Differences In Suicidal Ideation Research Articles

Exploring the association between consultation themes and suicidal ideation: a gender-stratified analysis of Hangzhou Mental Health Hotline (2014-2023)

BackgroundSuicide is a critical global public health issue that demands a better understanding of its complex causes and effective interventions. This study examines data from the Hangzhou Mental Health Hotline (2014-2023) to explore the relationship between consultation themes and suicidal ideation, with an emphasis on gender differences and how these associations changed during different phases of the COVID-19 pandemic.MethodsThis retrospective analysis covers 128,245 calls to the hotline over a decade. Chi-square tests identified differences in suicidal ideation across consultation themes and demographics. Multivariate logistic regression models were used to examine the relationship between specific themes and suicidal ideation, adjusting for confounders. The analysis was stratified by gender and pandemic phases to assess the interaction between gender and pandemic-related changes.ResultsThe incidence of suicidal ideation was highest during the mid-pandemic phase (11.95%), compared to the pre-pandemic (7.68%) and post-pandemic phases (10.66%). Additionally, the rate was slightly higher among female callers (9.8%) than male callers (9.4%). Physical illness (OR = 4.70, 95% CI: 3.71-5.91) had the strongest association with suicidal ideation, followed by mental health issues (OR = 3.35, 95% CI: 3.03-3.70). Compared to male callers, female callers were more significantly affected by physical illness (OR = 6.86 vs. OR = 3.71, p < 0.001) and mental health issues (OR = 6.81 vs. OR = 2.11, p < 0.001). In the context of romantic relationship problems, female callers had a higher likelihood of suicidal ideation (OR = 4.13 vs. OR = 1.88, p < 0.001). Similarly, marital and family issues were more strongly associated with suicidal ideation in female callers (OR = 4.58 vs. OR = 1.21, p < 0.001). During the global COVID-19 pandemic, the association between suicidal ideation and consultation themes among male callers showed a sharp upward trend, which eased after the pandemic. In contrast, the association among female callers gradually accumulated and continued to worsen in the later stages of the pandemic.ConclusionThis study highlights the necessity of implementing gender-sensitive mental health interventions tailored to different gender groups during and after global crises such as the COVID-19 pandemic, to safeguard public mental health effectively.

Latent groups from multidimensional factors and effects on suicidal ideation in older adults.

Suicide is a serious social problem among older adults. However, little is known about how multidimensional factors affect suicide of older adults. We classify the multidimensional suicidal risk types of older adults based on their characteristics and identify differences in suicidal ideation. Data were obtained via a nationwide online survey targeting 612 older adults over the age of 55 years. A latent profile analysis identified three profiles, one of which represented the optimal situation for these adults. We identified three distinct multidimensional suicidal risk types in older adults: high-risk predicament (24.5%), moderate-risk predicament (57.7%) and abundant internal/external resources (17.8%). In particular, depression, a major risk factor for suicide, was found together with self-neglect in each group. Multiple regression analysis showed that older adults in the moderate-risk predicament and high-risk predicament groups were more likely to have suicidal ideation than those in the abundant internal/external resources group. Our findings suggest that co-occurrence of depression and self-neglect represents a suicide risk pattern in high-risk older individuals. Therefore, local communities need to urgently screen and provide interventions for such older adults and strengthen their capacity for multidimensional aspects of life to prevent suicide in the long term.

Suicidality in Veterinarians: Trends at Different Career Stages and a Test of the Interpersonal Theory of Suicide

Objective The aim of this study was to investigate sex differences in suicide ideation and attempt at different career stages and test hypotheses derived from the Interpersonal Theory of Suicide (IPTS) in a sample of veterinarians. Method The sample of currently practicing veterinarians used for this study (N = 10,319) was derived from a larger sample. Participants completed an online self-report questionnaire. Results As predicted, women generally had a higher prevalence of suicide ideation and attempt across career stages, except men and women showed similar rates of suicide attempt after veterinary school. Contrary to hypotheses, no interaction effects between IPTS variables were observed. However, perceived burdensomeness, thwarted belongingness, and hopelessness exhibited the main effects of suicide ideation, and there were main effects of perceived burdensomeness and hopelessness on suicide attempt. Compared with perceived burdensomeness and thwarted belongingness, hopelessness had a relatively more robust relationship with suicide ideation. We also found a significant relationship between fearlessness about death and suicide attempt, but no relationship between self-reported pain tolerance and suicide attempt. Conclusions Some of our findings were consistent with the IPTS while others were not. Future research would benefit from a longitudinal examination of suicidality in veterinarians.

