Suicide Attempts Research Articles

What differentiates adolescents who have attempted suicide from those without suicidal history? A retrospective psychiatric inpatient study

BackgroundHistory of suicide attempts is one of the strongest predictors of adolescent suicide death. Our aim was to improve the comprehension of behavioral and socio-demographical characteristics of adolescent who have attempted suicide which can accelerate preventive and therapeutical measures.MethodsWe retrospectively analyzed medical data of 284 psychiatric inpatients aged 13–18. We performed an univariate and multivariate analyses for the whole group and female and male sex separately followed by a logistic regression analysis. The primary outcome measure was history of suicidal attempt (SA).Results115 out of 284 analyzed patients (40.5%) – 91 girls (subgroup 1) and 24 boys (subgroup 2) - had a history of SA. In the whole group SA was associated with female gender, cigarette smoking, nonsuicidal self-injury (NSSI) and neglect of emotional or social needs. In the subgroup of girls the most significant association was found between SA and cigarette smoking, followed by neglect of emotional and social needs, NSSI and the older age of receiving psychiatric help. In boys, the history of SA was associated with two factors: cigarette smoking and family victimization.ConclusionsThe only factor that showed significant association with SA consequently throughout all our study was cigarette smoking, which implies that in the high risk adolescents population cigarette smoking might be a more specific characteristic of the history of SA than NSSI and thus should not be neglected during first examination.

How the Covid-19 pandemic affected relationships, connectedness, and suicidality among asexual spectrum adults.

The impact of COVID-19 on personal and social relationships was considerable. Specifically, social distancing, meant to prevent disease spread, may have adversely impacted personal and social relationships. Suicidal ideation has been found to be more likely due to various health factors, including the isolation that was a result of the pandemic itself. While sex and gender minorities are often studied as a group, it is unknown whether the pandemic adversely affected the relationships and connectedness to others among individuals identifying on the asexual spectrum. Further, how might these effects have increased or decreased their risk of suicidality? Data from the 2022 Ace Community Survey was analyzed. Questions specifically pertaining to COVID-19 and the effects it had on relationship desire, as well as connectedness to others were assessed, along with suicidality, among adults identifying on the asexual spectrum. Those with an increased desire for queerplatonic relationships had a greater risk of both thoughts and attempts of suicide. Asexual individuals who felt less connected to parents, other family, and roommates had a greater risk of suicidal thoughts. However, those who felt more connected with mental health workers and healthcare professionals had an increased risk of thoughts and attempts of suicide. The more educated an asexual spectrum adult, the less likely they were to be suicidal. Relationships and connectivity among asexual spectrum adults were adversely affected by the pandemic, resulting in increased risk of suicidality. Creating ways to foster relationships among this population are important in advance of the next pandemic to ensure greater health and well-being.

Using Smartphone GPS Data to Detect the Risk of Adolescent Suicidal Thoughts and Behaviors.

