Adolescent Suicide Attempters Research Articles

Inhibition and Activation Systems of Behavior and Suicide Mediating Role of Cognitive Emotion Regulation

Objective: This study aimed to predict suicide attempts based on behavioral activation and inhibition systems (BAS/BIS) with the mediating role of cognitive emotion regulation (CER) strategies among adolescents of Abyek City. Materials and methods: The research methodology was descriptive-correlational. The cluster sampling method was used, and the resulting sample included 194 adolescents who responded to the BAS/BIS questionnaire (Carver & White, 1994), CER questionnaire, and Beck scale for suicide ideation. Path analysis was employed to evaluate the proposed model using AMOS 24.0 and SPSS 27 softwares. Results: The findings indicate that the proposed model is fitted with the data well. The results of path analysis showed that the BAS/BIS systems explain 27% of the variance of maladaptive CER and 61% of the variance of adaptive CER. In addition, maladaptive CER, BAS, and BIS explain 65% of the variance of suicide attempts. Conclusion: Low levels of BAS, high levels of BIS, and the use of maladaptive CER skills can be considered risk factors for suicide attempts in adolescents.

Adversity and suicidality during youth

ABSTRACT This analysis examined relationships between childhood adversities and the odds of suicide attempt(s) prior to age 17. Respondents (N = 2072) completed the survey through Amazon’s Mechanical Turk crowdsourcing platform. The sample was represented disproportionately by young adult women who identified as Caucasian. The sample was differentiated into subsets with versus without suicide attempt(s) prior to age 17. Suicide attempt(s) in this sample (22.4%) varied in number (once, n = 200; 9.7%; twice, n = 114, 5.5%; multiple, n = 150, 7.2%). The odds of suicide attempt(s) prior to age 17 were significantly (p < .001) higher for respondents reporting childhood sexual abuse (OR = 5.0), physical abuse (OR = 4.9), emotional abuse (OR = 3.7), peer bullying (OR = 3.1), parental neglect (OR = 1.6), and maternal battering (OR = 2.15). All adversities but exposure to maternal battering accounted for unshared variance in suicide attempts prior to age 17. Adverse Childhood Experiences Questionnaire exposure counts were associated with child and adolescent suicide attempts. Suicide risk did not appear to increment progressively by additional exposures after two co-occurring stressors. The odds of early suicide attempt(s) were markedly higher in this sample among respondents who were exposed to one or more forms of childhood adversity.

Unveiling convergent and divergent intrinsic brain network alternations in depressed adolescents engaged in non-suicidal self-injurious behaviors with and without suicide attempts.

Limited understanding exists regarding the neurobiological mechanisms underlying non-suicidal self-injury (NSSI) and suicide attempts (SA) in depressed adolescents. The maturation of brain network is crucial during adolescence, yet the abnormal alternations in depressed adolescents with NSSI or NSSI+SA remain poorly understood. Resting-state functional magnetic resonance imaging data were collected from 114 depressed adolescents, classified into three groups: clinical control (non-self-harm), NSSI only, and NSSI+SA based on self-harm history. The alternations of resting-state functional connectivity (RSFC) were identified through support vector machine-based classification. Convergent alterations in NSSI and NSSI+SA predominantly centered on the inter-network RSFC between the Limbic network and the three core neurocognitive networks (SalVAttn, Control, and Default networks). Divergent alterations in the NSSI+SA group primarily focused on the Visual, Limbic, and Subcortical networks. Additionally, the severity of depressive symptoms only showed a significant correlation with altered RSFCs between Limbic and DorsAttn or Visual networks, strengthening the fact that increased depression severity alone does not fully explain observed FC alternations in the NSSI+SA group. Convergent alterations suggest a shared neurobiological mechanism along the self-destructiveness continuum. Divergent alterations may indicate biomarkers differentiating risk for SA, informing neurobiologically guided interventions.

