Important Risk Factor For Suicide Research Articles

Older adults coping with critical life events - results of the revised demoralization scale in a representative sample of older adulthood.

High suicide rates in older adults are a relevant public health concern. Social isolation or widowhood as well as physical decline play a crucial role for suicidality in older adulthood. Previous evidence suggested that demoralization is an important risk factor for suicide. Whether demoralization is a relevant phenomenon in older adulthood which possibly could account for high suicide rates remains unclear. Demoralization Scale II (DS-II) scores assessed in a survey of the German general population were investigated with respect to older adults (aged ≥ 65 years). DS-II scores were compared between older (≥ 65 years) and younger (< 65 years) adulthood and between young-old (65-74y), middle-old (75-84y), and old-old (85+y) individuals. We tested the impact of sociodemographic factors on DS-II scores within older adults. The sample comprised N = 545 adults ≥ 65 years and N = 1922 adults < 65 years. DS-II scores increased in older compared to younger adults (F(1,2465) = 6.1; p = 0.013; d = 0.09) and further from young-old to old-old (Mdiff = 2.7; 95% CI 0.45, 5.46; p = 0.034). One-fourth of individuals ≥ 65 years and almost half of old-old individuals reported DS-II scores above the cut-off > 5. Living with a partner protected from demoralization in old-old individuals. This study provides first evidence for an increased rate of demoralization in very old adults, in particular women, which is partly related to partnership status. We suggest that demoralization is considered asacrucialentity in older adulthood which can be missed by standard psychological screenings.

Suicide and suicidality in Australian Defence Force veterans: A systematic scoping review.

Increased suicidality and suicide deaths among veterans of the Australian Defence Force have gained recent prominence. A systematic scoping review was conducted to identify, summarise and synthesise the existing literature relating to Australian veteran suicide and suicidality, with the objective of identifying future research priorities. We conducted a PRISMA-compliant systematic search on PubMed/MEDLINE, Embase and CINAHL databases for all manuscripts reporting primary data on suicide and suicidality in Australian veterans. The search was supplemented by grey literature and a search of reference lists. Manuscripts of any study type, published in the English language since the Vietnam era, were eligible for inclusion. A total of 26 articles and reports, utilising a variety of mostly quantitative approaches, were included in the review. Findings, especially in larger and more recent studies, indicate increased suicidality in the veteran population. Suicide deaths appeared to increase with transition out of the military. Mental illness was identified as an important risk factor for suicide and suicidality. Current service was identified as a protective factor against suicide. There was mixed evidence regarding the impact of operational deployment on suicide and suicidality. Gaps were identified in relation to the relative contributions to risk from transition, the various psychosocial correlates (for example, relationships, finances, employment), pre-service factors and the extent to which these are causal or mediating in nature. A better understanding of health service utilisation would also aid in targeting preventive efforts. Future research in these areas is warranted.

Insomnia moderates the association between psychotic-like experiences and suicidal ideation in a non-clinical population: a network analysis

Psychotic-like experiences (PLEs) have been associated with poor sleep quality and increased suicide risk. However, the association between PLEs, insomnia and suicide risk has not been thoroughly investigated in prior studies. In this study, we aimed to explore as to whether insomnia moderates the association between PLEs and suicidal ideation. The study was performed in 4203 young adults (aged 18–35 years, 63.8% females). Data were collected using self-reports. Moderation analysis demonstrated that PLEs are associated with higher levels of the current suicidal ideation only in participants with greater severity of insomnia (B = 0.003, p < 0.001). This analysis included age, gender, education, occupation and depressive symptoms as covariates. Moreover, the network analysis demonstrated that nodes representing PLEs are connected to the node of current suicidal ideation only in participants with greater severity of insomnia. The nodes of PLEs connected to the current suicidal ideation node captured PLEs representing deja vu experiences, auditory hallucination-like experiences and paranoia (edge weights between 0.011 and 0.083). Furthermore, nodes representing PLEs were the three most central nodes in the network analysis of individuals with higher levels of insomnia (strength centrality between 0.96 and 1.10). In turn, the three most central nodes were represented by depressive symptoms in the network analysis of individuals with lower levels of insomnia (strength centrality between 0.67 and 0.79). Findings from this study indicate that insomnia might be an important risk factor of suicide in people with PLEs, especially those reporting deja vu experiences, auditory hallucination-like experiences and paranoia.

