Lower Suicide Risk Research Articles

Gender Self-Confidence as a Protective Factor for Suicide Risk: Analysis of the Sample of Lithuanian Men.

BackgroundAlong with other suicide risk factors, masculinity has been analyzed as an important subject for suicidal behavior in men. This study examines masculinity as a gender self-confidence which is the intensity of an individual's belief that he meets his standards for masculinity. We use Hoffman and her colleague's concept, which provides two theoretical constructs as elements of gender self-confidence: gender self-definition and gender self-acceptance. Gender self-definition relates to how salient masculinity is in one's identity; gender self-acceptance relates to how positively one views his masculinity.MethodsThe quantitative research approach was applied in the study. The survey with a nonprobability quota sampling design was implemented to collect the data. The sample consisted of 562 Lithuanian men from various age groups and regions. The age of participants varied from 18 to 92 years (M = 42.99, SD = 17.18); 40.9% of men were from cities, 28.1% from towns, and 30.8% from rural locations. We used the Hoffman Gender Scale to measure gender self-definition and gender self-acceptance. Suicide risk was estimated with the Suicide Behavior Questionnaire—Revised. Patient Health Questionnaire-2 was used to measure depression symptoms as a controlled variable. Statistical analysis of regression and moderation was used to test the hypothesis.ResultsHigher gender self-definition and higher gender self-acceptance were associated with lower suicide risk. The moderation analysis showed that in men with relatively low gender self-definition, the effect of gender self-acceptance on suicidality was larger than in men with high or moderate gender self-definition.DiscussionWe conclude that a stronger gender self-confidence is an important protective factor in male suicide risk. Both, a smaller part of masculinity in one's identity and a negative view of one's masculinity have a cumulative effect on increased suicide risk. The findings have been discussed in accordance with the theories that explain suicidal behavior through the lenses of self-concept.

Suicidal ideation and behavior among subjects with substance abuse disorder related to pregabalin

BackgroundAlthough pregabalin abuse is increasing worldwide and may be associated with increased suicidal ideation and behavior, few studies were done in Egypt searching for the effect of pregabalin on suicide. Eighty-three patients meeting DSM-IV criteria for substance abuse disorders related to pregabalin were identified from the addiction clinic of EL Khanka Psychiatric Hospital in Egypt for this observational cross–sectional study. We intended to assess suicidal ideation and behavior in patients with substance abuse disorder related to pregabalin and to identify the effects of other comorbid substances of abuse. All participants were subjected to semi-structured interview designed to collect and identify the socio-demographic data and patterns of substances 'use ,The Structured Clinical Interview for DSM-IV Axis I Disorders to diagnose patients with substance abuse disorder “related to pregabalin,” Beck Scale for Suicidal Ideation for assessment of suicidal ideation and behavior and urine screening test for pregabalin and other substances of abuse.ResultsMost of participants used pregabalin continuously {86.7%}. More than seventy nine percent of the patients abused both pregabalin and other substances, tramadol 67.4%, heroin 66.3%, cannabis 65.1%, other drugs 44.6%, and benzodiazepines 27.7%. Screening urine test was positive in 62.7% of participants most frequently was heroin 41% and cannabis 34.9%. No suicidal ideation was found in 67.4%, 19.3% had low risk of suicide, and 13.3% had high risk of suicide so total participants who had suicidal ideation were 32.6%. There was statistical significant increase in risk of suicide among patients who were continuously abusing pregabalin and who had positive pregabalin urine test. There was significant positive correlation between Beck Suicidal Ideation score and duration of abusing pregabalin, maximum and daily dose of pregabalin. Also, there was a statistical significant relation between suicidal ideation and associated tramadol abuse and this was positively correlated with dose and duration of tramadol abuse.ConclusionsAbout one third of patients abusing pregabalin had a risk of suicide and this risk increased with associated tramadol abuse so pregabalin abuse is dangerous like other substances of abuse and must be used with caution under strict medical supervision

Mental health, suicide attempt, and family function for adolescents' primary health care during the COVID-19 pandemic.

