High Rates Of Suicidal Ideation Research Articles

Gestational malnutrition, hyperemesis gravidarum, and Wernicke's encephalopathy: What is missing?

Hyperemesis gravidarum (HG), or the severe nausea and vomiting of pregnancy, is one of the most dreaded complications of gestation, affecting between 1.5% and 3.0% of pregnant women. From the late 1800s to the mid-1980s, the etiology was frequently cited to have psychological and/or-later-perhaps hormonal origins, which have numbered at least 10. Current research has unearthed a genetic basis for HG that implicates growth differentiation factor 15, insulin-like growth factor binding protein 7, and hormone receptors (namely, glial cell line-derived neurogenic factor family receptor alpha-like and the progesterone receptor). Whatever the origins of this disease, it has caused immeasurable physiological and psychological damage to women, their fetuses, and their families. The psychological trauma includes a high rate of suicidal ideation as well as posttraumatic stress disorder. Whereas the healthcare costs are substantial for the mother with HG, the lifetime costs to the neonate include that which accompanies reduced employment earnings related to cognitive compromise. Another devastating outcome of severe HG can be Wernicke's encephalopathy (WE), which has a high fetal and maternal mortality rate. Our study explored 18 current reports of HG and WE. We highlighted additional presenting features we believe also accompany, and sometimes replace, the classically taught triad components of WE: ataxia, confabulation, and nystagmus. We agree with the conclusion made by Sheehan and Ironside in 1939 that thiamin alone may not reverse WE, and we offer possible explanations. Lastly, we offer suggestions for remediation.

Frequency and correlates of suicidal ideation and behaviors in treatment-seeking Post-9/11 Veterans

ObjectivePost-9/11 U.S. veterans and servicemembers are at increased risk for suicide, indicating an important need to identify and mitigate suicidal ideation and behaviors in this population. MethodUsing data modeling techniques, we examined correlates of suicidal ideation and behavior at intake in 261 Post-9/11 veterans and servicemembers seeking mental health treatment. ResultsOur sample endorsed high rates of suicidal ideation and behavior. Approximately 40% of our sample scored in a range on the Suicide Behaviors Questionnaire-Revised (SBQ-R), indicating high clinical risk for suicide. Results from multivariate analyses indicate that greater state and/or trait depression severity, greater anger and anger expression, less impulse control, and lower rank were consistently associated with suicidal ideation and behavior across our models. Negative posttraumatic thoughts about the self, gender, and military branch of service were also significantly associated with suicidal ideation and behavior. ConclusionsSuicidal ideation and behaviors are common in veterans seeking mental health treatment. State and/or trait depression, anger and impulse control were predictors of increased risk for suicidal ideation and behavior across models. Consistencies and differences across models as well as limitations and practical implications for the findings are discussed.

Examining the Relationship between Academic Expectations and Suicidal Ideation among College Students in India Using the Interpersonal Theory of Suicide

Objective As the second most populous country in the world, India accounts for over 20% of the global suicide deaths. Notably, young adults make up 38% of those who die by suicide in India. Yet, the literature on factors associated with suicide within this age group in India is limited. The Interpersonal Theory of Suicide (IPTS) posits thwarted belongingness and perceived burdensomeness as constructs that heighten the risk for suicide. Testing mechanisms that may mediate the relationship between common stressors for young adults in India, such as academic expectations, and suicidal ideation are important to better understand factors contributing to suicide risk within this country. Method Indian college students (N = 432, M age = 19.41, 73.1% male) completed questionnaires on academic expectations, thwarted belongingness, perceived burdensomeness, collectivism, and suicidal ideation. Results Current suicidal ideation was endorsed at a rate of 38%. Academic expectancy from the self, perceived burdensomeness, and thwarted belongingness was significantly associated with suicidal ideation. The only significantly mediated pathway was academic expectancy from others to suicidal ideation through perceived burdensomeness. Collectivism was not a significant moderator in the model. Discussion The sample endorsed high rates of suicidal ideation, highlighting the need for culturally appropriate interventions. Thwarted belongingness, perceived burdensomeness, and academic expectations from oneself may be relevant treatment targets for reducing suicidal ideation among college students in India. HIGHLIGHTS Over one-third of Indian university students endorsed suicidal ideation. Suicidal ideation related to one’s own more than others’ academic expectations. Results offer support for the Interpersonal Theory of Suicide within this context.

