History Of Suicide Research Articles

Risk factors and vulnerabilities amongst people who died whilst homeless or with a housing support need: a mixed-methods analysis of client case histories in a UK local authority area

BackgroundOver the last decade, deaths amongst homeless people in England and Wales have doubled, with the average age of death several decades younger than the general population. Due to limited availability, aggregating data on this cohort to understand compounding needs is difficult. Using a novel approach, we worked in partnership with homelessness and housing support services in a local authority area in southern England to review a sample of case histories of deceased clients known to these services, aiming to better understand risk factors driving this early mortality. MethodsA mixed-methods analysis was conducted using case histories, provided by homelessness services, of a cross-sectional sample of clients who died within a three-year period (2020/21–2022/23). Included were single people and childless couples in contact with services and either rough-sleeping, sofa-surfing, in temporary accommodation, or in ‘move-on’/permanent accommodation. Quantitative data were collected for circumstances of death, health issues, substance misuse, engagement with services, and risk factors, including histories of self-neglect, suicide and offending. Descriptive statistics were produced, as were narrative summaries describing each case history, which were thematically analysed. Findings60 individuals were included, with varying volumes and quality of data available for each client. Most deaths with a suspected cause recorded involved physical health issues/illnesses, with chronic conditions commonly identified. Despite a high prevalence of mental health and substance misuse issues, relatively few individuals were recorded as engaging with relevant specialist services. Self-neglecting behaviours, including failing to access/refusing assistance from services, were common. Themes identified included multiple compounding needs, difficulties living independently, poor engagement with services, and unstable lifestyles. InterpretationMultiple compounding needs were evident across this cohort; however, fluctuating circumstances, needs, and ability/willingness to engage with services presented challenges in providing support. Despite challenges in data collection, this methodology is replicable and provides valuable insights into compounding needs in a vulnerable population. FundingNo funding received.

Participation, barriers, facilitators and bullying experiences of trans people in sport and fitness: findings from a national community survey of trans people in Australia

ObjectivesThis study aimed to assess participation rates of transgender and gender diverse (trans) people in sport/fitness activities, compare mental health outcomes for trans people participating in sport/fitness with those who...

Adaptation of an evidence-based, preventive intervention to promote mental health in Hispanic adolescents: eHealth Familias Unidas Mental Health.

Youth internalizing symptoms (i.e., depression and anxiety), suicide ideation and attempts have been rising in recent years, including among Hispanics. Disparities in mental healthcare are concerning and require intervention, ideally prevention or early intervention. Familias Unidas is a culturally-syntonic, family-centered intervention effective in reducing youth drug use and sexual risk, with evidence of unanticipated effects on internalizing symptoms. This paper describes the systematic process used to adapt the eHealth version of the Familias Unidas intervention to more directly address internalizing symptoms and suicide risk in preparation for an effectiveness-implementation hybrid trial for youth with elevated internalizing symptoms, a history of suicide ideation/attempts, or poor parent-youth communication. The resulting eHealth Familias Unidas Mental Health intervention is described. Guided by a 4-phase framework, the steps in the adaptation process involved: assessment of the community and intervention delivery setting (pediatric primary care clinics); integration of previous intervention research, including intervention mechanisms of action; and expert and community consultation via focus groups. Focus group analyses showed that youth and parents perceived that the intervention was helpful. Their feedback was categorized into themes that were used to directly target mental health by addressing technology use, parent mental health, and social support. Effective and scalable preventive interventions are needed to address mental health disparities. The systematic adaptation process described in this paper is an efficient approach to expanding interventions while maintaining known, empirical and theoretical mechanisms of action. Findings from the ongoing effectiveness-implementation trial will be critical.

Risk of Suicide and Suicidality in Patients with Moderate to Severe Psoriasis: results from the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR).