Factors Associated With the Severity of Suicide Attempts by Poisoning in Adolescents

ObjectiveTo analyze factors associated with more severe outcomes of suicide attempt due to toxicological events in adolescents. MethodsA cross-sectional study involving adolescents between 10 and 19 years of age treated due to attempted suicide from 2017 to 2020. The dependent variable was the final severity, divided into two categories: asymptomatic or mild and moderate, severe or fatal, and the independent variables were those related to patients, exposure, and clinical conditions. For association analyses, logistic regression was used, with the calculation of the odds ratio (OR) and 95% confidence interval (95% CI). ResultsA total of 1462 suicide attempts in adolescents were evaluated, and 21.1% (N=306) were classified moderate, severe or fatal outcome. Suicide attempts due to toxicological events in adolescents showed a higher prevalence of the moderate, severe or fatal outcome in males (OR 1.52; 95% CI 1.11–2.07), in the summer months (OR 1.81; 95% CI 1.31–2.48) and in cases whose time until attendance was equal to or greater than 300min (OR 1.72; 95% CI 1.29–2.29), with evidence of increasing severity of cases over the years (2019: OR 1.87; 95% CI 1.21–2.98; 2020: OR 2.80; 95% CI 1.31–2.48). ConclusionsSince adolescents need a more rigorous psychosocial follow-up due to the adversities inherent to the age group, there is a clear need for better identification of striking prodromal signs of suicide attempts in order to develop therapeutic interventions and preventive strategies.

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

BackgroundMajor depressive disorders (MDD) and bipolar disorders (BD) are the most common psychiatric diagnoses of suicide attempts (SA) in adolescents. However, little is known regarding the differences in incidence and clinical-related features of SA between these two disorders. The study aims to examine the SA incidence and related factors in adolescents with MDD versus BD. MethodA retrospective survey was conducted in outpatients. SA incidence, demographic characteristics and substance use history were collected. Symptom Checklist-90 was used to measure the severity of symptoms. The Revised Chinese internet addiction scale and Barratt Impulsiveness Scale-11 were utilized to assess the presence of internet addiction and impulsiveness. The Childhood Trauma Questionnaire was used to measure childhood maltreatment subtypes. Results295 MDD and 205 BD adolescents were recruited. The incidence of SA for MDD and BD were 52.5 % and 56.4 %, respectively. BD adolescents who attempted suicide showed worse symptoms, higher rates of nicotine and alcohol use, higher motor and non-planning impulsivity, and a more childhood physical abuse proportion than MDD adolescents with SA. Physical abuse in childhood was found to be associated with SA in both disorders (OR = 1.998 for MDD; OR = 2.275 for BD), while higher anxiety (OR = 1.705), and alcohol use (OR = 2.094) were only associated with SA in MDD. LimitationsRetrospective, cross-sectional design cannot draw causality, and biases in self-report measurements cannot be ignored. ConclusionsThe findings revealed some difference between BD and MDD for adolescents with SA, and it emphasize significance of prompt identification and exact distinction between BD and MDD in adolescents.

The characteristics of suicide attempters in Chinese patients: Comparison of adolescents, youths, middle-aged and elderly

BackgroundPotential risk factors for suicide differ by age group. Therefore, this study aims to investigate the characteristics of patients with suicide attempts according to age group and any the relevant risk factors. MethodsThis study retrospectively reviewed the medical records of attempted suicide patients who were admitted to the emergency departments (ED) of the First Affiliated Hospital of Wenzhou Medical University between January 1, 2017, and December 31, 2021. Demographic information and clinical characteristics were collected. The participants were divided into four age groups and the characteristics of each group were compared. ResultsA total of 834 participants were included in this study. Suicide attempts were more prevalent in females, and the gender difference decreased with age. Having religious belief and less educated suicide attempts were concentrated in the elderly groups. Adolescents suicide attempts were more likely to occur in the spring, autumn and during non-office hours. Mental disorders were the major motivation for suicide among adolescents, and interpersonal and social problems were more prevalent among youths. Psychiatric medication was the leading suicidal substances among adolescents, while pesticides and herbicides were more prevalent in adults. The history of psychiatric diagnosis was more common in adolescents, while the history of somatic disorder was more prevalent in the elderly. ConclusionThis study confirmed differences in the demographic and clinical characteristics of patients in different age groups. Therefore, it is necessary to construct individualized intervention strategies for each age group based on the characteristics of the patients in order to reduce suicide.

Revisiting Associations Among Parent and Adolescent Religiosity and Early Adolescent Suicide Risk in the United States.

