Adolescent Attempters Research Articles

No association between acne treatment with retinoids and suicide attempts in adolescents: A case-control study

No association between acne treatment with retinoids and suicide attempts in adolescents: A case-control study

Factores de riesgo y protección para la ideación e intento de suicidio en adolescentes y jóvenes latinoamericanos: revisión sistemática

Suicidal behavior is constituted as a public health problem, and the literature is recognized extensively for enunciating risk and protection factors associated with the attempt of suicide. The evaluation of the methodological quality of the primary studies is required by systematic reviews, thus guiding decision-making regarding the design of interventions from the risk approach. The identification of the risk and protective factors associated with suicidal ideation and attempts in adolescents and young people in Latin America studies and the evaluation of the methodological quality of the included studies were the objectives of this systematic review. The databases CUIDEN, LILACS, Pubmed, Scielo, Science Direct, SCOPUS, EBSCO, and Medline were consulted, with the results being restricted to articles in the last 10 years.A total of 3,642 documents were obtained, from which 19 studies were included. Of the studies, 52.63% (n=10) were found to have a medium internal validity level, and 57.89% (n=11) were determined to have a medium global quality level. The most frequently reported family risk factors were family dysfunction and suicide background, with other factors including the presence of mental disorder, psychoactive substances consumption, physical violence, sexual violence, and the social factor.On the other hand, the study of protective factors was found to be limited, with family functionality and support being the most frequently reported evidence.

Risk of Suicidal Ideation or Attempts in Adolescents With Obesity Treated With GLP1 Receptor Agonists

Glucagon-like peptide 1 receptor agonists (GLP1R) are increasingly being used for the treatment of obesity in adolescents. It is currently unknown whether GLP1R treatment is associated with suicidal ideation or attempts in this population. To investigate the association between GLP1R initiation and suicidal ideation or attempts in adolescents with obesity. Retrospective propensity score-matched cohort study using electronic health records from the TriNetX global federated network between December 2019 and June 2024. The analysis included data from 120 health care organizations, mainly from the USA. Participants were adolescents aged 12 to 18 years with a diagnosis of obesity and evidence of an antiobesity GLP1R prescription or lifestyle intervention without GLP1R within the following year. Cohorts were balanced for baseline demographic characteristics, psychiatric medications and comorbidities, and diagnoses associated with socioeconomic status and health care access using propensity score matching. Initial prescription of GLP1R (study cohort) or lifestyle intervention without GLP1R (control cohort). Incidence of suicidal ideation or attempts based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes recorded in patient electronic health records during 12 months of follow-up. Diagnoses of upper respiratory tract infections (URTI) were used as negative control outcomes, and gastrointestinal symptoms (GI) were used as positive control outcomes. A total of 4052 adolescents with obesity and a concomitant antiobesity intervention were identified for the GLP1R cohort and 50 112 were identified for the control cohort. Propensity score matching resulted in 3456 participants in each balanced cohort. Prescription of GLP1R was associated with a 33% reduced risk for suicidal ideation or attempts over 12 months of follow-up (1.45% vs 2.26%; hazard ratio [HR], 0.67; 95% CI, 0.47-0.95; P = .02) and a higher rate of GI symptoms (6.9% vs 5.4%; HR, 1.41; 95% CI, 1.12-1.78; P = .003) but no difference in rates of URTI diagnoses. In this study, adolescents with obesity prescribed a GLP1R had a lower incidence of suicidal ideation or attempts compared with matched patients not prescribed GLP1R who were treated with lifestyle intervention. These results suggest a favorable psychiatric safety profile of GLP1R in adolescents. The detected reduction in HRs for suicidal ideation among adolescents with obesity prescribed GLP1R suggests potential avenues for future research.

Association between sleep disturbances and suicidal behavior in adolescents: a systematic review and meta-analysis.

Adolescents' health and well-being are seriously threatened by suicidal behaviors, which have become a severe social issue worldwide. Suicide is one of the leading causes of mortality for adolescents in low and middle-income countries, with approximately 67,000 teenagers committing suicide yearly. Although an association between sleep disturbances (SDs) and suicidal behaviors has been suggested, data are still scattered and inconclusive. Therefore, to further investigate this association, we conducted a meta-analysis to verify if there is a link between SDs and suicidal behaviors in adolescents without diagnosed psychiatric disorders. PubMed, CENTRAL, EMBASE, and PsycINFO were searched from inception to August 30th, 2024. We included studies reporting the estimation of suicidal behaviors in adolescents from 12 to 21 years of age, with SDs and healthy controls. The meta-analysis was based on odds ratio (OR, with a 95% confidence interval ([CI]), estimates through inverse variance models with random-effects. The final selection consisted of 19 eligible studies from 9 countries, corresponding to 628,525 adolescents with SDs and 567,746 controls. We found that adolescents with SDs are more likely to attempt suicide (OR: 3.10; [95% CI: 2.43; 3.95]) and experience suicidal ideation (OR: 2.28; [95% CI 1.76; 2.94]) than controls. This meta-analysis suggests that SDs are an important risk factor for suicidal ideation and suicide attempts in healthy adolescents. The findings highlight the importance of early identification of SDs to prevent suicidal behaviors in this population. PROSPERO, identifier CRD42023415526.

