Family History Of Suicidal Behavior Research Articles

A Risk Calculator to Predict Suicide Attempts Among Individuals With Early-Onset Bipolar Disorder.

To build a one-year risk calculator (RC) to predict individualized risk for suicide attempt in early-onset bipolar disorder. Youth numbering 394 with bipolar disorder who completed ≥2 follow-up assessments (median follow-up length = 13.1 years) in the longitudinal Course and Outcome of Bipolar Youth (COBY) study were included. Suicide attempt over follow-up was assessed via the A-LIFE Self-Injurious/Suicidal Behavior scale. Predictors from the literature on suicidal behavior in bipolar disorder that are readily assessed in clinical practice were selected and trichotomized as appropriate (presence past 6 months/lifetime history only/no lifetime history). The RC was trained via boosted multinomial classification trees; predictions were calibrated via Platt scaling. Half of the sample was used to train, and the other half to independently test the RC. There were 249 suicide attempts among 106 individuals. Ten predictors accounted for >90% of the cross-validated relative influence in the model (AUC = 0.82; in order of relative influence): (1) age of mood disorder onset; (2) non-suicidal self-injurious behavior (trichotomized); (3) current age; (4) psychosis (trichotomized); (5) socioeconomic status; (6) most severe depressive symptoms in past 6 months (trichotomized none/subthreshold/threshold); (7) history of suicide attempt (trichotomized); (8) family history of suicidal behavior; (9) substance use disorder (trichotomized); (10) lifetime history of physical/sexual abuse. For all trichotomized variables, presence in the past 6 months reliably predicted higher risk than lifetime history. This RC holds promise as a clinical and research tool for prospective identification of individualized high-risk periods for suicide attempt in early-onset bipolar disorder.Reprinted from Bipolar Disord 2022; 24:749-757, with permission from John Wiley and Sons. Copyright © 2022.

Psychosocial Factors, Pro-Inflammatory Markers & Serum Lipids among Patients with Suicidal Ideation & Suicidal Attempts

Background: Suicide is a worldwide serious problem. It is a leading cause of death, accounting for 1.3% of all deaths worldwide in 2019 and Approximately 703,000 people die by suicide every year. We aimed to study the personal, cognitive, psychosocial, personality traits, psychopathological, pro-inflammatory markers & serum lipids differences between patients with suicidal ideation and patients with suicidal attempts and to assess predictor factors that make suicidal ideation convert to suicidal attempt.
 Subjects and Methods: This cross-sectional case control study was carried on participant aged 18 – 50 years, both sexes. Suicidal behavior of the study sample was assessed using Beck Scale for Suicidal Ideation (BSSI) & participants were classified into three equal groups according to their score in BSSI and their history of recent suicidal attempt (suicidal ideation group, suicidal attempt group & control group). Participants’ sociodemographic data were evaluated by a questionnaire designed by the researcher and reviewed by experts. Psychiatric assessment was done using the Mini-International Neuropsychiatric Interview (MINI). Socioeconomic status & cognitive functions were assessed by the socioeconomic status scale for health research in Egypt & the Montreal Cognitive Assessment (MoCA) test, respectively. Personality was assessed by short form of EPQ-R (Revised Eysenck Personality Questionnaire). Assessment of impulsivity & stress were done by using the Barratt Impulsiveness Scale (BIS-11) & the Hassles and Uplifts Scale (HUS), respectively. Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) & the Positive and Negative Syndrome Scale (PANSS) were applied to determine the symptom severity in those diagnosed with depressive, anxiety & psychotic disorders.
 Results: Suicidal ideations & attempts were more common among psychiatric patients especially those suffering from depression. Suicidal behavior was associated with increased severity of depressive & anxiety symptoms. The most common method of suicidal attempts among females was drug overdose, while males used self-poisoning as the most popular method in attempting suicide. Risk of suicidal ideation & attempts increased in the following situations: younger age groups especially below 35 years, female gender, substance abuse, low socioeconomic level, past history & family history of suicidal behavior, neuroticism, psychoticism & introversion personality traits, impulsivity, high daily stress levels, increase in the severity of depressive & anxiety disorders, elevated [ESR, Hs-CRP & IL-6], lowered [total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) & triglycerides (TG)]. The following factors protected from suicidal behaviors: marriage, work and having jobs, Family and social support, playing sports, having hobbies & higher socioeconomic levels.
 Risk factors for transition of participants from suicidal ideation to suicidal attempt included female gender, being unmarried & unemployed, low socioeconomic level, poor social support, past history of suicidal behavior, neuroticism personality traits, impulsivity, high stress levels, depressive disorders, elevated [Hs-CRP & IL-6], and low [TC, LDL & TG]. Protective factors against transition from suicidal ideation to attempt included playing sports & extraversion personality traits.
 Conclusion: The problem of suicide is a frequent and a multifaceted problem among the general population.

