Lifetime History Of Suicide Research Articles

Development and codesign of flourish: A digital suicide prevention intervention for LGBTQ+ youth who have experienced online victimization

BackgroundLGBTQ+ youth experience disproportionately high rates of online victimization (OV), referring to harmful remarks, images, or behaviors in online settings, which is associated with suicidal risk. Current services have gaps in supporting LGBTQ+ youth facing OV events. To address these gaps, this study aims to develop Flourish, a digital suicide prevention intervention for LGBTQ+ youth who have experienced OV. MethodsQualitative interviews were conducted with 20 LGBTQ+ youth with past-year history of OV and lifetime history of suicidality, 11 of their parents, and 10 LGBTQ+-serving professionals. Subsequently, an iterative codesign process was conducted with 22 youth through individual and group design sessions, followed by usability testing. Data were recorded and transcribed. Qualitative interviews were analyzed using a qualitative description approach, and data from design sessions and usability testing were analyzed using rapid qualitative techniques. ResultsInterviews with youth, parents, and professionals suggested preferences for Flourish to be a partially automated, text message intervention leveraging web-based content that is a safe space for LGBTQ+ youth to seek support for OV through education, coping skills, and help-seeking resources. School and mental health services professionals considered the potential for implementing Flourish within youth services settings. Usability testing, assessed through the System Usability Scale, yielded an average rating of 91, indicating excellent perceived usability. ConclusionsFlourish has potential to be an acceptable intervention to support LGBTQ+ youth following OV. Future steps will include testing the feasibility and efficacy of Flourish and further examining Flourish's potential for implementation within services for LGBTQ+ youth.

Firearms Availability Among High-School Age Youth With Recent Depression or Suicidality.

Limiting firearm access is essential to decreasing teen suicide. Previous efforts have focused on household firearms; however, less is known about firearm access and possession among teens at increased suicide risk. Our objective was to estimate prevalence of firearm possession and access among high school-aged teens with recent depression and/or lifetime history of suicidality (DLHS). We conducted a probability-based, cross-sectional Web survey of 1914 parent-teen dyads between June 24, 2020, and July 22, 2020, with data weighted to generate a nationally representative sample of US teenagers (aged 14-18). Logistic regression analyses examined the difference between teens with and without DLHS for: (1) personal firearm possession, (2) perceived firearm access, and (3) method of firearm attainment. Among high school-aged teens, 22.6% (95% confidence interval [CI], 19.4-25.8) reported DLHS, 11.5% (95% CI, 8.7-14.3) reported personal firearm possession, and 44.2% (95% CI, 40.2-48.2) endorsed firearm access. Teens experiencing DLHS had increased perceived access (adjusted odds ratio, 1.56; 95% CI, 1.07-2.28) compared with non-DLHS peers. There was no association between DLHS and personal firearm possession (adjusted odds ratio, 0.97; 95% CI, 0.47-2.00). Among teens reporting firearm possession, those with DLHS were more likely to have acquired it by buying/trading for it (odds ratio, 5.66; 95% CI, 1.17-27.37) and less likely receiving it as a gift (odds ratio, 0.06; 95% CI, 0.01-0.36). High school-aged teens experiencing DLHS have higher perceived firearm access compared with lower-risk peers. Providers should speak directly to high school-aged teens at increased suicide risk about firearm access, in addition to counseling parents.

Lipid Profile and Impulsivity in Suicidal Patients with Major Depressive Disorder

Introduction Previous observational cohort studies showed an association between low serum lipid levels and suicide. This study was undertaken to examine the relationship between lipid parameters and impulsivity in suicidal patients with major depressive disorder (MDD). Methods The current study included 100 patients with MDD distributed as 50 patients with recent suicidal attempts and 50 patients with no lifetime history of suicide. Participants were subjected to Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) to confirm the diagnosis. The risk of suicide was assessed through the Suicide Probability Scale (SPS), while the intent and seriousness of suicide were assessed through Beck’s Suicidal Intent Scale. assessment of impulsivity was carried out through Barratt Impulsivity Scale. Serum lipid levels were measured in mg/dL after an overnight fast. Results Total cholesterol (TC) was found significantly lower in the suicidal group compared to the non-suicidal depressed group (p = 0.040). Low high-density lipoprotein (HDL) level was significantly correlated with suicidality and high suicide intent was correlated with hopelessness. Logistic regression for lipid profile in both groups revealed significant TC and low-density lipoprotein (LDL) as predictors for suicide. There was no significant correlation between impulsivity and characteristics of depression, suicide probability, suicide intent, and all elements of the lipid profile. Conclusions Low TC and LDL could predict suicidal behavior in patients with MDD. Impulsivity could not be a mediator or predictor of suicide risk in patients with MDD.

