Family History Of Suicide Research Articles

Pathways to suicide for children and youth in Guyana: A life charts analysis

Background: Suicide is the third leading cause of death among youth aged 15 to 29 years old globally. Guyana has the highest rate of youth suicide in the world, yet only limited research exists. Aim: The aim of this study is to identify key features of the suicide pathway for Guyanese children and youth and to distinguish meaningful subgroups. Method: The psychological autopsy (PA) method was used to generate life charts for 15 Guyanese children and youth (10–29 years) who died by suicide. Nineteen close contacts of these individuals were interviewed about the life events of the decedent between 6 months and 5 years after their death. Semi-structured interviews lasting 30 to 150 min took place between November 2021 and January 2022. The interview data were converted into life charts and these were reviewed to uncover meaningful subgroups of suicide pathways. Results: Three groups with distinct suicide pathways were identified: hard life (46%), mental illness (20%) and interpersonal stress (20%). There were also two male youths for whom the suicidal antecedents and pathways were unclear. Interpersonal stress, alcohol, exposure to suicide and family history of suicide were common factors identified across groups. Conclusions: The findings emphasise the role of both acute and protracted interpersonal stress for child and youth suicide in Guyana. The structure and dynamics of Indo-Guyanese families are discussed. Interventions recommended include enhancing child and youth community engagement, improving mental health and suicide literacy, alcohol restriction, increasing access to support services, and reducing stigma.

Unraveling the Spectrum of Deliberate Self-harm and Survivors of Suicide

Abstract Introduction: Among people who attempt suicide, some may have intent to die and some may not. At present, there are not many studies that have compared clinical profiles based on the intent of the attempt of suicide, i.e., low-intent group (deliberate self-harm [DSH]) and high-intent group (suicide survivors). Our study aims to compare the psycho-socio-demographic profile between DSH and suicide survivors. Materials and Methods: It was a cross-sectional study. A total of 100 patients were recruited for the study. The data were collected on sociodemographic variables, psychiatric disorders, suicide intent, anxiety, and depression. Grouping was done using Beck’s suicide intent as the determining dimension. The DSH and suicide survivors were defined by the psycho-socio-demographic characteristics of the patients. Results: Two groups with different traits emerged in aspects of age, gender, education, occupation, employment, residence, method of attempts, family history of suicide, physical illness, psychiatric diagnosis, well-being, hopelessness, depression, and anxiety scores, which showed statistically significant difference (P < 0.05) in the study. Conclusions: DSH and suicide survivors exhibit notable distinctions in their psycho-socio-demographic and clinical profiles.

Multidimensional analysis of heart rate variability and burden of illness in bipolar disorder

IntroductionPatients with bipolar disorder (BD) face disproportionate rates of cardiovascular disease. While several mechanisms have been proposed for this association, both are multifactorial and heterogeneous illnesses, and it is unlikely that any individual factor can account for a significant portion of their association. Potential mediators have been mostly studied in isolation even though they are interrelated. Furthermore, few studies have accounted for baseline cardiovascular functioning or burden of illness. MethodsWe sought to analyze the association between burden of illness, phase of the illness (e.g., depressive) and heart rate variability (HRV) in 48 patients diagnosed with BD using canonical correlation analysis. We hypothesized that the association between burden of illness and HRV measures would be different depending on the clinical phase (i.e., euthymia, depression or (hypo)mania). ResultsA longer duration of (hypo)manic episodes was associated with higher rates of hypertension and increased sympathetic activation, along with lower rates of migraine and family history of suicide. In the second canonical variable, a later age at onset of (hypo)manic episodes was associated with higher parasympathetic activity. LimitationsSmall sample size; while the magnitudes of correlations for these top functions were large, none of the models were statistically significant. ConclusionsThere are different dimensions to the association between burden of illness and HRV in BD. The first dimension could comprise higher sympathetic activation in the context of longer (hypo)manic episodes, with lower rates for clinical variables that have been associated with a predominant depressive polarity (e.g., family history of suicide and migraine).