Gender Differences in Suicidal Ideation during the COVID-19 Pandemic among Iranian Adolescents and its Contributing Factors

Objective Suicidal thoughts in adolescents are common. The COVID-19 pandemic may have further led to an increase. This cross-sectional random sample “online” survey study was conducted in 2021 on 703 adolescents in Iran using the Beck Scale for Suicidal Ideation. Univariate, bivariate, and multinomial regression analysis, and Odds Ratio (OR) were reported. Results The prevalence of suicidal ideation in this sample was 28% and with higher rates in female participants (p = 0.01). It was more prevalent in 16 to 21 years old participants than adolescents with age of 16 and lower. Participants who were academically successful had less suicidal thoughts. Discussion Considering the high rate of suicidal ideation among adolescents, it is an emergency that requires effective intervention.

Suicide ideation and male-female differences in major depressive disorder

Objective This study aimed to explore male-female differences in suicide ideation (SI) and suicide risk factors in major depressive disorder (MDD). Methods We analysed 482 adults (sample 1) and 438 elderly outpatients (sample 2) with MDD. Sample 1 was treated with different antidepressant combinations (escitalopram; bupropion plus escitalopram; venlafaxine plus mirtazapine) and assessed by means of the Concise Health Risk Tracking (SI), Quick Inventory of Depressive Symptomatology, Altman Mania Rating Scale and Psychiatric Diagnostic Screening Questionnaire. Sample 2 was treated with venlafaxine and assessed using the Hamilton scale for depression, Anxiety Sensitivity Index and Penn State Worry Questionnaire for anxiety, Beck Scale for Suicide Ideation and Repeatable Battery for the Assessment of Neuropsychological Status. Results In sample 1, females had greater depression severity (O.R 0.961 99%CI: 0.929 − 0.995), males reported more alcohol abuse (O.R 1.299 99%CI: 1.118 − 1.509) and active SI (O.R 1.109 99%CI: 1.005 − 1.255). In sample 2 men showed more severe SI (O.R 1.067; 99%CI: 1.014 − 1.122) and weight loss (OR = 5.89 99%CI: 1.01 − 34.19), women more gastrointestinal symptoms. Conclusions In these selected samples, although women had more severe depression, men had more suicide risk factors. Such differences might contribute to men’s increased suicide risk.

Feasibility of online managing cancer and living meaningfully (CALM) in Chinese patients with metastatic breast cancer: a pilot randomized control trial

Metastatic breast cancer could cause various psychological symptoms. Managing Cancer and Living Meaningfully (CALM) is a brief, manualized psychotherapy that has been validated for advanced cancer patients. We conducted a pilot randomized control trial (RCT) to verify the feasibility and preliminary efficacy of CALM therapy in this population. Patients who met the inclusion criteria were randomly assigned into CALM or Wait-list Control (WLC) groups. Patients in the CALM group received CALM therapy and usual care; patients in WLC group first received usual care and then underwent CALM therapy after completing all assessments. All patients were asked to complete three assessments: T0(baseline), T1(3 months), and T2(6 months). The primary outcomes was death anxiety; other outcomes were depression, distress, suicide ideation, attachment security, spiritual well-being and quality of life at the end of life. Analysis of Covariance (ANCOVA) and t-test were used for statistics analysis. Thirty-six patients were randomly assigned to either of the two groups, with 34 patients completing the three assessments. At six months, we found significant between group differences in suicide ideation, distress, and life completion between the CALM and WLC groups. At T2, patients in CALM group reported lower levels of depression (F = 5.016, p = 0.033, partial η2 = 0.143), distress (F = 7.969, p = 0.010, partial η2 = 0.257), attachment avoidance (F = 4.407, p = 0.044, partial η2 = 0.128), and better sense of life completion (F = 5.493, p = 0.026, partial η2 = 0.155) than patients in the WLC group. Compared with results of the T0 assessments, we found significant differences in socres for depression (T2&T0, t = − 2.689, p = 0.011, Cohen’s d = 0.940) and distress (T2&T0, t = − 2.453, p = 0.022, Cohen’s d = 0.965) between the two groups. CALM therapy was well received by the study population, and CALM therapy can reduce depression, distress, attachment avoidance while improving quality of life in Chinese metastatic breast cancer patients. A Phase III RCT was recommended to verify the impact of CALM therapy on psychological burden and survival in this population.Trial registration: This study is part of the “Preliminary application study for Managing Cancer and Living Meaningfully (CALM) therapy in Chinese advanced cancer patients” clinical trial, with the Trial Registration Number of ChiCTR1900023129 (13/05/2019) in the Chinese Clinical Trial Registry (ChiCTR) website. (https://www.chictr.org.cn/index.html).