The role of substance use disorders in the transition from suicide attempt to suicide death: a record linkage study of a Swedish cohort.

Suicidal behavior and substance use disorders (SUDs) are important public health concerns. Prior suicide attempts and SUDs are two of the most consistent predictors of suicide death, and clarifying the role of SUDs in the transition from suicide attempt to suicide death could inform prevention efforts. We used national Swedish registry data to identify individuals born 1960-1985, with an index suicide attempt in 1997-2017 (N = 74 873; 46.7% female). We assessed risk of suicide death as a function of registration for a range of individual SUDs. We further examined whether the impact of SUDs varied as a function of (i) aggregate genetic liability to suicidal behavior, or (ii) age at index suicide attempt. In univariate models, risk of suicide death was higher among individuals with any SUD registration [hazard ratios (HRs) = 2.68-3.86]. In multivariate models, effects of specific SUDs were attenuated, but remained elevated for AUD (HR = 1.86 95% confidence intervals 1.68-2.05), opiates [HR = 1.58 (1.37-1.82)], sedatives [HR = 1.93 (1.70-2.18)], and multiple substances [HR = 2.09 (1.86-2.35)]. In secondary analyses, the effects of most, but not all, SUD were exacerbated by higher levels of genetic liability to suicide death, and among individuals who were younger at their index suicide attempt. In the presence of a strong predictor of suicide death - a prior attempt - substantial predictive power is still attributable to SUDs. Individuals with SUDs may warrant additional suicide screening and prevention efforts, particularly in the context of a family history of suicidal behavior or early onset of suicide attempt.

A risk calculator to predict suicide attempts among individuals with early-onset bipolar disorder.

To build a one-year risk calculator (RC) to predict individualized risk for suicide attempt in early-onset bipolar disorder. Youth numbering 394 with bipolar disorder who completed ≥2 follow-up assessments (median follow-up length=13.1 years) in the longitudinal Course and Outcome of Bipolar Youth (COBY) study were included. Suicide attempt over follow-up was assessed via the A-LIFE Self-Injurious/Suicidal Behavior scale. Predictors from the literature on suicidal behavior in bipolar disorder that are readily assessed in clinical practice were selected and trichotomized as appropriate (presence past 6months/lifetime history only/no lifetime history). The RC was trained via boosted multinomial classification trees; predictions were calibrated via Platt scaling. Half of the sample was used to train, and the other half to independently test the RC. There were 249 suicide attempts among 106 individuals. Ten predictors accounted for >90% of the cross-validated relative influence in the model (AUC=0.82; in order of relative influence): (1) age of mood disorder onset; (2) non-suicidal self-injurious behavior (trichotomized); (3) current age; (4) psychosis (trichotomized); (5) socioeconomic status; (6) most severe depressive symptoms in past 6months (trichotomized none/subthreshold/threshold); (7) history of suicide attempt (trichotomized); (8) family history of suicidal behavior; (9) substance use disorder (trichotomized); (10) lifetime history of physical/sexual abuse. For all trichotomized variables, presence in the past 6months reliably predicted higher risk than lifetime history. This RC holds promise as a clinical and research tool for prospective identification of individualized high-risk periods for suicide attempt in early-onset bipolar disorder.

A specific “at risk” profile related to recent stressful life events in euthymic major depressive disorder