Brain-derived neurotrophic factor and C-reactive protein (CRP) biomarkers in suicide attempter and non-attempter major depression disorder (MDD) patients

BackgroundIn the available literature, levels of BDNF and CRP have been reported to correlate with suicide in depressive patients but there are inconsistencies in the results. We aimed to evaluate and compare BDNF and CRP concentrations in MDD patients with(MDD + SA) and without suicide attempts (MDD-SA) and healthy controls.Methods30 (MDD + SA) patients, 30 (MDD-SA) patients, and 26 healthy controls were enrolled in the study. Age, sex, and BMI of patients were recorded. Blood sample was obtained for measurement of BDNF and CRP. Smoking and drug history, family history of suicide, and history of self-harm were also documented. Data were analyzed with SPSS version 22 and R version 4.1.1.Results86 patients in three groups were evaluated (mean age: 28.45 ± 9.27 years, 56.71% female). Baseline and demographic parameters except for self-harm (40%, 3.3%, and 0% for MDD + SA, MDD-SA, and healthy controls, respectively, p = 0.001) did not differ between groups. CRP level was not significantly different between groups. BDNF showed a significant difference between groups (17.35, 16.45, and 19.43 for three groups, respectively, p < 0.001). An increase in BDNF decreased the odds of both depression and suicide. Roc curve showed excellent power for BDNF in discriminating MDD groups With healthy group.Roc can notdicrimiate MDD + SA and MDD-SA.ConclusionIn our study, the concentration of BDNF differed significantly between depressed patients with/without suicide attempts and healthy controls which shows the association of BDNF with depression development and not suicide attempts. We could not find any association between CRP level and suicide attempt but still larger cohorts are needed for a definite conclusion.

Classification of Suicide Attempt Risk Using Environmental and Lifestyle Factors in 3 Large Youth Cohorts

Suicide is the third-leading cause of death among US adolescents. Environmental and lifestyle factors influence suicidal behavior and can inform risk classification, yet quantifying and incorporating them in risk assessment presents a significant challenge for reproducibility and clinical translation. To quantify the aggregate contribution of environmental and lifestyle factors to youth suicide attempt risk classification. This was a cohort study in 3 youth samples: 2 national longitudinal cohorts from the US and the UK and 1 clinical cohort from a tertiary pediatric US hospital. An exposome-wide association study (ExWAS) approach was used to identify risk and protective factors and compute aggregate exposomic scores. Logistic regression models were applied to test associations and model fit of exposomic scores with suicide attempts in independent data. Youth from the Adolescent Brain Cognitive Development (ABCD) study, the UK Millennium Cohort Study (MCS), and the Children's Hospital of Philadelphia emergency department (CHOP-ED) were included in the study. A single-weighted exposomic score that sums significant risk and protective environmental/lifestyle factors. Self-reported suicide attempt. A total of 40 364 youth were included in this analysis: 11 564 from the ABCD study (3 waves of assessment; mean [SD] age, 12.0 [0.7] years; 6034 male [52.2%]; 344 attempted suicide [3.0%]; 1154 environmental/lifestyle factors were included in the ABCD study), 9000 from the MCS cohort (mean [SD] age, 17.2 [0.3] years; 4593 female [51.0%]; 661 attempted suicide [7.3%]; 2864 environmental/lifestyle factors were included in the MCS cohort), and 19 800 from the CHOP-ED cohort (mean [SD] age, 15.3 [1.5] years; 12 937 female [65.3%]; 2051 attempted suicide [10.4%]; 36 environmental/lifestyle factors were included in the CHOP-ED cohort). In the ABCD discovery subsample, ExWAS identified 99 risk and protective exposures significantly associated with suicide attempt. A single weighted exposomic score that sums significant risk and protective exposures was associated with suicide attempt in an independent ABCD testing subsample (odds ratio [OR], 2.2; 95% CI, 2.0-2.6; P < .001) and explained 17.6% of the variance (based on regression pseudo-R2) in suicide attempt over and above that explained by age, sex, race, and ethnicity (2.8%) and by family history of suicide (6.3%). Findings were consistent in the MCS and CHOP-ED cohorts (explaining 22.6% and 19.3% of the variance in suicide attempt, respectively) despite clinical, demographic, and exposure differences. In all cohorts, compared with youth at the median quintile of the exposomic score, youth at the top fifth quintile were substantially more likely to have made a suicide attempt (OR, 4.3; 95% CI, 2.6-7.2 in the ABCD study; OR, 3.8; 95% CI, 2.7-5.3 in the MCS cohort; OR, 5.8; 95% CI, 4.7-7.1 in the CHOP-ED cohort). Results suggest that exposomic scores of suicide attempt provided a generalizable method for risk classification that can be applied in diverse samples from clinical or population settings.