The relationship of coping skills with psychache in patients with depressive disorder.

Suicide is a leading cause of death and disability worldwide. Psychache (psychological pain) and diminished tolerance of psychaches are important risk factors for suicide. People experiencing psychaches of similar severity may not demonstrate the same levels of tolerance because of various coping skills. This study aimed to determine the relationship between psychache, tolerance for psychache, and coping skills in individuals with depression and healthy controls. We included 73 patients with depressive disorders without comorbid mental disorders and 65 healthy controls. We applied beck depression inventory, beck hopelessness scale, beck suicidal ideation scale, psychache scale, tolerance for mental pain scale (TMPS), and coping attitudes evaluation scale (COPE) to all participants. People with depression had significantly higher COPE dysfunction scores than those in the control group did. Patients who had previously attempted suicide attempt(s) previously had significantly higher beck hopelessness scale, beck depression inventory, COPE dysfunction, and psychache scale scores, and lower TMPS-10 scores than those who did not attempt suicide. Mediation analyses revealed that dysfunctional coping skills played a partial mediating role in the relationship between psychache and the TMPS. The study revealed that dysfunctional coping skills were related to suicidal ideation and previous suicide attempts. These findings suggest that improving coping skills could help reduce the severity of suicidal ideation.

Self-Harm Behaviors, Suicide Attempts, and Suicidal Ideation in a Clinical Sample of Children and Adolescents with Psychiatric Disorders

Suicidal ideation and self-harm behaviors have been found to be important risk factors for suicide. The aim of this study was to explore the rates of psychiatric disorders among different groups of patients with suicidal ideation, suicide attempts, and non-suicidal self-harm behaviors and to identify the associated socio-demographic and clinical variables. We conducted a cross-sectional study with emergency-admitted patients presenting with non-suicidal self-harm behaviors, suicide attempts, or suicidal ideation to the emergency room of the Child and Adolescent Psychiatry Clinic in Cluj-Napoca, Romania. Data were collected from the patients' charts using a questionnaire that contained socio-demographic and clinical variables. A total of 95 patients aged between 6 and 18 years were included in the study. Ingesting medication and cutting were the most frequently used methods to attempt suicide. Depression and mixed affective and conduct disorders were the diagnoses most commonly associated with suicidal behavior. Girls with depressive symptoms were more probable to have suicide attempts than boys, and girls with depressive symptoms and behavioral problems registered more self-harm behaviors. Further research should systematically examine the relationship between self-harm behaviors and suicide attempts and the profile of patients at risk of future suicide attempts.

Gambling problems predict suicidality in recently transitioned military veterans

ObjectiveThis study investigated associations between gambling problems and suicidality in Australian veterans. MethodsData drawn from n = 3,511 Australian Defence Force veterans who had recently transitioned to civilian life. Gambling problems were assessed using the Problem Gambling Severity Index (PGSI) and suicidal ideation and behaviour were assessed using items adapted from the National Survey of Mental Health and Wellbeing. ResultsAt-risk gambling and problem gambling were associated with increased odds of suicidal ideation [at-risk gambling: odds ratio (OR), 1.93; 95% confidence interval (CI), 1.47‒2.53; problem gambling: OR, 2.75; 95% CI 1.86‒4.06] and suicide planning or attempts (at-risk gambling: OR, 2.07; 95% CI, 1.39‒3.06; problem gambling: OR 4.22, 95% CI, 2.61‒6.81). The association with total scores on the PGSI and any suicidality was substantially reduced and became non-significant when controlling for the effects of depressive symptoms, but not financial hardship or social support. ConclusionsGambling problems and harms are important risk factors for suicide in veterans, and should be recognised in veteran-specific suicide prevention policies and programs, along with co-occurring mental health problems. Implications for public healthA comprehensive public health approach to reducing gambling harm should feature in suicide prevention efforts in veteran and military populations.