IntroductionStressful life events (SLE) may influence the illness course and outcome.ObjectivesThe present study aimed to characterize socio-demographic and clinical characteristics of euthymic major depressive disorder (MDD) outpatients with SLE relative to those without.MethodsThis sample included 628 (mean age=55.1 ± 16.1) currently euthymic MDD outpatients, among them 250 (39.8%) reported SLE and 378 (60.2%) did not.ResultsAfter univariate analyses, outpatients with SLE were most frequently widowed and lived predominantly with friends/others. Furthermore, compared to outpatients without SLE, those with SLE were more likely to have a family history of suicidal behavior, manifested melancholic characteristics and higher Coping Orientation to the Problems Experienced (COPE) positive reinterpretation/growth and less likely to manifest a comorbid panic disorder, residual interepisodic symptoms, have used psychiatric medications, and use current antidepressant medications. After regression analyses, having a family history of suicide (OR=9.697; p=≤.05), history of psychotropic medications use (OR=2.888; p=≤.05), and reduced use of antidepressants (OR=.321; p=.001) were significantly associated with SLE. Mediation analyses demonstrated that the association between current use of antidepressants and SLE was mediated by previous psychiatric medications.ConclusionsHaving a family history of suicide, history of psychotropic medications use, and reduced use of antidepressants may confer a specific “at risk” profile related to the enhanced vulnerability to experience SLE.DisclosureNo significant relationships.

Prevalence and correlates of suicidal behaviour in adolescents with bipolar disorder

ObjectiveTo examine the prevalence and correlates of suicidal behavior among adolescents with bipolar disorder (BD).Methods47 adolescents, ages 12 to 19 years (15.8 ± 2), meeting DSM-5 criteria for BD-I (n=40) and BD-II (n=7) were assessed using the KSADS-PL and tested with a battery of tests measuring mood, psychotic symptoms, life events and functioning. History of suicidal attempts (SA) was ascertained using the K-SADS-PL.Results: One third (n=15, 32%) of the BD sample had a lifetime history of SA. There were no differences in socio-demographics factors between SA versus non- SA. BD adolescents with lifetime SA, were more likely to have lower weight at birth, a lifetime history of comorbid eating disorder, non-suicidal self-injurious behavior, 2nd degree family history of suicide attempt, and more stressful life events as compared with non-attempters. Adolescents with lifetime history of SA also showed statistically significant higher scores in depression, suicidal ideation and anxiety as compared with BD adolescents without lifetime SA. Logistic regression analysis found that the most robust correlates of SA in adolescents with BD were having 2nd degree family history of SA, the interaction of self-injury behavior and comorbid eating disorder and increased number of life events. Limitations: Retrospective data. Small sample size. Since this is a cross-sectional study, no inferences regarding causality can be made. Conclusion: One third of the adolescents with BD have attempted suicide. These results are in agreement with previous studies. History of SA in adolescents with BD is strongly associated with family history of suicidal behavior, lifetime self-injury behavior with comorbid eating disorder and increased number of stressful life events.DisclosureNo significant relationships.

Factors associated with same-sex experience in people with non-psychotic mental disorders and suicidal ideation

IntroductionPeople with mental disorders who had same-sex experience (SSE) are at increased risk of self-injurious behavior probably due to the double stigma phenomenon, which severity varies in different societies. So far, there is a knowledge gap on factors associated with SSE in Russian psychiatric patients.ObjectivesWe aimed to investigate variables associated with homosexual experience in Russian patients with non-psychotic mental disorders (NPMD) and suicidal ideation (SI).MethodsIn a case-control study (1:1.5): 92 female patients with NPMD and SI with lifetime SSE were compared with 138 patients without homosexual experience. All patients underwent a psychiatric examination, Self-Injurious Thoughts and Behaviors Interview (Nock MK, 2007) and semi-structured interview to assess demographic, clinical, and behavioral features. Mann-Whitney, Fishers exact test and Pearson’s chi-squared were used as statistical methods.ResultsGroups did not differ in education level, marital status, family history of suicidal behavior, traumatic events exposure and lifetime eating disorders (all:p>0.05). More patients with SSE had family history of non-suicidal self-injuries (NSSI), were dissatisfied with their parenting style, had a higher number of unprotected sexual contacts with unfamiliar persons, practiced group sex, had a history of sexual abuse, illicit drug use experience, were smokers, had piercing and severe body modifications. Lifetime history of suicide plan, attempts and NSSI were significantly more common in people with SSE (all:<0.05).ConclusionsA number of suicide risk factors were found to be more prevalent in people with SSE. Homosexual experience in people with mental disorders is associated with an increased risk of NSSI, suicide plan development and suicide attempts.DisclosureNo significant relationships.

