Multiple Suicide Research Articles

Relationship Between the Feeling of Emptiness and Suicide Reattempt: Conclusions From Cross-Sectional and Longitudinal Analyses.

The feeling of emptiness is a complex subjective experience considered relevant in the suicidal process, acting as a risk factor for suicide ideation, attempts and even reattempts. However, empirical studies are still scarce. This study has three objectives: to compare emptiness levels in healthy people and those with suicide attempts; to compare the emptiness level between people with a single suicide attempt and multiple suicide attempts at baseline; and to study emptiness as a risk factor for the appearance of new suicidal attempts after an index one. In the study, 382 healthy controls and 58 participants with a recent suicide attempt (in the past 15 days) participated. All completed the feeling of emptiness scale (FES). Information was also collected on sociodemographic characteristics and history of suicide attempts. First, the control sample scores were compared with those of the clinical sample. Later, the single attempt and reattempt groups (any amount greater than one attempt at baseline) were compared. Finally, the clinical sample was followed for 1 year and 3 months (through clinical records). Survival analysis was performed. The clinical group obtained higher scores across the FES subscales, even when controlling for other relevant variables (p < 0.01). When comparing people with one versus several attempts, differences were also observed in all subscales except one, the reattempt group getting higher scores (p < 0.05). Regarding the survival analysis, the feeling of emptiness was significantly associated with the risk of reattempt (HR = 1.04; p < 0.05). All people who reattempted during follow-up belonged to the reattempt group at baseline. People who have attempted suicide present higher emptiness scores. Furthermore, emptiness appears to significantly predict the occurrence of new attempts at follow-up. The feeling of emptiness may be associated with the lack of vital meaning and disconnection from others, fundamental aspects of the ideation-to-action suicide models. Including emptiness in suicide assessments could increase clinicians' predictive ability.

Adolescent Psychotic Experiences and Adverse Mental Health Outcomes in Adulthood in a General Population Sample.

This study estimated risk of incident mental disorders in adulthood associated with both transient and persistent adolescent psychotic experiences (PEs). A nested case-control design was used within the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort study which recruited expectant mothers from 1991-1992. Participants consisted of 8822 offspring of ALSPAC mothers who completed the Psychosis-like Symptoms Interview Questionnaire (PLIKSi-Q). PEs were assessed using the PLIKSi-Q. Depressive disorders were assessed using the Short Mood and Feelings Questionnaire (SMFQ), anxiety disorders using the General Anxiety Disorder Assessment and the Clinical Interview Schedule-Revised, and psychotic disorder using the PLIKSi. Risk of incident depressive disorder, GAD, psychotic disorder, and past-year suicide attempts were compared amongst participants who had ever versus never reported a PE and those who reported persistent versus transient PEs. Adolescent PEs were associated with increased risk for incident depressive disorder (adjusted hazard ratio (aHR) = 1.62, 95% CI = 1.42, 1.84), GAD (aHR 1.23, 95% CI = 1.03, 1.47), psychotic disorder (adjusted odds ratio (aOR) = 5.08, 95% CI = 2.02, 12.79), and past-year suicide attempts (aHR = 2.56, 95% CI = 1.97, 3.25). Persistent PEs were associated with increased risk for depressive disorder (aHR = 1.81, 95% CI = 1.55, 2.12), generalized anxiety disorder (aHR = 1.34, 95% CI = 1.07, 1.68), and psychotic disorder (aOR = 7.39, 95% CI = 2.43, 22.19) but not past-year suicide attempts. Adolescent PEs are a risk factor for multiple mental disorders and suicide attempts, with persistent PEs conferring greater risk. Identifying interventions for adolescents who report PEs, particularly persistent PEs, could lessen the burden of multiple mental health disorders and suicide attempts.

Cardiovascular Disease, Genetic Susceptibility, and Risk of Psychiatric Disorders and Suicide Attempt: A Community-Based Matched Cohort Study Based on the UK Biobank.

