Current Suicide Research Articles

Perceived Entrapment, Goal Adjustment and Goal Ambivalence as Predictors for Suicide Ideation in High-Risk Prisoners

The integrated motivational-volitional (IMV) model of suicide presents a pathway between perceived entrapment to the development of suicide ideation. This cross-sectional, questionnaire-based study used a sample of 106 male high-risk prisoners, to explore the predictive power of entrapment and goal factors linked to self-regulation (goal adjustment and ambivalence about personal goals) for suicide ideation. A logistic hierarchical regression showed that four factors: goal re-engagement, goal disengagement, goal ambivalence and internal entrapment, as a set, were able to predict any current suicide ideation over and above established risk factors (depression, social support, rumination and history of suicidal behaviour), [Formula: see text](8) = 45.90, p < 0.001. As internal entrapment (odds ratio = 1.16) increased, this contributed significantly to the likelihood of current suicide ideation. This adds to findings that level of internal entrapment is an important factor in understanding the presence of suicide ideation and that this may also be applicable in prisoners. Interestingly, against the direction of hypotheses, higher willingness to engage with new goals (OR = 1.21) and lower historic suicide risk (OR = 0.87), also significantly contributed to the likelihood of current suicide ideation. Findings are discussed in relation to existing literature and with consideration of this specialist participant group.

The Insight Study: A Case-Control Psychological Autopsy Study Examining Factors Associated With Suicide in Middle-Aged People.

Despite current suicide prevention strategies, suicide rates are increasing in many Western countries in the 45-60 age group. To comprehend the high risk of suicide in this group, it is essential to gain insight into its risk factors. A case-control psychological autopsy study examined the differences between individuals who died by suicide (i.e., suicide cases) and those with psychological problems (i.e., living controls) between the ages of 45 and 60 years. Eighty-two informants were interviewed regarding 48 suicide cases and 23 controls. Controls were significantly more likely than suicide cases to have discussed the subject of euthanasia (45.5% vs.15.2%), to experience physical problems (95.7% vs. 70.8%), and to undergo treatment for these problems (73.9% vs. 39.6%). Suicide cases were more likely to be diagnosed with a depressive episode, depressive disorder (87.5% vs. 60.9%), but less likely to have current treatment for psychiatric disorders (70.8% vs. 95.7%). Suicide cases were more likely than controls to experience problems at work (85.4% vs. 60.9%), future financial problems (59.0% vs. 22.2%), and concerns about these problems (56.8% vs. 22.2). The results suggest possibilities for suicide prevention among middle-aged individuals through targeted interventions addressing mental healthcare, occupational settings, and financial distress.

Psychosocial Correlates of Loneliness and Suicidality in the Taiwanese General Population

ABSTRACTObjectivesTo estimate the prevalence of loneliness and to investigate the associations between loneliness and suicidality among the general population in Taiwan.DesignCross‐sectional analysis of random samples in surveys.SampleDuring 2016 and 2017, 2148 and 2098 participants (N = 4246) from a representative sampling of the Taiwanese population were interviewed via the computer‐assisted telephone system in Taiwan.MeasurementsThe study measured demographics, psychological distress, suicide risk factors, and loneliness status (single‐item measurement). The association between loneliness and psychosocial factors was analyzed using Spearman's correlation. Logistic regression was applied in the association between loneliness and current suicide ideation.ResultsAround 13.1% in the sample perceived feelings of loneliness. Loneliness status was significantly associated with increased psychological distress and suicide risks. The regression model indicated that the three most significant factors linked to loneliness were “no one trustworthy to talk to” (OR = 3.69), substance abuse (OR = 3.43), and depression (OR = 3.07), whereas self‐rated mental health (poor to good) (OR = 4.11), loneliness (OR = 2.59), and depression (OR = 2.09) were associated with current suicide ideation.ConclusionLoneliness was a significant suicide risk factor with multiple underlying psychosocial influences. Establishing support groups or service referrals through early psychosocial assessment could identify or alleviate loneliness and/or reduce suicide risk.