Prevalence and Predictors of Suicidal Ideation among Adolescents

Suicides among young people continue to be a serious problem. Suicide is the second leading cause of death for children, adolescents, and young adults. The objectives of the present study were to assess the prevalence and predictors of suicidal ideation among adolescents; associate suicidal ideation among adolescents with selected socio-demographic variables and predictors. Quantitative research approach and descriptive research design was adopted for the study. The study was conducted among 250 adolescents selected through purposive sampling technique from selected Colleges, Thrissur. The tool consisted of a semi structured questionnaire to assess the socio-demographic data, Columbia Suicidal Severity Rating Scale (C-SSRS) screen version to assess the prevalence of suicidal ideation and a structured questionnaire to assess the predictors of suicidal ideation among adolescents. Reliability and validity of the tools were established. Data were collected, tabulated and analyzed using descriptive and inferential statistics. The findings of the study revealed that the prevalence rate of suicidal ideation among adolescents is 28%. The predictors such as lack of teachers support (91.4%), social media abuse (74.3%), loneliness and hopeless (72.9%) are found in most of the adolescents. A statistically significant association was found between education of father (p=0.04) and education of mother (p=0.04) with suicidal ideation among adolescents at p&lt;0.05. The predictors such as family history of suicide (p=0.00), helplessness (p=0.04) and lack of parental support (p=0.01) have a statistically significant association with suicidal ideation among adolescents. The study concluded that the prevalence rate of suicidal ideation among adolescents is significant. The early identification of the predictors can prevent the actual occurrence of suicide among adolescents.

Predictive model of suicide risk in Colombian university students: quantitative analysis of associated factors

IntroductionThe risk of suicide and completed suicides among young university students presents critical challenges to mental and public health in Colombia and worldwide. Employing a quantifiable approach to comprehend the factors associated with these challenges can aid in visualizing the path towards anticipating and controlling this phenomenon.ObjectiveDevelop a predictive model for suicidal behavior in university students, utilizing predictive analytics.MethodWe conducted an observational, retrospective, cross-sectional, and analytical research study at the University of Manizales, with a focus on predictive applicability. Data from 2,436 undergraduate students were obtained from the research initiative “Building the Future: World Mental Health Surveys International College Students.”ResultsThe top ten predictor variables that generated the highest scores (ranking coefficients) for the sum of factors were as follows: history of sexual abuse (13.21), family history of suicide (11.68), medication (8.39), type of student (7.4), origin other than Manizales (5.86), exposure to cannabis (4.27), exposure to alcohol (4.42), history of physical abuse (3.53), religiosity (2.9), and having someone in the family who makes you feel important (3.09).DiscussionSuicide involves complex factors within psychiatric, medical, and societal contexts. Integrated detection and intervention systems involving individuals, families, and governments are crucial for addressing these factors. Universities also play a role in promoting coping strategies and raising awareness of risks. The predictive accuracy of over 80% in identifying suicide risk underscores its significance.ConclusionThe risk factors related to suicidal behavior align with the findings in specialized literature and research in the field. Identifying variables with higher predictive value enables us to take appropriate actions for detecting cases and designing and implementing prevention strategies.

Suicidal ideation, attempt and associated factors among prisoners in Northwest Ethiopia: A cross-sectional study.

Suicide is a prominent source of harm and death globally, and it is the leading cause of premature death among prisoners. Therefore, the main aim of this study was to determine the prevalence and factors associated with suicidal ideation and attempt among prisoners in Northwest Ethiopia. An institution-based cross-sectional study design was performed from May 23 to June 22, 2022. After proportional allocation to the three correctional institutions, a total of 788 study participants were randomly recruited. The World Health Organization Composite International Diagnostic Interview (CIDI) was used to evaluate suicide ideation and attempt. To determine factors associated with suicidal ideation and attempt, multivariate logistic regression analyses were conducted. At a 95% confidence interval (CI) of P-value <0.05, statistical significance was declared. The prevalence of suicidal ideation and attempt among prisoners was 23.6% and 10.7%, with 95% CI (20.76, 26.70) and (8.68, 13.02), respectively. Female sex (AOR = 2.38, 95% CI: 1.12, 5.05), family history of mental illness (AOR = 3.09, 95% CI: 1.93, 4.88), depression (AOR = 2.04, 95% CI: 1.43, 2.98), poor social support (AOR = 2.76, 95% CI: 1.56, 4.85) and previous incarceration (AOR = 1.84, 95% CI: 1.18, 2.86) were significantly associated with suicidal ideation. However, being single (AOR = 2.58, 95% CI: 1.47, 4.54), family history of suicide (AOR = 2.43, 95% CI: 1.18, 5.01), depression (AOR = 2.62, 95% CI: 1.59, 4.31) and previous imprisonments (AOR = 2.11, 95% CI: 1.20, 3.69) were associated with suicidal attempt. The prevalence of suicidal ideation and attempt among prisoners were found to be high. Therefore, the findings of this study recommend that early detection and design of prison mental health services should be delivered to develop mental health care, prevention, and intervention programs for incarcerated people to improve suicidal behavior in prison.

