Lifetime Prevalence Of Suicidal Ideation Research Articles

Suicidal ideation, plan, and attempt among men who have sex with men in Nepal: Findings from a cross-sectional study.

Men who have sex with men (MSM) are at increased risk for suicide, with a much higher prevalence of suicidality than the general population. While there is a growing interest in the identification of risk factors for suicidal behaviors globally, the understanding of the prevalence and risk factors for suicidal behaviors among MSM in the context of low- and middle-income countries is almost non-existent. Therefore, this study aimed to investigate suicidal ideation, plan, and attempts, and related factors among MSM in Nepal. A cross-sectional respondent driven survey was conducted on 250 MSM between October and December 2022. Bivariate and multivariable logistic regression was used to evaluate independent correlates of suicidal behaviors of MSM. Overall, the lifetime prevalence of suicidal ideation, plans, and attempts among MSM in this study were 42.4%, 31.2%, and 21.6%, respectively. MSM with depressive symptoms (aOR = 5.7, 95% CI = 2.4-14.1), advanced education (higher secondary and above; aOR = 2.9, 95% CI = 1.4-6.1), and smoking habit (aOR = 2.5, 95% CI = 1.2-5.3) were at increased risk for suicidal ideation. Similarly, those with depressive symptoms (aOR = 2.2, 95% CI = 1.1-4.8) and advanced education (aOR = 2.7, 95% CI = 1.2-5.7) were more likely to plan suicide, whereas young MSM were significantly more prone to attempting suicide (aOR = 2.7, 95% CI = 1.3-5.8). Interestingly, MSM with moderate to severe food insecurity were 2-3 times more likely to think about, plan, or attempt suicide (ideation: aOR = 3.5, 95% CI = 1.6-7.7; plan: aOR = 3.7, 95% CI = 1.6-8.3; attempt: aOR = 2.2, 95% CI = 1.1-4.6). The results suggest the importance of early assessment of suicidal behaviors among MSM and the need for tailored interventions to simultaneously address mental health problems and food insecurity to reduce suicide-related problems among Nepalese MSM.

Suicidality and homelessness: prevalence and associated factors of suicidal behaviour among homeless young adults in Southern Ethiopia

BackgroundResearch indicates that homelessness is associated with an increased risk of suicide. While street homelessness is a global problem, it is a disproportionately serious concern in low- and middle-income countries such as Ethiopia. Despite their high risk of suicidal thoughts and attempts, there has been limited research on this subject among homeless young people in Ethiopia. Therefore, we assessed the prevalence and factors contributing to suicidal behaviour among homeless young people in the southern region of this country.MethodsWe conducted a community-based cross-sectional study from 15 June to 15 August 2020 involving 798 homeless young adults in four southern Ethiopian towns and cities. The Suicide Behaviour Questionnaire-Revised (SBQ-R) was used to assess suicidal behaviour. Data were coded and entered into Epi-Data version 7 and analysed using SPSS version 20. We conducted a multivariable logistic regression analysis to identify factors associated with suicidal behaviour. Variables with a p-value of < 0.05 were considered statistically significant. An adjusted odds ratio with a 95% confidence interval was determined to indicate the association’s strength.ResultsThe overall prevalence of suicidal behaviour among young homeless individuals was 38.2% (95% CI: 34.8%, 41.5%). The lifetime prevalence of suicidal ideation, planning and attempt was 10.7% (95% CI: 8.6–12.9%), 5.1% (95% CI: 3.6–6.6%) and 3% (95% CI: 1.9–4.3%), respectively. A longer duration of homelessness (1–2 years) (AOR = 2.244, 95% CI: 1.447–3.481), stressful life events (AOR = 1.655, 95% CI: 1.132–2.418) and the stigma associated with homelessness (AOR = 1.629, 95% CI: 1.149–1.505) were significantly associated with suicidal behaviour.ConclusionThe results of our study indicate that suicide is a serious public health problem among homeless young people in southern Ethiopia. We have found associations between suicidal behaviour and stressful events, homelessness lasting for one to two years and stigma. Our study suggests that policymakers and programme planners need to develop a strategy for preventing, detecting and managing suicidal behaviour among street-dwelling homeless young adults, a vulnerable and understudied population. A community-based suicide prevention campaign is also essential for street-dwelling homeless young people in Ethiopia.