The associations between cardiovascular disease (CVD) and multiple psychiatric disorders and suicide attempt, and whether different genetic susceptibilities affect such links, have not been investigated clearly. Based on the UK Biobank, we conducted a matched cohort study involving 63 923 patients who were first hospitalized with a CVD diagnosis between 1997 and 2020, and their 127 845 matched unexposed individuals. Cox models were used to examine the subsequent risk of psychiatric disorders and suicide attempt (ie, anxiety, depression, stress-related disorder, substance misuse, psychotic disorder, and suicide behaviors) following CVD. We further performed stratified analyses by polygenic risk score for each studied psychiatric condition to detect the possible effects of genetic susceptibility on the observed associations. We found an increased risk of any psychiatric disorders and suicide attempt among CVD patients, compared with matched unexposed individuals, particularly within 1 year following the CVD (fully adjusted hazard ratio [HR] within 1 year, 1.83 [95% CI, 1.58-2.12]; HR after 1 year, 1.24 [95% CI, 1.16-1.32]). By subtype, the risk elevations existed for any psychiatric disorders and suicide attempt following most categories of CVDs. Analyses stratified by polygenic risk score revealed little impact of genetic predisposition to studied psychiatric conditions on these observed links. Patients hospitalized for CVD were at increased subsequent risk of multiple types of psychiatric disorders and suicide attempt, especially in the first year after hospitalization, irrespective of their genetic susceptibilities to studied psychiatric conditions, and these findings underscore the necessity of developing timely psychological interventions for this vulnerable population.

Associations between multiple sleep dimensions and suicide and non-suicidal self-injury: a cross-sectional study of 3828 Chinese young people.

Suicide and non-suicidal self-injury (NSSI) are preventable concerns in young people. Suicidal ideation (SI), suicidal plans (SP) and suicidal attempt (SA) are closely related to death. Sleep problems are known risk factors for suicide and NSSI. This study aimed to explore the relationship between sleep, suicidality and NSSI. Participants were 3,828 middle school and college students aged 11-23 years from urban and rural areas of Henan Province. Sleep, suicidal phenomena and NSSI were assessed by applying self-reported questionnaires. Chi-squared tests were utilized to demonstrate the demographic data and sleep variables. The correlation between sleep, suicidality and NSSI were explored by using binary logistic regression, while adjusting socio-demographic characteristics with multivariate models. Sleep variables except mid-sleep time were related to suicidal phenomena (P < 0.05). Greater social jet lag (SJL) [≥ 2h (h)] was associated with increased risk of SI [Odds ratios (OR) = 1.72, 95% confidence intervals (CI):1.40-2.11], SP (OR = 2.10, 95%CI:1.59-2.79) and SA (OR = 1.50, 95%CI:1.00-2.26). Non-only child participants with SJL (≥ 2h) had significantly increased odds of SI (OR = 1.75, 95%CI: 1.41-2.18) and SP (OR = 2.25, 95%CI: 1.66-3.05). Eveningness chronotype had the strongest correlation with SI (OR = 3.87, 95%CI:2.78-5.38), SP (OR = 4.72, 95%CI:2.97-7.50), SA (OR = 6.69, 95%CI:3.08-14.52) and NSSI (OR = 1.39, 95%CI:1.02-1.90). Overlong or short sleep duration, SJL, eveningness chronotype and other sleep abnormalities (e.g., daytime dysfunction, low sleep efficiency) were associated with a higher prevalence of SI, SP and SA. Additionally, eveningness was significantly correlated with NSSI among young people. These findings suggested the importance of assessing and intervening in sleep habits to prevent suicide and NSSI in young people.