Background: The study's purpose was to identify associations between mental health risk, suicide attempts, and family function. Methods: A correlational, descriptive, and cross-sectional study was carried out in a group of adolescents in the last grade of secondary school to establish the association between mental health risk, suicide attempt, and family functionality. The instruments used were the self-report questionnaire, the suicide risk assessment scale, and the family APGAR. Data analysis was performed using the artificial intelligence algorithm (gower clustering). Results: 246 adolescents responded to the three instruments, which made it possible to select those with correlations of sensitive interest and, based on these, an intervention plan. Psychological distress was found in 28%, psychotic symptoms in 85%, and problematic alcohol use in 9%. Good family functioning was identified in 34% and some type of family dysfunction in 66%. In terms of suicide risk, there was a low suicide risk of 74%, 24% medium risk, and 2% high risk. It could be shown that there is a correlation in a group of 15% of the respondents. Conclusions: The risk of suffering mental health deterioration and the suicide risk, during this pandemic period, seems to be related to family functionality.

Crisis-management, Anti-stigma, and Mental Health Literacy Program for University Students (CAMPUS): A preliminary evaluation of suicide prevention

Background: University students have specific risk factors for suicide, necessitating targeted prevention programs. This preliminary study evaluated the efficacy of the Crisis-management, Anti-stigma, Mental health literacy Program for University Students (CAMPUS) for reduction of risk factors and promotion of preventative behaviors. Methods: A total of 136 medical students attended the CAMPUS as a required course at the national university in Japan. The CAMPUS consisted of a lecture and two group sessions covering mental health literacy, self-stigma, and gatekeeper efficacy (e.g., identifying and helping at-risk individuals). The students were asked to role-play based on a movie about gatekeepers and scripts about self-stigma and suicide-related issues. Participants completed questionnaires on suicidal thoughts, depression, help-seeking intentions, self-efficacy as gatekeepers, self-concealment, and self-acceptance. A total of 121 students completed the questionnaires pre- and post-program, and 107 students also responded six months later. Results: Students demonstrated significantly reduced overall suicide thoughts six months post-program compared to before the program. In addition, gatekeeper self-efficacy, help-seeking intentions for formal resources, and self-acceptance were improved in the students six month after the program. Conclusions: The CAMPUS suggested effective at reducing suicidal people and promoting preventative psychological tendencies among medial students. This study was a one-group pre post design study without control group. The CAMPUS program was delivered as a mandatory requirement to a group with relatively low suicide risk. Further studies are required to assess its suitability for the general university student population.

Cause-Specific Mortality Among Norwegian Veterans Deployed to Afghanistan Between 2001 and 2019.

Norwegian military forces participated in the military campaign Operation Enduring Freedom in Afghanistan starting in 2001. Military personnel often show a "healthy soldier effect" in terms of lowered all-cause mortality when compared to the general population. However, military service in conflict areas is associated with an increased risk of death from external causes such as transport accidents and suicide after discharge. We aimed to investigate cause-specific mortality in a cohort of 9,192 Norwegian (7.5% women) veterans deployed to Afghanistan between 2001 and 2019. We followed cohort members from their first day of service in Afghanistan through 2019. We computed standardized mortality ratios (SMRs) with 95% CIs by comparing the observed number of deaths in our cohort with the expected number of deaths in the general population. Standardized mortality ratios were calculated for the full follow-up period among men and women separately, and among men only for two time periods: during deployment and after discharge from service in Afghanistan. We observed 77 deaths (3 women and 74 men), 10 of which occurred during deployment (war casualties, 1 woman and 9 men); all others occurred after discharge. All-cause mortality in women did not differ from that in the general population (SMR = 0.52, 95% CI 0.11-1.53). For men, the observed all-cause mortality was lower than the expected rate for the full follow-up period (SMR = 0.55, 95% CI 0.43-0.69), during deployment, and after discharge, while deaths because of transport accidents after discharge (13 cases) were more than twice as high as expected rates (SMR = 2.36, 95% CI 1.26-4.04). The 11 observed suicides gave a nonstatistically significant, lower suicide risk compared to the expected rates (SMR = 0.66, 95% CI 0.33-1.18). In accordance with the "healthy soldier effect," military service in Afghanistan was generally associated with a lower than expected risk of death both during deployment and after discharge. The risk of death from transport accidents was higher than expected after discharge, while the observed incidence of suicide did not differ from the expected rate in the general population.

