Frequency Of Suicidal Ideation Research Articles

Clinical and psychosocial factors associated with depression in patients with psychosis according to stage of illness.

This study investigated the clinical characteristics and psychosocial factors associated with depression in patients with early psychosis according to stage of illness. The present study includes patients who fulfil the DSM-5 criteria for schizophrenia spectrum and other psychotic disorders. Patients were divided into two groups according to illness stage (the acute stage of first-episode psychosis and stabilization phase of recent-onset psychosis). Clinically meaningful depression was defined as moderate or severe on the depression dimension of the Clinician-Rated Dimensions of Psychosis Symptom Severity scale in the DSM-5. In total, 340 (207 first-episode and 133 recent-onset) patients were recruited in this study. Patients with comorbid depression were characterized by frequent suicidal ideation, a past suicide attempt, and lower scores on the Subjective Well-being Under Neuroleptics and Brief Resilience Scale in both groups. Long duration of untreated psychosis and higher scores on the Early Trauma Inventory Self Report were associated with depression in the acute stage of first-episode psychosis. In the stabilization phase of recent-onset psychosis group, a monthly income and scores for sexual desire and on the Family Adaptability and Cohesion Evaluation Scale-III were significantly lower in patients with depression than in those without depression. Comorbid depression was associated with high suicidality, lower quality of life and poor resilience in patients with first-episode and recent-onset psychosis. Depression was associated with factors that had been present before the initiation of treatment in patients with first-episode psychosis and with environmental factors in those in the stabilization phase.

SUBJECTIVELY AND OBJECTIVELY RATED MIXED AFFECTIVE STATES IN A MIXED-AGE SAMPLE OF ADULTS WITH BIPOLAR DISORDER: ASSOCIATIONS WITH AGE, SUICIDALITY, SYMPTOM SEVERITY, COGNITION AND INFLAMMATION

SUBJECTIVELY AND OBJECTIVELY RATED MIXED AFFECTIVE STATES IN A MIXED-AGE SAMPLE OF ADULTS WITH BIPOLAR DISORDER: ASSOCIATIONS WITH AGE, SUICIDALITY, SYMPTOM SEVERITY, COGNITION AND INFLAMMATION

High rates of depression anxiety and suicidal ideation among inpatients in general hospital in China

Objective: To investigate the prevalence rates of depression anxiety and suicidal ideation among Chinese general hospital inpatients and to identify the potential associations with sociodemographics.Method: A cross-sectional survey was applied in a Chinese general hospital. A questionnaire set, including sociodemographic variables, Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale-7 (GAD-7), was completed by the participants. Clinically significant depression (CSD) and clinically significant anxiety (CSA) were defined as a score above 10 on the two scales. CSD and CSA are proxy measures but not specific diagnoses of mental disorders.Results: Data from 1329 patients were included in the final analysis. 422 (31.8%) reported clinically significant depressive symptoms, 83 (6.3%) reported frequent suicidal ideation, and 204 (15.3%) reported clinically significant anxiety. Household income was negatively associated with CSD. Inpatients with lower household incomes and educational levels had higher rates of CSA. Middle-aged inpatients were more prone to suicidal ideation, and stable marital status was related to less suicidal ideation.Conclusion: Depression, anxiety, and suicidal ideation were determined to be common psychological problems in Chinese inpatients. Chinese medical personnel must pay attention to the mental health conditions of inpatients, particularly inpatients with lower income, educational levels, and poor marital status.Key PointsThis is one of the first studies focusing on the prevalence of depression and anxiety in Chinese hospitalized inpatients in non-psychiatric departments of a general hospital.The PHQ-9 and GAD-7 were determined to be potential screening tools to aid Chinese medical workers in recognizing depression and anxiety in nonpsychiatric departments.The prevalence of depression, anxiety and suicidal ideation was observed to be relatively high in inpatients, which requires more attention from Chinese clinicians.

Adverse events reported by anxious school refusing adolescents receiving cognitive behavioral therapy with and without fluoxetine.