Facing depression: evaluating the efficacy of the EmpkinS-EKSpression reappraisal training augmented with facial expressions – protocol of a randomized controlled trial

BackgroundDysfunctional depressogenic cognitions are considered a key factor in the etiology and maintenance of depression. In cognitive behavioral therapy (CBT), the current gold-standard psychotherapeutic treatment for depression, cognitive restructuring techniques are employed to address dysfunctional cognitions. However, high drop-out and non-response rates suggest a need to boost the efficacy of CBT for depression. This might be achieved by enhancing the role of emotional and kinesthetic (i.e., body movement perception) features of interventions. Therefore, we aim to evaluate the efficacy of a cognitive restructuring task augmented with the performance of anti-depressive facial expressions in individuals with and without depression. Further, we aim to investigate to what extent kinesthetic markers are intrinsically associated with and, hence, allow for the detection of, depression.MethodsIn a four-arm, parallel, single-blind, randomized controlled trial (RCT), we will randomize 128 individuals with depression and 128 matched controls without depression to one of four study conditions: (1) a cognitive reappraisal training (CR); (2) CR enhanced with instructions to display anti-depressive facial expressions (CR + AFE); (3) facial muscle training focusing on anti-depressive facial expressions (AFE); and (4) a sham control condition. One week after diagnostic assessment, a single intervention of 90–120-minute duration will be administered, with a subsequent follow-up two weeks later. Depressed mood will serve as primary outcome. Secondary outcomes will include current positive mood, symptoms of depression, current suicidality, dysfunctional attitudes, automatic thoughts, emotional state, kinesthesia (i.e., facial expression, facial muscle activity, body posture), psychophysiological measures (e.g., heart rate (variability), respiration rate (variability), verbal acoustics), as well as feasibility measures (i.e., treatment integrity, compliance, usability, acceptability). Outcomes will be analyzed with multiple methods, such as hierarchical and conventional linear models and machine learning.DiscussionIf shown to be feasible and effective, the inclusion of kinesthesia into both psychotherapeutic diagnostics and interventions may be a pivotal step towards the more prompt, efficient, and targeted treatment of individuals with depression.Trial registrationThe study was preregistered in the Open Science Framework on August 12, 2022 (https://osf.io/mswfg/) and retrospectively registered in the German Clinical Trials Register on November 25, 2024. Clinical Trial Number: DRKS00035577.

Impact of behavioral inhibitory control and startle reactivity to uncertain threat on youth suicide risk.

Poor inhibitory control and exaggerated threat reactivity are two well-established risk factors for suicide. Theory suggests that these two factors may interact to influence suicide risk, although few studies have directly tested these relationships. In the present study, we examined the unique and interactive effects of inhibitory control (IC) and threat reactivity on self-reported suicide risk in a sample of 132 youth, ages 16-19. The stop signal task was used as a behavioral index of IC. Threat reactivity was captured using a modified version of the No-Predictable-Unpredictable threat paradigm that includes threat of predictable (P-) and unpredictable (U-) mild electrical shock. Startle eyeblink potentiation was measured throughout the task as an index of aversive responding. All participants completed a battery of well-validated self-report measures including current suicide risk. Hierarchical linear regression analyses controlling for age and sex revealed no main effects of IC or threat reactivity. However, there was a significant IC by reactivity to uncertain threat (U-threat) interaction. At lower levels of IC, greater startle reactivity to U-threat was associated with greater suicide risk. At higher levels of IC, there was no association between reactivity to U-threat and suicide risk. These results suggest that individual differences in IC and reactivity to U-threat interact to influence suicide cognitions, shedding light on potential subgroups of individuals who might be at elevated risk.

Temporal interaction of suicidal ideations and behaviors with loneliness in persistent depressive disorder - a feasibility study using ecological momentary assessment.

Individuals with persistent depressive disorder (PDD) are at increased risk for suicidality. Suicidality may be precipitated by loneliness. However, their temporal interplay in PDD has not been studied. We conducted a feasibility study using ecological momentary assessment (EMA) to measure short-term courses of suicidality and loneliness in 20 inpatients with PDD and current suicidality. EMA adherence of 13 completers was 81.3%. Suicidal ideations and loneliness varied with one standard deviation over three to six hours. This pilot study confirmed the feasibility of EMA in PDD and provided new insights in dynamics of suicidality and loneliness informing future study designs.

Temporal trends in suicide ideation and attempt among youth in juvenile detention, 2016-2021.

