Onset Of Suicidal Ideation Research Articles

Active suicidal ideation in an adolescent with autism spectrum disorder receiving methylphenidate: a case report

BackgroundMethylphenidate is a psychostimulant treatment widely prescribed in children and adolescents with attention deficit hyperactivity disorder. Although published studies are reassuring regarding the safety and tolerability of this treatment in the short and long term, there are case studies that have reported the possibility of serious adverse effects following methylphenidate initiation in children and adolescents.Case presentationIn the present study, we illustrate the case of a 13-year-old adolescent, who was diagnosed with autism spectrum disorder, attention deficit hyperactivity disorder, and other psychiatric comorbidities. The patient developed active suicidal ideation a few weeks after initiating methylphenidate. He also presented irritability accentuation, insomnia, decreased appetite, and an increase in temper tantrums after initiation of this treatment. Psychiatric evaluation, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), did not reveal major psychiatric disorders that could explain them, particularly mood disorders. The risk of suicide was assessed as high indicating a hospitalization and the immediate discontinuation of this treatment. The evolution was marked by a disappearance of suicidal thoughts 2 days after discontinuation of methylphenidate and a clear decrease in symptoms of poor tolerance. The authors were unable to establish a cause-and-effect link between the prescription of methylphenidate and the appearance of suicidal thoughts in this patient, but the results of studies already published seem to provide clues that could explain this link.ConclusionsThe purpose of this work is to alert clinicians to the possibility that young people who have multiple neurodevelopmental disorders may experience suicidal thoughts after starting methylphenidate even in the absence of mood disorders. The link between the prescription of this treatment and the onset of suicidal ideation is not as clear and requires more controlled studies. This suggests particular attention, such as informing the young people and their families beforehand and planning rigorous psychiatric evaluations after the prescription.

The relationship between anxiety and depression in adolescent depression patients: The mediating effect of hope level and coping modes

BackgroundAdolescents diagnosed with depression are particularly susceptible to anxiety and depressive symptoms, this vulnerability often diminishes their future expectations and overall outlook on life. The objective of this research was to scrutinize the associated risk factors of adolescent depression and delineated the interplay between anxiety and depressive symptoms. Concurrently, it sought to ascertain the latent mediating effects of hope levels and coping strategies within this framework. MethodsA mixed-methods research approach was employed. For the qualitative component, 18 adolescents with depression were interviewed following a semi-structured interview guide, with sessions audio-recorded. The data were subsequently transcribed and subjected to thematic content analysis. In the quantitative phase, a cross-sectional online survey was administered to 210 adolescents diagnosed with depression using Questionnaire Star, with data analysis performed using SPSS25.0 and AMOS 24.0. ResultsThe qualitative analysis identified three major themes and nine categories as key risk factors influencing the onset of adolescent depression. Three major themes were generated: school factors, family factors, and other factors. Nine categories were generated: heavy academic load, strained peer, and teacher-student relationships; unstable family structures, internal familial conflicts, and high parental expectations; a strong sense of social isolation, insufficient sexual education, and prevalent suicidal ideation or attempts. A nurturing and supportive school environment significantly bolsters adolescents' sense of hope and coping abilities, while a warm and encouraging family setting effectively mitigates psychological stress. Conversely, heightened loneliness and the onset of suicidal ideation are frequently linked to diminished hope and the adoption of maladaptive coping strategies. Hence, to comprehensively understand the intricate interplay of these factors, this study concentrated on the levels of hope and coping mechanisms, investigating their potential mediating role in adolescent anxiety and depression. Quantitative analysis revealed a positive correlation between anxiety and depression (r = 0.767, p＜0.01). Additionally, it was found that hope levels and coping strategies mediated the relationship between anxiety and depressive symptoms (β = −0.24–0.84 = 0.20, p < 0.001; β = 0.19–0.51 = −0.10, p < 0.01), with the mediating influence of hope levels being more significant than that of coping strategies. ConclusionEnhancing hope levels and fostering positive coping strategies are instrumental in aiding adolescents with depression to alleviate their anxiety and depressive symptoms. Moreover, this study underscored the importance of focusing on adolescents' mental health and providing them with emotional support, thereby increasing their hope levels and encouraging the adoption of positive coping mechanisms to effectively address their challenges.