Identifying epilepsy psychiatric comorbidities with machine learning.

People with epilepsy are at increased risk for mental health comorbidities. Machine-learning methods based on spoken language can detect suicidality in adults. This study's purpose was to use spoken words to create machine-learning classifiers that identify current or lifetime history of comorbid psychiatric conditions in teenagers and young adults with epilepsy. Eligible participants were >12years old with epilepsy. All participants were interviewed using the Mini International Neuropsychiatric Interview (MINI) or the MINI Kid Tracking and asked five open-ended conversational questions. N-grams and Linguistic Inquiry and Word Count (LIWC) word categories were used to construct machine learning classification models from language harvested from interviews. Data were analyzed for four individual MINI identified disorders and for three mutually exclusive groups: participants with no psychiatric disorders, participants with non-suicidal psychiatric disorders, and participants with any degree of suicidality. Performance was measured using areas under the receiver operating characteristic curve (AROCs). Classifiers were constructed from 227 interviews with 122 participants (7.5±3.1minutes and 454±299 words). AROCs for models differentiating the non-overlapping groups and individual disorders ranged 57%-78% (many with P<.02). Machine-learning classifiers of spoken language can reliably identify current or lifetime history of suicidality and depression in people with epilepsy. Data suggest identification of anxiety and bipolar disorders may be achieved with larger data sets. Machine-learning analysis of spoken language can be promising as a useful screening alternative when traditional approaches are unwieldy (eg, telephone calls, primary care offices, school health clinics).

Determinants and Predictive Value of Clinician Assessment of Short-Term Suicide Risk.

We examine the interrelations among clinicians' judgment of patients' suicide risk, clinicians' emotional responses, and standard risk factors in the short-term prediction of suicidal thoughts and behaviors. Psychiatric outpatients (n=153) with a lifetime history of suicide ideation/attempt and their treating clinicians (n=67) were evaluated at intake. Clinicians completed a standard suicide risk instrument (modified SAD PERSONS scale), a 10-point Likert scale assessment of judgment of patient suicide risk (Clinician Prediction Scale), and a measure of their emotional responses to the patient (Therapist Response Questionnaire-Suicide Form). The Columbia Suicide Severity Rating Scale and the Beck Scale for Suicide Ideation were administered at a one-month follow-up assessment (n=114, 74.5%). Clinician judgment of risk significantly predicted suicidal thoughts and behaviors at follow-up. Both the standard suicide risk instrument and clinician emotional responses contributed independently to the clinician assessment of risk, which, in turn, mediated their relationships with suicidal thoughts and behaviors. Our findings validate the importance of clinical judgment in assessing suicide risk. Clinical judgment appears to be informed both by concrete risk factors and clinicians' emotional responses to suicidal patients, highlighting emotional awareness as a promising area for research and training.

Increased prevalence of toxoplasma gondii seropositivity in patients with treatment-resistant schizophrenia

IntroductionPrevious studies suggested that patients with schizophrenia had an increased prevalence of antibodies against toxoplasma gondii (TG) and that those seropositive patients had higher symptom severity. However, there is no data on the relationship between treatment-resistant schizophrenia (TRS) and TG seroprevalence.ObjectivesTo determine the association between TRS and TG seropositivity, and to further investigate the relationship between TG seropositivity and different clinical features of schizophrenia.MethodsIn this cross-sectional study, we included 210 male inpatients with schizophrenia. TG seropositivity was determined by ELFA assay. Treatment-resistance was defined as a failure of at least 2 adequate anti-psychotic trials. Data were analyzed using χ2 test or Mann–Whitney test.ResultsThe rate of TG seropositivity in the entire sample was 52.3%, whereas 47.6% of patients met the definition for treatment-resistance. Seropositive patients had twice the rate of treatment–resistance compared to seronegative patients (63.6% vs. 30.0%, P &lt; 0.0001). Moreover, in the seropositive group, the patients were older (47.6 ± 12.2 vs. 39.81 ± 12.01 years, P &lt; 0.0001), had higher number of previous hospitalizations (13.9 ± 11.7 vs. 9.6 ± 8.5, P = 0.0073), and increased Calgary depression scale for schizophrenia (CDSS) total score (7.8 ± 4.5 vs. 6.3 ± 3.8, P = 0.012). There were no differences between the groups in the age of disease onset, smoking, positive and negative syndrome scale (PANSS) total, positive and negative scores, and the life-time history of suicide attempts.ConclusionsOur results support the hypothesis that TG seropositivity might contribute to treatment-resistance in schizophrenia, at least in male patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A multidimensional risk factor model for suicide attempts in later life.