Investigating adverse events associated with antidepressant treatments in adolescents is important given the concerns about increased risk of suicidal ideation and behavior in this age group. The aim of this study is to investigate adverse and serious adverse events associated with the treatment of anxiety (cognitive behavioral therapy (CBT)-only, CBT-plus-placebo, and CBT-plus-fluoxetine) in anxious school-refusing adolescents. A side-effect symptom checklist was completed by participants prior to commencing treatment and during treatment (weekly/fortnightly). CBT-plus-fluoxetine was well tolerated and not associated with higher levels of adverse events than the other treatments. Adverse events in all groups decreased over time, and the only adverse event distinct to fluoxetine was nausea. Baseline anxiety predicted higher levels of adverse events. There was one suicide attempt in the CBT-plus-placebo group but no statistically significant difference in suicide attempts between groups. Participants with a comorbid depressive disorder were more likely to report self-injury ideation but not suicidal ideation compared with those who did not have comorbid depressive disorder. Frequency of suicidal ideation and non-suicidal self-injury was significantly lower in the CBT-plus-fluoxetine group compared with the CBT-only group. Frequency of self-injury ideation was significantly lower in the CBT-plus-fluoxetine group compared with both other groups. Overall, the treatments were well tolerated and fluoxetine plus CBT appeared to be protective against suicidal ideation, non-suicidal self-injury, and self-injury ideation in this sample.

PTSD symptom clusters and suicide attempts among high-risk military service members: A three-month prospective investigation.

Suicide rates within the U.S. military are elevated, and the assessment and treatment of posttraumatic stress disorder (PTSD) has been identified as one potential conduit for suicide risk reduction. Despite increased interest in examining whether PTSD symptom clusters differentially predict suicide-related outcomes, to our knowledge no study has examined this question utilizing a prospective design for which suicide attempts is the outcome. Thus, the present study assessed whether PTSD symptom clusters differentially predict suicide attempts at 3-month follow-up and examined the moderating role of combat exposure. Participants were 758 military service members referred for psychiatric evaluation for suicide-related concerns and who provided both baseline and follow-up data (76.8% male, Mage = 25.20 y [SDage = 6.22 y], 61.6% White/Caucasian, 28.2% combat-exposed). Baseline PTSD symptom clusters scores were derived from an abbreviated version of the PTSD Checklist-Military Version (PCL-M). Suicide attempts occurring from baseline to follow-up were assessed with the Suicide Attempt Self-Injury Interview (SASII). Logistic regression models were utilized, controlling for baseline suicide risk severity (i.e., frequency of suicidal ideation, levels of suicidal intent, past suicide plans and attempts) and sociodemographic characteristics. The hyperarousal symptom cluster was the only significant predictor of subsequent suicide attempts and, moreover, this association was significant for combat-exposed service members but not for non-combat-exposed service members. PTSD hyperarousal symptoms, characterized in part by overarousal (e.g., agitation), should be considered in military suicide risk assessment and prevention efforts, particularly for combat-exposed service members. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Исследование психологических проблем и потребности в консультации педагога-психолога у школьников 7-х, 9-х и 11-х классов

This study investigated psychological problems and needs for school psychologist’s consultation in 7th, 9th, and 11th grade students. Students (N = 594) filled out a short survey where they rated the degree of their psychological problems (e.g., test anxiety, mood, learning problems, problems with parents, etc.) and a desire to receive consultation with the school psychologist about existing or potential problems. Regardless of age, students gave the highest ratings to test anxiety, problems with mood, and career choice. Girls demonstrated higher test anxiety and more negative mood compared to boys. Seventh grade students reported higher test anxiety than their older peers. Students indicated lower levels of problems with parents, peers, and learning. Nevertheless, 9th grade students reported higher levels of learning problems than 11th graders. About 7% of students reported frequent suicidal ideation. However, the majority of students from the total sample (80%) did not consider consulting the school psychologist regarding suicidality. Even fewer students were willing to consult with the school psychologist about test anxiety, mood, and learning problems. These findings can be used to improve school psychology services, design interventions, and provide psychoeducation to students.