Perceived Usefulness of Self-Guided Versus Collaborative Suicide Safety Plans in Online Help-Seekers.

Background: Suicide safety plans were originally devised to be paper-based and clinician-guided, but digital self-guided plans are now common. Aim: This study explored whether plan format (paper vs. digital), assistance (self-authored vs. collaboration), and suicide attempt history were associated with differences in suicidal ideation, suicide-related coping, and perceived usefulness. Method: An online sample of safety plan users (N = 131) completed a survey assessing suicidal ideation, suicide-related coping, and perceived usefulness of their plan. t tests compared outcomes by plan format, collaboration, and suicide attempt history. Pearson correlations explored associations between reasons for plan use, suicidal ideation, and suicide-related coping. Results: Suicidal ideation was significantly higher, and perceived usefulness significantly lower in participants with a past suicide attempt (vs. none) and in those who had collaborated to make their safety plan (vs. self-authored). Collaborators were largely health professionals. No significant differences were found between plan formats. Suicide-related coping was associated with higher perceived usefulness overall. Limitations: Our study design was cross-sectional, utilizing a largely young, female, English-speaking, online help-seeking sample. Conclusions: For clients with prior suicide attempts and higher levels of suicidal ideation, meaningful collaboration may be needed to find safety plan coping strategies that are perceived as useful.

Suicide ideation, attempts and deaths in people living with dementia (PLWD): A systematic review and meta‐analysis of prevalence and risk factors

AbstractBackgroundSuicide is a major public health concern. However, little is known about whether dementia is associated with suicide outcomes, and if so what the risk factors for suicide are in this group. This study aimed to conduct meta‐analyses to examine pooled associations between dementia and suicide outcomes (ideation, attempts, death by suicide) as well as pooled associations between risk factors (sex, dementia subtype) and suicidality in people living with dementia (PLWD).MethodSystematic searches were conducted in Medline, Embase, Psycinfo, Cinahl Plus, and Web of Science for keywords related to dementia and suicide. Quantitative studies with a sample of PLWD and suicidality as an outcome and that were available in English were included. Experimental studies, case reports and studies with a focus on euthanasia/assisted suicide, or self‐harm without suicidal intentionality were excluded. Relevant effect sizes were extracted and inverse variance weighted meta‐analyses were run using a random‐effects model.Result55 studies were included. Meta analyses showed that compared to people without dementia, having dementia was significantly associated with death by suicide (OR = 2.48, 95% CI:1.82;3.38), and suicidal ideation (OR = 2.29, 95% CI:1.75‐2.99), but not suicide attempts. Men with dementia were more at risk of attempting (OR = 1.28, 95% CI:1.25;1.31) and death by suicide (OR = 2.84, 95% CI:1.51;5.37) than women with dementia, but there was no difference in suicidal ideation. Compared with Alzheimer’s disease, people with vascular dementia (VaD), frontotemporal dementia (FTD), and other dementia (OD) types were significantly more likely to attempt suicide. People with Lewy body dementia (LBD) were significantly more likely to report suicidal ideation.ConclusionPLWD are at higher risk of suicidal ideation and death by suicide than those without dementia, but not suicide attempts. This could suggest that PLWD are not more likely to attempt suicide but are more likely to be successful when an attempt is made. Key risk factors for suicide attempts amongst PLWD are being male, sub‐type of dementia diagnosis (VaD, FTD and OD), while having a diagnosis of LBD is a risk factor for suicidal ideation. These results are important for understanding and managing risk in PLWD.

Factors Influencing Suicidal Ideation in Korean Female Adolescents with Sexual Intercourse Experience.