First Suicide Attempts in Early Adolescents: A Descriptive Outcomes Study

ObjectiveIn 2021, suicide was the second leading cause of death in early adolescent Americans ages 10-14. Research into suicidal behavior in this age group is limited. We report on prior psychiatric care, attempt method, and attempt outcomes in a cohort of 164 early adolescents accrued by first suicide attempt coming to medical attention. MethodsOur cohort constitutes a subsample from a previously reported retrospective-prospective study identified through the Rochester Epidemiology Project that recruited individuals making first suicide attempts coming to medical attention (index attempt, IA) during a 22-year period (1/1/1986-31/12/07). Among 1490 all-age index attempters followed until 12/31/2010, 164 (11.0%) were aged 10-14. Results3/164 died on IA (1.8% of the cohort; 2 females, 1 male). Nearly half (72/164, 43.9%) had no prior psychiatric history. Females were less likely than males to have seen a mental health provider (p=0.029) or been prescribed psychiatric medications (p<0.001) prior to IA. Medication overdose was the most common attempt method in females (81/128, 63.3%), while cutting or piercing wounds were the most common method in males (13/36, 36.1%). Females were significantly more likely than males to overdose (p=0.001). Of IA survivors, 19.9% (32/161) were initially medically hospitalized, 52.8% (85/161) were psychiatrically hospitalized—initially or in transfer—and 37.2% (60/161) were discharged without hospitalization. ConclusionMedication overdoses accounted for over half of all IAs and were significantly more common in females. While IA mortality was low relative to older patients from the all-age-cohort, morbidity was substantial with nearly a fifth of attempts severe enough to warrant medical hospitalization and more than half initial or eventual psychiatric hospitalization. These findings emphasize the importance of both means restriction and identification of early adolescents at risk before they make their first attempt.

Interaction of sexual violence perpetration and victimization on suicide attempts in Korean adolescents on additive and multiplicative scales: a population-based cross-sectional study

Interaction of sexual violence perpetration and victimization on suicide attempts in Korean adolescents on additive and multiplicative scales: a population-based cross-sectional study

Radiological and Clinical Aspects of Duodenal Atresia Associated with Situs Inversus: A Case Report

Duodenal atresias are rare digestive embryopathies that present as typical high intestinal obstructions. They are associated in 30 to 50% of cases with other anomalies such as Trisomy 21, situs inversus, congenital heart diseases, digestive tract anomalies, and biliopancreatic abnormalities, among others. Situs inversus is a particularly rare association. Radiologists must have a thorough understanding and be able to identify associated malformations to provide useful interpretations. The purpose of this work is to present their clinical and radiological aspects, as well as management approaches. The diagnosis is straightforward in the presence of bilious vomiting with a flat abdomen and findings from plain abdominal radiography. Ultrasound facilitates the identification of any associated malformations, including situs inversus.

Characteristics of Suicide Attempts in Adolescents: A Comparative Study between Adolescents and Adults

Characteristics of Suicide Attempts in Adolescents: A Comparative Study between Adolescents and Adults

Retrospective Evaluation of Adolescent Patients Presenting to the Emergency Department with Suicidal Attempt

Objective: Suicide attempts among adolescents are a major public health problem. It is important to understand the prevalence of suicide attempts in the adolescent population and the risk factors underlying the attempts so that the necessary precautions can be taken by health authorities. We therefore aimed to retrospectively evaluate the demographic and clinical characteristics of adolescent patients presented to the emergency department due to suicide attempts. Materials and Methods: This retrospective observational study included adolescent patients aged 10-19 years who presented to the emergency department for suicide attempt between August 01, 2018 and July 31, 2023. Ethics committee approval was obtained and data were collected from the hospital automation system through ICD codes. Demographic data, clinical characteristics, intervention methods, treatment processes and outcomes of the patients were analysed in detail. Results: Of the 126 patients included in the study, 80.2% were female, 19.8% were male, and the mean age was 184 months. 97.6% of the patients attempted suicide by ingestion of drugs or substances, and the rest of the patients preferred methods such as jumping from a height, firearm and sharp instrument use. Depression was the most common comorbid psychiatric disorder and was identified in 73.7% of the adolescents in the study. 42.1% of the patients presented to the emergency department with other complaints along with the suicide attempt. Treatments such as gastric lavage and activated charcoal were administered in the majority of admissions. Conclusions: This study reveals that suicide attempts are an important public health problem in the adolescent population and psychiatric disorders, especially depression, play a role in these attempts. It was observed that suicide attempts were more common among adolescent females. The findings emphasise the importance of early screening and interventions for the prevention and management of suicide attempts in adolescents. The findings of the study shed light on efforts to review and improve current management strategies and demonstrate the need for large-scale community-based studies.