Characteristics of Single vs. Multiple Suicide Attempters Among Adult Population: A Systematic Review and Meta‑Analysis

IntroductionSuicide is one of the leading causes of unnatural death worldwide. There might be meaningful differences between those individuals that attempt suicide once in their lifespan and those who make multiple attempts in terms of sociodemographic and clinical characteristics. There are no previous meta-analysis addressing this topic in the adult population.ObjectivesWe aimed to examine the factors that differentiate single and multiple suicide attempters in adult population.MethodsWe followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to conduct this review and meta-analysis. The review protocol was registered in PROSPERO. We carried out a systematic literature search in three databases to identify original studies that explored the differences between single and multiple suicide attempters among adult population. A total of 75 studies were included in the review and 69 were included in the meta-analysis.ResultsMultiple attempters were more likely to present certain disorders such as mood and psychotic disorders, as well as personality or substance use disorders. Higher suicide ideation and suicide intent scores also characterized this group. Childhood trauma experiences, stressful life events, and higher rates of hopelessness were statistically significant in multiple attempters.Conclusions Identifying the factors predicting multiple suicide attempts helps to delineate a high-risk suicidal profile that should be taken into account in the clinical and suicide prevention scenario.Disclosure of InterestNone Declared

Sociodemographic and Clinical Determinants of Psychiatric Hospitalization in Northern Greece: A descriptive study

IntroductionAccording to data, psychiatric re-admissions rates vary from 10%-80%, while they negatively affect the patients’ quality of life and life expectancy. The limitation of multiple psychiatric hospitalizations represents a clinical challenge for all mental health professionals.ObjectivesTo investigate risk factors of hospitalization in a sample of psychiatric patients in Northern Greece.Methods 1,633 records of psychiatry inpatients were examined retrospectively throughout the 10-year records of the Psychiatry Department of Papanikolaou General Hospital in northern Greece. The research was conducted between 2013 and August 2023. The sample was divided into subgroups according to gender, diagnosis, and year of hospitalization. A bivariate analysis was performed to examine relationships between the examined variables: (a.) place of residence; (b.) age; (c.) type of admission; (c.) hospitalization duration; (d.) number of lifetime hospitalizations; (e.) lifetime prosecutor’s orders for coercive examination; and (f.) lifetime suicide attempts.Results A fairly equivalent number of males and females was included in the study (M: 874; F: 759).The mean age of the sample was 44.7 years with males being younger than females (males 43.23; females 46.39). Males residing out of the co-capital as well as females residing within the co-capital of Greece, Thessaloniki, disclosed higher odds of being hospitalized (p&lt;0.03). Coercive hospitalizations represented 47% of cases, bore the highest duration (20.7 days), and involved the youngest patients. Coercively hospitalized male patients outnumbered their female counterparts (p&lt;0.001). Voluntary urgent hospitalizations duration was estimated at 17.04 days, followed by outpatient admissions (12.64 days) and transfers from other clinics (11.35 days). 37% of patients experienced psychosis while 35% experienced affective disorders. Males were more affected by psychosis (Odds Ratio: 1.35; p&lt;0.001). Females were more liable to affective disorders (OR: 1.78; p&lt;0.001). 7% of the sample had committed suicide attempts, with single suicide attempts being ten times higher than multiple suicide attempts (p&lt;0.001). Females were more than twice as likely as males to commit a suicide attempt (p&lt;0.001). Females tended more to be hospitalized self-willingly (p=0.0015) and to voluntarily terminate hospitalizations prematurely (p=0.0014). Patients with a single hospitalization were seven-fold compared to those with multiple hospitalizations (p&lt;0.001). The average lifetime hospitalization number for a patient was one hospitalization, while the average for a patient with previous hospitalizations was three.ConclusionsBeing in position to identify the patients in high-risk for hospitalization -as well as for suicide attempt- the clinician can proceed to initiatives such as treatment modifications or further involving the patient’s family.Disclosure of InterestNone Declared