Examining the temporal stability of suicide capability among undergraduates: A latent growth analysis

BackgroundRelatively few studies test the interpersonal psychological theory's monotonicity hypothesis. The monotonicity hypothesis proposes that suicide capability (i.e., fearlessness about death and pain tolerance) is stable or increases linearly with exposure to painful and provocative events. Research is conflicted, suggesting that suicide capability is static, decreases, or increases and returns to baseline. The current study thus tested this hypothesis in a sample of college students with histories of suicidal ideation. We hypothesized a stable and an increasing trajectory. MethodsParticipants were 206 undergraduates; primarily women (73%), on average 19.05 years old, heterosexual (85%), and first-years (69%). Participants completed a baseline battery of questionnaires on suicide risk factors and daily diaries on suicide capability and suicidal ideation for 90 days (n = 7,342 surveys, 40% compliance rate). Group-based trajectory analyses were conducted with the SAS macro PROC TRAJ. ResultsModeling revealed a three group quadratic model. Low (27.7%), Moderate (41.3%), and High (31.1%) suicide capability groups remained static over time. Baseline suicidal ideation, but not history of suicide attempts or family history of suicidal behavior, distinguished groups; participants with suicidal ideation at baseline were less likely to be in the low suicide capability group. LimitationsBrief, dichotomized assessments, and a high attrition rate. ConclusionsThese data showed temporal stability of suicide capability and suggest that the “acquired” component of capability may be overemphasized. Clarifying the stability and modifiability of suicide capability will enable empirically-based applications of the theory to suicide prevention.

Recent Stressful Life Events in Euthymic Major Depressive Disorder Patients: Sociodemographic and Clinical Characteristics.

BackgroundStressful life events (SLE) may influence the illness course and outcome. This study aimed to characterize socio-demographic and clinical features of euthymic major depressive disorder (MDD) outpatients with SLE compared with those without.MethodsThe present sample included 628 (mean age=55.1 ± 16.1) currently euthymic MDD outpatients of whom 250 (39.8%) reported SLE and 378 (60.2%) did not.ResultsAfter univariate analyses, outpatients with SLE were most frequently widowed and lived predominantly with friends/others. Moreover, relative to outpatients without SLE, those with SLE were more likely to have a family history of suicidal behavior, manifested melancholic features, report a higher Coping Orientation to the Problems Experienced (COPE) positive reinterpretation/growth and less likely to have a comorbid panic disorder, residual interepisodic symptoms, use previous psychiatric medications, and currently use of antidepressants. Having a family history of suicide (OR=9.697; p=≤.05), history of psychotropic medications use (OR=2.888; p=≤.05), and reduced use of antidepressants (OR=.321; p=.001) were significantly associated with SLE after regression analyses. Mediation analyses showed that the association between current use of antidepressants and SLE was mediated by previous psychiatric medications.ConclusionHaving a family history of suicide, history of psychotropic medications use, and reduced use of antidepressants is linked to a specific “at risk” profile characterized by the enhanced vulnerability to experience SLE.

The Role of Personal Factors and Learning Environment in Suicidal Ideation Among Tunisian Medical Students.

Objective: Little is known about specific professional factors influencing medical students' suicidal ideation and behavior. We aimed to evaluate the prevalence and correlates of suicidal ideation in Tunisian medical students. Method: This was a cross-sectional study; 390 second-cycle medical students were enrolled at the Faculty of Medicine of Tunis. Participants responded to an anonymous questionnaire containing sociodemographic data, educational factors, the Suicidal Ideation Questionnaire (SIQ), and the Depression, Anxiety and Stress scales (DASS-21). Results: Eleven students (2.8%) had made one or more suicide attempts in their lifetime. For a threshold value of 41 based on the SIQ scale, 7.9% of students were considered to have a potential risk of suicide. The multiple hierarchical linear regression analysis identified as main factors independently associated with suicidal ideation: tobacco consumption, perceived sleep quality, depression symptoms, the personal historyofsuicide attempt, the satisfaction with student-supervisor relationship, and choosingto study medicine. Conclusion: Suicide prevention efforts should target high-risk students with prior personal or family history of suicidal behavior. Moreover, medical school authorities should put in place effective strategies to optimize the learning environment at their institutions.