Data from the general population of youth show increases in suicide ideation and attempt in recent years, with rates of increase differing across sex and racial/ethnic groups. This study assessed trends in suicide ideation and attempt from 2016 to 2021 in youth in juvenile detention, across sex, age, and racial/ethnic groups. We leveraged state-wide suicide screening data of all detained youth (n = 53,769) from 2016 to 2021. We analyzed data for periods defined by statistically significant changes in trends of lifetime suicide attempt, past 6-month suicide attempt, and current suicide ideation. The prevalence of lifetime, but not past six-month, attempts increased, whereas the prevalence of current suicide ideation decreased annually from 2016 to 2021. Overall trends were qualified by distinct patterns among subgroups: rates of lifetime attempt increased among male, adolescent, and Black youth, while rates of current ideation decreased among male, adolescent, and White and Hispanic youth. These data document increasing rates of lifetime suicide attempts in detained youth from 2016 to 2021, especially among male and Black adolescents, concomitant with decreasing rates of current suicide ideation. Suicide prevention approaches for detained youth may need to prioritize variables besides or in addition to suicide ideation.

Systems modelling and simulation to guide targeted investments to reduce youth suicide and mental health problems in a low–middle-income country

BackgroundDespite suicide’s public health significance and global mental health awareness, current suicide prevention efforts show limited impact, posing a challenge for low- and middle-income countries. This study aimed to develop a dynamic simulation model that could be used to examine the potential effectiveness of alternative interventions for reducing youth mental health problems and suicidal behavior in Bogotá, Colombia.MethodsA system dynamics model was designed using a participatory approach involving three workshops conducted in 2021 and 2022. These workshops engaged 78 stakeholders from various health and social sectors to map key mental health outcomes and influential factors affecting them. A model was subsequently developed, tested, and presented to the participants for interactive feedback, guided by a moderator. Simulation analyses were conducted to compare projected mental health outcomes for a range of intervention scenarios with projections for a reference scenario corresponding to business-as-usual.ResultsA total of 6670 suicide attempts and 347 suicides are projected among 7 − 17-year-olds from January 1, 2023, to early 2031 under the business-as-usual scenario. Mental health issues among 12 − 17-year-olds are projected to increase from 18.9% (2023) to 27.8% (2031), and substance use issues from 2.29 to 2.49% over the same period. School-based suicide prevention and gatekeeper training are the most effective strategies, reducing total numbers of suicide attempts and suicides by more than 20% (i.e., compared to business-as-usual). However, discontinuous funding significantly hinders these effective suicide prevention efforts.ConclusionsSystems modelling is an important tool for understanding where the best strategic financial and political investments lie for improving youth mental health in resource-constrained settings.

Brief online suicide risk assessment of adults does not affect state mood, even in the context of elevated suicidality self-stigma, suicidal ideation and psychological distress.

The current study aimed to assess whether online suicide risk assessment affects state mood and is the first to examine if suicide-related self-stigma or coping related to suicidal ideation are predictors of mood change. The Australian participants (N = 661, Mage = 34.9, SD = 12.3, 57.1% female), recruited through a crowd-sourcing platform, completed a visual analogue mood measure before and after the Suicidal Ideation Attributes Scale (SIDAS), an assessment tool. Followed by a modified version of the Internalised Stigma Scale, the Brief COPE and DASS-21. State mood did not change from pre- to post-suicide risk assessment in the overall sample, t(662) = -.16, p = .868, d = -.01. Contrary to hypotheses, neither self-stigma nor coping were related to mood change following exposure to the SIDAS. The multiple regression model was not significant, F(9,643) = 1.16, p = .31., nor was any single predictor including gender, current Suicide risk β = -.04, t = -.80 or psychological distress β = -.09, t = -1.76, p = .08. These findings suggest that online exposure to a suicide risk tool is unlikely to be iatrogenic in relation to state mood, even in the context of elevated self-stigma, suicidal ideation and psychological distress.