Prevalence of suicidal behaviour among students living in Muslim-majority countries: systematic review and meta-analysis

Assessing suicidal behaviours among students would help to understand the burden and enhance suicide prevention. We aimed to determine the prevalence of suicidal behaviour among students living in Muslim-majority countries. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was conducted in Medline, EMBASE and PsycINFO. Meta-analyses were performed to pool the lifetime, 1-year and point prevalence rates for suicidal ideation, plans and attempts. From 80 studies, 98 separate samples were included in this analysis. The majority (n = 49) were from the Eastern Mediterranean, and 61 samples were of university students. The pooled prevalence of suicidal ideation was 21.9% (95% CI 17.4%-27.1%) for lifetime, 13.4% (95% CI 11.1%-16.1%) for the past year and 6.4% (95% CI 4.5%-9%) for current. The pooled prevalence of suicide plans was 6.4% (95% CI 3.7%-11%) for lifetime, 10.7% (95% CI 9.1%-12.4%) for the past year and 4.1% (95% CI 2.7%-6.2%) for current. The pooled prevalence of suicide attempts was 6.6% (95% CI 5.4%-8%) for lifetime and 4.9% (95% CI 3.6%-6.5%) for the past year. The lifetime prevalence of suicidal ideation was highest (46.2%) in South-East Asia, but the 12-month prevalence was highest (16.8%) in the Eastern Mediterranean. The study revealed notably high rates of suicidal behaviours among students living in Muslim-majority countries. However, the quality of studies, differences in regional and cultural factors, stages of studentship and methods of measurement should be considered when generalising the study results.

Frequency and correlates of lifetime suicidal ideation and suicide attempts among consecutively hospitalized youth with anorexia nervosa and bulimia nervosa: results from a retrospective chart review

BackgroundYouth with eating disorders (EDs) face an increased risk of a premature suicide death. Precursors of completed suicide are suicidal ideation and suicide attempts, which need to be well understood to prevent suicide. However, epidemiological data on the lifetime prevalence and clinical correlates of suicidal ideation and suicide attempts (i.e., “suicidality”) are lacking for the vulnerable group of inpatient ED youth.MethodsThis retrospective chart review was conducted at a psychiatric child and adolescent inpatient department, covering a 25-year period. Consecutively hospitalized youth with an ICD-10 diagnosis of anorexia nervosa (AN), restricting type (AN-R), binge-purging type (AN-BP), and bulimia nervosa (BN) were included. Data extraction and coding were standardized with trained raters extracting information from patient records according to a procedural manual and using a piloted data extraction template. The lifetime prevalence of suicidal ideation and suicide attempts was calculated for each ED subgroup, and clinical correlates of suicidality were analyzed via multivariable regression analyses.ResultsIn the sample of 382 inpatients aged 9–18 years (median age = 15.6, females = 97.1%; AN-R: n = 242, BN: n = 84, AN-BP: n = 56), 30.6% of patients had lifetime suicidal ideation (BN:52.4% ≈ AN-BP:44.6% > AN-R:19.8%, χ2(2,382) = 37.2, p < 0.001, Φ = 0.31), and 3.4% of patients reported a history of suicide attempts (AN-BP:8.9% ≈ BN:4.8% > AN-R:1.7%, χ2(2,382) = 7.9, p = 0.019, Φ = 0.14). Independent clinical correlates of suicidality were i) for AN-R a higher number of psychiatric comorbidities (OR = 3.02 [1.90, 4.81], p < 0.001), and body weight < 1st BMI percentile at hospital admission (OR = 1.25 [1.07,1.47], p = 0.005) (r2 = 0.20); ii) for AN-BP patients a higher number of psychiatric comorbidities (OR = 3.68 [1.50, 9.04], p = 0.004) and history of childhood abuse (OR = 0.16 [0.03, 0.96], p = 0.045) (r2 = 0.36), and iii) for BN patients a higher prevalence of non-suicidal self-injury (NSSI)(OR = 3.06 [1.37, 6.83], p = 0.006) (r2 = 0.13).ConclusionsAbout half of youth inpatients with AN-BP and BN had lifetime suicidal ideation, and one-tenth of patients with AN-BP had attempted suicide. Treatment programs need to address specific clinical correlates of suicidality, namely, low body weight, psychiatric comorbidities, history of childhood abuse, and NSSI.Trial registrationThis study was not a clinical trial but a retrospective chart review based on routinely assessed clinical parameters. The study includes data from human participants; however: (1) no intervention and no prospective assignment to interventions were performed, and (2) no evaluation of intervention in participants was accomplished.