Risk factors for suicide in cancer patients and preventive measures: a literature review

The aim of the study is to identify the main risk factors for suicide and review aspects of suicide prevention. Evidence shows that suicide is higher among cancer patients than in the general population. Lithuania has been in a leading position in suicides worldwide. It is very important to care about cancer patients’ emotional status because advances in health care offer great promise for patients’ physical health. Material and methods: This review was conducted using data sources from the PubMed electronic bibliography published over the past ten years. Articles were selected using the keywords “the risk factors”, “suicides”, and “the patients with cancer”. After selection, seventy-two articles were suitable for the analysis. Results and discussion: The main suicide risk factor was depression; a less frequent factor was other mental pathology. Symptoms such as pain, weakness and decreased physical capacity play an important role in the risk of suicide. Suicide was also affected by the localization of the tumour; a short time elapsed since diagnosis was also important. As in the general population, social, economic, and demographic factors such as male gender, loneliness, age, and low income are important risk factors for suicide among cancer patients. Conclusion: To reduce the risk of suicide in cancer patients, it is appropriate to create a united, practice-friendly suicide risk assessment system and develop psychoeducational training and psychological assistance for medical staff and family members.

Artificial intelligence assisted tools for the detection of anxiety and depression leading to suicidal ideation in adolescents: a review.

Epidemiological studies report high levels of anxiety and depression amongst adolescents. These psychiatric conditions and complex interplays of biological, social and environmental factors are important risk factors for suicidal behaviours and suicide, which show a peak in late adolescence and early adulthood. Although deaths by suicide have fallen globally in recent years, suicide deaths are increasing in some countries, such as the US. Suicide prevention is a challenging global public health problem. Currently, there aren't any validated clinical biomarkers for suicidal diagnosis, and traditional methods exhibit limitations. Artificial intelligence (AI) is budding in many fields, including in the diagnosis of medical conditions. This review paper summarizes recent studies (past 8 years) that employed AI tools for the automated detection of depression and/or anxiety disorder and discusses the limitations and effects of some modalities. The studies assert that AI tools produce promising results and could overcome the limitations of traditional diagnostic methods. Although using AI tools for suicidal ideation exhibits limitations, these are outweighed by the advantages. Thus, this review article also proposes extracting a fusion of features such as facial images, speech signals, and visual and clinical history features from deep models for the automated detection of depression and/or anxiety disorder in individuals, for future work. This may pave the way for the identification of individuals with suicidal thoughts.

Tumor markers and depression scores are predictive of non-suicidal self-injury behaviors among adolescents with depressive disorder: A retrospective study

BackgroundNon-suicidal self-injury (NSSI) is an important risk factor for suicide in adolescents with depressive disorders; therefore, it is important to predict NSSI occurrence as early as possible. Disturbances in biological rhythms are characteristic manifestations of depressive disorders and can lead to immune dysfunction, leading to changes in tumor markers. This study aimed to produce an index that utilizes tumor markers to predict NSSI behaviors among adolescents with depressive disorders.MethodsA total of 120 hospitalized adolescent patients with depressive disorders aged 14–24 years were included in this study. Participants were divided into NSSI and non-NSSI groups based on self-reports using the Ottawa Self-Injury Inventory. Demographics, tumor marker concentrations, other peripheral blood indices, Hamilton Depression Rating Scale (HDRS) scores, and Hamilton Anxiety Rating Scale (HAMA) scores were compared between the two groups. Logistic regression analysis was conducted to develop a joint index, and a receiver operating characteristic (ROC) curve was created to predict NSSI behaviors among adolescents with depressive disorders.ResultsCompared with the non-NSSI group, the NSSI group had significantly higher insight, retardation, insomnia, hopelessness, psychiatric anxiety, total HDRS and HAMA scores, and significantly higher levels of cancer antigen 125 (CA-125), cancer antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA). In addition, a joint index was developed by combining CA-125, CA19-9, CEA, HDRS total score, HAMA total score and age using multiple logistic regression to predict NSSI behaviors. The area under the curve was 0.831, with a sensitivity and specificity of 0.734 and 0.891, respectively.ConclusionA combination of depression score, tumor marker levels, and age can identify NSSI behaviors among adolescents with depressive disorders.