Suicidal Behaviour, including Ideation and Self-Harm, in Young Migrants: A Systematic Review

Young people experience high rates of suicidal ideation, self-harm, suicide attempt and death due to suicide. As a result of increasing globalisation, young people are increasingly mobile and can migrate from one country to another seeking educational and employment opportunities. With a growing number of young migrants, it is important to understand the prevalence of suicidal behaviour among this population group. We systematically searched Medline, Embase, and PsycINFO from inception until 31 March 2022. Eligible studies were those providing data on suicidal ideation, self-harm, suicide attempt, and death due to suicide. Seventeen studies were included in the review, some of which provided data on multiple outcomes of interest. Twelve studies provided data on suicidal ideation, five provided data on self-harm, eight provided data on suicide attempt, and one study had data on suicide death among young migrants. The quality of the included studies was varied and limited. The studies included in this review commonly reported that young migrants experience higher rates of self-harm and suicide attempt, but no major differences in suicidal ideation and suicide death compared to non-migrant young people. However, the limited number of studies focused on suicidal behaviour among young migrants highlights the need for further high-quality studies to capture accurate information. This will enable the development of policies and interventions that reduce the risk of suicidal behaviour among young migrants.

Urgent care and suicidal behavior in the child and adolescent population in a psychiatric emergency department in a Spanish province during the two COVID-19 states of alarm.

IntroductionThe COVID-19 outbreak and lockdown may have an impact in mental health among youth, but reports of psychiatry emergency department encounters in young Spanish population are scarce. The aim of this study is to characterize the reasons for psychiatric urgent care of youth during COVID-19 pandemic in our hospital.Material and methodsThis cross-sectional study compare visits to the psychiatry emergency department and their characteristics in young patients in the province of Lleida before and after the pandemic with special attention to the two states of alarm and suicidal behavior. Information regarding sociodemographic status, chief complaints, diagnosis, characteristics of suicidal behavior, and other data were obtained from the electronic medical records.ResultsWithin the total psychiatric emergency attendances, youth patients increased a 83.5% in the second state of alarm (p = 0.001). In this period patients were younger (p = 0.006), had less psychiatric history (p = 0.017) and their living conditions changed with an increase of those living with relatives (p = 0.004). Suicidal ideation care increased without statistical significance (p = 0.073). Multiple logistic regression identifies independent risk factors for suicidal behavior being female (OR: 2.88 [1.39–5.98]), living with relatives (OR: 3.49 [1.43–8.54]), and having a diagnosis of depression (OR: 6.34 [3.58–11.24]).ConclusionsThe number of young people seen in psychiatric emergencies during the chronic stage of the pandemic increased, and these were getting younger and without previous psychiatric contact. The trend to higher rates of suicidal ideation indicates that youth experienced elevated distress during these periods, especially women, living with relatives and presenting depression.

The impact of Gender Identity Clinic waiting times on the mental health of transitioning individuals