Suicidal thought and behavior in individuals with restless legs syndrome

BackgroundRestless legs syndrome (RLS) is associated with an unrelenting urge to move at night, which can cause chronic sleeplessness, depression, and despondency; thus increasing risk of suicide. We aimed to determine frequency of suicidal ideation and behavior in RLS. MethodsRLS and control participants were recruited through community and RLS Foundation advertisements. RLS diagnosis was confirmed using the Cambridge–Hopkins RLS Questionnaire and severity was assessed using the International RLS Study Group Severity Scale (IRLSS). Lifetime suicidal ideation (plan) and behavior (attempt) was assessed using the Suicidal Behavior Questionnaire-revised. The Brief Lifetime Depression Scale evaluated lifetime depression history. Forward stepwise logistic regression determined the odds of suicidal ideation or behavior. ResultsIn this study, 192 RLS and 158 control participants were comparable for age, sex, race, and other potential demographic confounders. In general, RLS was moderate-to-severe (mean IRLSS 26.4 ± 7.5). Significantly more RLS than control participants had lifetime suicidal ideation or behavior (27.1% vs. 7.0%; p < 0.00001) or lifetime depression history (65.6%% vs. 22.8%; p < 0.00001). The odds of having a lifetime suicidal ideation or behavior was higher in those with RLS [2.80 (1.29,6.11)], even after accounting for depression and other confounders. In RLS, the odds of lifetime suicidal ideation or behavior was increased if there was lifetime depression [7.37 (2.65,20.47)] or if RLS in the past was severe or very severe [2.36 (1.03,5.40)]. ConclusionsLifetime suicidal ideation or behavior is prevalent in RLS sufferers, and its likelihood is dependent on RLS severity and depression history.

The relationship between the frequency of suicidal ideation and sleep disturbance factors among adolescent earthquake victims in China.

This study aimed to examine the frequency of suicidal ideation (SI) and identify exposure variables, mental health, and sleep-related risk factors of SI among adolescents following the 2013 Ya'an earthquake. Participants consisted of 5563 adolescent students selected through random sampling from 11 primary and high schools in the counties most severely affected by the earthquake. They were asked to complete the Pittsburgh Sleep Quality Index, Children's Revised Impact of Event Scale-13, Short Mood and Feelings Questionnaire, and Screen for Child Anxiety-Related Emotional Disorders. Multinomial logistic analysis was used to identify possible relationships between SI and psychopathology, sleep problems, earthquake exposures or demographic characteristics. The mediation analysis was used to identify direct and indirect effects among sleep problems, psychopathology, earthquake exposures and SI. Our findings suggest that 29.5% of the sample experienced SI during the past year (12.9% once, 11.9% twice, 2.6% on 3-4 occasions and 2.1% on at least 5 occasions). Multiple sleeping problems, including trouble falling asleep, shorter sleep duration, and daytime dysfunction, showed independent associations with SI. The mediation analysis suggested that depression and anxiety mainly mediated the association of sleep with SI. This study was cross-sectional and did not include controls. No baseline data were collected prior to the earthquake. SI can be a serious problem among adolescents following a major earthquake, especially those who are older, who live in one-child households, or who are female. Years after a disaster, we found that exposure severity, psychopathology and sleep impairment all contributed to SI, and that earthquake exposure may have disrupted sleep and worsened mood, which in turn may have impacted SI. By enhancing teenagers' sleep management and shaping their activities, post-disaster intervention programs may help prevent SI among Chinese adolescents.

Different Clinical Presentations in Eating Disorder Patients with Non-Suicidal Self-Injury Based on the Co-Occurrence of Borderline Personality Disorder.

Non-suicidal self-injury (NSSI) and borderline personality disorder (BPD) features are common in patients with eating disorders (ED), yet little is known regarding the clinical presentation of ED patients who present with NSSI with and without BPD. The current study compared self-injurious, female ED inpatients with (n = 98; NSSI+BPD) and without BPD (n = 45; NSSI-only) on different self-reported clinical features. Results suggest that ED patients with NSSI+BPD differ from those with NSSI-only with regard to frequency of suicidal ideation, alcohol, drug or medication abuse, internalizing/externalizing psychopathology, interpersonal problems, and coping strategies, with the NSSI+BPD group demonstrating more impairment in each of these domains. Despite these differences in clinical presentation, however, groups did not differ in NSSI features. In sum, while self-injurious ED patients may present with similar NSSI behavior regardless of BPD diagnosis, those with NSS+BPD represent a group with much higher clinical complexity and greater treatment needs.