Differential Impact of Child Sexual Abuse and Family History of Suicidal Behavior in High-Risk Suicidal Patients

The current study aimed to compare suicide-related variables as a function of 1) family history of suicidal behavior and 2) child sexual abuse among patients hospitalized for a suicide attempt or active suicidal ideation. Family history of suicidal behavior and child sexual abuse were examined independently and in combination as a diathesis for a high-risk suicidal phenotype. A multicenter cross-sectional study was designed to compare data obtained from 292 patients hospitalized for suicidal behavior. Demographic and clinical variables were compared among Group 1 (patients who reported both family history of suicidal behavior and child sexual abuse), Group 2 (patients who reported only family history of suicidal behavior), Group 3 (patients who reported only child sexual abuse), and Group 4 (patients who did not report family history of suicidal behavior or childhood sexual abuse). A multinomial logistic regression was used to examine suicide-related variables associated with each group and to compare differences between groups. Group 1 and 3 endorsed a higher number of previous suicide attempts and were more likely to be younger at the first suicide attempt compared to Group 4. Group differences remained after adjustment in a multinomial regression model. The current findings suggest that child sexual abuse may be more strongly related to suicide risk among high risk patients than family history of suicidal behavior.

Comparison of familial and non-familial suicidal behaviors among people with major depressive disorder: Testing the discriminative predicting role of high-yield clinical variables

BackgroundSuicidal behavior in first-degree relatives of people diagnosed with major depressive disorder (MDD) increases the risk of suicidal behavior. Such an effect may be the result of genetic risk factors or environmental ones, including imitation, or both. Surprisingly few studies have examined this question and thus, there still is little known about the effect of first-degree family history of suicidal behavior on the type of suicidal behavior and profile of risk factors related to the diathesis for suicidal behavior. Even less is known about intra-familial risk transmission. MethodsPatients with MDD (n = 252) experiencing a current major depressive episode and who had a previous suicide attempt were studied. Those with and without a family history of first-degree relatives who had made a suicide attempt or died by suicide were compared across clinical and suicide-related characteristics. ResultsSuicide attempters with (FDR+, n = 59) and without a first-degree relative with suicide attempt or suicide (FDR−, n = 193) were similar in terms of type or frequency of suicide attempts, level of lifetime aggression and impulsivity, age of onset of depression and age at first suicide attempt. LimitationsCross-Sectional study. Lack of additional external validators. ConclusionsContrary to our hypothesis and the concept of “genetic anticipation”, a first-degree family history of suicide attempt or suicide in currently depressed attempters with MDD was not associated with a range of clinical and suicide-related characteristics. Longitudinal studies incorporating external validators and potential biological markers may advance this area of research.

Consultation-liaison psychiatric service utilization by suicide attempters.

Context:There is sparse Indian literature on consultation-liaison psychiatric (CLP) service utilization by suicide attempters who generally present first to the accident and emergency departments and are seen by the psychiatrist only after the initial stabilization.Aims:The aim of the study is to study the psychiatric referral, review, and psychopharmacological intervention rates among suicide attempters and to study factors associated with psychiatric referral.Settings and Design:Retrospective, medicolegal case register-based, explorative analysis of suicide attempters presents to a rural tertiary care hospital in south India.Subjects and Methods:Eight hundred and twenty-nine medicolegal case files of individuals whose diagnosis was recorded as either suicidal attempt, deliberate or intentional self-harm, and poisoning or hanging were analyzed for different variables.Statistical Analysis Used:Descriptive frequencies, Pearson's Chi-square and logistic regression analysis to know the association of psychiatric referral with different variables, were performed using the Statistical Package for the Social Sciences, version 16.Results:A little more than half of the suspected suicide attempters (51.4%) were referred for psychiatric review, and majority of those referred (93.7%) were reviewed by the psychiatrist. Psychiatric referral was significantly associated with a relatively younger age, positive past and family history of suicidal behavior, mode of attempt (pesticide poisoning and attempted hanging were more likely to be referred), and a longer duration of hospitalization.Conclusions:The low referral rate but an overwhelming review rate among those referred shows that probably referrer factors are responsible for this and so CLP for suicide attempters needs to be strengthened by sensitizing the referring doctors on the importance of the psychiatric referral and the need to avoid discharge within the first 24 h.