Suicide rates among adolescents continue to rise, but there are a lack of clinical tools to predict when youths may be at risk for suicidal behaviors. To identify whether geolocation metrics, assessed through an app installed on adolescents' personal smartphones, could detect the risk of next-week suicidal events and clinically meaningful suicidal ideation. This case series study included high-risk adolescents aged 13 to 18 years reporting a current affective and/or substance use disorder, oversampled for suicidal thoughts and behaviors (STB). Participants were recruited from the greater New York City and Pittsburgh communities through psychiatric outpatient programs, emergency departments, medical center research registries, and social media. Participants installed the Effortless Assessment Research System (EARS) software application onto their personal smartphones, which obtained passive sensor data, including geolocation metrics (via the global positioning system [GPS]), as well as weekly experience sampling data probing STB for the duration of the 6-month study. Adolescents also completed clinical assessments at baseline as well as during the 1-, 3-, and 6-month follow-up assessments. Statistical analysis was performed from March 2023 to November 2024. Repeated measures mixed-effects logistic models estimated whether weekly aggregates of geolocation features (ie, entropy, homestay, distance traveled) were associated with next-week suicidal events (ie, suicide attempts, psychiatric hospitalizations, emergency department visits for suicide concerns) and clinically meaningful ideation (via weekly experience sampling). Overall, 186 participants were included in this study (148 [79.6%] female; 19 [10.2%] Asian, 23 [12.4%] Black, and 106 [57.0%] White), with a mean (SD) age of 16.4 (1.7) years. Greater homestay (amount of time spent at home) on a given week, relative to one's own mean, was associated with 2-fold greater odds of suicidal events during the subsequent week (odds ratio, 1.99 [95% CI, 1.15-3.45]). Results were not significant for entropy and distance traveled metrics. However, using leave-future-out validation, the accuracy of the homestay model was modest (area under the receiver operating characteristic curve, 0.64 [95% CI, 0.50-0.78]). Advancements in smartphone technology afford unique opportunities to capture affective and behavioral dynamics that presage suicide risk. This case series study found that greater homestay obtained through smartphone GPS data over the course of a week, relative to one's own mean, was associated with greater odds of a suicidal event in the subsequent week. Although accuracy was modest, these findings offer a novel starting point for suicide prevention research, particularly as smartphone sensor data may have the capacity to identify who is at risk while also providing an opportunity to deliver clinical tools when that risk is greatest.

P-40 A RARE PRESENTATION OF PROLONGED HYPOGLYCEMIA: CONGENITAL LEPTIN DEFICIENCY AND INSULIN INTOXICATION

Abstract Introduction Congenital leptin deficiency (CLD) is caused by mutations in the LEP gene with an incidence of 1 in 4.4 million, presenting with symptoms such as hyperphagia, obesity. Insulin intoxication is also a rare condition that usually occurs as a result of a suicide attempt or, a medication error. There is not an algorithm for the management of insulin intoxication. Here, we report the only case in the literature presenting with congenital leptin deficiency and insulin intoxication. Clinical Case A 33-year-old woman was admitted to the hospital with dizziness, nausea, and unconsciousness. She had applied nearly 300 IU insulin aspart of committing suicide. She had congenital leptin deficiency, hypothyroidism, and prediabetes. She had leptin replacement during 2020-2021 and didn’t have a replacement since then. Her body mass index was 62.2. Her blood pressure was 95/60 mm/Hg, Sp02 was 88 %, and heart rate was 120 per minute. Her blood glucose was 29 mg/dl, and there was respiratory acidosis. Liver and renal function tests, electrolytes, coagulation parameters, and thyroid hormones were normal. Chest x-ray and brain tomography were normal. Despite subsequent infusion of 20% dextrose solution via central catheter, serum glucose could only be kept at 70-80 mg/dl. In the following hours patient’s consciousness, pH level, and oxygen saturation returned to normal. We had to follow the patient with a high concentration of glucose (150-200cc/h %10 dextrose) for ten days because of reappearing hypoglycemia. On the 10th day of follow-up, we stopped IV glucose for a short time and measured the fasting hormones shown in Table 1. at 7.00 a.m. As there was hypocortisolemia, we applied 5mg prednisolone twice daily in the following days. Twenty-four hours after cortisol administration, we could easily stop the IV glucose. We followed the patient with 5mg prednisolone twice daily and oral carbohydrate intake for three days and didn’t observe hypoglycemia. Afterwards, we stopped prednisolone and the patient was normoglycemic for the following days. We again measured the fasting hormones shown in Table 2. At 7.00 a.m. three days after the last dose of prednisolone. The patient was not hypoglycemic or hypocortisolemic since then; vital parameters were all normal and we discharged the patient. Conclusion Prolonged hypoglycemia may have occurred in different mechanisms. Our patient had a thick subcutaneous fat tissue because of CLD; therefore, absorption of insulin may have increased and half life may be prolonged. Also, high dose exogenous insulin may have triggered the production of insulin antibodies causing prolonged duration of insulin action and hypoglycemia. Moreover, deep hypoglycemia may have affected the pituitary-adrenal cortisol axis causing relative adrenal insufficiency. The steroid decreased the insulin antibodies and also corrected the relative cortisol deficiency. More cases and data are needed to shed light on this subject.Table 1: Table 2:

Sex differences in pain, suicidal ideation, and suicide attempts in patients with migraine.