“Esketamine” in Borderline Personality Disorder: focud on suicide ideation

IntroductionBorderline personality disorder is often associated with comorbid conditions such as eating disorders, mood disorders, and substance use disorders. The prevalence of BPD and major depressive disorder (MDD) are about 5.9% and 8%, respectively, but up to 80% of patients with BPD experience one or more episodes of MDD in their lifetime. BPD is associated with suicidal behaviors and self-harm, thei are also fifty times more likely than the general population to attempt or die by suicide, Up to 10% of BPD patients will die by suicideObjectivesOur aim is to verify if Esketamine could be effectiveness in treating patterns of behavior that have proven to be socially disruptive like self harm, suicidal attempts in patients with BPD. Suicidal ideation is a major risk factor for suicide in patients with TRD and BPD. The interval between the onset of suicidal ideation and suicide attempt is often very short, highlighting the need for urgent intervention and the development of new rapid-onset antidepressant therapies.MethodsWe recruited 25 adult subjects referred to the outpatient clinics of Pavia suffering from TRD with current Moderate-Severe Depressive Episode (scoring ≥ 22 on the MADRS). Of them 9/25 patients has a BPD. Study duration was 8 weeks.The following evaluation scales were administered before the first drug administration (T0) and repeated after one week (T1), four weeks (T2) and eight weeks (T3) of treatment: Montgomery Asberg Depression Rating Scale (MADRS), Columbia-Suicide Severity Rating Scale (CSSRS), and The Zanarini Rating Scale for BPD subgroup patients. We also collected sociodemographic and clinical information. Dosages and frequency of esketamine administration during the study period, adverse events and reasons for discontinuation were also recorded.ResultsA significant reduction of depressive symptoms was found at T1 and T2 compared to T0. Suicidal ideation disappeared as early as T1 and was maintained at T2, expecially in the BPD group. In the subgroup with borderline disorder we saw more improvement in impulsive (Self-mutilation and/or suicidal efforts; two other forms of impulsivity) and affective categories ( Inappropriate anger / frequent angry acts; chronic feelings of emptiness; mood instability) in Zanarini Rating Scale.ConclusionsOur findings support the safety and tolerability of esketamine in TRD and BPD comorbidity sample. It is noteworthy that esketamine has an action on various pathways that are considered defective in borderline patients. Glutamate plays a key role in personality traits such as impulsivity, aggression, and suicidal behavior. Treatment with esketamine could reduce the number of suicide attempts and help reduce the self-harm of BPD.Disclosure of InterestNone Declared

Exploring the Association Between Help-Seeking Intentions and Suicidal Ideation in Australian Adult Men.

Background: Men account for three-quarters of suicide deaths in Australia. Self-reliant masculine norms may act as barriers to men's help-seeking and contribute to suicidal ideation. Men who seek help may be less likely to experience suicidal ideation. Aim: We evaluated the association between help-seeking intentions and suicidal ideation in Australian adult men using data from Wave 2 of the Australian Longitudinal Study on Male Health (Ten to Men). Method: Using scores on the General Help-Seeking Questionnaire, we explored the association between informal help-seeking intentions (e.g., friend, family), formal help-seeking intentions (e.g., psychologist), overall help-seeking intentions (all sources), and new-onset suicidal ideation. We conducted logistic regression analyses using a sample of 7,828 men aged 18-60 years. Results: Increased overall help-seeking intentions and informal help-seeking intentions were significantly associated with lower odds of new-onset suicidal ideation, whereas formal help-seeking intentions were not significantly associated. Limitations: The cross-sectional design limits inferences about causality. Conclusion: Men who have greater informal help-seeking intentions may be less likely to experience a new onset of suicidal ideation; however, more longitudinal research is needed.

Association between long working hours and the development of suicidal ideation among female workers: An 8-year population-based study using the Korean Longitudinal Survey of Women & Family (2012–2020)

Long working hours and overwork have recently emerged as pressing public health concerns. We explored the association between long working hours and suicidal ideation in female workers. A total of 8017 women (24,331 observations) from the fourth to eighth waves of the Korean Longitudinal Survey of Women and Families (2012–2020) were analyzed. To address the repeated measurements within each participant, we employed a generalized estimating equation to estimate the odds ratio (OR) and 95% confidence intervals (CIs). The prevalence of suicidal ideation was 1.9% for those working 35–40 h/week and 4.4% for those working ≥55 h/week. Compared to individuals working 35–40 h/week, those working ≥55 h/week were more likely to experience concurrent suicidal ideation (OR [95% CI]:1.85 [1.43–2.39]). The OR (95% CI) of the association between long working hours and onset of suicidal ideation in the subsequent wave was 1.69 (1.20–2.38) for ≥55 h/week. In subgroup analysis, this association was pronounced among workers with low-income levels (OR [95% CI]: 1.97 [1.29–3.02]) and blue-collar occupations (OR [95% CI]: 2.27 [1.41–3.66]). Policy efforts are required to protect the mental health of female workers exposed to long working hours.