Assessing suicide risk in patients with obsessive-compulsive disorder: a dimensional approach.

Although an association has been found recently between obsessive-compulsive disorder and an increased risk of suicide, the prevalence of both suicidal ideation and attempts vary considerably and are generally assessed categorically. Our aims were to evaluate the prevalence of suicidal ideation and behaviors using a dimensional approach. The sample included 129 patients with obsessive-compulsive disorder. Suicidality was assessed by administering the Columbia-Suicide Severity Rating Scale. Logistic and linear regressions were used to examine predictors of suicidal ideation, severe suicidal ideation, and suicidal behavior. The lifetime prevalence of suicidal ideation and behaviors were 64.3% and 16.3%, respectively. Lifetime suicidal ideation was associated with the number of stressful life events, duration of illness, Hamilton Rating Scale for Depression scores, and family history of mood disorders. A family history of obsessive-compulsive disorder was associated with a lower probability of lifetime suicidal ideation. Severe suicidal ideation was related to greater severity of the most stressful life event, Hamilton Rating Scale for Depression scores, and longer duration of untreated illness. The probability of lifetime suicidal behavior was related to Hamilton Rating Scale for Anxiety scores, symmetry obsessions, and washing and checking compulsions. The probability of lifetime non-suicidal self-injurious behaviors was related to Hamilton Rating Scale for Anxiety scores. Recognizing predictors of suicidal ideation/behavior is crucial to identifying patients at greater risk.

Social network subtypes among socially disconnected older adults at risk for suicide: A latent class analysis.

We sought to characterize the social networks of older adults who report feeling lonely or like a burden on others, psychological states that are associated with risk for suicide according to the Interpersonal Theory of Suicide. We used a latent class analysis to identify distinct groups of older adults based on social network characteristics and perceptions of their networks within a sample of older adults endorsing loneliness and/or feeling like a burden. We examined associations between class membership and mental health outcomes. Four network types were identified: small, cohabitating networks with daily contact; moderate-sized family-oriented networks with multiple contacts weekly; moderate-sized friend-oriented networks with weekly contact; and average-sized mixed networks with weekly contact. The friend-oriented class reported the greatest loneliness, perceived burden, and lifetime prevalence of suicidal ideation and attempts. Social network composition may be more explanatory of loneliness and perceived burden than number of members alone. Profile differences in outcomes suggest utilizing tailored social connectedness interventions. Individuals with small-to-moderate networks may benefit most from interventions designed to build friendships. Individuals with many close confidants may benefit most from psychotherapy. Individuals reporting moderately frequent contact with moderately-sized networks may benefit from both intervention types.

Prevalence and correlates of suicidal behaviors in the Taiwan Psychiatric Morbidity Survey

Suicide is a huge global health burden. High suicide rates with a low prevalence of major depressive disorder were reported in East Asia. This study aimed to investigate the prevalence of suicidal behaviors in relation to the demographic characteristics and major depressive disorder in Taiwan. This study was based on the Taiwan Psychiatric Morbidity Survey, conducted between 2003 and 2005, a survey of common psychiatric disorders in a nationally representative sample of non-institutionalized civilians aged 18 or above. Demographic data, major depressive disorder, and suicidal behaviors were ascertained by a face-to-face interview using the paper version of the World Mental Health Survey Composite International Diagnostic Interview. According to the total sample of 10,135 participants, the lifetime prevalence of suicidal ideation, plans and attempts was 7.52% (S.E=0.46%), 1.31% (S.E.=0.16%) and 1.29% (S.E.=0.16%), respectively. Among suicide ideators, the conditional probability of making a suicide plan was 17.39% (S.E.=1.92%), and a suicide attempt 17.16% (S.E.=2.15%). Age ≤ 40, female sex, and major depressive disorder were related to a higher risk of suicidal behaviors in the general population; the former two were associated with further developing suicide attempts and the latter one developing plans among ideators. Despite low prevalence, major depressive disorder remained a significant risk factor for suicidal behaviors in Taiwan.

The Relationship between Suicidality and Socio-Demographic Variables, Physical Disorders, and Psychiatric Disorders: Results from the Singapore Mental Health Study 2016.