Urinary retention induced by psychotropics: A case report

IntroductionNeurological bladder is considered a functional disability that has a significant impact on the quality of life and psychological state of patients. Psychotropic drugs, in turn, can worsen the urinary dysfunction caused by this disease.ObjectivesOur objective is to illustrate, through the case of a patient suffering from a neurological bladder decompensated by the treatment of a characterized depressive episode, the link between these two pathologies.MethodsWe report the case of Ms. M.W., aged 51, with a history of high blood pressure stabilized under nebivolol and a neurological bladder diagnosed 10 years ago with episodic pollakiuria, admitted to the psychiatric department for repeated suicide attempts. She had never used psychoactive substances and had no family psychiatric history. The patient presented depressive symptoms evolving for 5 months. The diagnosis of a characterized depressive episode with melancholic features was made and the patient was treated with sertraline. From the first intake of the drug, the patient presented acute urinary retention (UR) requiring the placement of a permanent bladder catheter. The urinary symptoms improved upon stopping the treatment. Sertraline was changed to olanzapine and escitalopram. The patient stopped the treatment after one month because of the worsening of urinary symptoms requiring the installation of a suprapubic catheter. The urinary problem, together with the cessation of treatment, were responsible for a worsening of psychiatric symptoms leading to multiple suicide attempts. Given the advanced stage of the neurological bladder demonstrated by the urodynamic tests, our patient was treated with paroxetine, quetiapine and oxazepam along with psychotherapeutic education. The evolution was characterized by improvement in psychiatric symptoms and the urinary symptoms were stable.ResultsThe lack of improvement after treatment discontinuation could be explained by an underlying neurological bladder manifesting with pollakiuria. The current literature on UR induced by psychotropic treatments is quite rare limited in case reports. This effect occurs especially when selective serotonin reuptake inhibitors (SSRIs) are prescribed in combination with other antipsychotics. Unlike first generation antipsychotics, atypical antipsychotics have muscarinic receptor antagonist properties which can induce UR. Among atypical antipsychotics, olanzapine has been shown to have the greatest antimuscarinic effects. Regarding SSRIs, they are associated with a lower risk of UR than other antidepressants and sertraline had the highest risk of UR.ConclusionsSSRIs can induce UR particularly in combination with atypical antipsychotics. Coordination of care across multiple specialties and understanding the side effects of psychotropic medications can enable faster diagnoses and adequate management.Disclosure of InterestNone Declared

COVID-19 and Suicide Tendency: Prediction and Risk Factor Analysis Using Machine Learning and Explainable AI

INTRODUCTION: Pandemics and epidemics have frequently led to a significant increase in the suicide rate in affected regions. However, these unnecessary deaths can be prevented by identifying the risk factors and intervening earlier with those at risk. Numerous empirical studies have exhaustively documented multiple suicide risk factors. In addition, many evidence-based approaches have employed machine learning models to diagnose vulnerable groups, a task that would otherwise be challenging if only human cognition were employed. To date, to the best of our knowledge, no research has been conducted on COVID-19-related suicide prediction.OBJECTIVES: This research, aims to develop a machine-learning model capable of identifying individuals who are contemplating suicide due to COVID-19-related complexities and assessing the potential risk factors.METHODS: We trained a gradient-boosting model based on tree-based learners on 10067 data consisting of 76 features, which were primarily responses to socio-demographic, behavioural, and psychological questions about COVID-19 and suicidal behaviours.RESULTS: The final model predicted individuals at risk with an auROC score of 0.77 and a 95% confidence interval of 0.77 to 0.88. The optimal cutoff produced a sensitivity of 31.37 percent and a specificity of 82.35 percent in predicting suicidal tendencies. However, the auPRC was only 0.26, with a 95 percent confidence interval of 0.13 to 0.38, as the class distribution was extremely unbalanced. Consequently, the scores for precision and recall were 0.35 and 0.31, respectively.CONCLUSION: We investigated the risk factors, the majority of which were associated with sleeping difficulties, fear of COVID-19, social interactions, and other socio-demographic factors. The identified risk factors can be considered when formulating a policy to prevent COVID-19-related suicides, which can impose a long-term economic and health burden on society.