Psychoactive substances use before suicide: detailed analysis of all cases that occurred in the Brazilian Federal District in a 10-years period

BackgroundPsychoactive substances (PASs) are an important risk factor for suicide. This study investigated the sociodemographic characteristics, data related to the suicidal behavior, the methods employed, the circumstances of the events, and the use of PASs before dying in all suicides that occurred between 2005–2014 in the Brazilian Federal District, comparing cases with positive and negative detection for PASs in the post-mortem analysis to identify groups at greatest risk.MethodsA population-based, observational, cross-sectional study with an analytical aspect was conducted with suicides cases collected from local police, which toxicological examination was performed (headspace gas chromatographic-mass spectrometry-HS-GC/MS) for detection of ethanol and methanol in blood samples; immunoassay for other substances (cocaine, marijuana, benzodiazepine).ResultsThe results showed that the increase in the suicide rate was 10 × greater than the population growth, and 44% of the individuals used PASs before suicide. Individuals are more likely to die by suicide at home, be male, have tried before, and change their behavior days before death; they choose to hang as the method and are influenced by alcohol.ConclusionIdentifying what sociodemographic characteristics are associated with a fatal suicide attempt among individuals who use PASs and those who do not use and those who have/do not have mental disorders and what methods are employed could be employed as a path to better interventions. Thus, prevention actions could be planned and directed to individuals with greater risk.

Suicides in Turkey: 25-year trend (1995-2019).

The assessment of national suicide risks is considered critical in many countries for the establishment of suicide prevention initiatives aimed at considerably lowering suicide rates. The aim of this study is to identify at-risk suicide populations by reviewing the suicides in Turkey over a 25-year period. The Turkish Statistical Institute's suicide statistics for 1995-2019 in Turkey was retrospectively reviewed in current article. The data collected in the study was statistically analyzed using the MINITAB vn 14 software. Between 1995 and 2019, the total number of suicides in Turkey was 66,819, and suicide rates, especially in males, showed an increasing trend in this period. Males comprised 68.3% of the total cases, and most (27.2%) were aged 15-24 years. Suicides mostly occurred between May and July (27.7%), of individuals with a primary school level of education (51.7%) and who were married (6.0 per 100,000). Illness was most important risk factor for suicide (36.8%) and hanging (47.5%) was the leading suicide method in all age groups and in both genders. Despite the fact that Turkey's suicide rate is lower than many other countries, the growth in male suicide rates is concerning. Suicides are likely to become a severe problem in Turkey in the near future unless measures like education, psychiatric evaluations, the reactivation of psychological counseling service phone lines, and the establishment of youth counseling centers, as described in this paper, are taken.

Suicide &amp; Its Prevention

Suicide is the intentional infliction of death on oneself. It is the leading cause of death on the planet. Suicide is the third leading cause of death among 15 to 19-year-olds. 79 percent of global suicides occur in low- and middle-income countries. Ingestion of pesticides, hanging, and the use of firearms are among the most common methods of suicide in the world. India's suicide rate increased to 230,314 in 2016. Suicide was the leading cause of mortality in both the 15–29 and 15–39 year age groups. Over 800,000 people die by suicide every year around the world, with 135,000 (17%) of them being Indian citizens, who make up 17.5 percent of the global population. Every year, significantly more people try to commit suicide than actually do so. A past suicide attempt is the single most important risk factor for suicide in the general population. In 2012, Tamil Nadu had the highest suicide rate (12.5%), followed by Maharashtra (11.9%) and West Bengal (10.1%). (11.0 percent). In 2012, Tamil Nadu and Kerala had the highest suicide rates per 100,000 people among states with large populations. Male suicides outnumber female suicides roughly 2:1 in India. Suicides are estimated to number in the millions in India. For example, a study published in The Lancet predicted 187,000 suicides in India in 2010, despite the Indian government's official statistics claiming 134,600 suicides in the same year. According to WHO data, India's age-standardized suicide rate for women is 16.4 per 100,000 (6th highest in the world) and for males is 25.8 per 100,000 (22nd).