The contributions of religion to reduced suicide risk have been studied in adults and adolescents, though to our knowledge no comprehensive investigation has been conducted in early adolescents, at a time coinciding with emergence of suicide risk trajectories. In this largest study to date on this topic, we aimed to characterise the contributions of various measures of "private" and "public" religiosity to early adolescent suicide ideation (SI) and suicide attempt (SA) histories using information from a large, epidemiologically informed U.S. sample of adolescents (N = 7068; mean age = 12.89years, 47% female) and their parents. In all youth, parent-reported adolescent religious importance was associated with reduced odds of SA (OR = 0.75, CI = 0.61-0.92, P = .005). Muslim youth were more likely (OR = 1.52, CI = 1.02-2.22, P = .033), and Catholic youth were less likely (OR = 0.80, CI = 0.67-0.95, P = .014), to report SI. A variety of sex differences were noted, with significant protective associations of adolescent self-reported religiosity on SI and SA, religious service attendance on SI, and religious importance on SI, in female-but not male-youth; and significant protective associations of religious importance on SA in male-but not female-youth. Against expectations, there was no evidence that parent religiosity moderated the link between youth religiosity and SI or SA. These results shed light on the roles of cultural and familial context in youth suicide risk, which may ultimately be targeted in screening and interventional approaches.

Suicide and Suicide Risk in Adolescents.

Suicide is the second leading cause of death for 10- to 24-year-olds in the United States and is a global public health issue, with a recent declaration of a National State of Emergency in Children's Mental Health by the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children's Hospital Association. This clinical report is an update to the previous American Academy of Pediatrics clinical report, "Suicide and Suicide Attempts in Adolescents." Because pediatricians and pediatric health care providers are at the front line of care for adolescents amid a child and adolescent mental health crisis, and because of the chronic and severe shortage of mental health specialists, it is important that pediatric health care providers become facile with recognizing risk factors associated with suicidality and at-risk populations, screening and further assessment of suicidality as indicated, and evidence-based interventions for patients with suicidal ideation and associated behaviors. Suicide risk can be mitigated by appropriate screening, bolstering of protective factors, indicated treatment, community resources, and referrals to mental health providers when available.

Symptoms characteristics of personality disorders associated with suicidal ideation and behaviors in a clinical sample of adolescents with a depressive disorder.

Pathological personality traits have repeatedly been identified as important risk factors for suicidal ideation and behaviors. Moreover, impulsive-aggressive traits, have shown a consistent association with suicidal behaviors across the lifespan. Adolescence represents a critical period for the emergence of different personality traits, mood disorders, and suicidal behaviors, but the relationship between these variables remain poorly understood. These variables were examined in a cross-sectional case-control design involving three groups: 30 adolescents with a depressive disorder and past suicide attempt (Mean Age = 16.2, Females = 26), 38 adolescents with a depressive disorder but without past suicide attempt (Mean age = 16.0, Females = 29), and 34 healthy adolescent controls (Mean age = 15.2, Females = 22). Suicidal ideations were indexed using Suicidal Behavior Questionnaire (SBQ-R), psychiatric disorder assessed using a semi-structured questionnaire (K-SADS-PL), depressive symptoms with the Beck Depressive Inventory (BDI), symptoms characteristics of personality disorders with the Scheduled Clinical Interview for the DSM-IV (SCID-II) screening questionnaire, and impulsivity with the Barratt Impulsivesness Scale (BIS). Findings showed that impulsivity (F = 11.0, p < 0.0001) and antisocial symptoms characteristics of personality disorders (p < 0.001, d = 0.70) displayed the most robust association with adolescent suicide attempts. Borderline symptoms characteristics of personality disorders did not discriminate attempters from non-attempters but presented high correlations with suicidal ideation and depression severity. In an item-wise analysis, suicide attempt status was uniquely correlated with symptoms characteristics of an antisocial personality disorder. Suicide attempt status also correlated with non-suicidal self-injury and a chronic feeling of emptiness. The caveats of this cross-sectional study include the stability of symptoms characteristics of personality disorders in adolescence and the limited sample size. In sum, suicidal behaviors were characteristically correlated with increased impulsivity and antisocial symptoms characteristics of personality disorders, but other symptoms characteristics of personality disorders were relevant to adolescent depression and suicidal ideation. Understanding the emergence of symptoms characteristics of personality disorders and suicidal behaviors in a developmental context can ultimately inform not only the neurobiological origin of suicidal behaviors, but also provide new avenues for early detection and intervention.

Identifying important predictors of adolescent suicide ideation, planning, and attempt in low‐ and middle‐income countries

AbstractIntroductionOver 90% of all adolescent suicides occur in low‐ and middle‐income countries (LMIC), yet the majority of suicide research has focused on primarily high‐income countries (HIC).MethodUsing nationally representative data on 82,494 adolescents from thirty‐four LMIC, this research employed machine learning to compare the predictive effects of multiple determinants of suicidal behaviors previously identified in the literature.ResultsResults indicate that distinct predictors are present for suicidal ideation, suicidal planning, and suicide attempts in youth living in LMIC as well as shared predictors common to all three behaviors.ConclusionThese findings provide insights into the unique needs in global mental health policy and efforts within and across adolescents in LMIC.