Suicide rates and suicidal behaviour in displaced people: A systematic review.

BackgroundRefugees, and other forcibly displaced people, face mental distress and may be disproportionately affected by risk factors for suicide. Little is known about suicidal behaviour in these highly mobile populations because collecting timely, relevant, and reliable data is challenging.Methods and findingsA systematic review was performed to identify studies of any design reporting on suicide, suicide attempts, or suicidal ideation among populations of displaced people. A sensitive electronic database search was performed in August 2020, and all retrieved studies were screened for relevance by two authors. Studies were categorised by the population being evaluated: refugees granted asylum, refugees living in temporary camps, asylum seekers, or internally displaced people. We distinguished between whether the sampling procedure in the studies was likely to be representative, or the sample examined a specific non-representative subgroup of displaced people (such as those already diagnosed with mental illness). Data on the rates of suicide or the prevalence of suicide attempts or suicidal ideation were extracted by one reviewer and verified by a second reviewer from each study and converted to common metrics. After screening 4347 articles, 87 reports of 77 unique studies were included. Of these, 53 were studies in representative samples, and 24 were based on samples of specific target populations. Most studies were conducted in high-income countries, and the most studied population subgroup was refugees granted asylum. There was substantial heterogeneity across data sources and measurement instruments utilised. Sample sizes of displaced people ranged from 33 to 196,941 in studies using general samples. Suicide rates varied considerably, from 4 to 290 per 100,000 person-years across studies. Only 8 studies were identified that compared suicide rates with the host population. The prevalence of suicide attempts ranged from 0.14% to 15.1% across all studies and varied according to the prevalence period evaluated. Suicidal ideation prevalence varied from 0.17% to 70.6% across studies. Among refugees granted asylum, there was evidence of a lower risk of suicide compared with the host population in 4 of 5 studies. In contrast, in asylum seekers there was evidence of a higher suicide risk in 2 of 3 studies, and of a higher risk of suicidal ideation among refugees living in camps in 2 of 3 studies compared to host populations.ConclusionWhile multiple studies overall have been published in the literature on this topic, the evidence base is still sparse for refugees in camps, asylum seekers, and internally displaced people. Less than half of the included studies reported on suicide or suicide attempt outcomes, with most reporting on suicidal ideation. International research networks could usefully define criteria, definitions, and study designs to help standardise and facilitate more research in this important area.RegistrationPROSPERO CRD42019137242.

The Agrarian distress: Factors explaining the will to live among rural and distressed family farmers

This study examines the psychosocial determinants of mental health among family farmers with small plots of land. The study evaluates (mal)adaptive coping styles, amount of loan, land ownership, and psychological wellbeing in relation to suicide risk among farmers. 146 farmers were recruited from two villages in southern India, and a battery of validated and reliable questionnaires was used to assess self-reported psychological distress, economic status, and coping styles. Findings suggest that there was no significant association between the amount of a farmer’s loan and suicidal ideation (SI). However, SI was significantly related to the amount of land owned by the farmers, which was then mediated by self-criticism and anxiety. Additionally, farmers who adopted a “negative distraction” style of coping were at 1.87 higher odds of expressing SI; and farmers who engaged in "denial/blaming" coping styles were at 1.49 higher odds of having SI. Alternatively, farmers who used a “positive distraction” style of coping were at 0.60 lower odds of having SI; gender differences within coping styles were also identified. The findings highlight the need to introduce a multifaceted care pathway to tackle mental health, along with the economic needs of farmers at risk for suicide. • Distinct coping patterns to stress is uniquely related to suicide risk among farmers. • Negative distraction coping to stress put farmer at higher risk for suicide. • Positive distraction coping to stress put farmer at lower risk for suicide. • Lower land ownership may be an economic determinant of suicide risk for family farmers. • Suicide prevention strategies need to target both the economic and mental health needs.