Prevalence of suicidal behavior in bipolar type 1 patients

IntroductionThe prevalence of suicidal behavior in individuals diagnosed with Bipolar Disorder Type 1 is a topic of great concern within the field of psychiatry and mental health research. Bipolar Disorder Type 1 is characterized by extreme mood fluctuations that can contribute to a heightened risk of suicidal ideation, attempts, and completions in affected individuals.Objectives-To examine the socio-demographic and clinical profiles of Bipolar Type 1 patients admitted to the “C” psychiatry department at Hedi Chaker Hospital in Sfax, Tunisia.-To identify and understand the factors associated with suicidal behavior in this population. MethodsWe conducted a retrospective descriptive and analytic study of hospitalized patients suffering from bipolar disorder type 1 in the psychiatry department “C”, Hedi Chaker Hospital, Sfax Tunisia from 2021 to 2023. Socioeconomic data and clinical profiles of patients were collected from archived files.Results The total number of patients was 98, with an average age of 36.74 ± 12.3 years. The majority were single (67%), living with their families (76.5%), jobless (45.9%), and receiving family support (94.9%). In terms of psychoactive substance use, 81.6% have used tobacco, 46.9% have used alcohol, and 34.7% have used cannabis.Concerning family history, 55% of patients had at least one family member being treated for a mood disorder. Among them, 7.1% had attempted suicide, and 6.1% had died by suicide.Concerning the clinical profile of the study population, 28.6% had a personal somatic history. The diagnosis of bipolar disorder was made at the age of 27.52±8.6 years. 11.2% had a comorbid personality disorder with bipolar disorder.The majority of patients were on antipsychotics (95.9%), 84.7% were using mood stabilizers, 33.7% were prescribed anxiolytics, and only 4.1% were on antidepressants. Treatment compliance was poor in 61.2% of cases and 63.3% of patients had a poor insight.Ten percent of these patients had attempted suicide, 50% during a depressive episode, 50% occurring during a depressive episode, 30% during a manic episode, and 40% of attempts were related to discontinuation of treatment. 3.1% had used hanging, and 3.1% had engaged in voluntary drug ingestion as a method of self-harm. None of the suicide attempts necessitated intensive care hospitalization, but 60% of the individuals were admitted to psychiatric care. There was a statistically significant correlation between suicide attempts and a family history of suicide (p=0.049).ConclusionsBipolar patients face a heightened risk of suicide, which is closely tied to the distinctive attributes of the disorder, including biological factors, thymic decompensation, and psychological aspects. Consequently, managing their condition necessitates a tailored approach, demanding ongoing vigilance for individuals diagnosed with bipolar disorder.Disclosure of InterestNone Declared

Predictors of inpatient suicide in an Irish psychiatric service, a longitudinal case-control study.

Inpatient suicide remains difficult to predict. This study aimed to identify individual patient predictors to help identify those at greater risk. This case-control study was undertaken in an independent mental health service in Ireland. Cases were drawn from all admissions to the service between March 2004 and February 2019. Controls were matched for date of admission. Univariate and multivariate analyses were conducted. Thirty-three cases of inpatient suicide were compared to 132 controls. The inpatient suicide rate was 76.2 per 100,000 admissions. The rate of inpatient suicide fell in line with national rates despite less restrictive practices being implemented in the service. Males accounted for 66% of cases. Hanging was the most common method of suicide overall and among male patients, and drowning was the most common among females. Male gender, tertiary referral, an adverse psychosocial event during admission, a period of absence without leave and expressing hopelessness were identified as independent risk factors for inpatient suicide. Substance use, involuntary detention, family history of suicide, and number of previous admissions were not significant. While not highly sensitive, a period of absence without leave, tertiary referral and hopelessness are important predictors of inpatient suicide risk that treating teams should consider in care planning.