IntroductionWaiting times for gender identity services, even before the Covid-19 pandemic, have been a cause of concern. Despite the waiting time standard for planned elective care in the NHS being a maximum of 18 weeks, the average waiting time for a first appointment with a gender identity clinic is 18 months. This study aims to analyse the effect that these timings have on the transgender community, and whether they impact the risk of developing mental health conditions such as depression or anxiety.ObjectivesThis study’s main aim is to analyse the correlation between waiting times and mental health burden in the transgender community.MethodsA literature review and analysis on a transgender individual’s mental health and waiting times for Gender Identity Clinics; looking at any key themes and conclusions. Research papers were taken from MEDLINE, The International Journal of Transgender Health, Oxford Academic, SpringerLink and Emerald Insight, with studies publishing date ranging from 2014 – 2021.ResultsThe transgender population were found to have higher rates of suicidal ideation, depression and self harm compared to the general population. Longer waiting times were found to contribute to feelings of low mood and suicidal ideation, as well as decreasing overall quality of life.ConclusionsLonger waiting times can decrease a transgender individual’s quality of life and impact their overall mental wellbeing: especially with the impact of COVID-19 and the rise in referrals.DisclosureNo significant relationships.

Suicidal Behavior in Adolescent Girls with Eating Disorders

IntroductionEating disorders are associated with suicidal behavior in adolescents. But the relationship between subthreshold eating disorders and suicidality is not well understood.ObjectivesTo examine suicidal behavior in adolescent girls with eating disorders (ED) and subthreshold eating disorders (SED).MethodsThe study of 917 girls aged 12–17 used the Body Image and Eating Distress scale (Koskelainen et al., 2001) and questions about intentional self-harm (burns or cuts), suicidal thoughts and suicidal attempts. Adolescents were divided into three groups: girls with ED (n = 20); girls with SED (n = 88); and control group (CG, n = 809).ResultsSelf-harm was reported by 55% of girls with ED, 35.2% of girls with SED and 20.2% of CG girls (χ2 = 15.82, p <0.001). Suicidal ideation was reported by 65% of girls with ED, 51.1% of girls with SED and 27.2% of CG girls (χ2 = 21.86, p <0.001). Suicidal attempts were reported by 45% of girls with ED, 17.1% of girls with SED and 7.5% of the CG. There were no differences in the prevalence of self-harm and suicidal ideation between the ED and SED groups, rates of suicide attempts were 2.6 times higher in the ED group.ConclusionsGirls with both ED and SED have a high risk of suicidal behavior: 2.7-4.5 times higher rates of self-harm, 1.9-2.4 times higher rates of suicidal ideation, and 2.3-6 times higher rates of suicidal attempts. Management of such adolescents should include assessment of the risk of suicide.DisclosureThe study was supported by the Russian Science Foundation grant # 21-15-00033.

Young and lonely? Results from the COMET study

IntroductionThe sudden changes in daily routine due to the containment measures adopted for facing the COVID-19 pandemic have had an impact on the mental health of the general population. In particular, young adults are exposed to a higher risk compared to the general population to suffer from the consequences of the pandemic, in terms of anger and irritability, depressive symptoms and somatic complaints, insomnia, lack of motivation and loneliness. In particular, loneliness can be particularly pronounced during young adulthood.ObjectivesThis study aimed to describe the levels of loneliness in a sample of Italian young people during the national lockdown in 2020, evaluating clinical and socio-demographic differences and the role of coping strategies and levels of resilience.MethodsA sub-analysis of a sample of adults aged 18-34 years has been drawn on a larger cross-sectional observational national trial (COMET, 2020) in which, among other psychopathological dimensions, the levels of loneliness have been assessed by the UCLA scale short version.ResultsLevels of loneliness were particularly severe in a third of cases (risk factors: unemployment, low income and vulnerability in mental health), in association with depression, anxiety, stress, OCD symptoms, higher rates of suicidal ideation, sleep disturbance and excessive use of Internet. Levels of loneliness tended to increase over time.ConclusionsOverall, during the Italian COVID-19 lockdown young people have experienced quite high levels of loneliness: this dimension could represent a useful domain to assess in routine clinical practice.DisclosureNo significant relationships.