The Relationship Between Psychache and Suicide Risk With Spiritual Well-Being Levels of Patients Diagnosed With Depression.

BACKGROUND: Depression has long been accepted as a serious disability and burden globally, while suicide is a misunderstood and complex cause of death. Psychache is the psychological variable most strongly associated with suicidality. Spirituality is considered an important buffer against stressful events and may help people overcome distress and difficulties. AIMS: This study aims to determine how psychache and suicide risk are related to levels of spiritual well-being in patients with depression. METHODS: Data were collected using the Suicide Probability Scale, the Psychache Scale, and the Spiritual Well-Being Scale. The sample study consisted of 150 Turkish patients diagnosed with depression and receiving psychiatric care. RESULTS: It was found that higher level of spiritual well-being led to decreased risk of suicide and lower level of psychache. Suicide risk increased in parallel to the increasing levels of psychache (p < .001). CONCLUSIONS: It was observed that higher levels of spiritual well-being may promote a significantly lower risk of suicide and lower levels of psychache. Likewise, increasing levels of psychache may lead to an increase in suicide risk.

Psychoactive medication use and risk of suicide in long-term care facility residents.

ObjectivesTo investigate psychoactive medication use and risk of suicide in long‐term care facility (LTCF) residents aged 75 and above. A second aim was to investigate the role of psychiatric and medical conditions in the occurrence of suicide in LTCF residents.MethodsA Swedish national register‐based cohort study of LTFC residents aged ≥75 years between 1 January 2008 and 31 December 2015, and followed until 31 December 2016 (N = 288,305). Fine and Gray regression models were used to analyse associations with suicide.ResultsThe study identified 110 suicides (15.8 per 100,000 person‐years). Half of these occurred during the first year of residence. Overall, 54% of those who died by suicide were on hypnotics and 45% were on antidepressants. Adjusted sub‐hazard ratio (aSHR) for suicide was decreased in those who were on antidepressants (aSHR 0.64, 95% confidence interval 0.42–0.97), even after the exclusion of residents who had healthcare contacts for dementia or were on anti‐dementia drugs. The aSHR for suicide was more than two‐fold higher in those who were on hypnotics (2.20, 1.46–3.31). Suicide risk was particularly elevated in those with an episode of self‐harm prior to LTCF admittance (15.78, 10.01–24.87). Specialized care for depression was associated with increased risk, while medical morbidity was not.ConclusionsA lower risk of suicide in LTCF residents was found in users of antidepressants, while elevated risk was observed in those on hypnotics. Our findings suggest that more can be done to prevent suicide in this setting.

Risk Factors for Viral Non-Suppression among People Living with HIV and Major Depressive Disorder in Uganda

Background: Several studies indicate that depression is associated with non-viral suppression among persons living with HIV (PLWH) using antiretroviral therapy (ART) worldwide. However, among PLWH with major depressive disorder, factors associated with non-viral suppression remain uncertain. We determined the prevalence and identified the factors associated with viral non-suppression among PLWH with major depressive disorder using ART in Northern Uganda. Method: A total of 30 primary care HIV clinics across three northern districts (Gulu, Kitgum, Pader) participated in the study. Using baseline data from the SEEK-GSP study, a cluster-randomized trial in northern Uganda (2016-2019) that involved 1140 PLWH with mild to moderate major depressive disorder; we examined the demographic, clinical, and psychosocial factors using standardized questionnaires. Data on viral load was abstracted from clinic records and dichotomized into suppressed (<1000 viral copies/mL) and non-suppressed (≥1000 viral copies/mL). We used generalized linear regression models to evaluate the factors associated with non-viral suppression. Results: We recruited 1140 PLWH. The viral non-suppression prevalence was 12.2%. In multivariable analysis, the only baseline psychosocial variable independently associated with non-viral suppression was suicide risk (PRR = 1.56, 95% CI: 1.05 - 2.32, p-value = 0.029). The prevalence odds for non-viral suppression were 56% higher among depressed PLWH with moderate to high suicide risk than those with low suicide risk. Among clinical variables, duration on ART ≥ 4 years was independently associated with non-viral suppression (PRR = 1.62, 95% CI: 1.09 - 2.32, p-value = 0.015). Conclusions: Suicide risk and longer duration on ART are associated with non-viral suppression among anti-retroviral therapy users with mild to moderate major depressive disorder in Uganda. As ART is scaled up across Sub-Saharan Africa, first-line psychological care for depression and its complications is urgently needed in established HIV treatment centers.