Suicidality encompasses suicidal ideation, plans, and attempts. This paper aims to establish associations between suicidality and sociodemographic variables, physical disorders, and psychiatric disorders. The Singapore Mental Health Study 2016 was a population-level epidemiological survey, which determined the prevalence of physical disorders, psychiatric disorders, and suicidality. Questionnaires were used to determine socio-demographic information. A total of 6216 respondents were interviewed. Lifetime prevalence of suicidal ideation, planning, and attempts were 7.8%, 1.6%, and 1.6%, respectively. All components of suicidality were more likely in those with major depressive disorder, bipolar disorder, generalized anxiety disorder, alcohol use disorder, and chronic pain. Suicidal ideation and attempts were more likely in those with diabetes. Age above 65, being male, and a monthly household income of ≥ SGD 10,000 were associated with a lower likelihood of suicidal ideation. These findings indicate that there are high-risk groups for whom suicidality is a concern, and for whom interventions may be needed.

Prevalence and factors associated with suicidal ideation amongst college students in the Nelson Mandela Bay Municipality, South Africa.

BackgroundSuicidal behaviour amongst college students constitutes a significant social and public health problem globally. This study determined the prevalence and associated factors of suicidal ideation amongst students of higher education in the Nelson Mandela Bay Municipality (NMBM), South Africa.MethodsIn this institution-based cross-sectional study, a multistage cluster sampling of 826 participants, drawn from a college in NMBM, was conducted from January to March 2020. Data were collected with a standardised self-administered questionnaire. Multivariable logistic regression analysis was used to identify the factors associated with suicidal ideation.ResultsParticipants’ ages ranged from 18 to 24 years, with a mean age of 20.49 years (standard deviation, 1.88 years). The lifetime prevalence of suicidal ideation and plans in the preceding 12 months were 24.5% and 9.6%, respectively. The odds of suicidal ideation were higher in students who experienced bullying (adjusted odds ratio [AOR], 1.89; 95% confidence interval [CI], 1.35–2.65), mental illness (AOR, 1.89; 95% CI, 1.35–2.65), a history of sexual assault (AOR, 2.50; 95% CI, 1.20–5.21) and experience of sexual assault by or to a close family member (AOR, 1.69; 95% CI, 1.01–2.82). Underlying chronic illness was associated with a twofold risk for suicidal ideation in both sexes.ConclusionAbout a quarter of the students sampled at the college had experienced suicidal ideation and some had had suicidal plans in the preceding 12 months. Screening for the identified risk factors amongst the student population coupled with prompt interventions would mitigate the risk of suicide in the study population.

Suicidal ideation and psychological wellbeing of adolescents in Galle education division

Introduction: Suicide is a global health problem affecting individuals of all ages. Sri Lanka shows a high suicide rate with a considerable number reporting from young age group. As suicidal ideation are present in victims before committing suicide Therefore, this study was designed to assess suicidal ideation among adolescents in Galle, Sri Lanka. Besides, the study assessed the general psychological wellbeing and factors associated with it in youth. Methods: School-based screening was conducted in a conveniently selected sample of students from six national schools in the Galle educational division. Questionnaires assessed lifetime suicidal ideation, attempts, and present psychological well-being (General Health Questionnaire GHQ30 ). Results: There were 1479 participants, age 16-19 years with 52% females. The lifetime prevalence of suicidal ideation in the sample was 22% with 11% having active ideation. Previous suicidal attempts were 4%. Compared to participants with no suicidal ideation, individuals with passive and active ideations had poor psychological well-being (F=152.86, p &lt; 0.001). In logistic regression, the GHQ score predicted suicidal ideation [OR = 1.17, p &lt; 0.001]. Further, present psychological wellbeing was associated with age, gender, socioeconomic status, happiness at school, and happiness at home, explaining 18.6% variances in the regression model. Conclusion and Recommendations: There is a considerably higher number of adolescents having suicidal ideation, and therefore, it is crucial to screen and identify these adolescents for help. Proper sustainable programs need to be implemented for this purpose and attention should be paid to improve the socioeconomic status, happiness at school, and happiness at home. Further research is recommended to obtain more in-depth information on suicidal ideations.