Assessment of suicidal behavior and factors associated with a diagnosis of prostate cancer

OBJECTIVES:To determine the incidence of suicide risk in a group of patients who have been diagnosed with localized prostate cancer (PC) and to identify the factors that affect suicidal behavior.METHODS:Patients from a tertiary care oncology center in São Paulo, Brazil participated in this study and were interviewed after being diagnosed with low-risk or intermediate-risk PC, per the D'Amico risk classification, between September 2015 and March 2016. Patients underwent suicide risk assessment sessions using the Mini International Neuropsychiatric Interview (MINI), the Hospital Anxiety and Depression Scale (HADS), and the CAGE substance abuse screening tool before they started treatment and surveillance. Psychiatric treatment history, family history of suicidal behavior, and the use of psychotropic drugs were also examined.RESULTS:The prevalence of suicide risk among 250 patients who were recently diagnosed with low-risk or intermediate-risk PC was 4.8%. According to the HADS, 10.8% and 6.8% of patients had a positive score anxiety and for depression, respectively. Alcoholism was suspected in 2.8% of the group. Suicide risk was associated with anxiety (p=0.001); depression (p=0.005); being divorced, separated, widowed, or single (p=0.045); living alone (p=0.028); and prior psychological treatment (p=0.003).CONCLUSIONS:After being diagnosed with PC, patients who display risk factors for suicide should be monitored by a mental health team.

Altered brain processing of decision-making in healthy first-degree biological relatives of suicide completers.

Suicidal behavior is heritable, with the transmission of risk being related to the transmission of vulnerability traits. Previous studies suggest that risky decision-making may be an endophenotype of suicide. Here, we aimed at investigating brain processing of decision-making in relatives of suicide completers in order to shed light on heritable mechanisms of suicidal vulnerability. Seventeen healthy first-degree biological relatives of suicide completers with no personal history of suicidal behavior, 16 relatives of depressed patients without any personal or family history of suicidal behavior, and 19 healthy controls were recruited. Functional 3 T magnetic resonance imaging scans were acquired while participants underwent the Iowa Gambling Task, an economic decision-making test. Whole-brain analyses contrasting activations during risky vs safe choices were conducted with AFNI and FSL. Individuals with a family history of suicide in comparison to control groups showed altered contrasts in left medial orbitofrontal cortex, and right dorsomedial prefrontal cortex. This pattern was different from the neural basis of familial depression. Moreover, controls in comparison to relatives showed increased contrast in several regions including the post-central gyrus, posterior cingulate and parietal cortices, and cerebellum (culmen) in familial suicide; and inferior parietal, temporal, occipital, anteromedial and dorsolateral prefrontal cortices, and cerebellum (vermis) in familial depression. These findings most likely represent a complex combination of vulnerability and protective mechanisms in relatives. They also support a significant role for deficient risk processing, and ventral and dorsal prefrontal cortex functioning in the suicidal diathesis.

Antecedents of Suicide among Youth Aged 11-15: A Multistate Mixed Methods Analysis.

Suicide is the second leading cause of death for youth aged 11to 15, taking over 5,500 lives from 2003 to 2014. Suicide among this age group is linked to risk factors such as mental health problems, family history of suicidal behavior, biological factors, family problems, and peer victimization and bullying. However, few studies have examined the frequency with which such problems occur among youth suicide decedents or the context in which decedents experience these risk factors and the complex interplay of risk that results in a decedent's decision to take his/her own life. Data from a random sample of 482 youth (ages 11-15) suicide cases captured in the National Violent Death Reporting System from 2003 to 2014 were analyzed. The sample had fewer girls than boys (31 vs. 69 %) and comprised primarily White youth (79 %), but also African Americans (13 %), Asians (4 %), and youth of other races (4 %). Narrative data from coroner/medical examiner and law enforcement investigative reports were coded and analyzed to identify common behavioral patterns that preceded suicide. Emergent themes were quantified and examined using content and constant comparative analysis. Themes regarding antecedents across multiple levels of the social ecology emerged. Relationship problems, particularly with parents, were the most common suicide antecedent. Also, a pattern demonstrating a consistent progression toward suicidal behavior emerged from the data. Narratives indicated that youth were commonly exposed to one or more problems, often resulting in feelings of loneliness and burdensomeness, which progressed toward thoughts and sometimes plans for or attempts at suicide. Continued exposure to negative experiences and thoughts/plans about suicide, and/or self-injurious acts resulted in an acquired capacity to self-harm, eventually leading to suicide. These findings provide support for theories of suicidal behavior and highlight the importance of multi-level, comprehensive interventions that address individual cognitions and build social connectedness and support, as well as prevention strategies that increase awareness of the warning signs and symptoms of suicide, particularly among family members of at-risk youth.