The relationship between visual hallucinations, functioning, and suicidality over the course of illness: a 10-year follow-up study in first-episode psychosis

Visual hallucinations in psychosis are under-researched despite associations with increased illness severity, functional impairments, and suicidality in the few existing studies. Further, there are no long-term longitudinal studies, making it impossible to conclude if these associations are state or trait phenomena. In the current prospective longitudinal study, 184 individuals with first-episode psychosis were assessed with semi-structured clinical interviews and self-report questionnaires at baseline and 10-year follow-up. Participants were grouped based on lifetime experience of visual hallucinations: before or at baseline (VH+/+), first during follow-up (VH−/+), or never (VH−/−). Associations with functioning, suicide attempts, childhood trauma and other markers of illness severity were tested using multinomial logistic regression analysis. At baseline, the VH+/+ group (37.5%), but not VH−/+ (12.5%), had poorer functioning, higher symptom severity, a lower age at onset, and included more individuals with a history of multiple suicide attempts than the VH−/− group (50%). At follow-up, the VH−/+ group, but not VH+/+, had poorer functioning and higher symptom severity than the VH−/− group. However, the number of participants who committed multiple suicide attempts during the follow-up period was again significantly higher in the VH+/+ group. There was no association with childhood trauma. Hence, visual hallucinations are associated with impaired functioning and higher symptom severity, but only in the short-term. However, visual hallucinations that arise early in the course of illness are a risk indicator for repeated suicide attempts throughout the illness course. These findings highlight the relevance of assessing visual hallucinations and monitoring their development over time.

Risk Factors for Multiple Suicide Attempts in Adolescents From 10 Years Suicide Repository

Risk Factors for Multiple Suicide Attempts in Adolescents From 10 Years Suicide Repository

Emotion dysregulation, bullying, and suicide behaviors in adolescents

Background: Among adolescents, rates for suicide attempts and non-suicidal self-injury (NSSI) remain high. Adolescents also often experience bullying, which has been found to associate with increased risk of suicide attempts and NSSI. Emotion regulation difficulties are associated with both bullying victimization and self-harm behaviors in adolescents. Aims: The current study examined the relationship between emotion dysregulation and suicide attempts and NSSI with bullying as a moderating factor. Method: High school students (n = 804) completed self-report measures on emotion regulation difficulties, suicide attempts, nonsuicidal self-injury, and past-year bullying experiences. Results: Moderation analyses found that the relationships between multiple emotion dysregulation dimensions and suicide attempts were significant regardless of bullying experience, but the relationship was stronger when bullying was present. For NSSI, bullying only moderated the relationships between nonacceptance of emotions, limited emotion regulation strategies and NSSI, with stronger associations when bullying was present. Limitations: Different types of bullying were not assessed, all measures were self-report, and the community sample had relatively low clinical severity. Conclusion: Results indicate that poor emotion regulation and bullying victimization associate with greater frequencies of suicidal and nonsuicidal behaviors. These findings point to the need for self-harm prevention programs to address both bullying and emotion regulation skills.

Prevalence and correlates of unintentional nonfatal injuries among school-going adolescents in Central America.