Working hours and the onset of suicidal ideation and depressive symptoms: A 10-year nationwide longitudinal study in South Korea (2012–2022)

Long working hours are associated with adverse health outcomes. We investigated the association between working hours and suicidal ideation and depressive symptoms. We analyzed a nationally representative sample of 11,116 Korean workers, comprising 64,661 observations from 2012 to 2022, to investigate how working hours were associated with mental health problems. To account for repeated measurements in each participant, we employed a generalized estimating equation to estimate risk ratios (RRs) and 95% confidence intervals (CIs). Of the total observations, 13.1% reported working ≥55 h/week. The RR (95% CI) of the association between long working hours and onset of suicidal ideation in the subsequent year was 1.20 (0.95–1.53) for 41–48 h, 1.35 (1.02–1.78) for 49–54 h, and 1.56 (1.23–1.98) for ≥55 h/week, compared to 35–40 h/week. The RR (95% CI) of the association between long working hours and onset of depressive symptoms in the subsequent year was 1.19 (1.07–1.34) for 41–48 h, 1.11 (0.97–1.28) for 49–54 h, and 1.24 (1.10–1.40) for ≥55 h per week, compared to 35–40 h/week. Those working fewer than 35 h/week also had an increased risk of suicidal ideation and depressive symptoms. Policy interventions are needed to reduce excess working hours and protect workers’ mental health.

Longitudinal Associations Between Food Insecurity and Suicidal Ideation Among Adults Aged ≥65 in the Korean Welfare Panel Study.

Objectives : This study aimed to explore longitudinal associations between food insecurity and suicidal ideation, and the moderating roles of intervention programs. Methods: Data were derived from the 2012-2019 waves of the Korean Welfare Panel Study. Participants aged 65 at baseline (n = 4,425) and their annual follow-up measurements for a mean of 6.58years were included. Conditional fixed effects logistic regressions were used to test 1) associations between food insecurity and the onset of suicidal ideation; 2); whether associations were attenuated by food assistance and income support programs. Results: Food insecurity was associated with higher odds of suicidal ideation in the full sample (OR, 1.77; 95% CI, 1.37-2.29), among women (OR, 1.67; 95% CI, 1.24-2.26) and men (OR, 2.06; 95% CI, 1.25-3.40). The association between food insecurity and suicidal ideation was attenuated by participation in home-delivered meal services (OR, 0.43; 95% CI, 0.21-0.88). Conclusion: Food insecure older adults were more likely to consider committing suicide than their food secure counterparts. Food assistance through home-delivered meal services, but not other intervention programs, could weaken this link.

The effect of childhood adversities on the persistence of suicidal ideation and plans among college students: A longitudinal study

BackgroundExposure to childhood adversities (CAs) is known to be associated with the onset of suicidal ideation and plans. However, little is known regarding the contribution of CAs to their persistence. AimsThe study aims to examine the type, number and frequency of CA exposure on the persistence of suicidal ideation and plans at one-year. MethodData were drawn from the French portion of the World Mental Health International College Student survey. At baseline (n = 2661, response rate = 7,58 %), exposure to 12 types of CAs prior to age 18, lifetime mental disorders, lifetime and 12-month suicidal ideation and plans were assessed. At one-year follow-up (n = 1221), 12-month mental disorders, suicidal ideation and plans were assessed. Among those with a prior history of suicidal ideation, logistic regressions were performed to examine the role of CAs on the persistence of ideation and plans at one-year. ResultsAt baseline, frequency and number of CAs were associated with 12-month suicidal ideation and plans. Among lifetime ideators, 49.6 % reported 12-month suicidal ideation at follow-up. Physical abuse was associated with an increased risk of suicidal ideation and plan persistence at one year in univariate analyses. However, CAs were not associated with the persistence of suicidal ideation and plans at one-year in multivariate analyses. LimitationsRetrospective report of CA exposure, and low baseline response rate. ConclusionsUsing a fine-grained operationalization of CA exposure, CAs were not involved in the persistence of suicidal ideation or plans, their deleterious effect more likely to occur early in the course of psychopathology.