Suicide rate in South Korea is the highest among Organization for Economic Cooperation and Development countries. Particularly it is a major public health concern among adolescents. We investigated the factors affecting suicidal ideation among female Korean adolescents who had experienced sexual intercourse. This study was a secondary data analysis using the 18th Korea Youth Risk Behavior Survey, conducted using a complex sampling design in 2022. A complex sample multiple logistic regression was performed to analyze data of 1,166 female students who had experienced sexual intercourse. Among the general characteristics, significant differences in suicidal ideation depending on grade, household income, living with family, academic achievement, and allergic dermatitis were observed (P<0.05). Additionally, the factors significantly associated with suicidal ideation were contraceptive use, mental health (generalized anxiety disorder, depressive symptoms, loneliness, and stress), current smoking, drinking, insufficient sleep, and insufficient breakfast consumption (P<0.05). Multiple logistic regression analysis revealed that the factors affecting suicidal ideation were generalized anxiety disorder, perceived stress, loneliness, depressive symptom, and smartphone addiction. For female adolescents with sexual experience, negative mental health and smartphone addiction needed to be managed to reduce suicidal ideation.

GENDER DISPARITIES IN SUICIDAL IDEATION AMONG UNIVERSITY STUDENTS: A QUANTITATIVE STUDY

This study investigated gender-based differences in suicidal ideation among Koya University students. A total of 209 students participated in the study, comprising 104 females and 105 males. A scale for suicidal ideation was adopted to answer the research questions. The research was conducted using a quantitative survey design, and a non-random sampling technique (convenience sampling) was employed to collect the sample. The results indicated a statistically significant difference between males and females regarding suicidal ideation, with a higher prevalence among female students. These findings provide important insights into the issue of suicide among university students in the Kurdistan Region of Iraq.

Sex Differences in Suicidal Ideation: Mediating Effects of Alcohol Abuse/Dependence on Suicidal Ideation through Psychological Distress and Hopelessness.

This article aims to investigate the impact of psychological distress and hopelessness as mediators in the relationship between alcohol use disorder (AUD) and suicidal ideation among young adults. The study employed data from the 2019 National Survey on Drug Use and Health, focusing on participants aged 18 to 25. The PROCESS macro was used to conduct a moderated mediation analysis. The findings revealed that AUD, psychological distress, and hopelessness were all significant risk factors for suicidal ideation among young adults. Furthermore, psychological distress and hopelessness served as significant mediators in the relationship between AUD and suicidal ideation. The study highlights the need for interventions and treatments that address co-occurring alcohol use and psychological distress/hopelessness in both sexes, for young adults at risk of suicide. In summary, the study underscores the importance of recognizing the underlying factors that contribute to suicidal ideation among young adults, especially those with AUD, psychological distress, and hopelessness.

A national examination of suicidal ideation, planning, and attempts among United States adults: Differences by military veteran status, 2008–2019

There is a widening disparity in suicide deaths between United States (U.S.) military veterans and nonveterans. However, it is unclear if there are similar differences in suicidal ideation, planning, and attempts that often precipitate these deaths. A better understanding of trends in suicidal thoughts and behaviors could illuminate opportunities for prevention. We examined pooled cross-sectional data (N = 479,801 adults) from the 2008 to 2019 National Survey on Drug Use and Health. We examined differences in past-year suicidal ideation, suicide planning, and suicide attempts between U.S. veterans (n = 26,508) and nonveterans (n = 453,293). We conducted post hoc analyses to examine for differences in these relationships by race/ethnicity and sex. Lastly, we examined trends in these outcomes over time and tested for differences in trends by veteran status. Overall, veterans had significantly greater odds of past-year suicidal ideation (aOR = 1.33, 95% CI 1.20 to 1.47) and suicide planning (aOR = 1.52, 95% CI 1.30 to 1.78) compared to nonveterans. However, the association between veteran status and past-year suicide attempt was not statistically significant (aOR = 1.29, 95% CI 1.00 to 1.68). These relationships did not differ by race/ethnicity or sex (ps > 0.05). Among all adults, there were significant linear increases in past-year suicidal ideation, planning, and attempts (ps < 0.001). However, these trends did not differ between veterans and nonveterans (ps > 0.05). Veterans may be more likely to experience suicidal thoughts and behaviors than nonveteran adults. Upward trends in suicidal thoughts and behaviors among both veterans and nonveterans from 2008 to 2019 highlight opportunities for intervention.