Childhood adversities and suicidal behavior in the general population. The cross-sectional PEGASUS-Murcia Project

IntroductionThe aim of the present study is to estimate the lifetime prevalence of suicidal ideation, plans, and attempts in a regional representative sample and the association of these outcomes with sociodemographic factors, prior mental disorders, and childhood adversities. Material and methodsThe PEGASUS-Murcia project is a cross-sectional survey of a representative sample of adults in Murcia that is part of the WHO World Mental Health Survey Initiative. The Composite International Diagnostic Interview (CIDI 3.0) was administered face-to-face to 2621 participants (67.4% response rate). The main outcomes were suicidal ideation, plans, and attempts. Lifetime prevalence, age of onset, and risk factors (sociodemographic variables, mental disorders, and childhood adversities) were examined using multiple discrete-time survival models. ResultsLifetime prevalence of suicidal ideation, plans and attempts were 8.0% (standard error, SE: 1.1), 2.1% (SE: 0.3), and 1.2% (SE: 1.1), respectively. Prevalence of any childhood adversities was 22.1% (SE: 1.3) in the total sample and, even higher, among those with suicide related outcomes (ranging between 36.8% and 53.7%). Female sex, younger age, prior (to onset of the outcome) lifetime prevalence of mood disorders, number of mental disorders, and exposure to childhood adversity were associated with significantly increased odds of suicidal ideation and plans. ConclusionsLifetime prevalence estimates of suicidality are similar to those in community epidemiological surveys. Childhood adversities and mental disorders, especially mood disorders, are important risk factors for suicidality. Early detection of these adversities and disorders should be targeted in suicide prevention programs.

Factors Associated with Suicidal Ideation, and Attempt Among Cancer Patients in Ayder Comprehensive Specialized Hospital: Cross-Sectional, Mekelle, Ethiopia

Background: Cancer patients are at high risk for suicide, particularly, when they are informed about the cancer diagnosis. However, there is a limited study in Ethiopia therefore, assessing suicidal ideation, attempt, and its associated factors are needed for intervention. Methods: An institutional-based cross-sectional study was conducted from March to June 2019 at Ayder comprehensive specialized hospital with a total of 297 participants. Suicide module of the World Mental Health (WMH) survey initiative version adopted from the World Health Organization (WHO) and used to assess suicidal ideation and attempt. Binary logistic regression analysis employed to identify factors associated with suicidal ideation and attempt. Odds ratio with 95% CI and P-value &lt;0.05 was applied to identify significantly associated factors. Results: The lifetime prevalence of suicidal ideation and the attempt was found to be 27.9% [95%CI (22.3, 31.6)] and 8.4% [95%CI (5.2, 10.3)] respectively. Being female [AOR= 2.23, 95%CI (1.27, 3.92)], stage IV cancer [AOR=2.08, 95%CI(1.47, 3.81)], having depression and anxiety [AOR=2.31, 95%CI(1.24,4.32)], poor social support [AOR=3.70, 95%CI(2.01,6.78)], and level 4 performance status [AOR=3.73, 95%CI(1.71, 8.13)] were the factors associated with lifetime suicidal ideation. While being in level 4, performance status was also significantly associated with suicidal attempt. Conclusion: Both suicidal ideation and attempt among cancer patients are high. The suicidal ideation had a statistical association with sex, stage of cancer, having depression and anxiety, social support, and level of performance. Therefore, health education for early screening and treatment for depression and anxiety, and giving social support are crucial for the reduction of suicide.

Prevalence of suicidal ideation, plan, attempts and its associated factors in selected rural and urban areas of Puducherry, India.

The Union Territory of Puducherry has a high rate of suicide in India. This study aims to find the prevalence of suicidal ideation, plan and suicide attempts and the risk factors of suicidal behaviours. This community-based cross-sectional study was conducted among adults aged 18years and above in rural and urban areas of Puducherry, India. Columbia Suicide Severity Rating Scale questionnaire was used. Prevalence ratio was estimated to assess the factors associated. The 12-month and lifetime prevalence of suicidal ideation was reported to be 12.5% (95% CI: 10.4-15.0%) and 20% (95% CI: 17.4-22.9%), respectively. About 0.7% (95% CI: 0.3-1.5%) and 2.1% (95% CI: 1.2-3.3%) of the participants had suicide plan in past 12months and ever in their lifetime, respectively. Around 1% (95% CI: 0.5-2.0%) and 5.7% (95% CI: 4.3-7.6%) of the participants had attempted suicide in past 12months and ever in their lifetime, respectively. Family issues, physical abuse, unemployment and place of residence were significantly associated with suicidal ideation in multivariable analysis. Prevalence of suicidal ideation and suicide attempt were very high in the study area. Unemployment, physical abuse and family issues were significantly associated with suicidal behaviour.