Longitudinal effects of physical and social neighbourhood change on suicide mortality: A full population cohort study among movers and non-movers in the Netherlands

Associations between the residential neighbourhood environment and suicide mortality are well-established; however, most evidence is cross-sectional and not capable of incorporating place-based and residential moving-related neighbourhood changes. We studied how suicide mortality is associated with changes in the physical and social neighbourhood environment for movers and non-movers. Our retrospective analysis was based on longitudinal register data for the entire Dutch population aged 25–64 years enriched with annually time-varying data on the residential neighbourhood environment between 2007 and 2016. A total of 8,741,021 people were followed-up between 2007 and 2016 of which 10,019 committed suicide. Upward and downward neighbourhood change was measured by comparing neighbourhood conditions separately at two time points. Cox proportional hazard models indicated that movers had a significantly lower risk of suicide compared to non-movers. Suicide risk was lower for people experiencing improvements in social fragmentation and deprivation compared to those remaining in poor conditions. Change from rural to urban conditions also resulted in lower suicide risk, while a gain in green space put people at increased risk. For those stable neighbourhood conditions over time, suicide mortality was lower for men and women in urban vs. rural neighbourhoods as well as for women in neighbourhoods with low vs. high social fragmentation. Stable exposure to high levels of green space resulted in higher suicide risk among women. Interactions and stratification by moving type revealed associations between neighbourhood change and suicide were more pronounced in non-movers. Our findings suggest that neighbourhood improvements might contribute to a lower suicide risk, especially for long-term residents in poor neighbourhood conditions.

SUICIDAL TENDENCIES AMONG PARENTS, UPBRINGING CHILDREN WITH COMPLEX DEVELOPMENTAL DISABILITIES

The birth of a child with developmental disabilities changes the usual way of life of the family. The motives and causes of suicide cannot be reduced to a single classification, because they are largely subjective and depend on different characteristics of a person: gender, age, profession, worldview. manifestation of suicidal tendencies is a complex systemic phenomenon, we consider it necessary to use in the process of research battery techniques. As a result of the analysis of the content, features of application and efficiency of various techniques, we have chosen the following: 1) Beck's Hopelessness Scale (Beck et al. 1974); 2) Methods of diagnosis of subjective feelings of loneliness D. Russell and M. Ferguson; 3) Questionnaire "Risk-C"; 4) The method of incomplete sentences (according to O. Kucher). Spearman's correlation coefficient was also used to determine the relationship between the levels of subjective feelings of loneliness and hopelessness and the level of risk of suicidal ideation. The purpose of our study is to determine the predominant presence or absence of suicidal ideation and tendencies in the behavior of parents raising children with complex developmental disorders, as well as their relationship with such personal factors as subjective feelings of loneliness and hopelessness. Determining the nature of the relationship between subjective feelings of loneliness and the presence of suicidal tendencies in the subjects showed that the subjects with clear signs of suicidal tendencies of the majority are characterized by a high level of subjective feelings of loneliness. Among the subjects with some signs of suicidal tendencies, the most represented is the average level of subjective feelings of loneliness. Subjects who generally showed no signs of suicidal ideation had a low level of subjective feelings of loneliness. Subjects with a minimal level of suicide show mostly an average level of loneliness. In addition, subjects at high risk of suicide generally showed a high level of subjective loneliness. In subjects with a medium level of risk of suicide, the feeling of loneliness, in most cases, is also manifested at a medium level. If we talk about subjects with a low risk of suicide, the most pronounced is the low level of subjective loneliness.