Topiramate-Induced Suicidal Ideation and Olfactory Hallucinations: A Case Report

Antiepileptic drugs prescribed in the context of migraine have been reported to be potentially linked with an increased risk of suicidal ideation and behavior. Meta-analyses support the evidence that amongst antiepileptic drugs, Topiramate has the greatest potential for facilitating the occurrence of suicidal ideation and behavior. Studies indicate that this occurs via the increased incidence of mood disorders amongst the population with migraines using Topiramate as a treatment, with a slow and progressive onset of suicidal ideation (if any). We discuss the unique case of a 43-year-old man known to have chronic migraines, who presented with intense rapid-onset suicidal ideation and olfactory hallucinations, three weeks after the introduction of Topiramate for chronic migraines. After a negative extensive investigation panel to rule out common organic diseases, Topiramate was ceased. The suicidal ideation and olfactory hallucinations resolved in less than 24 h without further interventions. This case report highlights that rapid-onset suicidal ideation and olfactory hallucinations could be linked as an unusual side effect to the introduction of Topiramate. The removal of Topiramate from the patient’s pharmacological treatments prevented further psychological distress linked to ego-dystonic suicidal ideation and a resolution of olfactory hallucinations. He was discharged 48 h later.

Sexual Minority Status and Age of Onset of Adolescent Suicide Ideation and Behavior.

To determine if sexual minority adolescents have earlier onset of suicidality and faster progressions from ideation to plan and attempt than heterosexual adolescents. A population-based longitudinal cohort of 1771 adolescents participated in the NEXT Generation Health Study. Participants reported sexual minority status (defined by sexual attraction) in 2010-2011 and retrospectively reported age at onset of suicidality in 2015-2016. Sexual minority adolescents (5.8% of weighted sample) had higher lifetime risk of suicide ideation (26.1% vs 13.0%), plan (16.6% vs 5.4%), and attempt (12.0% vs 5.4%) than heterosexual adolescents. Survival analyses adjusted for demographic characteristics and depressive symptoms revealed positive associations of sexual minority status with time to first onset of suicide ideation (hazard ratio [HR] = 1.77; 95% confidence interval [CI] 1.03-3.06) and plan (HR = 2.69; 95% CI 1.30-5.56). The association between sexual minority status and age at onset of suicide attempt was stronger at age <15 (HR = 3.26; 95% CI 1.25-8.47) than age ≥15 (HR = 0.59; 95% CI 0.21-1.66). The association between sexual minority status and progression from ideation to plan was stronger in the same year of first ideation (HR = 2.01; 95% CI 1.07-3.77) than ≥1 year after first ideation (HR = 1.33; 95% CI 0.26-6.77). Sexual minority adolescents had earlier onset of suicidality and faster progression from suicide ideation to plan than heterosexual adolescents. The assessment of sexual minority status in routine pediatric care has the potential to inform suicide risk screening, management, and intervention efforts among early sexual minority adolescents.

Traumatic life-events and suicidality among Mexican adolescents as they grow up: A longitudinal community survey

ObjectiveLimited research exists on the impact of type and number of traumatic events on the incidence of suicide ideation and attempts (suicidality) among adolescents in low/middle income countries where violence is common. MethodWe estimated prospective associations of 7 types of events on the new occurrence of suicidality from a follow-up conducted in 2013 (n = 1071; ages 19–26) of the original Mexican Adolescent Mental Health Survey conducted in 2005 (ages 12–17), by using Hazard Ratios (HR) estimates. ResultsFor new onset of suicide ideation, those reporting “Ever raped or sexually assaulted” had the highest adjusted HR (3.8), followed by “Ever other traumatic event” (HR = 1.9), “Ever committed or witnessed violence” (HR = 1.7) and “Beaten as a child or witnessed physical fights at home” (HR = 1.5). For suicide attempt, those reporting “Ever beaten up by spouse, partner, someone else, mugged with a weapon, or stalked” (HR = 3.8) and “Ever other traumatic event” (HR = 2.0) had the higher hazards. Compared to those without a traumatic event, increased hazards of ideation and attempt were found for those reporting a greater number of types of events. ConclusionsOur sample is representative of the largest metropolitan area in Mexico but does not include other cities or age groups that may differ in risk factors. Traumatic events that happened in the eight years between waves are not considered. Traumatic events increased the risk of suicidality, independent of common mental disorders. Identifying and addressing these events in clinical settings may therefore be important for preventing suicide in this population.