The aim of this study is to report on the frequency of serious physical injuries (SPI) among adolescents in Central America during the previous decade, 2009-2018. In total, 15,807 school adolescents (14.4 years mean age; SD=1.4) from six Central American countries participated in cross-sectional Global School-based Student Health Surveys in 2009-2018 (ranging from 1,779 students in Honduras in 2012 to 4,374 students in Guatemala in 2015). The prevalence of SPI was 33.8 % (22.9 % once, 7.4 % 2 or 3 times and 3.6 % 4 or more times), ranging from 31.8 % in Guatemala to 45.0 % in Belize and 45.6 % in Panama. The most frequent causes of SPI included fall (11.4 %, ranging from 6.9 % in Costa Rica to 15.6 % in Panama), and the type of SPI was fracture/dislocation (5.7 %, ranging from 4.3 % in Costa Rica to 6.7 % in Panama). In adjusted Poisson regression, male sex,food insecurity, a history of alcohol intoxication, soft drink consumption, fast food intake, truancy, multiple sexual partners, psychological distress, physical fight, physically attacked, bullied, and suicide attempt were significantly associated with a higher number of injury event counts. Overall, about one in three adolescents in Central America had sustained unintentional injuries in the past 12months and several contributing factors were identified which if addressed could aid injury prevention among adolescents.

Does Suicide Risk Screening Improve the Identification of Primary Care Patients Who Will Attempt Suicide Versus Depression Screening Alone?

The effectiveness of suicide risk screening relative to depression screening alone among primary care patients has not been tested rigorously. This study compared the performance of multiple depression screening methods (Patient Health Questionnaire [PHQ]-2, PHQ-8, and PHQ-9) and multiple suicide risk screening methods (PHQ-9 item 9 and suicide-focused screening of "thoughts of killing yourself" during the entire lifespan, within the past month, and within the past week) in a convenience sample of primary care patients. A total of 2,744 patients (military personnel, family members, and retirees) from six military primary care clinics completed the PHQ-9 and screening for suicidal ideation (SI) during routine clinic visits. Follow-up phone interviews were conducted for one year post-baseline to assess the incidence of suicide attempts, the study's primary outcome. Sensitivity, specificity, accuracy, and F1 statistics were calculated for each screening method for identifying patients who attempted suicide. More than 65% of patients who screened positive for SI also screened positive for depression on the PHQ-9. Depression screening with the PHQ-9 correctly identified more patients who attempted suicide during follow-up than the PHQ-2, past week SI, and past month SI. The PHQ-9 correctly identified more patients who attempted suicide within 3 months than lifetime SI, but lifetime SI correctly identified more patients who attempted suicide within 6 and 12 months. Depression screening with the PHQ-9 was the most effective strategy for identifying patients who attempted suicide in the near term. Universal suicide risk screening is unlikely to meaningfully improve identification of higher-risk patients beyond PHQ-9 depression screening.

Elevated interoceptive deficits in individuals with eating disorders and self-injurious thoughts and behaviors: Areplication and extension.

People with eating disorders (EDs) frequently report self-injurious thoughts and behaviors (SITBs). We aimed to replicate and extend findings demonstrating greater interoceptive deficits according to SITB severity. We predicted that interoceptive deficits would be greater among people with versus without lifetime SITBs and among those with multiple suicide attempts compared with single attempts or nonsuicidal self-injury. We also predicted that interoception would be increasingly impaired with greater current suicidality severity. Adults (N = 118) seeking ED treatment reported current and lifetime SITBs upon admission to treatment. We used planned contrasts to compare interoceptive deficits (self-reported using the Eating Disorders Inventory) by SITB and current suicidality groups (assessed by self-report and clinical interview). Interoceptive deficits were greater among people with any SITB history compared to those without. People with multiple suicide attempts did not differ in interoceptive deficits from those with single attempts or only nonsuicidal self-injury. Interoceptive deficits were elevated among those with any current suicidality compared to those with no suicidal symptoms; interoceptive deficits did not differ according to severity of suicidality. Among those with EDs, interoceptive deficits are elevated among those with concurrent SITBs. Interventions aimed at improving interoception may reduce the risk for SITBs.