Vertebral Fractures in Pediatric Suicidal Jumpers: A Retrospective Study with Epidemiological and Clinical Analysis before and after the COVID-19 Pandemic

Background: From the beginning of the COVID-19 pandemic, reports in the literature confirm a significant increase in suicide attempts in children and adolescents. At the Bambino Gesù Pediatric Hospital Emergency Department (Rome, Italy), there was a dramatic increase in suicidal jumpers. Many of these presented vertebral fractures. Methods: This retrospective study includes all suicidal jumpers with vertebral fractures treated from April 2017 to March 2023. We collected and compared data from three years before to three years after the pandemic, analyzing vertebral fractures. Results: From April 2019 to March 2020, 141 cases of suicide attempt arrived at the emergency department. Five of these were suicidal jumpers without vertebral fractures. From April 2020 to March 2023, 362 cases of suicide were hospitalized and 19 were suicidal jumpers; 12 reported vertebral fractures (mean age 14 years). Seven patients were treated by percutaneous pedicle fixation. Three patients needed an open spinal surgery by posterior approach. One case with cervical fractures was treated by Halo-Vest. Conclusions: This is the first report that shows a sharp increase in vertebral body fractures due to suicide jumping attempts in children and adolescents. This could be a new epidemiological phenomenon persisting or even increasing over time in the pediatric population as a consequence of the COVID-19 pandemic.

Caracterización de la gravedad del intento de suicidio en adolescentes hospitalizados en un hospital público de Chile.

Adolescent suicide has increased in the Americas. In Chile, at-tempted suicide in adolescents is a public health problem that needs an urgent solution. A quantitative, comparative and retrospective study was conducted to provide the hospital with intervention strategies and articulation with the territorial mental health network. The sociodemographic and clinical aspects of 96 records of adolescents hospitalized for attempted suicide between Janu-ary 2017 and December 2018 were reviewed, compared, and related. Two study groups were formed: Group I, 14 adolescents previously hospitalized in the Intensive Treatment Unit and Group II, 82 adolescents who did not require this unit. Gender, age, education, history of sexual abuse, diagnoses of mental disorders, co-morbidities, previous mental health consultations, and caregivers with mental disorders were studied. Descriptive statistics and odds ratios were used. In group I, with 92% male adolescents, severe depression was observed in 57% of cases, and 100% of its members suffered sexual abuse; in group II, with 91% female adolescents, 79% moderate depression was found, 85.3% ab-normal personality development and 70% of its members suffered sexual abuse. Sexual abuse explained the highest percentage of the variance (29%). It is con-cluded that the hospital must consider the distinctive characteristics of the study groups and coordinate with the territorial network of mental health the continuity of care in its interventions.

Unveiling Adolescent Suicidality: Holistic Analysis of Protective and Risk Factors Using Multiple Machine Learning Algorithms

Adolescent suicide attempts are on the rise, presenting a significant public health concern. Recent research aimed at improving risk assessment for adolescent suicide attempts has turned to machine learning. But no studies to date have examined the performance of stacked ensemble algorithms, which are more suitable for low-prevalence conditions. The existing machine learning-based research also lacks population-representative samples, overlooks protective factors and their interplay with risk factors, and neglects established theories on suicidal behavior in favor of purely algorithmic risk estimation. The present study overcomes these shortcomings by comparing the performance of a stacked ensemble algorithm with a diverse set of algorithms, performing a holistic item analysis to identify both risk and protective factors on a comprehensive data, and addressing the compatibility of these factors with two competing theories of suicide, namely, The Interpersonal Theory of Suicide and The Strain Theory of Suicide. A population-representative dataset of 173,664 Norwegian adolescents aged 13 to 18 years (mean = 15.14, SD = 1.58, 50.5% female) with a 4.65% rate of reported suicide attempt during the past 12 months was analyzed. Five machine learning algorithms were trained for suicide attempt risk assessment. The stacked ensemble model significantly outperformed other algorithms, achieving equal sensitivity and a specificity of 90.1%, AUC of 96.4%, and AUCPR of 67.5%. All algorithms found recent self-harm to be the most important indicator of adolescent suicide attempt. Exploratory factor analysis suggested five additional risk domains, which we labeled internalizing problems, sleep disturbance, disordered eating, lack of optimism regarding future education and career, and victimization. The identified factors provided stronger support for The Interpersonal Theory of Suicide than for The Strain Theory of Suicide. An enhancement to The Interpersonal Theory based on the risk and protective factors identified by holistic item analysis is presented.