Psychological Impacts on Patients with Alcohol Use Disorder: a Study in Southern Taiwan with Alcohol Use Disorders Identification Test (AUDIT) in 2020

IntroductionAlcohol consumption is a risk factor for various comorbidities, such as cirrhosis, chronic sclerosing stomatitis, and neuropsychiatric disorders.ObjectivesOur study examined the associations between psychological factors and alcohol addiction of the individuals with alcohol use disorder (AUD) in Southern Taiwan.MethodsDemographic information as well as suicidal history and sources of stress were collected from 177 participants. The extent of alcoholism was assessed by AUDIT questionnaire. Demographic and linear regression analyses were performed with the Statistical Software Stata version 12.0 (StataCorp LP, College Station, TX, USA).ResultsDemographic data, suicidal history and the causes of stress of patients divided by AUDIT scores are shown in Table 1. Among 177 participants, 17 (9.6%) had suicidal thoughts, 4 (2.3%) had suicide plan, 22 (12.5%) self-injured, and four-fifth of patients lived under pressure. Patients who self-harmed were with significant lower AUDIT scores of -7.24 (95% CI: -11.49 – -3.00) (Table. 2). The AUDIT scores of patients with physical stress, interpersonal difficulties and loneliness increased significantly by 6.71 (95% CI: 3.19 – 10.30), 6.14 (95% CI: 2.15 – 10.13) and 5.02 (95% CI: 0.93 – 9.11), respectively (Table. 3).ConclusionsOur findings indicated negative correlation with alcohol use and auto-inflicted injury. However, previous study showed systematic assessment of the association between suicide and AUD, and considered alcohol an important risk factor for suicide, which is related to mental health and affected by different genders and drinking patterns. Our results may provide reference for estimation of the alcohol-related psychological effects in Taiwan.DisclosureNo significant relationships.

Psicosis and suicide risk: who, when and why

IntroductionSuicide rates in people diagnosed with a psychotic disorder can be up to 50 times higher than in the general population, with the lethality of attempts being significantly higher in this group, compared to people diagnosed with other psychiatric disorders. Furthermore, it is known that being male is associated with more serious suicide attempts and higher rates of completed suicides.ObjectivesTo reflect on the increased risk of suicide associated with psychotic disorders.MethodsCase report and literature review.ResultsCase report 40-year-old male, recently diagnosed with Schizophreniform Disorder and currently with persistent positive symptoms. He was admitted to our psychiatric hospitalization unit due to a voluntary overdose of almost 100 tablets (antihypertensives, antiarrhythmics, and benzodiazepines) and alcohol. He admits taking the pills with the aim of committing suicide. Literature review: - Around 10% of people diagnosed with schizophrenia commit suicide. - In young patients diagnosed with schizophrenia, suicide is the leading cause of death. - Between 15 and 65% of patients diagnosed with schizophrenia have depressive symptoms such as hopelessness. - Depressive symptoms in these patients seem to be directly proportionally with awareness of the disease (stigma, awareness of its severity and a sudden decrease in quality of life and social integration). - The risk of suicide increases especially in the first 10 years of the disease.ConclusionsPsychosis is an important risk factor of suicide and active preventive measures should be carried out in these patients.DisclosureNo significant relationships.

Low level of perfectionism as a possible risk factor for suicide in adolescents with attention-deficit/hyperactivity disorder

IntroductionPrevious research highlighted that adolescents with attention-deficit/hyperactivity disorder (ADHD) are four times as vulnerable to suicidal behavior as the healthy population. Maladaptive perfectionism is also viewed as an important risk factor for suicide. Yet, there are no studies which focused on the relationship between perfectionism and suicide among adolescents with ADHD.ObjectivesThe objective of the present study was to explore if perfectionism may be a risk factor for suicidal behavior in adolescents with ADHD.MethodsThe clinical group was recruited from outpatient clinics, while the non-clinical group was recruited from high schools around Hungary. The clinical group’s inclusion criterion was ADHD diagnoses, while the non-clinical group required the absence of any current or past psychiatric treatment or diagnoses.ResultsIn the ADHD group 88 adolescents participated, and 96 adolescents participated in the non-clinical group. There was no difference regarding the level of perfectionism in the groups, except one dimension of perfectionism, which is ‘Organization’. The ADHD group had significantly higher level of suicidal behavior than the control group ((χ2 (1) = 11.222, p &lt; .001, V = 0.25). Among the ADHD group adaptive perfectionism was significantly negatively correlated with suicidal behaviour.ConclusionsAdolescents with ADHD did not have a different level of perfectionism than the healthy control group only in ‘Organization’ trait. This result could add to the therapeutic work with adolescents diagnosed with ADHD with underlining the importance to focus on organizational skills. The result highlights that adaptive perfectionism appears to be a protective factor against suicidality.DisclosureNo significant relationships.