Psoriasis is associated with poor mental health and reduced quality of life. Although the high risk for depression in patients with psoriasis is well-established, their suicidality risk is uncertain. Previous studies provide contrasting results and have not included patients with clinically-confirmed severe disease. Our aim was to determine risk of suicide among patients with moderate to severe psoriasis compared with the general population, and investigate if psychiatric comorbidity or history of suicidality increases future suicidality risk in psoriasis. We further estimated the incidence of suicidal and self-injurious behaviours in patients. Analysis was performed using the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR). As controls, general population mortality and suicide data were used. There were 9 suicides in BADBIR. The incidence rate of suicide was 12.5 per 100,000 person-years (95% CI 6.53, 24.11) in BADBIR versus 11.0 per 100,000 person-years (95% CI 10.7, 11.3) in the general population in England and Wales. Among patients, psychiatric comorbidity or past suicidality was associated with higher risk for suicidal ideation, suicide attempts and self-injurious behaviours. Suicide rates among patients with moderate to severe psoriasis were not significantly higher compared with the general population. Suicide is a rare event and our results are limited by the uncertainty in the estimate reliability. However, considering the high depression prevalence in psoriasis, our findings support the need for prompt assessment of patients for psychiatric comorbidities and suicidality history. Further research is required on suicidal behaviours and the role of psoriasis severity.

University student suicides in Türkiye: Insights from two decades of media reports

University student suicides have emerged as a significant societal concern, reflecting challenges inherent in the transition to adulthood and academic pressures. This study aims to analyze two decades of national media coverage on university student suicides in Türkiye, examining demographic trends, suicide methods, and social factors implicated in these tragic incidents. A comprehensive scan of Turkish national media archives from January 1, 2004, to December 31, 2023, identified 213 unique reports of university student suicides. Data extracted included age, sex, year of incident, prior suicide attempts, geographic distribution, housing status, academic major, psychiatric history, social background, suicide method, and presence of suicide notes or social media posts. Statistical analyses utilized Fisher's Exact Test and Pearson's Chi-square to examine categorical data. Male students accounted for 61.6% (n=125) of reported suicides, with a mean age of 22.2 years (SD=3.05). The most common suicide method was jumping from height, differing by sex, with hanging prevalent among males and jumping more frequent among females. Mobbing emerged as a predominant social stressor implicated in suicide incidents, surpassing other factors reported in the literature. The findings highlight an alarming increase in media-reported university student suicides, predominantly affecting males and characterized by distinct suicide methods. The pervasive impact of mobbing underscores the urgent need for targeted interventions addressing social stressors, alongside comprehensive medical, psychological, social, and economic support systems within academic settings. Efforts should prioritize proactive mental health initiatives, policy reforms, and community-based interventions to mitigate suicide risks among university students.

How Does Virtual Reality Technology Affect Suicidal Ideation in Society?

Mental health issues such as anxiety and depression are on the rise in communities. Ignoring severe mental health issues can lead to suicide, which is a global public health issue. The use of advanced tools and methods to prevent suicide can help save human lives. Visual tools and virtual technologies have multiple applications in the medical and educational fields. The aim of this study was to investigate the effect of using virtual reality (VR) technology on suicidal thoughts. A quasi-experimental study was conducted, in which 189 individuals who had a history of suicide were tested. These individuals were divided into three groups: one control group and two intervention groups that received traditional and VR-based training for 90 days. The Beck Scale for Suicide Ideation was used. The posttest results after the training period showed that conducting the training course had a statistically significant effect on individuals' suicidal behaviour and those who participated in the VR-based training course had better improvements in suicidal thoughts. Therefore, the use of 3D simulation and visualisation tools can have a significant impact on individuals' thoughts and perceptions. The results of this study have practical implications for hospital managers and counsellors in healthcare centres to use VR technology in counselling and training courses to improve the behaviour of individuals with a history of suicide.

Effectiveness of a multidimensional collaborative approach versus usual care in the treatment of adult depression in primary care in Chile: study protocol for a single blinded cluster randomized controlled trial.