Addiction Lives: Ingeborg Rossow.

Addiction Lives: Ingeborg Rossow.

Association of temporomandibular disorder and high frequency of suicide ideation in Korean adolescents: a cross-sectional survey

Background: This study investigated the association between psychological factors and temporomandibular disorder (TMD) in a representative sample using data from the Korean nationwide survey.Methods: The study included 1337 adolescents. Participants provided demographic, socio-economic and behavioural information, and responses to questionnaires assessing their mental health status including perceived stress, depressed mood and suicidal ideation in the presence of TMD. In univariate analysis, t-test was used to test the association between TMD and risk factors by gender in a complex sampling design. Multivariate logistic regression analyses were used to examine the association between TMD and psychological factors.Results: Male adolescents with TMD were highly engaged with depressed mood and suicidal ideation (p = .0006, p = .0223), however, no psychological factors were significant in female adolescents (p < .05). Male adolescents with both depressed mood and suicidal ideation had significantly high rates of TMD (p = .0024). The risks for experiencing depressed mood (OR: 3.07) and suicidal ideation (OR: 2.564) were significantly associated with TMD in male adolescents after adjusting confounders.Conclusions: The results provide evidence that the depressed mood and suicidal ideation were associated with TMD in male adolescents. This study has important implications for enhanced screening and evaluation of mental health among patients with TMD according to gender.

Characteristics Associated with Non-Disclosure of Suicidal Ideation in Adults.

Suicide prevention efforts often depend on the willingness or ability of people to disclose current suicidal behavior. The aim of this study is to identify characteristics that are associated with non-disclosure of suicidal ideation. Data from the Dutch cross-sectional survey Health Monitor 2016 were used, resulting in 14,322 respondents (age 19+). Multiple logistic regression analyses were conducted to assess the strength of the associations between demographics and health-related characteristics as independent variables, and non-disclosure of suicidal ideation as the dependent variable. The mean age of the respondents was 60 years (SD 16.7) and 45% were male. Of these adults, 5% (n = 719) reported suicidal ideation in the past year, nearly half of which (48%) did not disclose suicidal ideation. Non-disclosure was significantly associated with social loneliness (OR = 1.29). Inverse significant associations were found for age (35–49 years, OR = 0.53), poor health status (OR = 0.63), frequent suicidal ideation (OR = 0.48), and severe psychological distress (OR = 0.63). The accuracy of this model was fair (AUC = 0.73). To conclude, non-disclosure is a substantial problem in adults experiencing suicidal ideation. Adults who do not disclose suicidal ideation are more likely to have few social contacts, while they are less likely to experience poor (mental) health and frequent suicidal thoughts.

Perceived effectiveness of NSSI in achieving functions on severity and suicide risk

Nonsuicidal self-injury (NSSI) continues to be a psychiatric problem for youth and young adults, and is a robust risk factor for suicidal thoughts and behaviors. Research has established that NSSI is motivated by intrapersonal and interpersonal functions; however, research on the perceived effectiveness of NSSI for achieving the desired functions is lacking. In the current study, it was expected that using NSSI to achieve intrapersonal functions would be rated as more effective than interpersonal functions, and that perceived effectiveness of NSSI would be differentially related to NSSI severity and suicide risk outcomes. In a sample of 264 adults with lifetime NSSI history (over 70% past year), intrapersonal functions were endorsed more than interpersonal functions, and were rated as significantly more effective. Overall, perceived effectiveness of NSSI for intrapersonal functions was significantly and positively predictive of NSSI severity, while interpersonal functions were significantly and negatively related. Perceived effectiveness of NSSI for intrapersonal functions, but not interpersonal functions, were significantly predictive of more frequent and intense suicide ideation and greater likelihood of suicide plans and attempts. Results highlight the importance of assessing the perceived effectiveness of NSSI for specific functions in identifying individuals at risk for more severe NSSI and suicide.

Predicting Suicide Attempts for Racial and Ethnic Groups of Patients During Routine Clinical Care.