Prevalence and determinants of suicidality among medical students in Oman

Objective The aim was to explore the stress sources and determine the prevalence of suicidal ideation among medical students and its association with demographic characteristics and stress factors. Patients and methods A cross-sectional study was conducted on Oman Medical College students of preclinical and clinical years. Data were collected using a semistructured questionnaire with sections on sociodemographic factors, stress factors, and assessment of suicidality. Prevalence of suicidal ideation and behavior in the past was assessed with the help of questions in the General Health Questionnaire pertaining to suicide. Results A total of 314 medical students participated in the study. The average age of the participants was 22.13 years. Most students who participated in the study were females (76.4%). Regarding the year of study, 66.6% of students belonged to the preclinical years, whereas 33.4% of participants were currently undergoing clinical training. The higher level of stress was associated with problems related to nutrition, poor sleep, emotional problems, and difficulties in the study courses. Overall, 33.4% of medical students had a lifetime prevalence of suicidal ideation. It was also seen that the rates of making a suicidal plan (8%) or attempting suicide (4.5%) were lower. Results also indicate that the prevalence of suicidal ideation is higher among students in the preclinical years when compared with students in clinical training. Conclusion The prevalence of suicidal ideation and attempts among medical students was in the higher range in international comparison. Medical students are future doctors who are in need to be protected from avoidable causes of morbidity and mortality including suicide. There is a necessity for further investigations to identify the core sources of emotional distress and academic burden in this population and then propose strategies consequently.

Borderline Personality Disorder With Depression Confers Significant Risk of Suicidal Behavior in Mood Disorder Patients-A Comparative Study.

ObjectiveWe investigated risk factors for suicidal ideation and behavior among currently depressed patients with major depressive disorder (MDD), major depressive episode (MDE) in bipolar disorder (BD), or MDE with comorbid borderline personality disorder (MDE/BPD). We compared current and lifetime prevalence of suicidal ideation and behavior, and investigated dimensional measures of BPD or mixed affective features of the MDE as indicators of risk.MethodsBased on screening of 1,655 referrals, we recruited 124 psychiatric secondary care outpatients with MDE and stratified them into three subcohorts (MDD, BD, and MDE/BPD) using the Structured Clinical Interview for DSM-IV I and II. We examined suicidal ideation and behavior with the Columbia Suicide Severity Rating Scale (CSSRS). In addition, we quantified the severity of BPD symptoms and BD mixed features both categorically/diagnostically and dimensionally (using instruments such as the Borderline Personality Disorder Severity Index) in two time frames.ResultsThere were highly significant differences between the lifetime prevalences of suicide attempts between the subcohorts, with attempts reported by 16% of the MDD, 30% of the BD, and 60% of the BPD subcohort. Remarkably, the lifetime prevalence of suicide attempts in patients with comorbid BD and BPD exceeded 90%. The severity of BPD features was independently associated with risk of suicide attempts both lifetime and during the current MDE. It also associated in a dose-dependent manner with recent severity of ideation in both BPD and non-BPD patients. In multinominal logistic regression models, hopelessness was the most consistent independent risk factor for severe suicidal ideation in both time frames, whereas younger age and more severe BPD features were most consistently associated with suicide attempts.ConclusionsAmong patients with major depressive episodes, diagnosis of bipolar disorder, or presence of comorbid borderline personality features both imply remarkably high risk of suicide attempts. Risk factors for suicidal ideation and suicidal acts overlap, but may not be identical. The estimated severity of borderline personality features seems to associate with history of suicidal behavior and current severity of suicidal ideation in dose-dependent fashion among all mood disorder patients. Therefore, reliable assessment of borderline features may advance the evaluation of suicide risk.

Lifetime prevalence of suicidal ideation and suicidal behaviors in gender non-conforming youths: a meta-analysis.