Smart Nanomedicine Targeting Endocytosis Mediated by Cancer Cell Surface Neuraminidase‐1

Human neuraminidase‐1 (NEU1) plays a much more profound function in human cancers than previously considered. It is demonstrated that cancer cell surface NEU1 is a desired gatekeeper for an innovative anticancer therapeutic nanomedicine enabling active drug‐targeting delivery by specific endocytosis into the cytoplasm. Nanosome, an antiadhesive nanoparticular shuttle, carrying multiple suicide substrates for NEU1 confers potent and universal inhibitory effects on the proliferation of human cancer cells, such as hepatocellular carcinoma (HCC) (HepG2, IC50 = 13.5 nM), lung cancer (A549, IC50 = 9.57 nM), and colon cancer (HT‐29, IC50 = 11.1 nM), in which irreversible inactivation of cell surface NEU1 is essential for the intracellular trafficking and subsequent lysosomal membrane permeabilization by nanosomal aggregation due to the formation of “sialidase corona” through irreversible inactivation of NEU1–NEU4 residing in lysosome. Nanomedicine targeting membrane‐tethered NEU1 allows efficient delivery of hydrophobic sorafenib (Nexavar), a RAF family kinase inhibitor for the treatment of advanced renal cell carcinoma and unresectable HCC at the recommended dose of 400 mg orally twice daily, into endolysosome, resulting in a potent and sustainable inhibition (IC50 = 3.1–6.2 nM at 24–96 h after coincubation) against HepG2 cell growth.

Investigating the co-occurrence of marijuana use and prescription opioid misuse with multiple suicide attempts among adolescents with a history of suicidal ideation

This study investigated the co-occurrent association of marijuana use and prescription opioid misuse with multiple suicide attempts among adolescents with a history of suicidal ideation. Data came from the 2019 Youth Risk Behavior Survey. The sample was comprised of adolescents ages 14–18 who reported suicidal ideation during the past year (n = 2,562). Multinomial logistic regression was used to examine the co-occurring association of marijuana use and prescription opioid misuse with multiple suicide attempts. Of the 2,562 adolescents who experienced suicidal ideation, 19.2 % also attempted suicide multiple times during the past year and 19.0 % reported ever using marijuana and misusing prescription opioids, 8.8 % misused prescription opioids only, and 33.3 % used marijuana only. In the multivariate model, for adolescents who used marijuana and misused prescription opioid, the risk of attempting suicide once was 1.77 times higher (RRR = 1.77, 95 % CI = 1.22–2.59) and the risk of multiple suicide attempts was 3.23 times higher (RRR = 3.23, 95 % CI = 1.95–5.33) when compared to adolescents who had never used marijuana nor misused prescription opioid. The risk of multiple suicide attempts was greater for bisexual and racial/ethnic minority adolescents and adolescents who felt sad or hopeless. Interventions that prevent prescription opioid misuse among adolescents may be effective in mitigating suicide attempts.

Characteristics of Single vs. Multiple Suicide Attempters Among Adult Population: A Systematic Review and Meta-Analysis.

We aimed to examine the factors that differentiate single and multiple suicide attempters in adult population. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to conduct this review and meta-analysis. The review protocol was registered in PROSPERO. We carried out a systematic literature search in three databases to identify original studies that explored the differences between single and multiple suicide attempters among adult population. There might be meaningful differences between those individuals that attempt suicide once in their lifespan and those who make multiple attempts in terms of sociodemographic and clinical characteristics. There are no previous meta-analysis addressing this topic in the adult population. A total of 75 studies were included in the review and 69 were included in the meta-analysis. Multiple attempters were more likely to present certain disorders such as mood and psychotic disorders, as well as personality or substance use disorders. Higher suicide ideation and suicide intent scores also characterized this group. Childhood trauma experiences, stressful life events, and higher rates of hopelessness were statistically significant in multiple attempters. Identifying the factors predicting multiple suicide attempts helps to delineate a high-risk suicidal profile that should be taken into account in the clinical and suicide prevention scenario.