Major depression (MD) is a prevalent and disabling condition in Chile, with most cases being treated at the primary care level. In Chilean primary care, the authors have identified key factors associated with more complex presentations of MD and a poorer prognosis, such as a history of childhood trauma, suicidality, and comorbidities. These findings underscore the need for a multidimensional, trauma-informed, and interprofessional approach to the treatment of depression. This protocol is a two-arm, single-blinded, cluster RCT to compare the effectiveness of a collaborative multidimensional approach for depression (CMAD) versus usual care to treat MD in primary care clinics in Chile. In total, 394 depressed adults from 18 to 65 years of age in twelve clinics located in Chile's Maule Region will be consented to participate in the study. Patients and care teams from each clinic will be randomized to the intervention or to the control arm.Interprofessional teams in the intervention arm will attend 27 hours of didactic and active learning sessions focused on clinical competences to effectively engage, treat and follow up patients with the factors associated to the complex presentation of MD. Team in the control arm will receive 27 didactic sessions on current clinical guidelines for MD.Patients of both arms will be blindly assessed at baseline, three months, and six months. The primary outcome will be the reduction in depressive symptoms, with secondary outcomes including improvements in anxiety symptoms, interpersonal and social functioning, and treatment adherence. This protocol proposes the evaluation of an intervention designed to improve depression symptoms by enhancing the clinical competencies of primary care teams. These competencies are structured around collaborative care and trauma-informed practices. NCT05016388, registered on 16 August 2021 at ClinicalTrials.gov.

Medication Adherence and Functioning in Individuals With Bipolar Disorder Type I.

To determine the correlation between medication adherence and functioning in individuals with bipolar disorder (BD) and the predictors of functionality. This cross-sectional and correlational study was conducted with 145 individuals with BD type I. Data were collected using a Patient Information Form, the Medication Adherence Rating Scale, and Functioning Assessment Short Test. Findings showed that most participants did not take medication as prescribed. Medication adherence was negatively correlated with functionality. Predictors of functionality were years of treatment, number of hospitalizations, working status, medication adherence, family history of mental illness, and history of suicide. Medication nonadherence is a fundamental problem for individuals with BD. Nursing interventions to increase functionality and medication adherence among this at-risk group should be planned and implemented. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Suicidal thoughts are associated with reduced source attribution of emotion.

Approximately 9% of people think about suicide during their lifetime. Suicidal thoughts are consistently associated with perceived failures in emotion regulation. However, factors contributing to these perceptions remain insufficiently clear. New evidence suggests that when people know little about the cause of their emotions (i.e., low source attribution of emotion), they perceive themselves as less successful in regulating them. Therefore, emotion regulation deficits in people with suicidal thoughts might be related to lower knowledge about sources of emotions. We examined this question in two ecological momentary assessment studies (N₁ = 396, N₂ = 195). We found that participants with current suicidal thoughts knew less about the sources of their emotions compared to participants with no suicidal thoughts history (Studies 1 and 2), and even when compared to controls with similar levels of psychiatric symptoms but no history of suicidal thoughts (Study 2). Using language processing, we found that written descriptions of the source of participants' emotions were less concrete among those with suicidal thoughts compared to participants with no suicidal thoughts history. Among suicidal participants, suicidal thoughts were more likely to be present in moments when participants knew less than usual about the source of their negative emotions (Study 2), and low knowledge of the source was associated with more frequent and prolonged suicidal thoughts (Studies 1 and 2). Finally, lower perceived success in emotion regulation mediated the association between source attribution of emotion and the occurrence of suicidal thoughts. Findings suggest that reduced knowledge about the source of negative emotions might increase the risk for suicidal thinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence and factors associated with suicidal behaviors among domestic workers