Comparison of Suicidal Ideation and Depressive Symptoms Between Medical and Pharmacy Students

Objective. The purpose of the study was to compare suicidal ideation among medical and pharmacy students and characterize related symptoms.Methods. The authors conducted a cross-sectional, retrospective study to compare suicidal ideation among medical and pharmacy students at a single public university during 2009 to 2020. Respondents' voluntary and anonymous responses to the Interactive Screening Program (ISP) Stress and Depression Questionnaire are reported.Results. The authors analyzed responses from 619 medical and 214 pharmacy students collected over 11 academic years. There was no significant difference between medical and pharmacy students who endorsed suicidal ideation (13.5% vs 17.3%, respectively). The Patient Health Questionnaire-9 (PHQ-9) scores were significantly different between medical and pharmacy students, with more pharmacy students reporting moderate to severe depression (24.3% for medical vs 35.1% for pharmacy). Compared to medical students, more pharmacy students also endorsed anhedonia, a reduced capacity for pleasure (13.4% vs 24.3%, respectively), sleep problems (29.6% vs 42.6%, respectively), and fatigue (46% vs 64.4%, respectively). Pharmacy students also reported more intense affective states such as "feeling your life is too stressful" and "feeling intensely anxious or having anxiety attacks." Relationships and physical/mental health/substance abuse were common themes that emerged from the qualitative data.Conclusion. While there was no significant difference in suicidal ideation between pharmacy and medical students, the prevalence is alarming compared to the general population. More pharmacy students endorsed symptoms of depression and intense affective states that could impair functioning. Future studies may focus on mitigation strategies for suicidal ideation among health professions students.

Mental Health Outcomes Among American Indian and Alaska Native U.S. Army Soldiers: A Serial Cross-Sectional Analysis.

American Indian and Alaska Native (AI/AN) individuals in the USA experience higher rates of mental illness and preventable death than the general population. Published research demonstrates that AI/AN veterans experience similar disparities to other minorities compared to non-minority veterans; few studies, however, have assessed mental health outcomes in AI/AN active duty military members. The objective of this study was to determine differences in depression, anxiety, hazardous alcohol consumption, and suicidal ideation among AI/AN soldiers compared to soldiers of other races during the Coronavirus Disease 2019 (COVID-19) pandemic. We conducted repeated cross-sectional electronic surveys to assess the mental health of active duty and activated reserve U.S. Army soldiers within three commands in the Northwestern Continental United States , Republic of Korea, and Germany during May-June 2020 (T1) and December 2020-January 2021 (T2). The primary exposure of interest in the present analysis was race and ethnicity, and the primary outcomes were probable depression with functional impairment (subsequently "depression"), probable anxiety with functional impairment (subsequently "anxiety"), hazardous alcohol use, and suicidal ideation. Multivariable logistic regression models were used to determine the association between demographics and COVID-19 concerns on mental health outcomes for each time point. A total of 21,293 participants responded to the survey at T1 (participation rate = 28.0%), and 10,861 participants responded to the survey at T2 (participation rate = 14.7%). In the multivariable model, AI/AN participants had 1.36 higher adjusted odds of suicidal ideation (95% CI: 1.02-1.82) at T1 and 1.50 greater adjusted odds of suicidal ideation at T2 (95% CI: 1.00-2.24), when compared to non-Hispanic White participants. During T1, there was no significant difference detected between AI/AN and non-Hispanic White participants for anxiety (adjusted odds ratio: 1.21; 95% CI: 0.91-1.60) (TableIV). However, AI/AN participants had 1.82 greater adjusted odds of anxiety when compared to non-Hispanic White participants at T2 (adjusted odds ratio: 1.82; 95% CI: 1.29-2.57). There were no significant differences detected between AI/AN participants and non-Hispanic White participants in multivariable models for either depression or hazardous alcohol use at both time points. Although we hypothesized that all adverse mental health outcomes would be higher for AI/AN service members at both time points, there were no significant differences at each of the time points analyzed for most of the outcomes analyzed. However, differences in suicidal ideation were found at both time points. Analyses and proposed interventions should account for diversity and heterogeneity of AI/AN populations.

Bariatric Surgery and Suicide Risk in Patients With Obesity.

