Thinking About Suicide for a Long Time: A Scoping Review of Empirical Studies on Persistent Suicidal Ideation

A Global Call for Action to Prioritize Healthcare Worker Suicide Prevention During the COVID-19 Pandemic and Beyond.

Suicide is a major public health concern accounting for 800 000 deaths globally each year. Although there have been many advances in understanding suicide risk in recent decades, our ability to predict suicide is no better now than it was 50 years ago. There are many potential explanations for this lack of progress, but the absence, until recently, of comprehensive theoretical models that predict the emergence of suicidal ideation distinct from the transition between suicidal ideation and suicide attempts/suicide is key to this lack of progress. The current article presents the integrated motivational–volitional (IMV) model of suicidal behaviour, one such theoretical model. We propose that defeat and entrapment drive the emergence of suicidal ideation and that a group of factors, entitled volitional moderators (VMs), govern the transition from suicidal ideation to suicidal behaviour. According to the IMV model, VMs include access to the means of suicide, exposure to suicidal behaviour, capability for suicide (fearlessness about death and increased physical pain tolerance), planning, impulsivity, mental imagery and past suicidal behaviour. In this article, we describe the theoretical origins of the IMV model, the key premises underpinning the model, empirical tests of the model and future research directions.

BackgroundThis study sought to examine the association between prospective suicidal behavior and variability, intensity, and persistence of suicidal ideation (SI) in bipolar disorder (BD).MethodsData were drawn from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a naturalistic study of 4360 outpatients 15 years or older with BD. In separate models, logistic regressions with suicidal behavior (first attempt or death by suicide) as the outcome variable and SI variability (fluctuating levels of SI over time, measured as ordinal dispersion of SI score), intensity (median SI score over time in study), or persistence (number of visits with reported SI) as the explanatory variables were used to examine the relationship between SI characteristics and odds of future suicidal behavior events.ResultsAfter adjusting for possible confounders, the odds of prospective suicidal behavior were 1.2 times greater per 10% increase in SI variability. SI persistence was not associated with suicidal behavior. For SI intensity, a median SI score of ‘rare/fleeting’ or ‘several days’ of SI was not associated with suicidal behavior, but the odds of prospective suicidal behavior were nearly five times greater for participants with the highest observed median SI intensity score of ‘nearly every day’.ConclusionsThe findings suggest that, in BD participants, monitoring SI variability may be clinically useful for assessing suicide risk.

Cognitive contributors to the chronification of suicidal ideation: The role of suicide-specific rumination and comfort from suicidal thoughts.

Introduction: child and adolescent mental health became a public health priority due to the increase in suicidal ideation and behaviors, a phenomenon associated with inactive lifestyles and increased sedentary behavior in urban contexts. Objective: the study aimed to analyze the relationship between physical activity and mental health as a preventive strategy against suicidal behaviors in children and adolescents from the city of Guayaquil, considering differences by sex and age group. Methodology: a quantitative, non-experimental, cross-sectional study with a correlational-explanatory scope was conducted. the sample consisted of students aged 10 to 17 years from educational institutions in Guayaquil. Validated questionnaires were applied to measure levels of physical activity, sedentary behaviors, and indicators of mental health and suicidal behaviors. The analysis included descriptive statistics, correlation tests, and comparisons by sex and age. Results: the findings showed a high prevalence of low and moderate levels of physical activity and elevated sedentary time. significant negative associations were identified between physical activity and suicidal ideation, planning, and attempts, as well as positive relationships between sedentary behavior and these outcomes. Relevant differences were observed according to sex and age group. Discussion: the results were consistent with previous research indicating the protective effect of physical activity and the negative impact of sedentary behavior on adolescent mental health. Conclusions: physical activity constitutes a relevant preventive strategy for promoting mental health and reducing the risk of suicidal behaviors in children and adolescents from Guayaquil.