BackgroundDue to urbanization and changes in family structure, the need for domestic workers has surged in many developing countries, including Rwanda. While being employed as a domestic worker presents financial benefits to many of them and their dependents, it also comes with risks and difficulties that might harm the domestic worker's mental health.AimThis study aimed to determine the prevalence and factors associated with suicidal behaviors (i.e., suicidal ideations, plans, and attempt(s)) among domestic workers in Rwanda.MethodIn this cross-sectional study, data was captured from 884 domestic workers in Kigali, Rwanda. Suicidal ideation was measured using questions from the General Health Questionnaire (GHQ-28), while suicide attempts and plans were measured using questions adopted from previous studies in the region. The methods used/plan to attempt suicide were also captured from individuals with a recent history of suicide plan/attempt(s). Three separate regression models were employed to ascertain the factors associated with suicidal behaviors.ResultsThe prevalence of past-year suicidal behaviors was 32.5% for suicidal ideations, 9.5% for suicide plans, and 7.8% for suicidal attempts. Being female and having a chronic medical illness were linked to a higher risk of participating in any form of suicidal behavior. Suicidal ideations were less likely to occur among those who attained secondary education. However, more years of working as a domestic worker were associated with an increased likelihood of suicidal ideations. Having more than five dependents at work increased the likelihood of experiencing suicidal plans or attempts among domestic workers. For those who attempted suicide, overdosing with medications/drugs was the most common method of attempting.ConclusionDomestic workers have prevalent suicide behaviors, especially among females and those with a chronic medical illness, more years of work experience, and those with many household members at work. Based on the present study, for domestic workers at risk, there is a critical need for focused mental health interventions and support networks in various sectors of the domestic labor force.

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.

Typologies of Psychiatric Diagnoses Among Inpatients with Recent Suicide Attempts

Objective Psychiatric multimorbidity is a well-documented risk factor for suicide. However, diagnostic heterogeneity and patterns of comorbidity likely exists within the population of those who attempt suicide. Person-centered statistical approaches, such as latent class analysis (LCA), extract distinguishable groups differentiated by prevalence and comorbidity of psychiatric disorders. Method The present study used LCA to identify typologies of psychiatric heterogeneity in a sample of 213 inpatients (M age = 33.04 [SD = 12.67]; 57.3% female; 62.4% White; 23.9% Hispanic/Latino) with a history of suicide attempt who were recruited for a suicide prevention clinical trial. Class differences in suicide history characteristics; demographic characteristics; and cognitive-affective and behavioral risk factors, obtained from an initial evaluation involving the administration of a semi-structured diagnostic interview, suicide risk assessment, and battery of self-report measures, were explored. Results LCA identified three classes in the best-fitting solution: Depressive-High Comorbidity (n = 68), Depressive-Low Comorbidity (n = 86), and Bipolar (n = 59). The Depressive-Low Comorbidity class reported less severe suicidal ideation (p < .001), anxiety (p < .001), stress (p < .001), unlovability beliefs (p = .006), and impulsivity (p < .001). The Depressive-Low Comorbidity class also reported fewer actual attempts than the Bipolar class (p = .001) and fewer interrupted attempts than the Depressive-High Comorbidity class (p = .004). Conclusions The Depressive-High Comorbidity and Bipolar classes consistently endorsed higher levels of suicide risk factors. These findings may help to illuminate typologies of suicide attempters with unique clinical needs, which is an essential step toward personalized medicine.

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).

Substance use patterns and mental health comorbidities in youth with a history of depression or suicidality: Findings from TX-YDSRN

BackgroundThere is a robust relationship between depression and substance use in youth, with higher levels of substance use associated with greater depressive symptomatology. However, previous research has examined individual substances, without consideration of psychiatric comorbidities. Here, we investigate patterns of substance use among depressed and/or suicidal youth within the context of psychiatric comorbidities. Methods945 youth with depression and/or suicidality from the Texas Youth Depression and Suicide Research Network (TX-YDSRN) were assessed for current use of alcohol, nicotine, cannabis, and other drugs and comorbid psychiatric diagnoses. We used latent class analysis to identify patterns of past-year substance use, then examined if demographics or psychiatric disorders predicted class membership. ResultsWe identified three patterns of substance use: non-use (63.4 %), moderate likelihood of using alcohol, nicotine and cannabis (23.8 %), and high likelihood of using all substances (12.7 %). Compared to non-users, individuals in the moderate and high likelihood classes were more likely to be older. Individuals in the high likelihood class were more likely to have a substance use disorder, ADHD, and higher suicidality scores. LimitationsWe cannot ascertain the causal or temporal ordering of substance use and psychiatric diagnoses due to the cross-sectional nature of the study. ConclusionsUsing a brief, self-report measure of substance use, we identified three classes of substance users differing in probability of past-year use, which were predicted by older age and some psychiatric comorbidities. While research on universal screening of substance use in youth remains limited, we discuss who may benefit from such screening among depressed youth.