Impulsivity Impacts Suicidality in Patients with Alcohol Use Disorder with and without Comorbid Depression

Abstract Objective: The independent rôle of impulsivity in alcoholism patient’s suicidality is less elucidated. In this study, we intended to investigate how impulsivity and depression contribute to suicidality in patients with alcohol use disorder (AUD). Methods: We recruited 27 adult patients with AUD and major depressive disorder (AUD with MDD) and 33 with AUD only (AUD without MDD). We assessed suicidality, alcohol use severity, depression severity, impulsivity, and other psychiatric comorbidities. Suicidality was quantified for the frequency of previous history of suicide attempts and for current suicide intent/tendency. Impulsivity was measured using the Barratt Impulsiveness Scale (BIS). We addressed how impulsivity contributed to both suicidality indices in multiple ordinal regressions. Results: Patients with AUD with MDD versus those with AUD without MDD showed significantly higher suicidality (p < 0.001), significantly more severe alcohol (p < 0.01), significantly more polysubstance use (p < 0.05), significantly more anxiety comorbidities (p < 0.05), and significantly higher BIS scores (p < 0.001). In a better-fitting final model using regression with stepwise elimination, the BIS total score was independently and significantly associated with current suicide tendency (p < 0.05) and frequency of previous suicide attempts (p < 0.01). In contrast, the Hamilton Depression Rating Scale-17 score was significantly associated only with current suicidal tendencies (p < 0.01), but not with the frequency of previous attempts. Conclusion: Depressed patients relative to nondepressed individuals with AUD showed higher suicidality, Barratt impulsivity, and severity of alcohol use. Across groups, BIS impulsivity but not the severity of depression was found to predict suicidality. We suggest that suicide prevention efforts may include assessment of impulsivity in AUD patients.

Prevalence of current suicidal thoughts and lifetime suicide attempts in individuals with cancer and other chronic diseases in Germany: Evidence for differential associations from a representative community cohort

BackgroundResearch indicates an elevated risk for suicidal thoughts and behaviors (STBs) among individuals with cancer, but community-based studies on the prevalence of STBs in comparison to the general population and other chronic diseases are lacking. MethodsData was drawn from the representative population-based, prospective Gutenberg Health Study (GHS). Participants (N = 12,382; age: M = 59.5, SD = 10.8; 48.9 % women) completed highly standardized medical assessments and validated questionnaires such as the PHQ-9. In addition to prevalence estimates (stratified by STBs and gender), logistic regression models were calculated (controlling for confounders). ResultsThe sample included 1910 individuals with cancer, 8.2 % of whom reported current suicidal thoughts and 2.0 % reported lifetime suicide attempts. There was neither a significant association between a cancer diagnosis and suicidal thoughts (p = .077) nor suicide attempts (p = .17) in models adjusting for age, gender, and income. Other chronic diseases were linked to suicidal thoughts and attempts only in men. LimitationsAlthough the investigation of the two kinds of STB are a strength of the study, the items' different time frames complicate comparisons. In addition, the cross-sectional design limits the ability to understand observed relationships and to identify periods of risk. ConclusionThis study expands the evidence base regarding the vulnerability to STBs in individuals with cancer, including long-term survivors. It highlights their heterogeneity, differential risk factors underlying suicidal thoughts and attempts, and the relevance of other (contextual) factors shaping an individual's susceptibility to suicidal crises.

Review on the Integration of Just-in-time Adaptive Intervention and Internet-based Cognitive Behavioral Therapy in Reducing Suicidal Thoughts and Behavior

Suicide remains a major public health challenge in the world. The current suicide prevention approaches face challenges in timing mismatch, access barriers, and lack of personalization, complicating the environment for successfully reducing suicidal thoughts and behaviors (STBs). Mobile health has been an emerging but effective approach to supporting and treating mental illnesses. The strengths of Just-in-Time Adaptive Interventions (JITAI) and Internet-based Cognitive Behavioral Therapy(iCBT) are potential approaches to resolving the current challenges of suicide prevention. This paper examines the definitions of JITAIs and iCBT and explores their use in mitigating suicidal thoughts and behaviors. It is proposed that the integration of JITAIs and iCBT could address the current obstacles in preventing suicidal thoughts and behaviors due to their advantages in availability, accessibility, and personalization. However, this integration also has its limitations, necessitating further research. The paper underscores the necessity of future empirical studies on the combined use of JITAIs and iCBT to reduce suicidal thoughts and behaviors.

Participatory Design in Suicide Prevention: A Qualitative Study of International Students' Experiences of Adapting the LivingWorks safeTALK Programme.