Self-harm and Suicidality Experiences of Middle-Age and Older Adults With vs. Without High Autistic Traits

Suicide has been identified as a leading cause of premature death in autistic populations. Elevated autistic traits have also been associated with higher rates of self-harm, suicidal ideation, and suicidal self-harm in the general population, but this has yet to be examined in older age. Using baseline cross-sectional data from the PROTECT study, middle-age and older adults with high autistic traits (n = 276) had significantly higher rates of suicidal ideation, deliberate self-harm, and suicidal self-harm than an age/sex-matched comparison group (n = 10,495). These differences represented a 5- to 6-fold increase in likelihood for self-harming and suicidality. These findings, which remained when controlling for depression symptoms, suggest that middle-age and older adults with high autistic traits may be particularly at risk of self-harm and suicidal behaviours.

Brief Report: Exploratory Evaluation of Clinical Features Associated with Suicidal Ideation in Youth with Autism Spectrum Disorder.

There has been a heightened awareness of an increased risk of suicidality among individuals with autism spectrum disorder (ASD) due to high rates of suicidal ideation (SI) in this population (11-66%). The current study investigated the rate of parent-endorsed SI and associated clinical features in 48 youths with ASD (Age; M: 12.97years, SD: 2.33). SI was endorsed in 18.75% of participants. Youth with SI exhibited significantly higher levels of affective problems, externalizing problems, feelings of humiliation and rejection, and symptoms related to perfectionism. Results indicate that co-occurring mental health problems are associated with suicidal ideation and provide relevant targets for psychotherapeutic intervention. This preliminary study in a modest sample suggests the value of further research in larger samples to replicate and generalize these findings.

Complex pain phenotypes: Suicidal ideation and attempt through latent multimorbidity.

Given the relatively high rates of suicidal ideation and attempt among people with chronic pain, there is a need to understand the underlying factors to target suicide prevention efforts. To date, no study has examined the association between pain phenotypes and suicide related behaviors among those with mild traumatic brain injuries. To determine if pain phenotypes were independently associated with suicidal ideation / attempt or if comorbidities within the pain phenotypes account for the association between pain phenotypes and suicide related behaviors. This is a longitudinal retrospective cohort study of suicide ideation/attempts among pain phenotypes previously derived using general mixture latent variable models of the joint distribution of repeated measures of pain scores and pain medications/treatment. We used national VA inpatient, outpatient, and pharmacy data files for Post-9/11 Veterans with mild traumatic injury who entered VA care between fiscal years (FY) 2007 and 2009. We considered a counterfactual causal modeling framework to assess the extent that the pain phenotypes during years 1-5 of VA care were predictive of suicide ideation/attempt during years 6-8 of VA care conditioned on covariates being balanced between pain phenotypes. Without adjustment, pain phenotypes were significant predictors of suicide related behaviors. When we used propensity scores to balance the comorbidities present in the pain phenotypes, the pain phenotypes were no longer significantly associated with suicide related behaviors. These findings suggest that suicide ideation/attempt is associated with pain trajectories primarily through latent multimorbidity. Therefore, it is critical to identify and manage comorbidities (e.g., depression, post-traumatic stress disorder) to prevent tragic outcomes associated with suicide related behaviors throughout the course of chronic pain and mild traumatic brain injury management.

Investigation of suicide probability in sexually abused adolescents and the associated factors

ObjectiveThe objectives of this study are to compare the suicide probability of adolescent sexual abuse victims with a control group. MethodThe study group consisted of 120 adolescents (105 female, 15 male) who had experienced sexual abuse, and the control group comprised 120 adolescents with sociodemographic features similar to those of the study group. Participants completed the following questionnaires: the Suicide Probability Scale, Brief Symptom Inventory, and child Post-Traumatic Stress Disorder Reaction Index. ResultsThe study group reported greater hopelessness, higher rates of suicidal ideation, increased hostility/impulsivity, and had higher general suicide probability subscale scores (determined via the Suicide Probability Scale) compared to the control group. Of the sexual abuse victims, general suicide probability scores were found to be higher among females and among subjects who indicated abuse involving contact and penetration, blaming oneself or their families for the abuse and the development of post-traumatic stress disorder and/or major depressive disorder following the abuse. ConclusionsOur findings showed that individuals who had suffered sexual abuse were more likely to be at risk of suicide and that certain features of the victim, the abuse, and the abuser also related to the probability of suicide.