Accuracy and transportability of machine learning models for adolescent suicide prediction with longitudinal clinical records

Machine Learning models trained from real-world data have demonstrated promise in predicting suicide attempts in adolescents. However, their transportability, namely the performance of a model trained on one dataset and applied to different data, is largely unknown, hindering the clinical adoption of these models. Here we developed different machine learning-based suicide prediction models based on real-world data collected in different contexts (inpatient, outpatient, and all encounters) with varying purposes (administrative claims and electronic health records), and compared their cross-data performance. The three datasets used were the All-Payer Claims Database in Connecticut, the Hospital Inpatient Discharge Database in Connecticut, and the Electronic Health Records data provided by the Kansas Health Information Network. We included 285,320 patients among whom we identified 3389 (1.2%) suicide attempters and 66% of the suicide attempters were female. Different machine learning models were evaluated on source datasets where models were trained and then applied to target datasets. More complex models, particularly deep long short-term memory neural network models, did not outperform simpler regularized logistic regression models in terms of both local and transported performance. Transported models exhibited varying performance, showing drops or even improvements compared to their source performance. While they can achieve satisfactory transported performance, they are usually upper-bounded by the best performance of locally developed models, and they can identify additional new cases in target data. Our study uncovers complex transportability patterns and could facilitate the development of suicide prediction models with better performance and generalizability.

A Study to Assess the Effectiveness of Structured Teaching Program regarding Knowledge on Premenstrual Syndrome and it's Management among the Adolescent Girls of selected High School, Mangaluru

The adolescent belongs to vital age group is not only because of entrant population to parenthood but also some threshold between childhood and adulthood. An each adolescent attempt to cross this threshold, face various physiological, psychological, and developmental changes. Menstruation refers to the monthly discharge of blood and other substances from the uterus (through the vagina) in non-pregnant adult female. The treatment of premenstrual symptoms can sometimes be as challenging that general management include a healthy life style, proper food pattern before menstrual period, aerobic exercise, reduce sugars, avoid salt, increase of fibre intake, adequate rest and sleep. Inadequate hygiene methods of sanitary protection lead to not only the health problems. But it also leads to adolescent girls dropping out of school thus negatively impact on education. Hence, the researcher planned to improve the knowledge of adolescent girls on management of premenstrual symptoms. Premenstrual symptoms prevalence from 5-20% from moderate to severe clinically applicable premenstrual complaints and up to 75% of all women of fertile age may experience symptoms of premenstrual syndrome. Exact cause of premenstrual syndrome is unknown, but several factors may given to the conditions. Premenstrual symptoms changes with hormonal variations and will vanish with pregnancy and menopause.

Vitamin B12 and folate deficiencies, elevated homocysteine and their roles in the biochemical basis of neuropsychiatric diseases in children and adolescents: Case series, review and recommendations

Objective: Vitamin B12 and folate deficiencies can be frequently seen in children and adolescents and may manifest with neuropsychiatric symptoms. Vitamin B12 and folate deficiencies and the associated increase in homocysteine are related to one-carbon metabolism (OCM) and may play a role in the pathogenesis of childhood and adolescent psychiatric disorders. Therefore, a case series and review on OCM will be presented here. Method: Twelve cases with vitamin B12 and folate deficiency and increased homocysteine among those admitted to the child and adolescent psychiatry clinic were retrospectively examined. Results: It was found that vitamin B12 and folate deficiency and increased homocysteine may cause depressive symptoms, anxiety disorders, obsessive compulsive disorder, anger control problems, self-harming behaviors, suicidal thoughts, and attempts in children and adolescents. Conclusion: According to these data, vitamin B12 and folate deficiency and the resulting increase in homocysteine may cause psychiatric symptoms in some children and adolescents. In addition, literature on OCM has been reviewed. The diagnosis and treatment methods for vitamin B12 and folate deficiencies are summarized for clinicians.

Depression, Rumination, and Suicide Attempts in Adolescents With Mood Disorders: Sex Differences in This Relationship.