To examine sex-specific associations between non-cephalic pain and suicidal ideation and suicide attempts in patients with migraine, controlling for depression and other risk factors for suicide. In patients with migraine, co-occurring pain conditions are common and are associated with worse physical and psychosocial function, but the association with suicide has not been determined. In this cross-sectional analysis, we included 10,690 patients with migraine who were consecutively recruited from headache clinics. All participants provided information on sociodemographic status, headache, Widespread Pain Index (WPI), suicidal ideation, and suicide attempts. Relative risks (RRs and 95% confidence intervals [CIs]) for factors associated with suicidal ideation and suicide attempts were calculated. In this migraine cohort, more females reported non-cephalic pain than males (78.7% [6511/8271] vs. 66.7%, [1613/2419]; p < 0.001). The prevalences of suicidal ideation and suicide attempts were higher in female patients than male patients in those aged 20-59 years (p < 0.001), and the differences diminished after the age of 60 years. In female patients, a WPI ≥4 was associated with increased suicidal ideation and suicide attempts, and dysmenorrhea was associated with suicidal ideation (RR 1.27, 95% CI 1.12-1.43), while lower back pain was associated with both suicidal ideation (RR1.35, 95% CI 1.18-1.55) and suicide attempts (RR 1.48, 95% CI 1.19-1.84). In male patients, a WPI ≥2 was associated with increased suicidal ideation, and no individual pain site was associated with suicidal ideation or suicide attempts. In both sexes, there was a dose-response association between the number of pain sites and suicidal ideation and suicide attempts; and pain that had lasted for 2 years and extreme pain intensity were associated with suicide attempts. Non-cephalic pain was associated with suicidal ideation and suicide attempts, with observed differences in pain threshold and individual pain sites found between sexes. Patients with migraine and co-occurring pain conditions, chronic pain, or extreme pain are distinct subgroups of patients at risk of suicide who require sex-specific and integrated risk assessment by multidisciplinary teams.

The Association Between College Enrollment and Suicide Attempts by Race and Ethnicity.

Little is known about how race and ethnicity influence the association between college enrollment and past-year suicide attempts. In this brief report, therelationshipbetween college enrollment and past-year suicide attempts varied across racial groups in a nationally representative sample of 12,474 full-time college enrolled and unenrolled young adults. Only White students displayed a protective association between enrollment and past-year suicide attempts (aOR, 0.32; 95% CI, 0.17, 0.62). Race and ethnicity significantly moderated the relationship between enrollment and past-year suicide attempts for Black/African American (P = 0.003) and multiracial (P = 0.03) compared to White young adults.

Identification of distinct pesticide poisoning patterns in Brazil: a cross-sectional cluster analysis of epidemiological data.

This study aimed to identify distinct patterns of pesticide poisoning in Brazil through the cluster analysis of epidemiological data from 2011 to 2019. A cross-sectional analysis of 49,233 confirmed pesticide poisoning cases was conducted using multiple correspondence analysis and hierarchical clustering. Data from the Brazilian Notifiable Diseases Information System were analyzed by region, demographics, and exposure types. Three distinct clusters were identified. Cluster 1 was characterized by severe cases, predominantly involving suicide attempts (~90%), required treatment (99.1%) and fatality rates (93.2% of all cases). Exposures were mostly domestic and occurred via ingestion, with a strong prevalence in the Northeast. Cluster 2 consisted mainly of pediatric cases, marked by accidental and acute domestic exposures, and showed minimal representation in the Southeast and South regions. Cluster 3 had a male predominance (80.1%) and was strongly associated with occupational and chronic exposures, involving cutaneous and respiratory routes, and was most prevalent in the Central-West. The study reveals significant regional and demographic disparities in pesticide poisoning across Brazil. These findings underscore the urgent need for targeted public health interventions and stricter pesticide regulations to address regional vulnerabilities and mitigate pesticide-related harm.