Suicidal Behaviors in a Nationally Representative Sample of School-Going Adolescents Aged 12\u201317 Years in Eswatini

The burgeoning body of evidence suggests that the aggregated 12-month prevalence estimates of suicidal behaviors (ideation, planning, and attempt) are relatively higher among in-school adolescents in Africa, although country-specific data on the phenomena are still inadequate from the continent. We sought to estimate the 12-month prevalence and identify some of the correlates of suicide behaviors among school-going adolescents in Eswatini. We analyzed the nationally representative data from the 2013 Eswatini World Health Organization Global School-based Student Health Survey, using univariate, bivariate, and multivariate statistical approaches. Of the 2,513 analytical samples, 17.0% (95% confidence interval [CI]: 15.4–18.4%) reported suicidal ideation, 21.0% (95% CI: 19.3–22.6%) made a suicide plan, and 15.5% (95% CI: 14.1–16.9%) attempted suicide during the previous 12 months. The final adjusted logistic models indicated health risk behavior (i.e., marijuana use), adverse interpersonal factors within the family (e.g., intrusion of privacy by parents), and school contextual factors (e.g., bullying victimization, physical fights) to be associated with increased odds of suicidal behaviors among females. However, predominantly, school-related interpersonal factors (e.g., bullying victimization, physical fights) showed strong associations with increased odds of suicidal behaviors among males. Generally, parental monitoring, parental understanding, and social support at school were associated with reduced odds of suicidal behaviors. The multi-level nature of our findings underscores the need for multi-contextual and multi-sectoral intervention and prevention programs and policy approaches targeted at mitigating the onset of suicidal ideation and possible transition to suicidal planning, attempt, and potential death by suicide in this young population.

Suicidalité en période périnatale : quels sont les facteurs associés ?

ObjectivesSuicide is the leading cause of maternal mortality in high-resource countries. The onset of suicidal ideation is a major risk factor for suicide attempts. Suicidality has a major impact on the mother-baby relationship and on child development. The main objective of the study was to identify factors associated with the occurrence of perinatal suicidal ideation in women requiring hospitalization. The secondary objectives of the study were to describe the socio-demographic and clinical characteristics of this specific population, to specify the follow-up procedures at hospital discharge and to develop a semi-directed interview framework for psychiatric evaluation of perinatal patients admitted to a psychiatric hospital in order to better identify those at risk of suicide and improve overall management, particularly in terms of referral to existing perinatal care services. MethodsDescriptive and retrospective study carried out at the Specialized Hospital Center of women hospitalized in the perinatal period between 2014 and 2019. The inclusion criteria were: inpatient pregnant or postpartum within one year of delivery, 16 to 43 years. A keyword search was performed to retrieve the computerized records. All records matching the inclusion criteria were included. We studied the occurrence of suicidal ideation according to the main known clinical and socio-demographic risk factors. ResultsThe sample included 25 pregnant patients and 57 post-partum patients. The presence of a psychiatric history increased the risk of suicidal ideation by 4.38 (P<0.03). The association between the occurrence of a stressful life event and the risk of suicidal ideation onset was close to significant (P<0.10). One third of the patients had been admitted for a reason related to suicidality. Less than one-third of the patients had been referred to existing perinatal services. ConclusionsSuicidality in the perinatal period has a major impact on the dyad as well as on the whole family. The search for suicidal ideas must be systematic during psychiatric interviews, a fortiori when a psychiatric history has been authenticated. Every patient hospitalized in adult psychiatry should be referred to specialized outpatient perinatal psychiatry services. Prevention involves raising awareness and training of all health professionals, networking, but also informing the general public.

Suicidal behaviours among deaf adolescents in Ghana: a cross-sectional study.