Current suicide prevention approaches are not adapted to international student needs, and participatory design is a method that may facilitate the development or adaptation of appropriate programmes for this group. This qualitative study investigated the experiences of international university students studying in Australia who participated in a co-consultation process to adapt the LivingWorks safeTALK suicide prevention programme. Eight international students from the co-consultation workshop completed semi-structured interviews about their workshop experience. The data were analysed using reflexive thematic analysis. The findings showed that participants found the co-consultation process empowering and engaging. They also reported that the experience promoted mutual learning and challenged simplistic views of suicide. No students reported experiencing distress. Suggestions for improving participatory design for international students focussed on enhancing participant interaction, supporting quiet voices to be heardand ensuring understanding of mental health and suicide through shared language. This study underscores the value of participatory design in suicide prevention, emphasising its potential to empower international students and facilitate culturally sensitive programme adaptations. International students were involved in the co-consultation process to redevelop the training content and provided a series of recommendations for improving such processes for international students in the future. The two researchers who conducted the interviews and data analysis were former international students.

Psychological resilience and suicidality in the general population: A cross-sectional study based on data from the National Mental Health Survey of Korea 2021

BackgroundThe relationship between suicidality and resilience is underexplored among the general population. This study aimed to explore the relationship between lifetime, one-year, and one-month prevalence of suicidality (ideation, plan, attempt) and resilience in the general population. MethodsData on suicidality, resilience, prevalence of major mental disorders, and other key psychological factors were collected from the National Mental Health Survey of Korea 2021. Interviewees comprised 5511 South Koreans aged 18–79 years. The contribution of resilience to suicidality was evaluated using Rao–Scot logistic regression, adjusting for possible confounders such as mental disorder prevalence and demographic and psychological characteristics. ResultsSignificantly lower resilience levels were noted among participants who reported lifetime, one-year, and one-month suicidal ideation, plan, or attempts. High resilience levels predicted no suicidal ideation, plans, and attempts in the lifetime, and no suicidal ideation and plans in the one-year and one-month time frames. LimitationsFirst, this study's cross-sectional design has limitations for ascertaining a causal relationship between resilience and suicidality. Second, because the number of participants who had attempted suicide in the past year and reported suicidal thoughts/attempts in the past month was small, there were limitations in the analysis of suicidality in these time frames. Third, it was difficult to rule out the mediating effects of personality and temperament on the relationship between resilience and suicidality. ConclusionsHigh resilience levels predicted lower lifetime and current suicidal ideation and suicidal planning in the general population. This study shows that psychological resilience is an important factor in evaluating an individual's current suicidality.

Obstructive respiratory disease in U.S. veterans: Prevalence, characteristics, and health burden

ObjectiveTo examine the psychiatric and physical health burden of obstructive respiratory disease in a nationally representative sample of U.S. Veterans. MethodsSecondary data analyses were conducted using data from the 2019–2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of U.S. Veterans. Participants self-reported health professional-diagnosed obstructive respiratory disease (i.e., asthma, chronic bronchitis or chronic obstructive pulmonary disease). Veterans who reported obstructive respiratory disease (n = 502) were compared to veterans without this disease but with at least one or more other medical conditions—controls (n = 3169) on measures of sociodemographic, trauma, psychiatric, and physical health characteristics. Multivariable regression analyses examined independent associations between obstructive respiratory disease and psychiatric conditions and physical characteristics. ResultsA total 12.5% of the sample reported a diagnosis of obstructive respiratory disease. Compared to controls, veterans with obstructive respiratory disease were more likely to be female, unmarried/partnered, lower income, residing in the Midwest, receiving VA healthcare, and had greater lifetime and childhood trauma burden. In adjusted analyses, veterans with respiratory disease had 47–91% greater odds of screening positive for current posttraumatic stress, major depressive, and generalized anxiety disorders, and had 48% greater odds of current suicide ideation. They were also more likely to have lifetime nicotine use disorder and had more medical comorbidities and more severe somatic symptoms. ConclusionsObstructive respiratory disease is prevalent among U.S. veterans and associated with significant mental and physical health burden. Results highlight the need for timely screening and treatment for psychiatric and medical conditions that are highly comorbid with obstructive respiratory disease in this population.

Advancing suicide prevention in Germany, Austria and Switzerland: a qualitative study.