Depression, Rumination, and Suicide Attempts in Adolescents With Mood Disorders: Sex Differences in This Relationship.

Can sports participation be a protective factor against suicide-related outcomes in adolescents: a systematic review.

Suicide-related outcomes among adolescents have become a serious public health problem worldwide. Emerging evidence suggests that sports participation may interact with suicide-related outcomes. The objective of this systematic review is to systematically review and summarize the association between sports participation and suicide-related outcomes among adolescents. A systematic review according to PRISMA Statement (International Platform of Registered Systematic Review and Meta-Analysis Protocols registration: INPLASY202330072) https://inplasy.com/inplasy-2023-3-0072/. The literature search was conducted in three electronic databases: Web of Science, PubMed, and EBSCOhost. A total of 16 studies (12 cross-sectional studies, 4 prospective studies) met the inclusion criteria were evaluated. Strong consistent evidence was found for the negative association between suicidal ideation, suicide attempts, and sports participation among adolescents. There was insufficient evidence to support consistency in the association between sports participation and suicide plans, and no evidence regarding gender differences between sports participation and these suicide-related outcomes. Furthermore, there was heterogeneity in the measures of sports participation and suicide-related outcomes across the included studies. Evidence suggests that more sports participations are associated with lower suicidal ideation and suicide attempts in adolescents. However, the directionality of the observed associations should be examined based on more high-quality longitudinal studies in the future.

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

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. 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. 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. 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.

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.

Safety Planning Intervention Training Among Early Career Mental Health Professionals: Perception of Self-Efficacy, Usefulness and Feasibility

Introduction In 2021, in Argentina there were 3,639 deaths by suicide, equivalent to one death every three hours. Evidence indicates that brief suicide preventive interventions in emergency services, such as the Safety Planning Intervention (SPI), effectively reduce future suicidal ideation and attempts in both adults and adolescents. Objective To evaluate the perception of self-efficacy, and the feasibility and usefulness of a training in SPI in early career mental health professionals. Method Sixty-nine early career mental health professionals from Buenos Aires participated in a 3-hour SPI training. Through an online survey, measurements were taken in three times: before and after the training and 8–10 weeks after the training. Results All participants completed the pre- and post-training measures, and 43 of them completed the follow-up survey. Post-training measures showed an increase in self-efficacy, maintaining the effect at 8–10 weeks. The SPI was found useful and feasible to be implemented in clinical care. More than half of the participants reported having used the SPI during follow-up. Conclusion Results suggest that training in SPI is associated with an increased perception of self-efficacy of early career mental health professionals; this is maintained after 2 months post-training. In addition, the intervention is perceived as feasible, acceptable and useful for professionals in training.

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.

Attention-Dominated Cognitive Dysfunction May Be a Biological Marker for Distinguishing SA from SI in Adolescents: A Network Analysis Study Based on Adolescent Depression.

Suicidal behavior is strongly correlated with depressive symptoms and the degree of suicidal ideation. Cognitive impairment may have varying degrees of influence on suicidal ideation (SI) and suicidal attempts (SA). The aim of this study was to identify the cognitive biomarkers that distinguish suicidal ideation from suicidal attempts in adolescents. The cross-sectional sample comprised 54 adolescents with major depressive disorder (MDD) and 32 healthy controls (HC). The THINC-it was utilized to assess cognitive function of all the samples. Suicidal ideation was examined by the Positive and Negative Suicide Ideation Scale (PANSI). Based on the type of data, one-way ANOVA or Kruskal-Wallis was performed to investigate group differences. Bonferroni post-hoc analysis was employed for regulating type I error for pairwise comparisons. Network analysis was used to compare the networks associated with suicidal ideation, depression symptoms, and cognitive function between SA and SI. The depression symptoms (HAMD-17) (F=72.515, P<0.001) and suicidal ideation (PANSI) (F=267.952, P<0.001) in the SA were higher than those in the SI. Analysis of between-group differences showed SA performed worse in THINC-it, especially in "Spotter (SP)" (P=0.033), "Objective cognition score (OS)" (P=0.027) and "Composite score (CS)" (P=0.017). Compared with SI, network analysis revealed that SA had a unique network of cognitive function, depressive symptoms, and suicidal ideation. Nevertheless, both networks exhibit comparable performance concerning the node strength of cognitive function. Within their separate networks, the aspects of CS, OS, and SP have emerged as the three most crucial elements. Adolescents with SI or SA exhibit a broad spectrum of cognitive impairments. Attention impairment can be beneficial in discerning between SI and SA. Future interventions for adolescent suicide can center on attention and the comprehensive cognitive ability that it represents.