Differences between female suicidal patients with family history of suicide attempt and family history of completed suicide

BackgroundFamily history of suicidal behavior and suicide are both risk factors for suicide. However, the effects of family history of suicide versus suicide attempts on patient suicidal behavior remain unclear. The aim of the present study was to understand if family history of suicide as compared to family history of suicide attempts or no family history of suicidal behavior evidences different associations with suicidal behavior among psychiatric patients. MethodParticipants included 157 female patients between the ages of 18 and 65years admitted at the Dr. Braulio A. Moyano Neuropsychiatric Women's Hospital. ResultsSeventy-nine patients (50.3%) reported no family history of suicidal behavior (NFHSB), while 78 patients (49.7%) reported a family history of suicidal behavior. Specifically, 41 patients (26.1%) reported a family history of suicide attempt (FHSA) and 37 patients (23.6%) reported a family history of suicide (FHS). These groups showed significant differences between family history of psychopathology and number of previous suicide attempts. Patients with an FHSA were more likely to present with a greater number of previous suicide attempts as compared to patients with NFHSB and FHS. ConclusionThere is an association between the number of suicide attempts and family history of suicide attempts in female patients hospitalized for suicidal behavior.

Cognitive inhibition in depression and suicidal behavior: a neuroimaging study.

Cognitive inhibition deficits have previously been found in suicide attempters. This study examined the neural basis for these deficits in depressed patients with and without a history of suicidal behavior. Functional magnetic resonance imaging was used to measure brain activation during the Go/No-Go response inhibition task in 25 unmedicated and depressed middle-aged suicide attempters, 22 unmedicated depressed patient controls with no personal or family history of suicidal behavior, and 27 healthy controls. Whole-brain analyses were conducted with SPM12. Suicide attempters exhibited an elevated number of commission errors relative to both control groups. However, suicide attempters did not differ from patient controls in terms of brain activation for any contrast. Analyses showed a significant association between depression and brain activation in the left inferior frontal gyrus and medial thalamus during Go v. No-Go, and in the bilateral parietal cortex and left orbitofrontal cortex during No-Go v. baseline. These regions were correlated with psychological pain, suicidal ideation and global functioning. There was no association between brain activation and personal histories of suicidal act. Our study suggests that deficits in cognitive inhibition, in relation to the inferior frontal gyrus, thalamus, orbitofrontal cortex and parietal cortex, are related to the depressive state and not specifically to suicide vulnerability. We hypothesize that state-related deficits may add to trait-like cognitive impairments to facilitate suicidal acts. These different types of cognitive impairments may necessitate different therapeutic strategies for the prevention of suicide.

Suicide and Family Contagion

Background Suicidal behaviour is generally considered to be a multi-determined act with psychosocial, personality, family, psychiatric, biologic, genetic and psychodynamic risk factors. Recent studies have suggested that one important suicide risk factor is having a family history of suicidal behaviour and the media often report on the contagious effect of suicide. There is a need to understand the risk factors for suicide so that interventions …

Impulsive aggression, delay discounting, and adolescent suicide attempts: effects of current psychotropic medication use and family history of suicidal behavior.

Impulsive-aggressive behaviors have been consistently implicated in the phenomenology, neurobiology, and familial aggregation of suicidal behavior. The purpose of this study was to extend previous work by examining laboratory behavioral measures of delayed reward impulsivity and impulsive aggression in adolescent suicide attempters and never-suicidal comparison subjects. Using the Point Subtraction Aggression Paradigm (PSAP) and the Delay Discounting Task (DDQ), the authors examined delay discounting and impulsive aggression in 40 adolescent suicide attempters, ages 13-18, and 40 never-suicidal, demographically matched psychiatric comparison subjects. Overall, suicide attempters and comparison subjects performed similarly on the PSAP and DDQ. There was a significant group by current psychotropic medication use interaction (p=0.013) for mean aggressive responses on the PSAP. Group comparisons revealed that attempters emitted more aggressive responses per provocation than comparison subjects, only in those not on psychotropic medication (p=0.049), whereas for those currently treated with psychotropic medication, there were no group differences (p>0.05). This interaction effect was specific to current antidepressant use. Among all subjects, family history of suicidal behavior (suicide or suicide attempt) in first degree relatives was significantly correlated with both delay discounting (r=-0.22, p=0.049), and aggressive responding (r=0.27, p=0.015). Family history of suicidal behavior was associated with delay discounting, but not with aggressive responding on the PSAP, after controlling for relevant covariates. In this study, impulsive-aggressive responding was associated with suicide attempt only in those not being treated with antidepressants. Future work to replicate and extend these findings could have important therapeutic implications for the treatment of depressed suicide attempters, many of whom are affected by impulsive aggression.