Suicide is a significant public health problem, impacting individuals, families and communities worldwide. Effective suicide prevention requires a comprehensive approach with diverse integrated interventions and collaboration across sectors, stakeholders and professions. This study aims to identify challenges, gaps and success factors in current suicide prevention efforts in Germany, Austria and Switzerland, providing specific recommendations for advancement. We conducted online, semi-structured interviews with 36 suicide prevention experts from Germany, Austria and Switzerland, incorporating perspectives from policy, science and practice. Interviews were conducted between September 2022 and February 2023, audio-recorded, transcribed verbatim and analyzed using the Framework method. Despite progress in national strategies and coordinated efforts for suicide prevention, challenges such as resource scarcity, stigma and structural issues in psychiatric and psychotherapeutic care persist. The interviewees identified several areas for advancement, including developing targeted prevention measures for men and older people, strengthening collaboration across sectors, stakeholders and professions, and increasing the involvement of individuals with lived experience. While the COVID-19 pandemic has exacerbated challenges in psychiatric and psychotherapeutic care, it has concurrently strengthened interest in suicide prevention among policymakers and the media. National suicide prevention strategies play a crucial role in setting priorities, raising public awareness, and guiding action. However, since most suicide prevention efforts are still predominantly health sector-driven, a more comprehensive approach is needed to promote the involvement of all relevant actors and address suicidality as a collective societal responsibility. Tailoring prevention programs for risk groups like older people and men is important, as these populations show high suicide rates and face a lack of targeted interventions. Our study underscores the importance to continuously monitor, refine and strengthen collaborative and evidence-based suicide prevention efforts.

Guiding prevention initiatives by applying network analysis to systems maps of adverse childhood experiences and adolescent suicide.

Suicide is a leading cause of death in the United States, particularly among adolescents. In recent years, suicidal ideation, attempts, and fatalities have increased. Systems maps can effectively represent complex issues such as suicide, thus providing decision-support tools for policymakers to identify and evaluate interventions. While network science has served to examine systems maps in fields such as obesity, there is limited research at the intersection of suicidology and network science. In this paper, we apply network science to a large causal map of adverse childhood experiences (ACEs) and suicide to address this gap. The National Center for Injury Prevention and Control (NCIPC) within the Centers for Disease Control and Prevention recently created a causal map that encapsulates ACEs and adolescent suicide in 361 concept nodes and 946 directed relationships. In this study, we examine this map and three similar models through three related questions: (Q1) how do existing network-based models of suicide differ in terms of node- and network-level characteristics? (Q2) Using the NCIPC model as a unifying framework, how do current suicide intervention strategies align with prevailing theories of suicide? (Q3) How can the use of network science on the NCIPC model guide suicide interventions?

Immunological alterations in patients with current and lifetime suicide ideation and attempts: Examining the relationship with depressive symptoms

BackgroundSuicidal ideation and attempt (SI/SA) have been associated with dysregulation of the immune response and inflammation. However, few studies have explored how innate and acquired cellular immunity impact on the peripheral immune response. Our study addresses this gap by examining the composition of peripheral immune cells and humoral markers among individuals with current SI/SA, individuals with a history of SI/SA, and healthy controls (HC). Additionally, we aim to explore whether depressive symptoms settle the relationship between inflammation and SI/SA. MethodsThis is a multicenter case-control study that included 105 participants. Clinical and demographic characterists together with hemogram parameters, soluble pro and anti-inflamatory factors, and specific innate and adaptive immune cell populations were compared among patients with current SI/SA (n = 21), a history of lifetime SI/SA (n = 42), and HC (n = 42). ResultsPatients with both current and lifetime SI/SA had a significant increase in the absolute count of monocytes and in the monocyte/lymphocyte ratio (MLR). Additionally, patients with current and lifetime SI/SA showed a significant increase in high-sensitivity C- reactive protein (hs-CRP), and patients with lifetime SI/SA also showed higher levels of Erythrocyte Sedimentation Rate (ESR). The cellular inflammatory status of patients with SI/SA was characterized by altered proportions of monocytes with higher levels of nonclassical and intermediate monocytes. No differences were observed in the number of lymphocytes and the proportion of CD4 and CD8 between patients and HC, but we found differences in markers of exhaustion of CD4 lymphocytes, with increased levels of Programmed cell death protein 1 (PD1) in Current SI/SA and Lymphocyte activation gene 3 (LAG3) in Current SI/SA and Lifetime SI/SA compared to HC. The plasmainflammatory status was marked by higher levels of soluble Triggering receptor expressed on myeloid cells 2 (sTREM2) in patients with lifetime SI/SA compared to HC. Finally, the multinomial analysis indicates that inflammation and depressive symptoms are independently associated with SI/SA. ConclusionThis study highlights the association of immunological alterations with SI/SA. Furthremore, SI/SA is independently influenced by depressive symptoms and inflammation. This may have important therapeutic implications, as in these patients, it may be necessary to treat the inflammatory process beyond treating the depressive symptoms.