Characterizing persistent urinary incontinence after successful fistula closure: the Uganda experience

Obstetric fistula is a devastating childbirth injury. Despite successful closure of the fistula, 16% to 55% of women suffer from persistent urinary incontinence after surgery. This study assessed the type and severity of persistent incontinence after successful fistula closure and its impact on the quality of life of Ugandan women post-fistula treatment. This cross-sectional study enrolled women with a history of obstetric fistula repair who continued to have persistent urinary incontinence (cases, N=36) and women without incontinence (controls, N=52) after successful fistula closure. Data were collected in central and eastern Uganda between 2017 and 2019. All the participants completed a semistructured questionnaire. Cases underwent a clinical evaluation and a 2-hour pad test and completed a series of incontinence questionnaires, including two novel tools designed to assess the severity of incontinence in low-literacy populations. Cases were more likely to have acquired a fistula during their first delivery (63% vs 37%, P=.02), were younger when they developed a fistula (20.3±5.8 vs 24.8±7.5 years old, P=.003), and were more likely to have had >2 fistula surgeries (67% vs 2%, P≤.001). Cases reported a much higher rate of planned home birth for their index pregnancy compared to controls (44% vs 11%), though only 14% of cases and 12% of controls actually delivered at home. Cases reported higher rates of pain with intercourse (36% vs 18%, P=.05), but recent sexual activity status (intercourse within the previous six months) was not significantly different between the groups (47% vs 62%, P=.18). Among cases, 67% reported stress incontinence, 47% reported urgency incontinence, and 47% reported mixed incontinence. The cough stress test was successfully done with 92% of the cases, and of these, almost all (97%) had a positive cough stress test. More than half (53%) rated their incontinence as "very severe," which was consistent with objective findings. The 24-hour voiding diary indicated both high urinary frequency (average 14) and very frequent leakage episodes (average 20). Two-hour pad-tests indicated that 86% of cases had >4 g change in pad weight within 2 hours. Women with more severe incontinence reported a more negative impact on their quality of life. The mean score of the International Consultation on Incontinence Questionnaire-Quality of Life was 62.77±12.76 (range, 28-76, median=67), with a higher score indicating a greater impact on the quality of life. There was also a high mental health burden, with both cases and controls reporting high rates of suicidal ideation at any point since developing fistula (36% vs 31%, P=.67). Women with obstetric fistulas continue to suffer from severe persistent urinary incontinence even after successful fistula closure. Both stress and urgency incontinence are highly prevalent in this population. Worsening severity of incontinence is associated with a greater negative impact on the quality of life.

Evaluating an Evidence-Based Parenting Intervention Among Filipino Parents: Protocol for a Pilot Randomized Controlled Trial.