Psychiatric admissions after hospital presented deliberate self-harm in the young: A national study

Follow-up psychiatric care is crucial for young adults presenting to hospitals because of deliberate self-harm (DSH). However, who receives such care is not sufficiently understood. We therefore investigated the clinical and sociodemographic correlates of admissions to psychiatric inpatient treatment immediately following general hospital treatment of DSH in this age band. All episodes of hospital presented DSH among patients aged 18–35 years during the period 2008–2018 were identified from the Norwegian Patient Register. The outcome was admissions to psychiatric inpatient treatment immediately after discharge from the general hospital. The correlates of such admissions were calculated using binomial generalized estimating equation. Of 26.166 identified DSH episodes, 21.4% were admitted to psychiatric inpatient treatment. Admissions were most common for patients with a history of psychiatric treatment and a recorded diagnosis of psychosis-, mood- or personality disorders. Adjusted for other psychiatric factors, alcohol- or substance misuse diagnoses and repeated presentations of DSH were inversely associated with admissions to psychiatric inpatient treatment. Young adults admitted to psychiatric inpatient treatment following DSH have a high burden of psychiatric morbidity and risk factors for suicide. However, the inverse association seen for two important risk factors for suicide, alcohol- or substance misuse and repeated DSH, warrants further attention.

Is age of self-harm onset associated with increased frequency of non-suicidal self-injury and suicide attempts in adolescent outpatients?

BackgroundSelf-harm in adolescents is an increasing public health concern and an important risk factor for suicide. We aimed to examine how age of self-harm onset in adolescents was associated with frequency of subsequent suicidal and non-suicidal self-harm (NSSI) episodes, and how age of onset and duration of self-harm may influence the frequency of self-harm.MethodsData from 103 adolescents with recurrent self-harm recruited from child and adolescent psychiatric outpatient clinics were collected through clinical interviews and self-reports, and analysed with negative binomial and hurdle models.ResultsA lower age of self-harm onset and a longer duration of self-harm were both significantly associated with increased frequency of subsequent episodes of NSSI and risk of a first suicide attempt. There was an increase in repeated suicide attempts when the age of onset of self-harm decreased and the duration increased, and dramatically more for long duration of NSSI before first suicide attempt.ConclusionInitiating self-harm behaviour at the youngest age had the highest risk of increased frequency of NSSI and suicide attempts. Longer duration of self-harm behaviour increased this risk. This underlines the importance of early identification of self-harm behaviour in adolescents, and the use of effective interventions.

Patterns of Suicide Ideation Across Eight Countries in Four Continents During the COVID-19 Pandemic Era: Repeated Cross-sectional Study.

BackgroundThe COVID-19 pandemic and countries’ response measures have had a globally significant mental health impact. This mental health burden has also been fueled by an infodemic: an information overload that includes misinformation and disinformation. Suicide, the worst mental health outcome, is a serious public health problem that can be prevented with timely, evidence-based, and often low-cost interventions. Suicide ideation, one important risk factor for suicide, is thus important to measure and monitor, as are the factors that may impact on it.ObjectiveThis investigation had 2 primary aims: (1) to estimate and compare country-specific prevalence of suicide ideation at 2 different time points, overall and by gender and age groups, and (2) to investigate the influence of sociodemographic and infodemic variables on suicide ideation.MethodsA repeated, online, 8-country (Canada, the United States, England, Switzerland, Belgium, Hong Kong, Philippines, and New Zealand), cross-sectional study was undertaken with adults aged ≥18 years, with measurement wave 1 conducted from May 29, 2020 to June 12, 2020 and measurement wave 2 conducted November 6-18, 2021. Self-reported suicide ideation was derived from item 9 of the Patient Health Questionnaire-9 (PHQ-9). Age-standardized suicide ideation rates were reported, a binomial regression model was used to estimate suicide ideation indication rates for each country and measurement wave, and logistic regression models were then employed to relate sociodemographic, pandemic, and infodemic variables to suicide ideation.ResultsThe final sample totaled 17,833 adults: 8806 (49.4%) from measurement wave 1 and 9027 (50.6%) from wave 2. Overall, 24.2% (2131/8806) and 27.5% (2486/9027) of participants reported suicide ideation at measurement waves 1 and 2, respectively, a difference that was significant (P<.001). Considerable variability was observed in suicide ideation age-standardized rates between countries, ranging from 15.6% in Belgium (wave 1) to 42.9% in Hong Kong (wave 2). Frequent social media usage was associated with increased suicide ideation at wave 2 (adjusted odds ratio [AOR] 1.47, 95% CI 1.25-1.72; P<.001) but not wave 1 (AOR 1.11, 95% CI 0.96-1.23; P=.16). However, having a weaker sense of coherence (SOC; AOR 3.80, 95% CI 3.18-4.55 at wave 1 and AOR 4.39, 95% CI 3.66-5.27 at wave 2; both P<.001) had the largest overall effect size.ConclusionsSuicide ideation is prevalent and significantly increasing over time in this COVID-19 pandemic era, with considerable variability between countries. Younger adults and those residing in Hong Kong carried disproportionately higher rates. Social media appears to have an increasingly detrimental association with suicide ideation, although having a stronger SOC had a larger protective effect. Policies and promotion of SOC, together with disseminating health information that explicitly tackles the infodemic’s misinformation and disinformation, may importantly reduce the rising mental health morbidity and mortality triggered by this pandemic.