Gender identity represents a topic of growing interest in mental health research. People with non-conforming gender identity are prone to suffer from stigmatization and bullying and often present psychiatric issues, which may in turn lead to a high prevalence of suicidal ideation and behaviors. The present meta-analysis aimed to estimate the prevalence of suicidal ideation and suicidal behaviors in gender non-conforming children, adolescents and young adults. A systematic search was performed in Web of Science and PsycINFO from inception to December 2018. We selected cross-sectional and cohort studies including youths (up to 25years) with a diagnosis confirmed by a clinician according to international classifications, or after a direct interview with a peer. A random-effects meta-analysis was computed for the following outcomes: non-suicidal self-injury (NSSI), suicidal ideation and suicide attempts. Overall, we found a mean prevalence of NSSI of 28.2% (9 studies, 3057 participants, 95% CI 14.8-47.1). A similar prevalence (28%) was found for suicidal ideation (6 studies, 2249 participants, 95% CI 15-46.3), while the prevalence of suicide attempts was 14.8% (5 studies, 1039 participants, 95% CI 7.8-26.3). Subgroup analyses revealed no significant differences according to biological sex. Given the prevalence of suicidal behaviors in gender non-conforming youths, it appears desirable to implement therapeutic and support strategies for this population. Moreover, educational interventions directed to parents, teachers, mental health professionals and general community should be promoted to struggle against stigma and social isolation, factors that may contribute to increasing the risk of suicidal behaviors.

Suicidal Ideation and Attempt among Homeless People: a Systematic Review and Meta-Analysis.

Globally, suicide is a major public health problem among homeless people. Suicidal ideation and attempt are remarkably higher among homeless people as compared to the general population and they are linked with greater risk of complete suicide. However, no systematic review and meta-analysis has been conducted to report the consolidated magnitude of suicidal ideation and attempt among homeless people. We searched PubMed, Embase, and Scopus to identify pertinent studies on suicidal ideation and attempt among homeless people. A meta-analysis of the studies was conducted using a random effect model. We also conducted a sensitivity analysis and Cochran's Q- and the I2 test was employed to evaluate heterogeneity. Publication bias was assessed by Egger's test and visual inspection of the symmetry in funnel plots. In total, 20 eligible studies with 27,497 homeless people matched the inclusion criteria. Nineteen studies assessed suicidal attempt and thirteen studies assessed suicidal ideation among homeless people. The pooled current and lifetime prevalence of suicidal ideation was 17.83% (95% CI;10.73-28.14) and 41.60% (95% CI; 28.55-55.95), respectively whereas the pooled current and lifetime prevalence of suicidal attempt was 9.16% (95% CI;4.10-19.20) and 28.80% (95% CI; 21.66-37.18), respectively. We found a considerable heterogeneity between the studies, but we found no significant publication bias. The current review revealed a remarkably higher magnitude of suicidal ideation and attempt among homeless people as compared to the estimated prevalence in the general population. The concerned stakeholders need to give attention to address this problem emphasizing more on prevention and treatment strategies as well as utilizing holistic approaches to address the potential predictors of suicide among homeless people including physical, mental, and substance use problems.

Suicidal ideation and attempts in population-based samples of women: temporal changes between 1989 and 2015

BackgroundLittle is known about temporal changes in the prevalence of self-reported suicidal ideation and attempts within general populations of women. The aim of this study was to assess the prevalence of self-reported suicidal ideation and attempts over a 26 year period (1989–2015) among women from the general population aged 20–49 years. A further aim was to investigate associations between sociodemographic factors and lifetime suicidal ideation over this study period.MethodsA total of 2072 structured personal interviews were performed with a stratified population-based sample of women between 1989 and 2015. Questions about lifetime suicidal ideation and attempts as well as sociodemographic factors were assessed at four data collection waves. Lifetime prevalence of suicidal ideation and attempts were compared through analysis of differences between two independent proportions and their 95% Confidence Intervals (CI). Associations between sociodemographic factors and lifetime suicidal ideation were estimated by weighted odds ratios (OR).ResultsWomen aged 20–30 years reported higher lifetime prevalence of suicidal ideation in 2013–2015 compared to 1989–1991 (45 and 33% respectively). Rates of lifetime suicide attempts remained similar between these time points (3.5 and 3.1% respectively). Women aged 31–49 years reported higher lifetime prevalence of suicidal ideation in 2013–2015 compared to 2000–2002 (35.4 and 23.1% respectively). In this age group, lifetime suicide attempts increased from 0.0% in 2000–2002 to 3.6% in 2013–2015. Women aged 20–30 years who were single, unemployed or had low educational attainment had higher OR of lifetime suicidal ideation compared to the reference categories in most of the study waves. In 2013–2015, young students had lower OR of lifetime suicidal ideation (OR 0.34; 95% CI 0.17–0.69) compared to those with employment. Women aged 31–49 years, who were single, had higher OR of lifetime suicidal ideation (OR 2.61; 95% CI 1.06–6.44) than married, cohabiting women and this was observed in 2013–2015.ConclusionThe results raise a general concern about an increasing trend in suicidal ideation among young and middle-aged women. The current study expands on previous research by demonstrating that sociodemographic factors may show changing patterns in the associations with lifetime suicidal ideation over time.