Attention speed and anterior cingulate cortex volume in female and male veterans with suicide ideation and attempts

IntroductionAn average of 17.5 Veterans died by suicide each day in 2021, highlighting the importance of research and prevention efforts aimed at suicide risk. Attentional processes have emerged as a possible predictor of suicide behaviors (SB), yet associated neural correlates remain understudied, particularly in the Veteran population.MethodsThe current study examines sustained and selective attention performance as indexed by the Ruff 2 &amp;amp; 7 Selective Attention Test and anterior cingulate cortex (ACC) volume as they relate to SB in Veterans. A subset of Veterans also completed a structural magnetic resonance imaging protocol. Participants were grouped on history of suicidal ideation (SI), suicide attempt (SA), and no SB (HC).ResultsAnalyses from the Ruff 2 &amp;amp; 7 test showed that Veterans with a history of SA performed more slowly on Automatic Detection Speed (ADS) and Controlled Search Speed (CSS) compared to Veterans with SI and no SB. SI and SA group differences on ADS and CSS remained after Bonferroni correction, and CSS differences remained after controlling for depressive and anxious symptoms. There were no between-group differences on Ruff 2 &amp;amp; 7 Accuracy measures. When analyses were divided by sex, males with a history of SA performed more slowly than SI and HC on ADS and more slowly on CSS and Total Speed than males with a history of SI. Results remained significant after controlling for depressive and anxious symptoms. When Bonferroni corrections were applied, males with a history of SA performed more slowly on ADS, CSS, and Total Speed compared to males with a history of SI. Female Veterans with a history of SA performed more slowly than female HC on CSS only; however, these findings were no longer significant after controlling for depressive and anxious symptoms. No significant differences were found between female groups on ADS or Total Speed. Measures of left rostral ACC gray matter (GM) volume for the combined female and male Veteran sample were positively correlated with ADS and CSS scores in HC but not SA. Conversely, right rostral ACC GM volume negatively correlated with ADS and CSS scores in the SA group but not HC. Right rostral ACC white matter volume correlated positively with ADS and CSS in HC.DiscussionThese findings highlight associations between attention speed, ACC volume, and SB even after controlling for acute mood symptoms, in addition to emphasizing the importance of including sex in analyses.

Metabolomic Changes in Major Depressive Disorder Adolescent Females with or without Suicide Attempts.

The incidence of Major Depressive Disorder (MDD) is high among adolescent females, and MDD is often accompanied by suicide attempts (SAs), which have a serious negative impact on health. However, changes in lipids, thyroid hormone, and brain metabolism among female adolescents with MDD and the relationships between these three markers and MDD with SA have yet to be elucidated. This study enrolled 71 MDD patients with SA (MDD+SA), 66 MDD patients without SA (MDD-SA), and 47 healthy controls (HCs). We analysed the lipid and thyroid hormone levels and magnetic resonance spectroscopy results of the subjects. Low levels of social support, high levels of life stress, and high levels of suicidal ideation (SI) were risk factors for SA. In MDD patients, 1) thyroid stimulating hormone was positively correlated with triglyceride (TG) and N-acetyl aspartic acid (NAA)/creatinine in the prefrontal cortex (PFC) and negatively correlated with high-density lipoprotein and the choline/creatinine in the thalamus; 2) free thyroxine was negatively correlated with the choline/creatinine in the thalamus; 3) total cholesterol, TG, low-density lipoprotein, and choline/NAA in the PFC were positively correlated with the severity of SI and suicide risk; and 4) NAA/creatinine in the thalamus was negatively correlated with the severity of SI and suicide risk. In female adolescents with MDD, there are significant synergistic changes in lipids, thyroid hormones, and brain metabolism-related factors, and the changes in these indicators may be related to the pathological mechanism of SA.