Internalized Stigma and Resistance Against Stigma as Risk Factors for Suicide in Individuals with Schizophrenia: A Cross-Sectional Study.

Identifying the relationship between internalized stigma and suicide is critical in dealing with schizophrenia. We aimed to examine how internalized stigma and its subcomponents affect suicidality in patients with schizophrenia. The second aim of this study was to identify the risk factors for internalized stigma in schizophrenia. We assessed 114 patients diagnosed with schizophrenia. Structured Clinical Interview for the DSM-5 (SCID-5), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale (CDS), Internalized Stigma of Mental Illness (ISMI), and Suicide Probability Scale (SPS) were applied to the sample. Multivariable linear regression analysis was conducted to determine the risk factors of internalized stigma. Statistically significant correlation between stigma resistance and all SPS scores was found. The correlation between stigma resistance and suicidal thought was independent of the CDS and PANSS scores of the sample. Stigma resistance and depressive situation were the predictive factors for SPS. Only depressive state of the group predicted the level of internalized stigma in the regression analysis. Stigma resistance is an important risk factor for suicide in schizophrenia. Clinicians should focus on interventions to increase resistance against stigma and to determine the depressive situation of patients with schizophrenia.

Comparative risk of suicide by specific substance use disorders: A national cohort study

Substance use disorders (SUDs) are important risk factors for suicide, yet little is known about how suicide risks vary by specific SUDs. We examined these risks for the first time in a large general population to facilitate comparisons across SUDs. A national cohort study was conducted of all 6,947,191 adults in Sweden. SUDs (opioid, sedative/hypnotic, hallucinogen, cannabis, amphetamine, cocaine, and alcohol use disorders) were identified using inpatient, outpatient, and crime data, and suicide deaths using nationwide death data with follow-up during 2003–2016. Cox regression was used to compute hazard ratios (HRs) for suicide death while adjusting for sociodemographic factors and psychiatric, SUD, and somatic comorbidities. Co-sibling analyses assessed for confounding by unmeasured shared familial (genetic and/or environmental) factors. In 79.8 million person-years of follow-up, 15,616 (0.2%) suicide deaths were identified. All SUDs were associated with significantly increased risks, with HRs ranging from 12- to 26-fold and 2.5- to 6.4-fold before and after adjusting for covariates, respectively. After adjusting for all covariates, opioid use disorder was the strongest risk factor (HR, 6.39; 95% CI, 5.53–7.38) (P ≤ 0.002 compared with any other SUD), followed by sedative/hypnotic use disorder (4.62; 4.06–5.27) (P ≤ 0.009 compared with any other SUD except opioid or hallucinogen). Most associations persisted after controlling for shared familial factors, consistent with causal effects. In this large national cohort, all SUDs were associated with significantly increased risks of suicide death, especially opioid and sedative/hypnotic use disorders. These findings may improve risk stratification and inform interventions to prevent suicide in the highest-risk subgroups with SUDs.