Epidemiology of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background: a representative study

BackgroundData on the prevalence of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background are scarce. There are hints that this population is at risk. The aim of the study is to investigate the epidemiology of suicidal ideation, suicide attempts, and direct self-injurious behavior in adolescents with a migration background in Germany while taking gender-specific differences into consideration.MethodsA representative study with N = 10,638 students (mean age 14.91 years, SD = .73).) in the state of Lower Saxony in Germany was conducted. In the 2014–2015 school year, 672 classes were selected by randomly sampling different school types. The participation rate was 84.1%, excluding any classes for which the director refused to provide consent. A total of 49.8% were female adolescents, and 23.3% of the participants had a migration background. Target variables were assessed with items from the Ottawa Self-Injury Inventory, the Self-Harm Behavior Questionnaire and the Self-Harm Inventory, partly adapted.ResultsOf all students, 7.6% had a lifetime history of suicide attempts, and 36.6% answered with a rating of at least “rarely” when asked to rate the lifetime prevalence of suicidal ideation. The 12-month prevalence of direct self-injurious behavior was 17.8%. Adolescents with a migration background showed a significantly higher prevalence of all three constructs (p = .006; p < .001; p = .006). Male students with a migration background reported a significantly higher lifetime prevalence of suicide attempts (4.7% vs. 3.1%) than native males (p = .009). Female students with a migration background reported a significantly higher lifetime prevalence of suicide attempts (15.9% vs. 10.4%) and suicidal ideation (“often” 12.1% vs. 8.9%) than native female students (p < .001; p = .008).ConclusionOur assessment indicates an elevated risk for suicidal behaviors in adolescents with a migration background. From research on adults, it is known that the dominant motives for suicidal behavior in migrants are associated with their migration history/situation. As suggested by Cramer and Kapusta’s (Front Psychol 8:1756, 2017) theoretical model, the Social-Ecological Framework of Theory, Assessment, and Prevention, there is a need for culturally sensitive preventions that take into account the specific reasons for suicide attempts in migrants.

Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study

BackgroundThis study aims to understand suicidal ideation and suicide attempts among transgender individuals through an in-depth analysis of a nation-wide population general survey in China. MethodsTransgender Men (TM) and Women (TW) were investigated through a cross-sectional survey. A structured questionnaire was used to investigate participants' demographic information, perceived sexuality conflicts, childhood adversity and mental health conditions. Logistic regression models were utilized to investigate risk factors associated with suicidal ideation and suicide attempts in these groups. We also conducted a quasi-meta-analysis in order to compare the prevalence of suicidal ideation and attempted suicide between general and transgender populations in China. ResultsA total of 1309 participants across 32 provinces and municipalities in China took part in this survey, out of 2060 valid questionnaires. In this transgender population, the lifetime prevalence of suicidal ideation and an attempt at suicide were 56.4% and 16.1%, respectively. This estimated prevalence rate is far greater than in Chinese community samples. For all transgender people, disliking birth-assigned sex, seeking sex reassignment surgery, having intense conflicts with parents, lifetime history of suffering from major depressive disorder, a recent episode of depression, self-harm, and seeking mental health services were significantly associated with increased risk of suicidal ideation. An education level of high school or equivalent, being married and/or separated/divorced, having intense conflicts with parents, or self-harm and seeking mental health services were all significantly associated with increased risk of suicide attempt. Although most risk factors for TM and TW were equivalent across groups, differences were observed in both suicidal ideation and suicide attempt models. LimitationsThe cross-sectional study design and lack of follow-up data are limitations of this study. ConclusionsThis is the first study to examine suicide within a Chinese transgender population. The clinical implications of these findings for Chinese mental health professionals are discussed. Also, the evidence from this study can be used to inform the practices of suicide prevention workers, and policy makers working with the transgender population.