MMPI-2-RF triarchic psychopathy domain scores as concurrent and prospective predictors of suicide ideation and behavior among psychiatric inpatients

Existing research from community and forensic samples suggests possible associations between triarchic model of psychopathy traits (Boldness, Meanness, Disinhibition) and suicidal ideation and behavior, but little is known about these associations among those from settings likely to include a significant number of suicidal patients. The present study examined MMPI-2-RF (Ben-Porath & Tellegen, 2008) triarchic domain scores (Sellbom et al., 2016) and suicidal ideation and behavior among 1098 psychiatric inpatients assessed for suicidal ideation and behavior at admission, two-weeks, three-months, and six months. The sample was evenly split by gender [52.1 % male (n = 572), 47.9 % female (n = 526)] with a mean age of 31.88 (SD = 13.61). Overall, the most consistent associations between triarchic traits and suicidal ideation and behavior were for Boldness, which was negatively correlated with suicidal ideation and behavior for both female and male inpatients at admission (r ≈ −0.20 to −0.30) and, to some extent, at follow-up (r ≈ 0.02 to −0.22). Higher levels of Meanness and Disinhibition were associated with having multiple prior suicide attempts, but only for male inpatients. Regression analyses examining the Boldness by Disinhibition interaction revealed that low Boldness was associated with higher suicidal ideation at all levels of Disinhibition while high Boldness and high Disinhibition was associated with the lowest levels of suicidal ideation. Limitations of the study and clinical implications of the results are discussed.

Factors associated with the recurrence of suicidal thoughts and behaviours among depressed Veterans who have attempted suicide

ABSTRACT The recurrence of suicidal thoughts and behaviours represent a common threat to the wellbeing and lives of people who attempt suicide. It is not clear whether suicide risk models reflect risk for multiple suicide attempts, especially in high-risk groups. Factors associated with the recurrence of suicidal ideation and attempts was assessed in 82 military Veterans who had attempted suicide. Participants completed clinical diagnostic interviews and self-reported assessments of suicidal thoughts and behaviours, depression severity, hopelessness and burdensomeness. Hopelessness, perceived burdensomeness and beliefs about suicide were associated with the recent recurrence of suicidal ideation among Veterans who attempted suicide. Beliefs about suicide, suicidal planning and help seeking following a suicide attempt were significantly associated with multiple suicide attempts. Suicide postvention interventions should target beliefs about suicide and adaptive help seeking in depressed military Veterans who have attempted suicide.

Multiple Sclerosis and Suicide Attempts: A Review including a Meta-Analysis of Prevalence

Background. Multiple sclerosis is an autoimmune inflammatory demyelinating disorder, and persons diagnosed with multiple sclerosis have a shorter life expectancy than the general population. Recent meta-analyses have examined the association between MS and suicide and between MS and suicidal ideation. The objective of the present review was to examine if MS is associated with a higher risk of suicide attempt. We hypothesised that MS patients were at increased risk of suicide attempts. Methods. Four databases (PubMed including MEDLINE, EMBASE, Web of Science, and PsycINFO) were searched systematically for studies assessing the risk of attempted suicide in people with MS. Eligibility criteria were studies designed as cohort, case-control, or cross-sectional studies with attempted suicide as the outcome and published in English. Lifetime prevalence of suicide attempt was calculated through a meta-analysis, and the results were presented as a forest plot. Sensitivity analyses were used to investigate the heterogeneity among studies. Results. 13 studies were identified from 533 records, providing a total population of 50,004 participants of whom 599 had attempted suicide. The weighted overall prevalence of suicide attempts among people with MS was 0.04 (95% CI 0.02-0.06) with a Cochran’s Q value of 591.05, which rejected the null hypothesis of homogeneous studies. The performed sensitivity analysis resulted in an I 2 of 81% as the lowest possible value, which still indicated a high level of heterogeneity. Conclusion. To our knowledge, this is the first study to examine the association between MS and suicide attempts in a meta-analysis. The results suggest a significant association between MS and suicide attempts. However, the small number of the included studies and the heterogeneous nature of these studies indicate a need for more studies based on more homogeneous samples.