BackgroundElderly suicide is a public health problem worldwide, and the risk factors are multidimensional. Chronic mental health problems, personality traits, stressful life events, comorbid medical conditions, social isolation, unemployment, and poverty are associated with higher risk for suicide in later life. There was a relative paucity of data on the neurobiological markers of elderly suicide.ObjectiveThis study examines the conjoint roles of cerebrovascular risk factors (CVRFs) and other established biopsychosocial risk factors in older adults who had made a recent suicide attempt.DesignA cross-sectional, case-controlled study.SettingA tertiary care setting in a public sector and a community setting.Subjects and methodsCases (N=77) were nondemented Chinese adults aged ≥65 years, enrolled in a regional psychogeriatric service following a suicide attempt; comparison subjects (N=99) were community-dwelling nondemented older adults with no lifetime history of suicide. Measures of sociodemographic profile, life events, suicidal behavior, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I psychopathology, personality traits, functional status, physical health, CVRFs, and executive cognitive functions were administered.ResultsWeighted sum of CVRF score was significantly higher in older women who had made a recent suicide attempt (mean: 10.56; standard deviation [SD]: 5.46) than comparison subjects (mean: 7.24; SD: 4.04) (t=3.52, P=0.001; df=99). Logistic regression showed that CVRF score (Exp[B]: 1.289, P=0.033), DSM-IV depressive disorders (current) (Exp[B]: 348, P<0.001), number of life events in the past 12 weeks (Exp[B]: 10.4; P<0.001), and being married (Exp[B]: 12.2, P<0.048) significantly increased odds for suicide attempt status in older women (Nagelkerke R2: 0.844). Association of CVRF score and suicide attempt status was not observed in older men for whom number of life events in the past 12 weeks (Exp[B]: 9.164; P<0.001), higher neuroticism (Exp[B]: 1.028; P=0.048), and impaired performance on a Modified Card Sorting Test (Exp[B]: 0.646; P=0.032) significantly increased odds for suicide attempt status in a logistic regression model (Nagelkerke R2: 0.611).ConclusionRisk factors for cerebrovascular diseases may be associated with higher risk for attempted suicide in older women, but not in older men. Older men and women have distinct risk factor profiles that may inform targeted intervention and prevention strategies.

S.02.02 Gene–environment interactions and suicidal behaviour

Suicidal behaviors can result from a complex interaction between social stressors and individual vulnerability. Evidence suggests a specific neural processing of social cues in suicide attempters without knowledge of how it relates to real-world experiences.To investigate the association between brain activity during experimental social exclusion (measured by functional MRI) and psychological pain in daily life (assessed by Ecological Momentary Assessment) in patients with a lifetime history of suicide attempt.Thirty-three euthymic females with a history of a major depressive episode were recruited: 13 suicide attempters and 20 affective controls (no history of suicide attempt). Functional MRI scans were acquired while participants played the Cyberball game, a validated social exclusion paradigm. After fMRI, participants completed EMA for a one-week period. Five times per day, they were asked to rate their psychological pain, hopelessness and the negativity of daily events. EMA indices (psychological pain, hopelessness and their interaction with negative events) were correlated with cerebral activations using a ROI approach (orbitofrontal, dorsal and ventrolateral prefrontal cortices, anterior cingulate cortex and insula) in each group.We found a negative correlation between daily ratings of psychological pain and orbitofrontal activation for exclusion versus inclusion during the Cyberball game in suicide attempters but not in affective controls. We did not find correlations between cerebral activation and daily hopelessness ratings.Small sample sizeScanner-based orbitofrontal activity during social exclusion relates to psychological pain in daily life which participates in suicide risk among vulnerable individuals.