First-onset and persistence of suicidal ideation in university students: A one-year follow-up study

The Acceptability of Suicide Among Rural Residents, Urban Residents, and College Students from Three Locations in China

ObjectivesAssociation between employment contract (temporary vs. permanent) and suicidal ideation (persistent suicidal ideation [i.e., with onset before COVID‐19] or newly developed under COVID‐19 pandemic) was examined using a nationally representative cross‐sectional study in Japan.MethodsAn Internet survey was conducted from August to September 2020. The participants’ inclusion criteria for this study were as follows: (i) 20–65 years old, (ii) employees (excluding self‐employed, students, retired, housewives, and unemployed). The associations of suicidal ideation with the employees’ factors were analyzed using the multinomial logistic regression model, adjusting for covariates (sex, age, marital status, education, company size, industries, and a history of psychiatric disease).ResultsOf total 12 249 participants, 72.4% were permanent and 27.6% were temporary employees. The prevalence was 8.5% for persistent suicidal ideation and 3.2% for newly developed suicidal ideation in the COVID‐19 pandemic. Temporary employment was significantly associated with persistent suicidal ideation (adjusted odds ratio [aOR] = 1.36 [95% confidence interval, CI: 1.16–1.59]; P < .001), but not associated with newly developed suicidal ideation (aOR = 1.10 [0.85–1.42]; P = .457) after adjusting the covariates. Sensitivity analysis showed temporary employment was significantly associated with persistent suicidal ideation only in women. Newly developed suicidal ideation was significantly higher among participants of a young age, employees in drinking/eating/hotel business industry, and those having a history of psychiatric disease than among the counterparts.ConclusionsWorking on a temporary employment contract was associated with persistent suicidal ideation under conditions of COVID‐19 outbreaks in Japan. However, the result showed no significant difference in newly developed suicidal ideation. Further longitudinal study will be needed to examine the risk of being employed on an unstable occupational contract in the prolonged pandemic.

The effect of childhood adversities on the persistence of suicidal ideation and plans among college students: A longitudinal study

Psychosocial predictors of persistent suicidal ideation among Chinese adolescents: A longitudinal study

Twelve-month suicidal ideation, incidence and persistence among college students pre-pandemic and during the pandemic: A longitudinal study

Association between early suicidal trajectories in first-episode psychosis and 10-year follow-up: TIPS registry-linked study

A Suicide-Specific Diagnosis – The Case Against

BackgroundPrior studies have demonstrated a link between parental psychopathology and offspring suicidal behavior. However, it remains unclear what aspects of suicidal behavior among adult offspring are predicted by specific parental mental disorders, especially in Africa. This study set out to investigate the association between parental psychopathology and suicidal behavior among their adult offspring in a South African general population sample.MethodParental psychopathology and suicidal behavior in offspring were assessed using structured interviews among 4,315 respondents from across South Africa. The WHO CIDI was used to collect data on suicidal behavior, while the Family History Research Diagnostic Criteria Interview was used to assess prior parental psychopathology. Bivariate and multivariate survival models tested the associations between the type and number parental mental disorders (including suicide) and lifetime suicidal behavior in the offspring. Associations between a range of parental disorders and the onset of subsequent suicidal behavior (suicidal ideation, plans, and attempts) among adult offspring were tested.ResultsThe presence of parental psychopathology significantly increased the odds of suicidal behavior among their adult offspring. More specifically, parental panic disorder was associated with offspring suicidal ideation, while parental panic disorder, generalized anxiety disorder and suicide were significantly associated with offspring suicide attempts. Among those with suicidal ideation, none of the tested forms of parental psychopathology was associated with having suicide plans or attempts. There was a dose–response relationship between the number of parental disorders and odds of suicidal ideation.ConclusionsParental psychopathology increases the odds of suicidal behavior among their adult offspring in the South African context, replicating results found in other regions. Specific parental disorders predicted the onset and persistence of suicidal ideation or attempts in their offspring. Further research into these associations is recommended in order to determine the mechanisms through which parent psychopathology increases the odds of suicidal behavior among offspring.

Predicting Hospitalization Versus Discharge of Suicidal Patients Presenting to a Psychiatric Emergency Service