The aim of this study was to examine variation in suicide ideation and its relationship to risk of suicide attempt in the subsequent 90days by race and ethnicity. Participants were adults who completed the Patient Health Questionnaire depression module (PHQ9) during an outpatient encounter between January 10, 2010, and December 12, 2012 (N=509,945 patients; N=1,228,308 completed PHQ9). Data came from the Virtual Data Warehouse from four health care systems in the Mental Health Research Network. The sample was majority female (73.7%), primarily 30-64years old (60.1%), healthy (64.5% comorbidity index=0), and over half were non-Hispanic White (52.9%). Only Asian patients (OR: 1.31; 95% CI: 1.24, 1.39) had higher odds of reporting suicide ideation when compared to non-Hispanic White people. All racial and ethnic groups had increased risk for suicide attempt with increased frequency of suicide ideation. The PHQ9 item 9 can be used as an indicator of suicide ideation and risk for suicide attempt up to 90days after the reported ideation in racial and ethnic minority patients during routine clinical care.

Posttraumatic Stress and Suicidality Among Firefighters: The Moderating Role of Distress Tolerance

Firefighters report high rates of suicidality and posttraumatic stress disorder (PTSD). This investigation explored the moderating role of distress tolerance (DT) in the association between PTSD symptomatology and suicidality in firefighters. Covariates included trauma load, depressive symptom severity, gender, race, age, and education. The sample was comprised of 765 (94.0% male; Mage = 38.8, SD = 8.6) trauma-exposed firefighters who completed a questionnaire battery. Structural equation modeling was employed. PTSD symptom severity was significantly, positively associated with global suicide risk, suicidal ideation/attempt, frequency of suicidal ideation, lifetime threat of suicide, and perceived likelihood of future suicide attempts. Lower levels of DT were significantly associated with higher frequency of past-year suicidal ideation. Significant interactive effects were noted; firefighters with higher levels of PTSD symptom severity and low levels of DT had the highest levels of global suicide risk and perceived likelihood of future suicide attempt. Clinical and research implications are discussed.

Self‐conscious emotions and suicidal ideation among women with and without history of childhood sexual abuse

AbstractBackgroundSuicidal ideation and the self‐conscious emotions of guilt and shame are frequently encountered in psychotherapy. However, research regarding the relationship between self‐conscious emotions and suicidal thoughts has been limited, particularly in the context of women's experiences of childhood sexual abuse.AimsThe purpose of this study was to investigate the relationship between suicidal ideation and experiences of guilt and shame among women seeking psychotherapy, and to examine the role of childhood sexual trauma in this relationship.Materials and MethodsParticipants were 68 women attending an outpatient psychotherapy clinic who completed questionnaire measures of depression, guilt and shame, suicidal ideation, and childhood trauma.ResultsZero‐order and partial correlations found direct positive associations between frequency of suicidal thoughts and both guilt and shame. Hierarchical regression analysis found significant interactions between sexual abuse and self‐conscious emotions. Among women without a history of sexual abuse, frequency of suicidal ideation was associated with guilt. Among women who had suffered childhood sexual trauma, frequency of suicidal ideation was associated with shame.DiscussionThese preliminary findings suggest that shame may be an important target in therapy for women with sexual abuse trauma, and indicate directions for future research.ConclusionClinicians addressing suicidal ideation need to consider the nuanced relationship between self‐conscious emotions and clients’ experience of trauma.

Predictors of Suicide Attempts in Clinically Depressed Korean Adolescents.

We examined predictors of suicide attempts in clinically depressed adolescents in Korea and gender differences in suicidal behavior. In total, 106 adolescents diagnosed with depressive disorder were recruited in South Korea. We assessed various variables that might affect suicide attempts, and used a structured interview for the diagnosis of depression and comorbidities and to evaluate suicidality. Demographic and clinical characteristics of the subjects were compared between suicide attempt and non-suicide attempt groups and we examined significant predictors of suicide attempts. Gender differences in suicidal ideation and suicidal behavior were also analyzed. Among 106 depressed participants, 50 (47.2%) adolescents were classified in the suicide attempt group. Generally, the suicide attempt and non-suicide attempt group shared similar clinical characteristics. The suicide attempt group had more females, more major depressive disorder diagnoses, more depressive episodes, and higher suicidal ideation than the non-suicide attempt group. Suicidal ideation was the only significant predictor of suicidal attempt, regardless of gender. Higher suicidal ideation frequency scores and more non-suicidal self-injurious behaviors were shown in the female suicide attempt group than the male suicide attempt group. It is recommended that suicidal ideation be assessed regularly and managed rigorously to decrease suicide risks in depressive adolescents.