Barriers to and Facilitators of Mental Health Treatment Among Suicidal Individuals.

Many suicidal individuals do not access outpatient treatment, and those who do often do not receive empirically supported treatments for reducing suicide risk. Few studies have investigated the barriers to and facilitators of outpatient mental health (MH) treatment among suicidal individuals. We used a survey to understand the experiences of those with a history of suicidal ideation. Participants (N = 111) with a history of suicidal ideation during adulthood answered questions about their history of suicidal thoughts and behaviors (STBs), MH treatment, and their perceptions of barriers to and facilitators of treatment. We found that participants who reported a lifetime suicide attempt endorsed greater barriers to (t(106) = 2.76, p = .003) and weaker facilitators of (t(109) = -1.8, p = .037) receiving outpatient treatment for STBs; additionally, attitudinal barriers were associated with having made a suicide attempt (OR = 3.47, 95% CI [1.18, 10.20], p = .024). These results emphasize the importance of efforts to bolster facilitators and mitigate barriers to treatment for STBs. Future work should continue to elucidate treatment barriers and facilitators to improve treatment engagement for suicidal individuals.

What is veteran suicide prevention really about? Questions from the community to researchers

Military veterans are one of the most researched groups in healthcare in the United States. This population has extremely high rates of suicide attempts and completions. Despite increasing research focus, millions of dollars in funding, and being designated as a high clinical priority, rates of suicidal behavior continue to rise among veterans. Veterans are extremely concerned about this trend and critical of some suicide prevention projects. This study engaged 20 veterans who are connected to individuals within the military community who have attempted or completed suicide. Through semi-structured interviews, participants expressed a profound sense of disconnection from existing policies, treatments, and strategies aimed at preventing veteran suicide. During the course of the interviews, participants posed their own questions: Why is the public really concerned about veteran suicide? Why won’t the public recognize its part in the veteran suicide epidemic? Why won’t the medical industry listen and collaborate with us? This study underscores the critical need for all stakeholders involved in veteran suicide prevention to reflect on these concerns and to incorporate veterans’ insights into future prevention strategies, creating a more responsive and effective approach.

Sex differences in prevalence and clinical correlates of subclinical hypothyroidism in Chinese patients with first-episode untreated major depressive disorder

BackgroundPrevious studies showed sex differences in the prevalences of both major depressive disorder (MDD) and subclinical hypothyroidism (SCH). This study aimed to further compare the prevalence and correlates of moderate-to-severe SCH between male and female Chinese MDD patients.MethodsA total of 1706 first-episode drug naïve Chinese patients with MDD were recruited. Depressive symptoms were assessed by the 17-item Hamilton Depression Rating Scale, psychotic symptoms by the Positive and Negative Syndrome Scale and anxiety symptoms by the Hamilton Anxiety Rating Scale. Serum thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) concentrations were measured by chemiluminescence immunoassay. Moderate-to-severe SCH was defined as serum TSH > 8 mIU/L with normal fT4.ResultsThe prevalence of moderate-to-severe SCH was 10.4% in male patients and 15.1% in female patients (χ2 = 7.22, p < 0.01). In female patients, binary logistic regression showed that systolic blood pressure (SBP), suicide attempts and psychotic symptoms (all p < 0.001) were associated with moderate-to-severe SCH. In male patients, SBP and psychotic symptoms were associated with moderate-to-severe SCH (both p < 0.001), while suicide attempts and severe anxiety were not (p > 0.05).ConclusionsOur findings reveal a higher prevalence rate of moderate-to-severe SCH in female untreated first-episode MDD patients compared with males. Moreover, there is a positive association between suicide attempts and moderate-to-severe SCH only in female MDD patients.