Mortality and Cause of Death Among Youths Previously Incarcerated in the Juvenile Legal System

More than 50 000 youths are incarcerated in the United States on any given day, and youth incarceration has been linked to lasting adverse outcomes, including early mortality. Improving our understanding of the factors associated with early mortality among incarcerated youths can inform appropriate prevention strategies. To examine mortality rates and causes of death among youths previously incarcerated in the juvenile legal system. This retrospective longitudinal population-based cohort study compared mortality rates between youths aged 11 to 21 years incarcerated from 2010 to 2017 with same-aged nonincarcerated Medicaid-enrolled youths in the state of Ohio. Data from January 2017 to December 2019 were collected from juvenile incarceration, Medicaid, and death certificate information in Ohio. Incarceration in the state of Ohio's juvenile legal system. Number, characteristics, and causes of deaths. Poisson regression incidence rate ratios (IRRs) compared mortality rates between previously incarcerated and Medicaid-enrolled youths. Among 3645 incarcerated youths, 3398 (93.2%) were male, 2155 (59.1%) Black, 1307 (35.9%) White, and 183 (5.0%) other race and ethnicity. Overall, 113 youths (3.1%) died during the study period. Homicide was the leading cause of death in formerly incarcerated youths (homicide: 63 [55.8%]; legal intervention [ie, death due to injuries inflicted by law enforcement]: 3 [2.7%]). All-cause mortality rates were significantly higher among previously incarcerated youths than Medicaid-enrolled youths (adjusted IRR [aIRR], 5.91; 95% CI, 4.90-7.13) in every demographic subgroup. Compared with Medicaid-enrolled youths, mortality rates for previously incarcerated youths were highest for homicide (aIRR, 11.02; 95% CI, 8.54-14.22), overdose (aIRR, 4.32; 95% CI, 2.59-7.20), and suicide (aIRR, 4.30; 95% CI, 2.22-8.33). Formerly incarcerated Black youths had a significantly higher risk of homicide (aIRR, 14.24; 95% CI, 4.45-45.63) but a lower risk of suicide (aIRR, 0.18; 95% CI, 0.04-0.89) and overdose (aIRR, 0.31; 95% CI, 0.10-0.99) than White youths who were incarcerated. Previously incarcerated youths aged 15 to 21 years were significantly more likely to die than youths aged 22 to 29 years, irrespective of cause of death (aIRR for youths aged 22-29 years, 0.09; 95% CI, 0.06-0.14). In this study, youths with a history of incarceration were significantly more likely to experience early mortality compared with nonincarcerated Medicaid-enrolled youths. Delinquency and violence prevention strategies that incorporate a culturally informed approach and consider sex and developmental level are critical.

The Relationship Between Depression, Perceived Social Support, and Suicide Risk in Natural Disaster Survivors.

Natural disasters often cause a wide array of post-traumatic psychological difficulties among survivors. Increased suicide risk was recently added to the list of lingering traumatic reactions that interfere with natural disaster survivors' adjustment and recovery. The purpose of this study was to investigate the relationship between psychological symptoms, perceived social support, and the risk of suicide among natural disaster survivors in Korea. A total of 451 Korean national disaster survivors participated in this study. Their depressive and post-traumatic stress symptoms, perceived social support, and suicide risk were measured. The participants were classified into three groups (minimal, low, and high suicide risk), and the psychosocial factors of the three groups were compared. The risk of suicide increased with the severity of depressive symptoms and decreased as social support (particularly family support) increased. Depressive symptoms were identified as the most potent predictor of suicidality. Several psychosocial factors, particularly depressive symptoms, may have an impact on suicide risk in natural disaster survivors. Therefore, it is essential to focus on their depressive symptoms when assessing and treating natural disaster survivors.