In a large multisite cohort of Veterans who underwent Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy, we compared the 5-year suicidal ideation and attempt rates with matched nonsurgical controls. Bariatric surgery has significant health benefits but has also been associated with adverse mental health outcomes. Five-year rates of suicidal ideation and suicide attempts of Veterans who underwent Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy from the fiscal year 2000-2016 to matched nonsurgical controls using sequential stratification using cumulative incidence functions (ideation cohort: n=38,199; attempt cohort: n=38,661 after excluding patients with past-year outcome events). Adjusted differences in suicidal ideation and suicide attempts were estimated using a Cox regression with a robust sandwich variance estimator. In the matched cohorts for suicidal ideation analyses, the mean age was 53.47 years and the majority were males (78.7%) and White (77.7%). Over 40% were treated for depression (41.8%), had a nonrecent depression diagnosis (40.9%), and 4.1% had past suicidal ideation or suicide attempts >1 year before index. Characteristics of the suicide attempt cohort were similar. Regression results found that risk of suicidal ideation was significantly higher for surgical patients (adjusted hazard ratio=1.21, 95% CI: 1.03-1.41), as was risk of suicide attempt (adjusted hazard ratio=1.62, 95% CI: 1.22-2.15). Bariatric surgery appears to be associated with a greater risk of suicidal ideation and attempts than nonsurgical treatment of patients with severe obesity, suggesting that patients need careful monitoring for suicidal ideation and additional psychological support after bariatric surgery.

Gender Differences in Suicide Ideation

Objectives: The purpose of this study is to examine suicide ideation among adults in Korea and to identify variables affecting the ideation. Methods: Data for the study were taken from the 2018 Korean General Social Survey which collected them from a national sample of 1,031 adults aged 18 and up who lived in households in Korea using face-to-face interviews with a structured questionnaire. The data were analyzed with descriptive statistics, bivariate analysis and logistic regression analysis. Results: The rate of suicide ideation is 12.7%. Although the rates of the suicide ideation are not significantly different between males and females, the variables affecting the suicide ideation are very different for males and females. Among the variables, health condition is the most important predictor of suicide ideation. Conclusions: Policies and programs for the prevention of suicide need to develop with consideration the different characteristics between males and females in suicide ideation.

Association of suicidal ideation and depression with the use of proton pump inhibitors in adults: a cross-sectional study

Proton pump inhibitors (PPIs) were found to be associated with depression. This study aimed to find the cross-sectional association between recent PPI use and suicidal ideation. Item 9 of Patient Health Questionnaire-9 (PHQ-9) of the US National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018 was used to categorize whether or not the participants had suicidal ideation. The secondary outcome of this study was depression and the scores of the PHQ-9 were used as the depression diagnostic instrument. The study population included 16,881 participants who were over 20 years old. The bivariate Rao-Scott χ2 test showed a significant association between PPI use and suicidal ideation (P < 0.001) and a stronger association was observed between PPIs and depression (P < 0.001). Multiple logistic regression analysis of the education, gender, race and age-adjusted model revealed that the PPI users had a 2.34 (95% CI 1.66–3.31) greater risk of having suicidal ideation than the non-PPI users. Middle-aged participants (40–49 years) showed the greatest number of differences in suicidal ideation between PPI and non-PPI users (P < 0.001). Future research should continue to consider the psychiatric effects of taking PPIs.

Gender differences in suicidal ideation, suicide attempts, and suicide death among people living with HIV: A systematic review and meta-analysis.

Although excess mortality, especially suicide, is a critical trait in people living with HIV, consensus about gender differences in these areas is lacking. We conducted meta-analyses to examine gender differences in suicidal ideation, suicide attempts, and suicide death among people living with HIV. We systematically searched PubMed and Web of Science for studies written in English. In this review, suicide among people living with HIV includes suicide death, suicidal ideation, and suicide attempts. Studies reporting the suicide prevalence among males and females living with HIV were eligible for inclusion in our review. Odds ratios (ORs) and 95% confidence intervals (CIs) served as the effect size index. Fixed-effects or random-effects meta-analyses were chosen based on the size of the heterogeneity. A total of 27 studies comprising 801 017 participants from 11 countries were included in the meta-analysis. The overall prevalence of suicidal ideation was 18.0% (95% CI 13.3%-22.8%) in males and 20.8% (95% CI 16.4%-25.1%) in females, and there was a statistically significant higher risk of suicidal ideation in females living with HIV (OR1.30; 95% CI1.09-1.56; p < 0.05). The overall prevalence of suicide attempts was 16.8% (95% CI9.0%-24.5%) in males and 24.7% (95% CI 12.4%-37.1%) in females, and there was a statistically significant higher risk of suicide attempts in females living with HIV (OR1.34; 95% CI1.02-1.75; p < 0.05). The pooled prevalence of suicide death was 1.2% (95% CI0.5%-1.9%) among males and 0.2% (95% CI0.1%-0.3%) among females, and the risk of suicide death between genders was not statistically significant (OR0.78; 95% CI0.50-1.24; p=0.298). There were gender differences in suicidal ideation and suicide attempts among people living with HIV. Females living with HIV were more likely to experience suicidal ideation and make suicide attempts, but there were no statistically significant gender differences in suicide death. Appropriate initiatives to optimize the recognition, treatment, and management suicide behaviours of males and females living with HIV may narrow this gender gap.

