 95% CI, 1.10-1.15 for model 2). Individuals with atopic AR were more likely in almost all measures to have despair, suicidal thinking, and suicide attempts than individuals with non-atopic AR. Females with AR were more likely to have suicide attempts and middle school students were more likely to have despair, suicidal thoughts, and suicide attempts. The results of this study warrant future studies investigating why AR is so closely associated with despair, suicidal ideation, and suicide attempts, with the goal of establishing suicide prevention strategies as well as improving overall mental health for adolescents.

BackgroundSuicide is a leading cause of death in South Korea (hereafter ‘Korea’), and there is evidence that body weight and perceived weight affecting suicide have a significant effect on suicidal behavior in adolescence. This study investigated the association between body mass index (BMI), perceived weight, and suicide attempts in adolescents.MethodsWe included nationally representative data for a total of 106,320 students in our final analysis. We calculated and stratified BMI (underweight, normal weight, overweight) to determine the correlation between BMI and suicide attempts. We stratified the participants into three groups (perceived as underweight, normal weight, and overweight) for subjective body weight perception to analyze the relationship between subjective body weight perception and suicide attempts. We further analyzed the combination of BMI and subjective body weight perception to determine the relationship between suicide attempts and distorted subjective weight perception.ResultsCompared with perceiving oneself as having a normal weight, the odds ratios (ORs) for suicide attempts were significantly increased in the group perceiving themselves as overweight. In addition, those who perceived themselves as overweight but were underweight according to their BMI were at significantly increased risk of suicide attempts relative to those who perceived themselves as about the right weight.ConclusionsThere was a significant association with suicide attempts in the underweight and perceived overweight group. This shows the importance of combining BMI and perceived weight when examining the relationship between weight and suicide attempts in adolescents.

OBJECTIVESSuicide and drinking problems in adolescents are increasing every year, and it is known that suicide is related to drinking. This study aims to identify the relationship between binge drinking experience (BDE) and suicide attempts in Korean adolescents.METHODSThe Ninth Korean Youth Risk Behavior Web-based Survey (KYRBS), conducted in 2013, was used for analysis. Multiple logistic regression analysis was used to identify the relationship between BDE and suicide attempts, and the relationship between BDE and suicide attempts in middle and high school students was stratified by age.RESULTSBDE and suicide attempts were highly related. The odds ratio (OR) of attempted suicide in BDE was 1.63 times (95% confidence interval [CI], 1.28 to 2.09) higher then non-drinking in males. And the OR of attempted suicide in females was 1.21 times (95% CI, 1.07 to 1.37) higher then non-drinking in non-BDE, 1.79 times (95% CI, 1.47 to 2.19) higher in BDE. BDE was associated with suicide attempts in males aged 12 or 13 years (OR, 3.97; 95% CI, 1.57 to 10.03) and in females aged 15 years (OR, 2.66; 95% CI, 1.79 to 3.96).CONCLUSIONSBDE is an important factor related to suicide attempts in adolescents. In order to reduce suicide attempts, it is necessary to educate the youth about the regulation of BDE and drinking prevention.

Suicide and suicidal behavior are major public health problems, especially among adolescents and young adults. Previous research has established links between parental bonding and suicidality; however, it remains unclear whether parental bonding is associated with suicide ideation, the progression from suicide ideation to suicide attempts, or both. This study examined the relation of parental bonding to suicide ideation and suicide attempts in adolescents from two settings: (1) acute psychiatric care (n=172) and (2) high school (n=426). All participants were administered validated measures of parental bonding, suicide ideation, and suicide attempts, as well as emotion dysregulation, loneliness, and self-worth. In the psychiatric sample, lower parental care significantly differentiated adolescents with a history of suicide attempts from those with suicide ideation only or without histories of suicidality. This pattern remained even after controlling for other known correlates of suicidality (i.e., emotional dysregulation, loneliness, and low self-worth). Similar effects were found in the community sample, although these findings failed to reach statistical significance. In both samples, parental overprotection was not associated with suicide ideation or suicide attempts. Results suggest that parental care may be an important risk factor for youth suicidal behavior and may help differentiate suicide attempters from suicide ideators.