Investigating the Characteristics of Suicide And its Relationship with Family History of Suicide

Background: Several factors contribute to suicide attempts. To the best our knowledge, there is no study has been conducted to investigate the impact of a family history of suicide on suicide attempts. Objectives: This study aims to examine the characteristics of suicide and its association with a family history of suicide. Materials and Methods: This historical cohort study was carried out on individuals admitted to Shahid Beheshti Hospital in Taft and Shah Wali Hospital in Yazd for suicide attempts between 2018 and 2019. The study examined 73 individuals with a family history of suicide and 332 without such a history. It recorded demographic details, methods of suicide attempts, and family histories concerning the patients' mothers, fathers, and siblings. Data were collected and subsequently analyzed using ndependent t-tests, Mann-Whitney tests, chi-square and Fisher's exact test. A significance level of P &lt; 0.05 was considered. Results: The average age of the subjects was 28.02 ± 10.8 years, with 295 (72.8%) of the participants being women. There were no significant differences in mean income (P = 0.99), marital status (P = 0.06), gender (P = 0.35), place of residence (P = 0.06), and education level (P = 0.37) between individuals with and without a family history of suicide. Furthermore, our results indicated that the prevalence of mental illness was significantly higher in individuals with a family history of suicide (P &lt; 0.001). The average number of suicide attempts was 1.05 ± 1.90 for those with a family history and 1.21 ± 0.50 for those without, a difference that was statistically significant (P = 0.002). The timing, method, and reasons for suicide attempts were not associated with a family history of suicide. Conclusions: A family history of suicide was associated with an increased number of suicide attempts. There was no correlation between family history and gender, occupation, place of residence, number of children, timing of suicide, method of suicide, reason for suicide, and educational status of the patients. However, a significant relationship was found between a family history of suicide and a history of mental illness among the patients, indicating a higher prevalence of mental illness in the group with a family history compared to those without.

Characteristics of deaths by suicide in postmortem studies in Brazil: A systematic review and meta-analysis.

Suicide is one of the leading causes of death, with a trend for its increase in Brazil in past decades. This study aimed to review the characteristics of suicides in Brazilian postmortem studies. Studies investigating suicide deaths in Brazil, and based on autopsy or psychological autopsy were included. Proportions were pooled across studies with the use of random and fixed effects models. 6777 references were retrieved from six databases (searches up to January, 2023), and 45 studies included. In autopsy studies (k = 37, n = 16,231), substance use at toxicological analysis was found in 36.42% of cases (95% CI: 30.05-43.32), previous suicide attempts in 23.92% (95% CI: 6.73-57.78). In psychological autopsy studies (k = 8, n = 139), previous suicide attempts were reported in 28.09% (95% CI: 19.74-38.28), psychiatric conditions/symptoms in 90.67% (95% CI: 67.79-97.82), family history of suicidality in 21.33% (95% CI: 13.5-32.03). Most suicide deaths were reported in males and took place at the victim's home, hanging was the most frequent suicide method. Included studies presented significant limitations in quality assessment. Future studies should present more robust methodology, including bigger samples, the use of controls, and validated methodology.

Effectiveness of Suicide Prevention Training Package on the Level of Knowledge about Suicide Risk Management