COMPARISON OF CLINICAL AND CRIMINAL CHARACTERISTICS OF MALE AND FEMALE CASES IN THE PRISONER SERVICE FOR MURDER OR ATTEMPTED MURDER

Background: The aim of the study is to compare male and female cases who were in the prisoner service and committed murder/attempted murder in terms of clinical and criminal characteristics. Methods: Information about 101 female and 101 male cases who were admitted to the prisoner service for murder and/or attempted murder were collected through a data form as a result of examining the hospitalization files. Results: The rate of men having psychotic disorders (50.8%) was found to be higher than the rate of women (20.4%). While men's rates of having antisocial personality disorder are higher than women's rates, women's borderline personality disorder rates are significantly higher than men's rates. The rate of women's previous history of suicide (50.5%) is higher than the rate of men's history (35.6%). It was seen that the rate of women admitted to the service to be their first crime was higher (87.1%) than men (46.5%). Conclusion: It is important to take gender-based differences into account and organize personalized treatment during the forensic treatment process. More clinical research on gender differences in homicide crimes is needed.

Prevalence of polypharmacy and factors impacting psychotropic prescribing patterns in women of childbearing potential at inpatient mental health services in Qatar.

Women may experience unique mental disorders due to hormone shifts. Rates of schizophrenia and bipolar disorder are similar between genders, but onset and symptoms may differ. Women tend to use more psychotropic drugs due to limited therapeutic options. This study was aimed to estimate the prevalence of psychotropic polypharmacy among females of childbearing potential and factors impacting prescribing patterns. This was a quantitative retrospective chart review for patients admitted to inpatient units at the Mental Health Hospital in Qatar. SPSS® Statistics was used for data analysis. In addition to descriptive statistics applied, linear regression and binary logistic regression models were used to examine the clinical and sociodemographic factors associated with polypharmacy and full therapeutic response upon discharge, respectively. An alpha value of 0.05 was used. Of the 347 patients, 52.7% of the patients received a prescription of at least two psychotropic drugs upon discharge. Around two-thirds (63.1%) were prescribed at least one antipsychotic. Potential predictors of polypharmacy were age (p = 0.027), longer hospital stay (p = 0.003), family history (p < 0.001), absence of suicidal history (p = 0.005), and a diagnosis of a mood disorder (p = 0.009), or a diagnosis of a psychotic disorder (p = 0.015). A full response upon discharge was less likely to occur in patients with a longer stay (OR = 0.940; p = 0.029) and in those with a substance use disorder (OR = 0.166; p = 0.035). There is a notably high prevalence of total polypharmacy upon discharge. Some identified factors are modifiable. Evidence-based prescription practices through hospital guidelines and education should be emphasized to avoid unreasonable polypharmacy.

Pilot study of telehealth delivery of horticultural therapy (TeleHT) as an acceptable intervention and in reducing suicide risk factors in veterans