A Quality Improvement Initiative to Decrease Behavioral Health Unit Readmission Rates.

Youth behavioral health inpatient beds are limited during a time of crisis. Around one-third of youth admitted to a behavioral health unit (BHU) will be readmitted within 1year of discharge, with 8% to 13% being admitted within 30days. In one study, they found that more than one-third of patients initially admitted for suicidal ideation or attempt were readmitted within 7days. Our objective was to decrease 7-day and 30-day readmission rates to our BHU by 20% by May of 2023. We collected baseline data through medical record review for our pediatric BHU readmissions from July 2020 until July 2021. Interventions, such as standardized workflows and checklists, were trialed with Plan-Do-Study-Act (PDSA) cycles beginning October 2021 until November 2022. Performance was analyzed using statistical process control charts (U-charts). Sustainment was tracked through December 2023. Length of stay (LOS) was tracked as a balancing measure. Compliance with our readmission checklist was tracked as a process measure. Both 7-day and 30-day readmission rates to the pediatric BHU decreased as interventions were initiated and adopted. The rates of patients readmitted within 7 and 30days decreased from a baseline mean of 5.54 to 2.83 (49%) and 11.52 to 7.38 (36%) per 100 hospitalizations, respectively. The LOS for the BHU decreased from 5.58 to 5.09days. The readmission checklist was used for 81 out of 83 patients, or 97.5%. Adoption of multiple interventions produced a decrease in readmissions to a pediatric BHU.

Depressive Symptoms Among Older Gay Men: What Are the Most Important Determinants?

Background: Studies have shown that gay men experience higher levels of depression and are more likely to report suicidal ideation, plans, and attempts over their lifetime compared to heterosexual men. However, most studies have been conducted with adolescents and young adults, while there is a lack of research focusing on older adults. The aims of this study are to assess the level of depressive symptoms among older gay men and examine the associations between five key factors—loneliness, internalized homophobia, self-esteem, ageism, health behavior—and depressive symptoms. Methods: The convenience sample included seventy-nine gay men living in the community. Prospective participants were recruited by facilitators of social and support groups, who either distributed the questionnaire directly to members on-site or forwarded a link to their emails. All study measures used were valid and reliable. Results: Participants’ mean level of depression exceeded the scale’s cutoff point for detecting depression, indicating mild depression. Four variables made a significant contribution to the explanation of depression, with loneliness having the largest contribution, followed by ageism, internalized homophobia, and health behavior. The regression model explained a very high percentage of the depression variance (83%). Conclusions: These four factors are central to understanding depression among older gays. Medical and social professionals should recognize their significance and incorporate them into the treatment provided to those in need. Further studies are needed to gain a deeper understanding of the factors associated with depression in this vulnerable population.

A multidimensional assessment of adverse events associated with paliperidone palmitate: a real-world pharmacovigilance study using the FAERS and JADER databases

ObjectivePaliperidone palmitate is a second-generation antipsychotic that has undergone extensive investigation in clinical trials. However, real-world studies assessing its safety in large populations are lacking. As such, this study aimed to comprehensively evaluate real-world adverse drug events (ADEs) linked to paliperidone palmitate by employing data mining techniques on the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database and the Japanese Adverse Drug Event Report (JADER) database.MethodsThe study retrieved ADE reports from the FAERS database covering the period from 2009 through the third quarter of 2024, and from the JADER database covering the period from 2013 through the second quarter of 2024. Utilizing disproportionality analyses such as the reporting odds ratios (ROR), proportional reporting ratios (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item Poisson shrinkage (MGPS), significant associations between ADEs and paliperidone palmitate were evaluated.ResultsA total of 27,672 ADE reports related to paliperidone palmitate were identified in FAERS, with 285 significantly disproportionate preferred terms (PTs) identified by all four algorithms. Paliperidone palmitate-associated ADEs encompassed 27 System Organ Classes (SOCs). The top three PTs with the highest reported cases were off-label use, drug ineffective, and hospitalization. Common ADEs included increased blood prolactin, galactorrhea, and schizophrenia, which was consistent with drug label. Noteworthy, unexpected signals not listed in the drug label were also identified, such as psychosexual disorders, prolactin-producing pituitary tumors, suicide attempt, and sudden death. The median onset time for all ADEs was 40 days. Furthermore, gender-based difference in risk signals was detected. Females are more likely to experience elevated blood prolactin and weight increase, whereas males are more prone to sexual dysfunction. Among the 1,065 ADE reports from the JADER database, we identified 51 positive signals, 35 of which overlapped with those found in FAERS, including schizophrenia, hyperprolactinemia, and erectile dysfunction.ConclusionThe study findings from two independent databases serve as crucial references for ensuring the safe of paliperidone palmitate. Additionally, the gender-specific monitoring references provided can enhance clinical surveillance efforts and facilitate more effective risk identification.