Introduction: Suicide is the intentional action taken by a person to end his or her own life. It is a major public health and mental health problem. This study was an attempt to find out the effectiveness of suicide prevention training package on the level of knowledge about suicide risk management among general population at Thrissur. Objectives: To assess the level of knowledge on suicide risk management before and after intervention, to compare the pretest and posttest level of knowledge of the people about the suicide risk prevention and management after giving suicide prevention training package and to associate the level of knowledge of the people in selected socio- demographic characteristics about the suicide risk prevention and management. Methodology: The study was conducted among 50 selected samples from 15 houses. The research design of the study was pre-experimental one group pre-test post-test design and samples were selected using purposive sampling method. The knowledge regarding suicide risks, warning signs and risk management were assessed with help of questionnaire consisting 3 sections and a total of 25 questions and the socio-demographic variables were assessed with help of demographic profile. The tool and interventions were validated by 5 experts including one psychiatrist. Results: The findings show that out of 50 samples 21 samples (42%) were belongs to the age group of 18 to 34 years. 14samples (28%) belong to the age group of 35 to 49 years. 11 samples (32%) belongs to the age group of 50- 64 years and only 4 samples (8%) belong to &gt;65 years. Most of the 21 persons were samples were females (32%), married (24%) and living in a nuclear family (46%). Majority of them were graduated (42%), about 34% completed secondary/higher secondary education, 20% completed primary education and 4% were illiterate. Most (44%) of them were unemployed, 26% were having a professional job and 22% were having a non- professional job and about 8%of them were retired. Majority (88%) of them was above poverty level and living in rural area (60%). 66% of them were suffering from medical related diseases, 10% were suffering from psychiatric illness and 18% were suffering from other illnesses. About 4% of them were having a family history of suicide. Among them 31 samples (62%) had moderate knowledge and only 2 of them (4%) had adequate knowledge and 12 of them (34%) had poor knowledge. Discussion: At the end of the study, investigator found that there is a significant increase in the level of knowledge of people after giving suicide prevention training package. And also found that there is no significant association exist between demographic variables and knowledge level of sample.

Behavioral and psychosocial factors related to mental distress among medical students.

Physicians die by suicide at rates higher than the general population, with the increased risk beginning in medical school. To better understand why, this study examined the prevalence of mental distress (e.g., depressive symptoms and suicide risk) and behavioral and psychosocial risk factors for distress, as well as the associations between mental distress and risk factors among a sample of medical students in a pre-COVID-19-era. Students enrolled in a large California medical school in 2018-2019 (N = 134; 52% female) completed questionnaires assessing sociodemographic characteristics, depression and suicide family history, health behaviors, and psychosocial wellbeing. Assessment scores indexing mental distress (e.g., depressive symptoms, thoughts of suicide in the past 12 months, suicide risk, and history of suicidality) and risk factors (e.g., stress, subjective sleep quality, alcohol use, impostor feelings, and bill payment difficulty) were compared across biological sex using chi-squared tests, and associations between mental distress and risk factors were determined through logistic regression. Elevated mental distress indicators were observed relative to the general public (e.g., 16% positive depression screen, 17% thought about suicide in previous 12 months, 10% positive suicide risk screen, and 34% history of suicidality), as well as elevated risk factors [e.g., 55% moderate or high stress, 95% at least moderate impostor feelings, 59% poor sleep quality, 50% screened positive for hazardous drinking (more likely in females), and 25% difficulty paying bills]. A positive depression screen was associated with higher stress, higher impostor feelings, poorer sleep quality, and difficulty paying bills. Suicidal ideation in the previous 12 months, suicide risk, and a history of suicidality were independently associated with higher levels of impostor feelings. Higher scores on assessments of depressive symptoms and suicidal thoughts and behaviors were related to several individual-level and potentially modifiable risk factors (e.g., stress, impostor feelings, sleep quality, and bill payment difficulties). Future research is needed to inform customized screening and resources for the wellbeing of the medical community. However, it is likely that the modification of individual-level risk factors is limited by the larger medical culture and systems, suggesting that successful interventions mitigate suicide risk for medical providers need to address multiple socio-ecological levels.

Differential characteristics of bipolar I and II disorders: a retrospective, cross-sectional evaluation of clinical features, illness course, and response to treatment

BackgroundThe distinction between bipolar I and bipolar II disorder and its treatment implications have been a matter of ongoing debate. The aim of this study was to examine differences between patients with bipolar I and II disorders with particular emphasis on the early phases of the disorders.Methods808 subjects diagnosed with bipolar I (N = 587) or bipolar II disorder (N = 221) according to DSM-IV criteria were recruited between April 1994 and March 2022 from tertiary-level mood disorder clinics. Sociodemographic and clinical variables concerning psychiatric and medical comorbidities, family history, illness course, suicidal behavior, and response to treatment were compared between the bipolar disorder types.ResultsBipolar II disorder patients were more frequently women, older, married or widowed. Bipolar II disorder was associated with later “bipolar” presentation, higher age at first (hypo)mania and treatment, less frequent referral after a single episode, and more episodes before lithium treatment. A higher proportion of first-degree relatives of bipolar II patients were affected by major depression and anxiety disorders. The course of bipolar II disorder was typically characterized by depressive onset, early depressive episodes, multiple depressive recurrences, and depressive predominant polarity; less often by (hypo)mania or (hypo)mania-depression cycles at onset or during the early course. The lifetime clinical course was more frequently rated as chronic fluctuating than episodic. More patients with bipolar II disorder had a history of rapid cycling and/or high number of episodes. Mood stabilizers and antipsychotics were prescribed less frequently during the early course of bipolar II disorder, while antidepressants were more common. We found no differences in global functioning, lifetime suicide attempts, family history of suicide, age at onset of mood disorders and depressive episodes, and lithium response.ConclusionsDifferences between bipolar I and II disorders are not limited to the severity of (hypo)manic syndromes but include patterns of clinical course and family history. Caution in the use of potentially mood-destabilizing agents is warranted during the early course of bipolar II disorder.