BackgroundFilipino Americans underuse mental health and preventive care services even though studies have indicated that Filipino youth experience high rates of suicidal ideation, substance abuse, and teen pregnancies, whereas adults experience immigration stress, discrimination, and depression. Evidence-based parenting interventions provided in early childhood have proven to be effective in preventing the onset and escalation of child mental health disorders. In a pilot randomized controlled trial, we found that participation in the Incredible Years Basic Parent Training Program (IY) improved parenting stress and positive parenting practices and decreased child internalizing and externalizing symptoms among Filipino families. A fully powered trial is needed to determine the efficacy of IY as a prevention program among Filipino families.ObjectiveThe aims of this study are to describe the design and rationale of a randomized controlled trial evaluating the effects of the web-based IY program among parents recruited from multiple community-based settings and its impact on parenting practices, parenting stress, and child problem behavior among Filipino Americans and describe the impact of COVID-19 on our study protocols.MethodsThis study uses a randomized controlled 2-arm individually randomized group treatment pretest–posttest design for 180 parent–child dyads. Individuals are eligible if they are ≥18 years, live in California, and have at least one Filipino child aged 8-12 years. Consenting participants are randomly allocated to receive either the 12-week IY parenting intervention (intervention arm) or American Academy of Pediatrics’ Bright Future handouts and placed on a waitlist to receive IY posttrial (waitlist control arm). Primary outcomes include the Parent Practices Interview and the Parenting Stress Index. Secondary outcomes will be measured using the Child Behavior Checklist (completed by parent) and will include child internalizing and externalizing behaviors and total problems. Data are collected at baseline and 3- and 6-month follow-ups.ResultsChanges made to the protocol owing to COVID-19 include administration of surveys remotely and implementation of the intervention on the web. The pandemic has provided an opportunity to evaluate the effectiveness of a web-based version of IY that may improve access and increase use of the intervention. Recruitment and data collection procedures are still ongoing and are expected to be completed by December 2022.ConclusionsOur research will determine whether IY promotes positive parenting practices and prevents child internalizing and externalizing behaviors in healthy but high-risk populations such as Filipino families. It will also uplift cultural narratives and add to the evidence base for web-based parenting programs and their implementation in real-world settings. If found efficacious, IY has the potential to prevent behavioral health disparities in this understudied and high-risk Filipino population and can be scaled, adapted, and implemented in other at-risk racial and ethnic minority communities.Trial RegistrationClinicalTrials.gov NCT04031170; https://clinicaltrials.gov/ct2/show/NCT04031170International Registered Report Identifier (IRRID)DERR1-10.2196/21867

Mitigating the Impact of Coronavirus Disease-2019 on Child and Family Behavioral Health: Suggested Policy Approaches

Mitigating the Impact of Coronavirus Disease-2019 on Child and Family Behavioral Health: Suggested Policy Approaches

The hope & wellness screening toolkit: developing a community based suicide and substance use screening program for American Indians and Alaska Natives

ABSTRACT Suicide is a leading cause of death in the U.S. In American Indian/Alaska Native (AI/AN) urban communities and rural reservation communities, youth experience high rates of suicidal ideation, attempts, and deaths. An urban AI organization partnered with a university to respond to this crisis with SAMHSA funds that supported the development and implementation of youth suicide prevention and intervention programming through screening, identification, and treatment of youth. They engaged the community in developing suicide prevention and intervention programming, and designed and tested procedures for implementing community-based suicide screenings, which led to the creation of the Hope & Wellness Screening Toolkit.

Suicidal ideation in a sample with a first-episode of restrictive eating disorders: The role of biomarkers

This study investigates the associations between the presence of suicidal ideation (SI), depressive symptoms and potential biomarkers in a sample with treatment-naïve first episode restrictive eating disorder The observational study included 77 patients and 53 controls matched by age and socioeconomic status. We used the Beck Depressive Inventory focusing particularly on item 9, which measure the severity of SI. We found high rates of SI (40.8%) and depression (52.9%). Serum ​​levels of homocysteine were significantly higher among patients who reported SI compared with patients without SI (t = 2.47; p = .016; d = 0.595). Greater depressive symptoms were significantly correlated to lower levels of vitamin B12 (t = 2.08; p = .041; d = -0.504) and folic acid (U = 403.5; p = .015; d = -0.039). Serum levels of homocysteine were inversely correlated to those of vitamin B12 ​​(rho = -0.310; p < 0.01) and folic acid (rho = -0.329; p < 0.01). The results may not be generalizable to patients with purgative behaviors or males. Our study suggests that patients with restrictive eating disorder seem to have a higher rate of SI and depressive symptoms in the early stages of the disease. These results show the importance of affective symptoms and their role in the pathogenesis and illness outcome. Moreover, the evidence from this study suggest that elevated homocysteine ​​levels could be related to the presence of SI. Therefore, early detection and treatment of these patients could lead to an improvement in their prognosis.