Effect of a Short, Animated Storytelling Video on Transphobia Among US Parents: Randomized Controlled Trial.

Parents play a pivotal role in supporting transgender and gender diverse (TGD) youth. Yet only 35% of TGD youth describe their home as a gender-affirming place. Lack of parental support contributes to recent findings that TGD youth are approximately three times more likely to attempt suicide than their cisgender peers. In contrast, parents' affirmation of their children's gender identity significantly improves their mental health outcomes, by reducing anxiety, depression, and suicidality. Addressing the urgent need for effective, scalable interventions, this study evaluates a novel digital approach: short, animated storytelling videos. We hypothesized that our 2.5-minute video intervention would reduce antitransgender stigma, or transphobia, and improve attitudes toward gender diverse children among US parents. We recruited 1267 US parents, through the Prolific Academic (Prolific) online research platform, and randomized them into video intervention or control groups. We measured transphobia using the Transgender Stigma Scale, and attitudes toward transgender children using the gender thermometer, before and after watching the video. We compared outcomes between the two groups using 2 × 3 ANOVA. Both groups were invited to return 30 days later for follow-up assessment, before being offered posttrial access to the intervention video, which portrayed an authentic conversation between a mother and her transgender child. Single exposure to a short, animated story video significantly reduced transphobia and improved attitudes toward transgender children among US parents, immediately post intervention. We observed a significant group-by-time interaction in mean Transgender Stigma Scale scores (F2,1=3.7, P=.02) and significant between-group changes when comparing the video and control groups from baseline to post intervention (F1=27.4, P<.001). Effect sizes (Cohen d) indicated small to moderate immediate changes in response to the 2.5-minute video, though the effect was no longer observed at the 30-day follow-up. Gender thermometer scores revealed significant immediate improvements in the attitudes of participants in the video intervention arm, and this improvement was sustained at the 30-day time point. Short, animated storytelling is a novel digital approach with the potential to boost support and affirmation of transgender children, by offering authentic insights into the lived experiences of TGD youth. Repeated exposures to such interventions may be necessary to sustain improvements over time. Future studies could test a series of short, animated storytelling videos featuring the lived experiences of several TGD youth. Evaluating the effect of such a series could contribute to the fields of digital health communication and transgender health. Digital approaches, such as short, animated storytelling videos, that support empathy and acceptance of TGD youth could foster a more inclusive society in which every child can thrive.