Suicidal risk and protective factors in major affective disorders: A prospective cohort study of 4307 participants

BackgroundSuicidal behavior is strongly associated with major affective disorders, but there is a need to quantify and compare specific risk and protective factors in bipolar disorder (BD) and major depressive disorder (MDD). MethodsIn 4307 extensively evaluated major affective-disorder participants with BD (n = 1425) or MDD (n = 2882) diagnosed by current international criteria, we compared characteristics among those with versus without suicidal acts from illness-onset through 8.24 years of follow-up. ResultsSuicidal acts were identified in 11.4 % of participants; 25.9 % were violent and 6.92 % (0.79 % of all participants) were fatal. Associated risk factors included: diagnosis (BD > MDD), manic/psychotic features in first-episodes, family history of suicide or BD, separation/divorce, early abuse, young at illness-onset, female sex with BD, substance abuse, higher irritable, cyclothymic or dysthymic temperament ratings, greater long-term morbidity, and lower intake functional ratings. Protective factors included marriage, co-occurring anxiety disorder, higher ratings of hyperthymic temperament and depressive first episodes. Based on multivariable logistic regression, five factors remained significantly and independently associated with suicidal acts: BD diagnosis, more time depressed during prospective follow-up, younger at onset, lower functional status at intake, and women > men with BD. LimitationsReported findings may or may not apply consistently in other cultures and locations. ConclusionsSuicidal acts including violent acts and suicides were more prevalent with BD than MDD. Of identified risk (n = 31) and protective factors (n = 4), several differed with diagnosis. Their clinical recognition should contribute to improved prediction and prevention of suicide in major affective disorders.

PREDISPOSING FACTORS FOR THE INCIDENCE OF SUICIDE IN YOUNG PEOPLE

Introduction: Suicide stands out as a global public health problem, as this practice intentionally involves the act of causing one’s own death. Thus, several factors and circumstances contribute to such an event occurring. In view of the above, this study is justified by its academic, scientific and social relevance, whose purpose is to put on the agenda all epidemiological aspects and risk factors that are directly related to the incidence of care among young people. In this respect, the relevance of this research aims at contributing to science and notoriety in the face of this social problem in which suicide encompasses. Objective: To evaluate the main factors that trigger the risk of suicide in the young population. Methodology: The methodology selected for the basis of this study was the integrative literature review, with a descriptive approach. This integrative review will be carried out through data searches through the scientific bases: LILACS, SCIELO and BDENF. Results and Discussion: Consequently, the main risk factors for suicide among adolescents are the presence of stressful life events, exposure to different types of violence, drug use, family history of suicide, family problems, financial problems, and they are shown to be related to media influence. In addition, the literature points out that the male public is more likely to commit suicide. Conclusion: Considering that this research highlights and emphasizes the importance of knowing the predisposing factors for the incidence of suicide, it is important to take into account the need to develop strategies and prevention to reduce risks. In this sense, it is proposed to strengthen support networks for young people.

Suicide in adolescents: A case study

Suicidal behavior is the most violent behavior that a person commits against himself. Suicidal behavior is a complex form of behavior in which biological, psychological, cultural, environmental and social factors are effective together, which deeply affect the individual, his environment, society and subsequent generations. The etiology of suicidal behavior in adolescents includes problems such as psychiatric illness, domestic violence and restlessness, mental disorders, social events, previous suicide attempts, loss of family relatives, parental divorce, physical and/or sexual abuse, and substance use. Suicide attempt in children and adolescents; emerges as a growing public health problem. In this study, it was aimed to investigate the risk factors of suicidal behavior in adolescents and to examine the case sample. According to the results of the research, the presence of existing depressive symptoms before the Z.D. suicide attempt, previous suicide attempts, being in adolescence, having acute stresses, etc. Presence of risk factors such as suicide, loss of a lover, having a family history of suicide and being alone in the suicide attempt suggest that Z.D. is the trigger. In the presence of risk factors that increase the risk of suicide, it is important to recognize the triggers in advance and to plan an intervention.