Suicide attempts among Taiwanese lesbian, gay, bisexual, and transgender adults during the 2018 Taiwan referendum on same‐sex issues

PurposeTo examine suicide attempts and the influencing factors among Taiwanese lesbian, gay, bisexual, and transgender (LGBT) adults during the 2018 Taiwanese referendum on same‐sex issues.Research design and methodsThe 2018 Taiwanese referendum was held on November 24. A cross‐sectional online survey was conducted between October 2018 and February 2019. A total of 1012 self‐identified LGBT adults were included in the final sample.ResultsAmong the 1012 Taiwanese LGBT adults, the rates of suicide attempts ranged from 9.1% to 24.4%. A younger age, being a student, having low income, having mental health issues, and having a high level of depressive symptoms were associated with a significantly higher risk of suicide attempts in the participants. Conversely, having a postgraduate degree, having high self‐esteem, and perceiving support from friends and family were associated with a lower risk of suicide attempts.ConclusionThis is the first study to investigate suicide attempts among LGBT individuals and the influencing factors within the context of a same‐sex marriage referendum in an Asian country. The results of this study demonstrate the importance of suicide prevention measures for the LGBT community, particularly during times of increased social stress and conflict between social groups with diverse sexual and gender identities.Clinical relevanceThe results of this study suggest that nurses’ and health‐care providers’ sensitivity toward LGBT patients and their knowledge and skills in providing culturally competent care are key factors in suicide prevention for LGBT adults. Therefore, nurses and health‐care providers must be provided with training courses on culturally competent care.

Ethnicity and suicide risk: A population-based study from England

Using multiple linked electronic health databases, we conducted a large case-control study in England from 2001 through 2019 to examine the association between ethnicity and suicide risk. Asian, Black and Other ethnic groups had a significantly lower suicide risk compared to White individuals, with those of Asian ethnicity having the lowest risk (Odds Ratio 0.53, 95% Confidence Interval 0.47–0.60). This ethnicity related suicide risk was significantly altered by socio-demographic characteristics. These factors can inform the assessment and stratification of suicide risk, as well as the targeting of public health measures designed to reduce suicide incidence.

Association of the type of counselor with suicidal ideation and suicide attempts: a survey of South Korean adolescents

BackgroundCounseling for adolescents who consider or attempt suicide may help reduce suicide rates. However, the impact of the type of counselor (e.g., father, mother, sibling, friend, teacher, other) on suicidal ideation/suicide attempts remains unclear. Therefore, we examined this association in Korean adolescents.MethodsUsing data from the 2015 Korea Youth Risk Behavior Web-based Survey of 65,485 adolescents, we examined risk factors for suicidal ideation/suicide attempts according to sex using a multiple logistic regression analysis. In a subgroup analysis, we investigated the associations between counselor type and suicidal ideation/suicide attempts stratified by the cause of stress for both sexes.ResultsMale participants were less likely to consider suicide when counseled by their mother (odds ratio [OR] 0.80; 95% confidence interval [CI] 0.70–0.90) or friend (OR 0.89; 95% CI 0.80–0.99) and to attempt suicide when counseled by a friend (OR 0.74; 95% CI 0.60–0.92) than were those who did not receive any counseling. Female participants were less likely to attempt suicide when counseled by their mother (OR 0.66; 95% CI 0.53–0.82) or friends (OR 0.70; 95% CI 0.58–0.83) than when not counseled. Furthermore, adolescents with achievement/career choice-related and family problems were at a lower risk of suicide ideation/suicide attempts when counseled by their mother or friend than when they received no counseling.ConclusionsSuicidal ideation/suicide attempts showed different associations for both sexes in accordance with the type of counselor. Even if counseling by specialists for issues such as achievement/career choice-related or family matters is needed, the risk of suicide could be reduced through counseling by the people around them. Therefore, adolescents should form mutually supportive relationships through active communication with surrounding people.

Temporally informed random forests for suicide risk prediction.