How difficult is to study the relationship between insomnia, circadian rhythms, inflammation and suicide attempt

How difficult is to study the relationship between insomnia, circadian rhythms, inflammation and suicide attempt

Adverse Childhood Experiences, Race/Ethnicity, and Suicidality Among Florida High School Students

Previous studies have well-documented that adverse childhood experiences (ACEs) are associated with negative health outcomes, including suicidal thoughts and behaviors. As historically marginalized groups have long experienced poorer socio-emotional outcomes due to systemic and institutional racism, racial stress, and related factors, surprisingly little is known about how ACEs matter across racial/ethnic adolescent groups. This study aims to fill this gap by analyzing data from the 2022 Florida Youth Substance Abuse Survey (FYSAS). Utilizing logistic regression models, we investigate how ACEs influence adolescent suicidal thoughts and behaviors. Results reveal a significant link between ACEs and these outcomes, indicating that higher ACE scores correlate with increased risk of suicidal thoughts and attempts. Racial/ethnic variations in ACE effects on suicidality are observed among non-Hispanic Black and Hispanic/Latinx youth. We also find that despite generally experiencing fewer ACEs, Asian American youth were nearly 30% more likely to have suicidal thoughts than non-Hispanic White youth.

The Etiopathogenic Mosaic of Suicidal Behaviour.

Suicidality is among the most controversial concepts in multi-disciplinary studies worldwide, regardless of the form and approach. The etiopathological variability in suicidal ideation correlates with the heterogeneity of the clinical and behavioural patterns of self-harm attempts, which significantly impact the prognosis and quality of life of patients. The main objective of the present study was to identify and outline the spectrum of factors predisposing to suicide, with the whole suite of consequences and manifestations in ideation and behaviour. In this regard, the research literature of the last decade contains numerous articles dealing with the theoretical premises pertaining to both the statistical and the profoundly psychological and philosophical dimensions of suicide. The micro-environment favouring the clinical evolution of self-harm/self-destructive thoughts and attempts to the terminal, final act integrates individual medical-biological and psychological factors into the overall social reality. Knowledge of the whole etiopathogenic amalgam with clinical-evolutionary implications allows for the development of methods and tools for the early assessment and prevention of suicidal risk. At the same time, the present study aims to qualitatively focus on the subjective motivation declared by patients regarding the internal, individual catalyst of suicidal ideation and attempts on a predominantly psycho-social coordination.

Suicidal thoughts and behaviors among gender-minority adolescents in the emergency department.

Gender-minority youth, whose gender identity differs from their sex assigned at birth, have elevated suicide risk compared to cisgender youth, yet few studies examine their suicide risk in the emergency department (ED). Our objectives were to determine the prevalence of and assess risk and protective factors associated with prior suicide attempt (SA) and recent suicide ideation (SI) among gender-minority adolescents in the ED. We conducted a secondary analysis of gender-minority adolescents in the Emergency Department Screening for Teens at Risk for Suicide (ED-STARS) multicenter, random-series prospective cohort study. Prior SA and recent SI were based on the Columbia Suicide Severity Rating Scale and Ask Suicide-Screening Questions, respectively. We conducted Firth's logistic regressions to assess risk and protective factors associated with prior SA and recent SI. Of 6641 adolescent participants in ED-STARS, 280 (4.2%) identified as gender minority. Of the gender minorities, 72% presented with a nonpsychiatric complaint, 37% admitted to a prior SA, and 25% reported recent SI. Prior SA was associated with the number of self-harm methods in the prior 12 months (adjusted odds ratio [aOR] 1.5, 95% confidence interval [CI] 1.3-1.9), sexual minority (aOR 5.0, 95% CI 2.5-10.6), and mother's history of prior SA (aOR 3.6, 95% CI 1.5-9.2). Recent SI was associated with hopelessness (aOR 4.2, 95% CI 1.5-13.9), lower positive affect (aOR 0.9, 95% CI 0.8-1.0), sexual minority (aOR 8.3, 95% CI 2.5-37.8), five or more self-harm events in the prior 12 months (aOR 4.9, 95% CI 2.1-11.6), and number of illicit drug classes (aOR 1.9, 95% CI 1.2-3.2). Among gender-minority ED adolescent patients, one in three experienced a SA prior to the ED visit. One in four endorsed SI within 2 weeks of the ED visit. The identified risk and protective factors among gender-minority adolescents may inform future ED-based efforts to detect and reduce suicide risk.