Identification of Risk Factors for Suicide and Insights for Developing Suicide Prevention Technologies: A Systematic Review and Meta-Analysis

Suicide is a termite that engulfs close to seven hundred thousand people worldwide each year. Existing work on risk factors that predict suicide lacks statistical associations, does not consider most countries, and has a wide range of risk factor domains. The goal of this systematic review and meta-analysis is to enhance our current understanding of suicidality by identifying risk factors that are most strongly associated with suicide and their impact on developing technological interventions for suicide prevention. A search strategy was carried out on four databases: (1) PsycINFO, (2) IEEE Xplore, (3) the ACM Digital Library, and (4) PubMed, and twenty-five studies were included based on the inclusion criteria. Factors statistically associated with suicide are any diagnosed mental disorder, adverse life events, past suicide attempts, low education level, loneliness or high levels of isolation, bipolar disorder, depression, multiple chronic health conditions, family history of suicide, sexual trauma, and being female. Domain-wise, comorbid disorders, and behavior-related risk factors are most strongly associated with suicide. We present a new hierarchical model of risk factors for suicide that advances our understanding of suicide and its causes. Finally, we present open research directions and considerations for developing suicide prevention technologies.

A family history of suicide in bipolar disorders: powerful, powerless

IntroductionWhen completing the medical record of a patient with bipolar disoder (BD), hardly anything is more impacting than a family history of completed suicide (FHS). In fact, FHS is a main risk factor for personal suicide attempts and death in this population. There are few modifiable protective factors against suicide in BD, such as lithium treatment and absence of substance abuse.ObjectivesWe aimed to explore the relationship between a FHS and clinical characteristics in patients with BD. Given the impact that FHS has on the individual and on healthcare professionals, we hypothesized that it would modify behaviors towards a higher prevalence of the modifiable protective factors against suicide, namely more treatment with lithium and less drug addiction.MethodsThis is a cross-sectional study that included all patients with BD that were followed up in a specialised unit between 1998 and 2020. Only subjects with complete information on FHS were retained for the analysis. We assessed sociodemographic and clinical data and described it with measures of frequency, central tendency and dispersion. Differences between subjects with and without FHS were calculated with χ², Fisher’s exact test and Student’s t-test as appropriate. We set the significance level at p≤0.05. All tests were two-tailed.ResultsThe sample consisted of 480 subjects with a mean age of 45.9 years (standard deviation 14.4, range 18-88), of which 54.4% (n=261) were women. 69.2% (n=332) had a diagnosis of BD type I and 30.8% (n=148) of BD type II. 77 subjects (16%) had a FHS. Regarding differences between groups, those with relatives who had committed suicide did not show statistically significant differences in terms of sociodemographic variables (age, gender, civil status, employment) or key clinical features (type of BD, illness duration, psychotic features, predominant polarity, rapid cycling, number of lifetime manic and depressive episodes, comorbid personality disorder), neither did they have a higher use of lithium (55.8% vs 59.3%, p=0.572) nor lower substance use disorder (10.9% vs 15.5%, p=0.34). Predictably, people with FHS had a higher prevalence of family history of mental and affective disorders (96.1% vs 70.9%, p&lt;0.001; 86.3% vs 56.3%, p&lt;0.001) and of stressful life events (71.6% vs 58.9%, p=0.05). Personal lifetime suicide attempts also tended to be higher (36.4% vs 26.7%, p=0.088).ConclusionsContrary to our hypothesis, in our sample of subjects with BD a FHS was not associated with a higher prevalence of the modifiable protective factors against suicide. Therefore, although suicide has a major impact both in families and healthcare professionals, our results suggest it does not modify attitudes towards prevention in a real-life scenario. The main limitation of our study is its cross-sectional design, which does not allow for causal inference. In conclusion, there is room for improvement in the fight against suicide.Disclosure of InterestNone Declared