24-Hour warning signs for adolescent suicide attempts.

Little is known about when youth may be at greatest risk for attempting suicide, which is critically important information for the parents, caregivers, and professionals who care for youth at risk. This study used adolescent and parent reports, and a case-crossover, within-subject design to identify 24-hour warning signs (WS) for suicide attempts. Adolescents (N = 1094, ages 13 to 18) with one or more suicide risk factors were enrolled and invited to complete bi-weekly, 8-10 item text message surveys for 18 months. Adolescents who reported a suicide attempt (survey item) were invited to participate in an interview regarding their thoughts, feelings/emotions, and behaviors/events during the 24-hours prior to their attempt (case period) and a prior 24-hour period (control period). Their parents participated in an interview regarding the adolescents' behaviors/events during these same periods. Adolescent or adolescent and parent interviews were completed for 105 adolescents (81.9% female; 66.7% White, 19.0% Black, 14.3% other). Both parent and adolescent reports of suicidal communications and withdrawal from social and other activities differentiated case and control periods. Adolescent reports also identified feelings (self-hate, emotional pain, rush of feelings, lower levels of rage toward others), cognitions (suicidal rumination, perceived burdensomeness, anger/hostility), and serious conflict with parents as WS in multi-variable models. This study identified 24-hour WS in the domains of cognitions, feelings, and behaviors/events, providing an evidence base for the dissemination of information about signs of proximal risk for adolescent suicide attempts.

Recurrence of adolescent suicide attempt and self-harm (RASS study): Effectiveness of single therapeutic project.

This retrospective cohort study aims to understand the effectiveness of the Singular Therapeutic Project (STP) implemented in a Child Psychosocial Care Center in preventing recurrence of self-harm and suicide attempt (SA), by comparing the group of patients who adhered to the STP with the group that did not adhere completely. Data were collected from the medical records of adolescents with self-harm or SA during the period from 2015 to 2019. The primary outcomes analyzed were recurrence of SA, self-harm, and hospitalization; and the secondary outcomes analyzed were demographics, diagnosis, number of appointments, and negative life events. A total of 228 adolescents were included. After multivariate analysis, social service consultations decreased risk in 94.6% (HR .054, 95% CI: .004-.681) of the cases, but risk was increased by 23 times if there was an episode of self-harm among family members and/or friends (HR 23.641, 95% CI: 1.394-400.8). Additionally, in terms of SA, adherence to family interventions reduced the risk by 66.2% (HR .338, 95% CI: .125-.913). Victims of prejudice, racism, homophobia, transphobia presented a 3.7-fold increased risk (HR 3.766, 95% CI: 1.058-13.401). The STP interventions were effective in reducing the recurrence of self-harm and SAs in adolescents.

Suicide attempt among Malaysian school-going adolescents: relationship with bullying

BackgroundAccording to World Health Organization (WHO), the fourth leading cause of death among adolescents aged 15 -19 years is suicide. The National Health and Morbidity Survey (NHMS) 2017 reported that suicidal attempts among school adolescents increased from 6.8%—6.9% as compared to NHMS 2012. Suicide attempts can cause significant negative impacts on health, social and economic status. Bullying is one of the factors for adolescent suicide attempts, and its relationship to suicidality in adolescents has been shown in numerous research.ObjectivesThis study examined the relationship between suicide attempts and bullying among school adolescents in Malaysia.MethodsData from the Malaysia NHMS 2017, a nationwide study that adopted a two-stage cluster sampling design, were analysed. The survey used a self-administered questionnaire in bilingual language adapted from GSHS developed by WHO. Participants were secondary school students aged 13 -17 in all states. Descriptive and multiple logistic regression analyses were performed using IBM SPSS version 28.ResultsA total of 27,497 school adolescents participated in the study. Results showed that 6.9% of school adolescents had attempted suicide. There was 16.2% of adolescents being bullied. Multiple logistic regression revealed that students who were bullied were more likely to have suicide attempts (aOR 4.827, 95% CI: 4.143, 5.624) P < 0.001.Discussion/conclusionThis study revealed that bullying is associated with suicide attempts among school adolescents in Malaysia. The respective authority should consider and plan effective measures to curb bullying among school adolescents.