Impact of parental divorce versus separation due to migration on mental health and self-injury of Chinese children: a cross sectional survey

BackgroundThere has been an increasing prevalence of parental separation in China due to divorce or migration for work in recent decades. However, few studies have compared the impacts of these two types of separation on children’s mental health. This study aimed to investigate how parental divorce and parental migration impact children’s mental health and self-injurious thoughts and behaviors (SITB), while considering positive factors, including parent-adolescent communication and psychological resilience.MethodsWe randomly recruited participants in grades 5–8 from 18 schools in 2 counties in Anhui Province. A self-administered questionnaire was conducted to measure children’s mental health, SITB, parent-adolescent communication, psychological resilience, and socio-demographic characteristics.ResultsData from 1026 children with both parents migrating (BLBC), 1322 children with one parent migrating (SLBC), 475 children living in a divorced family (DC) and 1160 children with non-migrating parents (NLBC) were included. Regression model results showed that, compared to the other three groups (BLBC, SLBC, NLBC), DC exhibited higher internalizing problems (p < 0.05), higher externalizing problems (p < 0.01), less prosocial behaviors (p < 0.05), and higher rates of suicidal ideation (SI) (p < 0.05) and non-suicidal self-injury (NSSI) behaviors (p < 0.05) when adjusting for social-demographic variables. However, when further adjusting for parent-adolescent communication and psychological resilience, DC no longer had higher levels of internalizing problems, externalizing problems, NSSI and SI than left-behind groups (BLBC, SLBC).ConclusionsThe experience of separation from divorced parents had stronger negative effects on the mental health of children than was observed in LBC. The Chinese government should design special policy frameworks that provide support to DC.

BDNF, A Focus to Major Depression

Major depressive disorder is characterized, among other symptoms, by depressed mood and anhedonia associated with a high rate of suicidal ideation. In recent years, research has shown reduced expression of the brain-derived neurotrophic factor (BDNF) in limbic areas of individuals with depression. This reduction of BDNF is reversed by antidepressants in animal models of stress. Stress is one of the main triggers of mood disorders such as depression. Also, administration of BDNF increases the number of serotonergic fibers and serotonergic innervation, indicating an increase of serotonin in the synaptic cleft by this neurotrophin. Thus, BDNF appears to be one of the targets of antidepressant drugs for the increase of monoamines and remission of symptoms of major depression. The purpose of this review was to show the evidence that indicates BDNF as a molecular substrate for vulnerability to depression and the response of this substrate to the antidepressants.

Prolonged exposure to violence: Psychiatric symptoms and suicide risk among college students in the Palestinian territory.

Objective: Little is known about the risk for suicide in those exposed to prolonged political and domestic violence. Thus, this study aims to explore suicidal ideation and attempts in a community sample of Palestinian students and identify the extent to which clinical variables are associated with suicidal ideation. Method: A cross-sectional design was utilized in this study, and 303 college and university students aged 18 to 23 from seven campuses in the Palestinian territory voluntarily and anonymously completed self-report questionnaires that assessed 12 months of suicidal ideation and attempts, posttraumatic stress symptoms (PTSS), depression, anxiety, and sleep problems. Results: The results showed high rates of suicidal ideation and attempts within the last 12 months. Severe symptoms of PTSS, depression, and sleep problems were reported compared with other college samples. An exploratory path analysis showed that PTSS is directly associated with suicidal ideation and indirectly by its association with sleep problems and depressive symptoms. Conclusion: The results highlight the elevated mental health difficulties of students living under prolonged exposure to violence and could be helpful to policy and decision-makers in health care and academic institutions in implementing and design interventions aim to reduce depression and PTSS. Screening for PTSS and depression is a vital first step in suicide prevention efforts in college students exposed to trauma. Future studies should assess the types of traumatic stress exposure and health risk behaviors to offer a more in-depth view. (PsycInfo Database Record (c) 2021 APA, all rights reserved).