Suicide is one of the leading causes of death worldwide, yet clinicians find it difficult to reliably identify individuals at high risk for suicide. Algorithmic approaches for suicide risk detection have been developed in recent years, mostly based on data from electronic health records (EHRs). Significant room for improvement remains in the way these models take advantage of temporal information to improve predictions. We propose a temporally enhanced variant of the random forest (RF) model-Omni-Temporal Balanced Random Forests (OT-BRFs)-that incorporates temporal information in every tree within the forest. We develop and validate this model using longitudinal EHRs and clinician notes from the Mass General Brigham Health System recorded between 1998 and 2018, and compare its performance to a baseline Naive Bayes Classifier and 2 standard versions of balanced RFs. Temporal variables were found to be associated with suicide risk: Elevated suicide risk was observed in individuals with a higher total number of visits as well as those with a low rate of visits over time, while lower suicide risk was observed in individuals with a longer period of EHR coverage. RF models were more accurate than Naive Bayesian classifiers at predicting suicide risk in advance (area under the receiver operating curve = 0.824 vs. 0.754, respectively). The proposed OT-BRF model performed best among all RF approaches, yielding a sensitivity of 0.339 at 95% specificity, compared to 0.290 and 0.286 for the other 2 RF models. Temporal variables were assigned high importance by the models that incorporated them. We demonstrate that temporal variables have an important role to play in suicide risk detection and that requiring their inclusion in all RF trees leads to increased predictive performance. Integrating temporal information into risk prediction models helps the models interpret patient data in temporal context, improving predictive performance.

Low cholesterol level as a possible suicide risk factor

High cholesterol levels are widely recognized as cardiovascular risk factors. However, lower or higher cholesterol levels can be in a solid relationship with several mental disorders, too. Our study aims to raise awareness about the fact that hypocholesterolemia is involved in various mood disorders and even suicidal behavior looks to be much more frequent. Our current study implicates 200 psychiatric patients. These subjects had suicidal ideation upon hospital referral. In the first 24 hours, their total cholesterol levels were measured and the severity of self-harm intentions was evaluated with the Modified Scale for Suicide Ideation by Miller et al. Results: By the obtained evaluation score we differentiated 3 groups: 52 patients with low suicide risk, 49 with moderate risk and 99 with high suicide risk. In this last group, 83 patients had their serum total cholesterol level under 4,5 mmol/L (84%). By comparison, in the low-risk category only 3 patients (6%) and in the moderate-risk 13 patients (29%) were with such levels. Clear conclusion cannot be drawn due to the reduced number of our patients, due to the absence of long-term consequent monitorization, and due to the heterogeneity of the studied population. Considering these data, a possible usefulness of total cholesterol levels in psychiatric patients may be suggested as a screening tool for the severity of suicidal ideation. Orv Hetil. 2021; 162(43): 1732-1739.

Imaging the Influence of Red Blood Cell Docosahexaenoic Acid Status on the Expression of the 18 kDa Translocator Protein in the Brain: A [11C]PBR28 Positron Emission Tomography Study in Young Healthy Men

BackgroundDocosahexaenoic acid (DHA) shows anti-inflammatory/proresolution effects in the brain. Higher red blood cell (RBC) DHA in humans is associated with improved cognitive performance and a lower risk for suicide. Here, we hypothesized that binding to the 18 kDa translocator protein (TSPO), a proxy for microglia levels, will be higher in individuals with low DHA relative to high DHA levels. We also postulated that higher TSPO would predict poor cognitive performance and impaired stress resilience. MethodsRBC DHA screening was performed in 320 healthy males. [11C]PBR28 positron emission tomography was used to measure binding to TSPO in 38 and 32 males in the lowest and highest RBC DHA quartiles. Volumes of distribution expressed relative to total plasma ligand concentration (VT) was derived using an arterial input function–based kinetic analysis in 14 brain regions. Results[11C]PBR28 VT was significantly lower (by 12% and 20% in C/T and C/C rs6971 genotypes) in males with low RBC DHA than in males with high RBC DHA. Regional VT was correlated positively and negatively with RBC DHA and serum triglycerides, respectively. No relationships between VT and cognitive performance or stress resilience measures were present. ConclusionsContrary to our hypothesis, we found lower TSPO binding in low-DHA than in high-DHA subjects. It is unclear as to whether low TSPO binding reflects differences in microglia levels and/or triglyceride metabolism in this study. Future studies with specific targets are necessary to confirm the effect of DHA on microglia. These results underscore the need to consider lipid parameters as a factor when interpreting TSPO positron emission tomography clinical findings.