Substance use, racial/ethnic identity, and suicidal ideation during COVID-19 lockdown in an international adult sample

Although research has examined disparities in suicidal ideation across multiple groups, few investigations have analyzed such disparities in the context of COVID-19 pandemic. Furthermore, there is limited research on differences within and across countries, further limiting the extent to which meaningful comparisons can be made. Therefore, this study examines risk and protective factors of suicidal ideation during COVID-19 lockdown in adults across five countries. Adults (N = 2,509) from the United States, Italy, Spain, Saudi Arabia, and India completed a survey to measure suicidal ideation, recent drug use, and sociodemographic factors. Prevalence of suicidal ideation was assessed using simple and multivariable logistic regression models, and severity of suicidal ideation was analyzed via a multinomial multivariable logistic regression. Cohen's d statistics were reported for all analyses to report effect size. In the United States subsample, racial/ethnic minorities endorsed a significantly greater prevalence of suicidal ideation compared to their White peers (aOR = 2.31, 95% CI: 1.26–4.27, d = 0.46). However, no significant racial differences in suicidal ideation were found in other countries. Past 90-day illicit drug use was associated with greater prevalence (aOR = 1.38, 95% CI: 1.06–1.80, d = 0.18) and severity (aRRR = 2.17, 95% CI: 1.33–3.53, (aRRR = 0.43) of suicidal ideation during COVID-19 lockdown. This study further highlights the social disparities that exist in suicidal ideation during COVID-19 lockdown in international samples, for which greater medical and mental health interventions are critical. As such, targeted multicomponent interventions that address substance use are important for reducing the rising prevalence and severity of COVID-related suicidal ideation.

Analysis of suicide ideation and its influencing factors among nursing staff of different grades in different hospitals during their career

Objective: To analyze the prevalence and related factors of suicide ideation among nurses in different levels of hospitals in Shandong Province, and to analyze the relationship between them. Methods: From June to July 2020, 1644 nurses in Shandong Province were surveyed by multi-stage stratified cluster sampling. The suicidal ideation of nurses was investigated by suicidal ideation screening. Social support and mental health were measured by the perceived social support scale (pass) and kessler10 scale respectively. The simple coping style scale (SCSQ) was used to evaluate the coping styles of the subjects when they encountered problems. Logistic regression was used to analyze the influencing factors of suicidal ideation, Amos software was used to establish the path model of suicidal ideation related factors, and the maximum likelihood estimation was used to test the path model coefficient. Results: The incidence of suicidal ideation among nurses in secondary hospitals during their career was 8.44%, and that in tertiary hospitals was 11.66%. There was no significant difference in suicidal ideation among nurses at all levels in secondary hospitals (P>0.05) . The main factors related to suicidal ideation were unmarried and others (OR=0.362, 95%CI=0.155, 0.844, P=0.019) , social support (OR=1.084, 95% CI=1.059, 1.109, P=0.000) and mental health status (OR=0.921, 95% CI=0.890, 0.953, P=0.000) . The suicide ideation of skilled nurses in tertiary hospitals was higher than that of other levels (P<0.05) . The related factors of suicide ideation mainly included unmarried and others (OR=0.369, 95% CI=0.214, 0.636, P=0.000) , night shift (OR=1.889, 95%CI=10.57, 3.377, P=0.032) , general self-rated social status (OR=2.377, 95%CI=1.031, 5.483, P=0.042) , physical disease (OR=2.747, 95%CI=1.601, 4.714) , P=0.000) , Social support (OR=0.960, 95%CI=1.042, 1.077, P=0.000) and mental health status (OR=0.942, 95%CI=0.922, 0.963, P=0.000) . Social support and mental health have a direct effect on suicidal ideation. Self-assessment of social status, social support and physical disease can affect suicidal ideation by affecting mental health. Conclusion: It is necessary to pay more attention to the mental health status of nurses at different levels in different hospitals during their career, improve their social support level, and improve their cognition of the practice environment.