Suicide Prevention Programs Currently Available to US Veterans: A Scoping Review

It is widely recognized the high suicide rate among United States (US) veterans is a major ongoing public health problem. Suicide prevention programs that specifically target veterans are varied in their implementation and success rates. A scoping review was conducted to examine what types of suicide prevention programs are currently available for US veterans and their effectiveness. From this scoping review, 361 articles were located from two electronic databases, and 26 suicide prevention programs were located through the US Department of Veterans Affairs (VA) webpage/electronic resources. Of the 361 peer reviewed articles, 33 were classified as highly relevant and selected for full review, and 22 were identified as needing further review for relevance to the topic or target population. Nineteen VA webpage/electronic resources were classified as highly relevant and selected for full review. After implementing the inclusion and exclusion criteria, 28 journal articles and 16 VA webpage/electronic resources were included in this scoping review. Although the scoping review demonstrated there is a wide variety of suicide prevention programs available for US veterans, the review also indicated that (a) suicide prevention programs in use by the VA are not being widely disseminated in the peer-reviewed literature and (b) there is significantly more dissemination on the study of causes of suicidality than programs being implemented to prevent suicidal behavior. As a result, available research suggests additional research should be conducted on suicide prevention programs and more dissemination of current suicide prevention activities should take place.

Certain immune parameters may have a significant impact on suicidal behaviour - a naturalistic study among psychiatric in-patients

IntroductionSeveral research already proved the role of certain immunological factors (neutrophil-lymphocyte (NLR), monocyte-lymphocyte (MLR) and platelet-lymphocyte (PLR) ratio, and C-reactive protein (CRP)) in the background of suicidal behaviour.ObjectivesThe aim of this research was to study the association between routinely measurable low-grade inflammation parameters and suicidal behaviour among patients in the acute psychiatric care setting.MethodsThe study population included psychiatric in-patients (N=100) consecutively treated with depressive disorders and/or suicidal behaviour in a University Clinic between December 1, 2020 and December 31, 2021. Three different patient-groups were generated based on their suicidal behaviour: suicide attempters (N=55) including recent attempters(N=36) and past attempters (N=19) and non-suicidal patients (N=45), who never had a suicide attempt. Basic socio-demographic data, the severity of depression and immunological parameters (white blood cell count: lymphocytes, monocytes, neutrophil, eosinophil, basophil granulocytes; thrombocytes; C-reactive protein) were recorded.Descriptive analyses and multivariate regression model were performed with RStudio version 4.2.3.ResultsCRP was significantly higher (2.00 vs. 1.00; p=0.007) in suicidal patients (N=55), however other immunological parameters did not differ significantly between the suicidal and the non-suicidal groups (NLR: 2.02 vs. 2.19; MLR: 0.22 vs. 0.11; PLR: 118 vs. 130). NLR and MLR showed significantly higher values (NLR: 2.83 vs. 1.93, p=0.021; MLR: 0.28 vs. 0.11, p=0.01) for those who currently attempted suicide (N=36) compared to the patients with no or past suicide attempt (N=64). In the regression analysis, the NLR and MLR showed significantly higher values in current suicide attempters even when gender, age, suicidal risk and severity of depression were included in the model. However, no significant differences were found when comparing current and past suicide attempters with the non-suicidal patients.ConclusionsDespite the small number of cases in the samples, our results confirmed the association of certain immunological parameters (NLR, MLR) and acute suicidal behaviour. This relationship was found to be independent of depression and its severity. Our data suggest that, unlike the NLR and MLR parameters, the higher CRP value may not be related to acute suicide attempt, but rather to suicidal vulnerability, as a trait-marker. Markers of chronic systemic inflammation may help in the prediction of suicidal behaviour and in the development of new therapeutic options, however, further prospective studies are needed to identify the specific role of immunological factors in suicidal behaviour more precisely.Disclosure of InterestNone Declared