Associations between depressive symptoms with suicide behaviors and negative relationships with mother and father in early adolescents: a population-based study.

Adolescent-parent negative relationships may favour depressive symptoms only (DS<inf>only</inf>) and more strongly those plus suicide ideation (DSSI) or attempt (DSSA) in early adolescents (10-16 years). We assessed their associations which remain poorly addressed. This study included 1256 middle-school adolescents from north-eastern France (mean age 13.5±1.3). They completed a questionnaire gathering socioeconomic features, academic performance, substance (alcohol, tobacco, cannabis and other substances) use, relationships with father and mother, depressive symptoms, last-12-month suicide ideation, and lifetime suicide attempt. For depressive symptoms and suicide attempt, the time of the first occurrence during adolescent's life course was also gathered. Data were analyzed using multinomial logistic regression models and Kaplan-Meier survival estimates. Many adolescents suffered from DS<inf>only</inf> (8.0%), DSSI (2.5%) and DSSA (3.9%) and from negative relationships with father only (NR<inf>father</inf>, 11.2%), mother only (NR<inf>mother</inf>, 6.1%), and both parents (NR<inf>both parents</inf>, 10.9%). DSSA was more strongly associated (P<0.001) with NR<inf>mother</inf> (sex-age-adjusted odds ratio saOR=14.34) and NR<inf>both parents</inf> (saOR=12.15) than NR<inf>father</inf> (saOR=4.57). Similar results were found for DSSI (saOR 12.90, 12.23 and 2.16, respectively) and DS<inf>only</inf> (saOR 4.18, 4.84 and 3.18, respectively). These results remained strong when controlling for socioeconomic features, academic performance and substance use (contribution reaching 62%). The risk early began and then steadily increased over time. Adolescent-parent negative relationships favor DS<inf>only</inf> and more strongly DSSI and DSSA. Mother had a much higher role than father. The role and support of both parents should be considered for prevention and care to reduce adolescents' mental health difficulties.

Association between allergic rhinitis and despair, suicidal ideation, and suicide attempts in Korean adolescents: a nationally representative study of one million adolescents.

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.

6.97 Comparison of Suicidal Thoughts and Behaviors in Adolescent Suicide Attempters With and Without the Presence of Psychotic Features

6.97 Comparison of Suicidal Thoughts and Behaviors in Adolescent Suicide Attempters With and Without the Presence of Psychotic Features

Correlation Between Systemic Immune-Inflammation Index and Suicide Attempts in Children and Adolescents with First-Episode, Drug-Naïve Major Depressive Disorder During the COVID-19 Pandemic.

This study aims to investigate the association between the systemic immune-inflammatory index (SII) and suicide attempt (SA) in children and adolescents with first-episode, drug-naïve Major Depressive Disorder (MDD) during the COVID-19 pandemic. A retrospective study was conducted on 263 MDD patients hospitalized at the Third Hospital of Fuyang City between 2020 and 2022. Patients were categorized into two groups based on the presence of previous SA. The study compared the differences in SII and clinical characteristics between the two groups and used the receiver operating characteristic (ROC) curve to determine the optimal critical value of SII and the area under the curve. Binary logistic regression was used to analyze the independent risk factors for SA. Compared with the patients without SA history, the patients with a personal history of SA had a higher mean HDRS scores (Z=-2.369, p=0.018), higher mean neutrophil count (Z=-2.870, p=0.004), higher mean platelet count (Z=-2.155, p=0.031), and higher mean SII (Z=-3.170, p=0.002). The optimal critical SII determined by the ROC curve was 548.15 (sensitivity = 63.2%, specificity = 83.1%), and the area under the curve was 0.661. After adjusting for gender, age, BMI, illness duration and HDRS score, the risk of total SA in patients with high SII was 8.296 times higher than in those with low SII (OR = 8.296, 95% CI: 3.803-18.095, P < 0.001), The risk of recent SA was 13.922 times higher in patients with high SII than in those with low SII (OR = 13.922, 95% CI: 5.587-34.693, p < 0.001). However, high SII was not a risk factor for past SA (OR = 0.547, 95% CI: 0.062-4.842, P=0.587). SII may be an inexpensive, easily accessible strategy that can assist in determining suicide risk in adolescents with MDD.