Incidence and correlates of suicide attempts in adolescents with major depressive versus bipolar disorders: A cross-sectional study

The Last Straw: Conflicts and Suicide Attempts in Armenian Adolescents

Background Differentiating between nonsuicidal self‐injury (NSSI) and suicide attempts (SA) in adolescents is crucial due to distinct underlying motivations, treatment needs, and potential outcomes associated with each behavior. This study explores biomarkers, specifically β ‐endorphin and endocannabinoids [anandamide (AEA), 2‐arachidonoylglycerol (2‐AG), N‐palmitoylethanolamide (PEA), and oleoylethanolamide (OEA)], in adolescents admitted for NSSI and/or SA. Objectives We aimed to explore potential differences in different variables among adolescents hospitalized for NSSI, SA, or both. Method This pilot study enrolled 68 adolescents admitted for NSSI and/or SA at Puerta de Hierro University Hospital. Excluding those with endocrine issues, participants underwent clinical assessments, blood collection, and serum analysis for ACTH, cortisol, and β ‐endorphin, with endocannabinoids measured via LC–MS. Clinical tools, such as the MINI Kid and CTQ and statistical analyses via SPSS and Stata aimed to elucidate behavioral and biological differences between NSSI and SA groups. Results No sociodemographic factor differentiated the groups. Gestational diabetes and depression during pregnancy were more frequent in the NSSI group ( p = 0.047 and p = 0.003, respectively). Abnormal presentation at birth was overrepresented in the SA group ( p = 0.001). Familial antecedents of either suicide or SB were more frequently reported in the NSSI + SA group ( p = 0.027 and p = 0.035, respectively). Blood PEA and β ‐endorphin were significantly elevated in the SA group ( p &lt; 0.006 and 0.014, respectively). Discussion This study identified shared risk factors across NSSI and SA, with distinct variables for each group, including β ‐endorphin and PEA biomarker elevations linked to SA.

PurposeTo evaluate the associations and interaction between sexual violence perpetration and victimization on suicide attempts using a large representative sample of adolescents from South Korea.MethodsBased on data from 515,247 adolescents aged 12–18 years from the Korea Youth Risk Behavior Web-Based Survey (2006–2012), a nationally representative repeated cross-sectional survey, we obtained self-reports of suicide attempts over the past year and of lifetime sexual violence perpetration and victimization. Using complex survey weights, weighted logistic regression models were employed to estimate the odds ratios (ORs). The interaction analyses were conducted on both additive and multiplicative scales. All analyses were conducted separately for boys and girls.ResultsLifetime prevalence of sexual violence perpetration were 1.3% for boys and 0.4% for girls, and about 40% of those perpetrating sexual violence were also victims. After adjusting for several covariates, sexual violence perpetration was independently associated with suicide attempts in boys (ORadjusted for boys 1.80 [95% confidence intervals: 1.53, 2.11]), whereas in girls, the association was only marginally significant (ORadjusted for girls 1.27 [1.00, 1.63]). We found the negative multiplicative and additive interaction between the sexual violence perpetration and victimization on suicide attempts for both boys and girls (the ratio of ORs 0.30 [0.23, 0.39] for boys and 0.20 [0.12, 0.31] for girls; relative excess risk due to interaction − 1.20 [–1.91, − 0.50] for boys and − 2.33 [–3.00, − 1.66] for girls).ConclusionSexual violence perpetration and victimization were independently and interactively associated with suicide attempts in adolescents, with a sub-additive interaction found between these two variables. Public mental health services and policies should recognize the importance of actively involving adolescents who had sexually perpetrated others as key intervention targets.