ObjectivesConverging evidence indicates that Horticultural Therapy (HT) contributes to significant reductions in stress, loneliness, and depression, notable risk factors for suicidality. This pilot study aimed to assess the initial feasibility and acceptability of HT when virtually administered. InterventionTelehealth-delivered horticultural therapy (TeleHT) was administered to groups of Veterans, including those with elevated suicide risk over the course of four weeks. Participants were each sent a package through the mail of at-home gardening supplies that were used to facilitate multisensory, nature experiences during weekly HT sessions administered via Zoom. Outcome measuresParticipants completed thermometer-based scales for the suicide risk factors of stress, loneliness, depression, and pain before and after each TeleHT session. Post-intervention qualitative assessments were completed upon the conclusion of the four-week intervention. ResultsSignificant reductions in stress, depression, and loneliness risk were observed from weekly pre- to post-session measures (p < 0.05), with 89.1 % HT completion rate. Stress, pain, depression, and loneliness indices also showed small to medium sized symptom reduction amongst Veterans with no history of suicidality (Cohen’s d=−0.70, d=−0.49, d=−0.62, d=−0.71), while those with elevated suicide risk at baseline also showed reduction in these risk factors with small to medium effect sizes (d=−0.58, d=−.018, d=−0.46, d=−0.41). Qualitative post-intervention assessments indicated a high degree of acceptability and pointed to the inclusion of mailed gardening packages as particularly relevant to positive experiences. ConclusionsWhile future work is needed to fully assess efficacy, findings from this pilot study demonstrate an initial feasibility and acceptability through a high retention rate and positive qualitative assessments for TeleHT that mirror that of the in-person intervention.

Childhood trauma and suicide risk: Investigating the role of adult attachment

BackgroundSuicide is a leading cause of death globally and a serious public health concern. Childhood trauma has been found to be associated with adult suicide vulnerability. Recent research has turned attention to investigating the role of attachment in the context of the childhood trauma-adult suicide relationship. The current study investigated for the first time whether attachment influences and moderates the childhood trauma-suicidality relationship, using a daily diary design, in the general population. Methods481 participants completed questionnaires assessing experiences of childhood trauma, attachment patterns, and history of suicidality. 243 participants continued to a daily diary phase where measures of daily stress, defeat and entrapment were completed for 7 consecutive days. ResultsHigher levels of childhood trauma were associated with a history of suicide ideation and attempt and also higher levels of daily defeat, entrapment and stress during the 7 day study. Similarly, higher levels of attachment anxiety and avoidance were associated with a history of suicide ideation and attempt together with higher levels of daily defeat, entrapment and stress. However, the effects of childhood trauma on suicide history and on daily suicide vulnerability factors were not moderated by attachment anxiety or avoidance. LimitationsThe measure of childhood trauma was a retrospective self-report tool that may be influenced by memory biases. ConclusionsChildhood trauma and insecure attachment are implicated in adult suicide risk. Interventions aimed at mitigating the negative effects of childhood trauma and insecure attachment should also incorporate components that target modifiable risk factors such as defeat, entrapment and stress.

Subclinical hypomanic experiences in young adults after sleep deprivation are independent of depressive disorders, chronotype or 5-HTTLPR polymorphism

Introduction The acute antidepressant effect of sleep deprivation (SD) in patients with depressive disorders has been studied for more than 60 years. However, hypomanic mood swings after partial or total SD have also been described in people without diagnosed mental disorders. Studying this phenomenon in the general population may yield insights about the mechanisms of therapeutic SD, mania and bipolar disorders. Methods A cross-sectional sample of young adults was recruited and classified into those who described having regularly occurring subclinical hypomanic experiences (ROHE) after SD and those who did not. History of psychiatric and physical illness, with screening for depression and mania, as well as alcohol or drug consumption, family history of depressive disorders or suicide, 5-HTTLPR polymorphism, and MEQ-SA chronotype were collected. Results A total of 251 participants were included; 39.0% indicated regularly having subclinical hypomanic experiences after SD. These experiences were not associated with depressive or mania screening, history of psychiatric illness, family history, 5-HTTLPR polymorphism, or MEQ-SA chronotype. Conclusions ROHE after non-therapeutic SD seem to be a relatively common phenomenon in young adults, independent of depressive mood state. Our results suggest that therapeutic SD may depend on a physiological phenomenon of subclinical affective disturbance after SD that affects a part of the general population, independent of psychiatric diagnosis. Further studies could elucidate associated factors and contribute to our understanding of (hypo-)manic mood states.