Clinical Correlates of Planned and Unplanned Suicide Attempts.

Suicide attempters differ in the degree of planning for their suicide attempts. The purpose of this study was to identify differences between individuals who make planned (≥3 hours of planning) and unplanned (<3 hours of planning) suicide attempts. Depressed suicide attempters (n = 110) were compared based on degree of planning of their most recent suicide attempt on demographic and clinical variables. Participants who made planned suicide attempts were more likely to have family history of completed suicide, more severe and frequent suicidal ideation, greater trait impulsivity, and greater suicidal intent and more severe medical consequences for both their most recent and most serious suicide attempts. These results suggest clear clinical differences based on the degree of suicide attempt planning. Severe suicidal ideation, high suicide intent, family history of suicide completion, and high levels of motor impulsivity contribute to a phenotype that is at greater risk of planned, highly lethal suicide attempts.

Suicidal ideation at 1-year post-stroke: A nationwide survey in China.

Few studies on suicidal ideation have been conducted in post-stroke patients in China. This national study examined suicidal ideation at 1-year post-stroke and explored its demographic and clinical correlates. A total of 1418 patients with ischemic stroke were included in 56 hospitals nationwide. Demographic, clinical characteristics and neuro-imaging information were collected with standardized instruments, including assessment of stroke severity, depression, cognitive impairment, stroke recurrence, physical disability and insomnia. Suicidal ideation was measured using item 3 of the Hamilton Rating Scale for Depression. The frequency of suicidal ideation in this study was 6.6%. Multivariate analyses revealed that disability (OR=2.07, 95% CI=1.09-3.05), stroke recurrence (OR=4.13, 95% CI=1.74-9.77) and insomnia early (OR=1.87, 95% CI=1.03-3.39), middle (OR=2.66, 95% CI=1.46-4.85) and late (OR=2.35, 95% CI=1.31-4.19) at the 1-year follow-up and post-stroke depression (OR=2.16, 95% CI=1.23-3.82) were significantly associated with post-stroke suicidal ideation. Post-stroke depression, disability, insomnia and stroke recurrence are possible risk factors of suicidal ideation that warrant attention in clinical practice.

Factors Associated With High Frequency of Suicidal Ideation in Medically Ill Veterans

Suicide is a leading cause of death, and rates are especially high among medically ill, older individuals. Health-related psychosocial correlates of suicidal ideation (SI) may be particularly important for medically ill older adults as they may clarify who may benefit from interventions to reduce SI. This study examined whether demographic, physical health, and/or health-related psychosocial factors were associated with high frequency of SI in older, medically ill Veterans experiencing elevated anxiety or depression. This cross-sectional study included 302 Veterans with (1) a cardiopulmonary condition and functional impairment and (2) elevated symptoms of depression and/or anxiety. Participants were classified as having either no, low, or high SI, based on self-reported ideation, from the Patient Health Questionnaire-9. SI was reported in 26.8% of the full sample and high SI was reported by 12.6% of participants. Logistic regression analyses predicting high versus no SI found the odds of high SI increased 4.7 times (95% confidence interval, 2.6-8.3) for each 1-unit increase in maladaptive coping and 4.1 times (95% confidence interval, 1.2-14.3) for each 1-unit increase in physical health severity/functional limitations. Older, medically ill Veterans with comorbid depression and/or anxiety frequently reported SI and were at greater risk of experiencing a high frequency of SI if they engaged in maladaptive coping strategies and/or had high levels of functional impairment. Effective interventions to reduce SI for this population should focus on reducing maladaptive coping and minimizing negative behavioral, cognitive, and emotional reactions to functional limitations.