BackgroundA growing global concern is that suicide research has paid little attention to young people with disabilities, particularly, in low- and middle-income countries (LAMICs). We aimed to estimate the 12-month prevalence of suicidal ideation and attempt and describe some associations among deaf adolescents in Ghana.MethodsThis is a cross-sectional anonymous self-report survey involving a nationally representative random sample of 450 school-going deaf adolescents. Data analysis included bivariate and multivariable approaches.ResultsThe overall 12-month prevalence of suicidal ideation was 19·3% (95% confidence interval [CI] = 15·8–23·3) and suicidal attempt was 15·6% (95% CI = 12·3–19·2). Although alcohol use and parental divorce were strongly associated with increased odds of both suicidal ideation and attempt, high subjective mental well-being was associated with reduced odds of both suicidal ideation and attempt. Living with no parents and being a final year student were associated with suicidal ideation, while male gender was associated with suicidal attempt.ConclusionsThe prevalence of suicidal behaviours among school-going deaf adolescents in this study compares with estimates among in-school non-deaf adolescents in Ghana and other LAMICs in Africa, and also highlights the need for prevention efforts against the onset of suicidal ideation and possible transition to attempt and suicide among deaf adolescents.

Supplemental Material for The Role of Temperament in the Onset of Suicidal Ideation and Behaviors Across Adolescence: Findings From a 10-Year Longitudinal Study of Mexican-Origin Youth

Supplemental Material for The Role of Temperament in the Onset of Suicidal Ideation and Behaviors Across Adolescence: Findings From a 10-Year Longitudinal Study of Mexican-Origin Youth

School Social Work in Preventing Suicide Ideation Among Minority Ethnic Boarding Students in Vietnam

<i>Background and objective:</i> Adolescence is the time of greatest risk for the first onset of suicidal ideation. Suicidal ideation among adolescents is a public health problem in Vietnam, especially among ethnic minority students. This study described the prevalence of suicidal ideation among adolescents in mountainous areas of Vietnam. The paper recommended developing school social work activities to address mental health issues and prevent suicidal behaviours for the students. <i>Method:</i> In 2019, a school-based survey based on the GSHS questionnaire was conducted in one boarding school in Dien Bien province, Vietnam, and 164 students were included in the study. <i>Result and Conclusion: </i>Analysis revealed that out of a total of 164 students surveyed, 20/164 children have suicidal thoughts, accounting for 12.19%; in which male students intend to commit suicide are 7 (accounting for 35%), and female students with suicidal thoughts are 13 (accounting for 65%). Besides, the study found that schools had diverse activities to prevent student suicide such as directly supporting students through psychological counselling, awareness-raising, life skills education, organizing teacher training, strengthening the connection between families and schools. However, these activities have not achieved the expected effectiveness. This study recommends promoting the role of school social work in preventing and reducing student suicide in the area.

Suicidal ideation and aggression in childhood, genetic variation and young adult depression

BackgroundSuicidal thoughts and behaviors have been studied in association with a variety of risk factors. The aim of the present study was to determine if levels of child/adolescent aggression and/or variation in candidate genes previously associated with suicidal behaviors in adults would influence the presence of suicidal ideation in childhood/adolescence, and to determine if ideation was associated with young adult depression. MethodsA longitudinal study of children, adolescents and young adults who were at high or low risk for alcohol and other substance use disorders by familial background were assessed. The Child Behavior Checklist (CBCL) aggression scale scores with derived subtypes (physical and relational) and genetic variation (ANKK1, DRD2, COMT, SLC6A4, HTR2C) were used as predictors of the presence and onset of suicidal ideation in childhood using survival analysis. Structural equation models (SEM) were fit to determine the relative importance of the predictors controlling for background variables. ResultsCBCL aggression was significantly associated with child/adolescent suicidal ideation. One SNP in the ANKK1 gene (rs1800497), one in the HTR2C gene (rs6318), and two haplotypes, AAAC in the ANKK1-DRD2 complex and the CCC haplotype of the HTR2C gene, were significantly associated with the presence and onset of child/adolescent suicidal ideation. Follow up in young adulthood showed a significant relationship between suicidal ideation in childhood/adolescence and young adult depression. ConclusionsGenetic variation and presence of elevated aggression scores from the childhood CBCL are significant predictors of childhood suicidal ideation. Suicidal ideation in childhood and being female are predictors of young adult depression.

Suicidal ideation, suicide attempt, and non-suicidal self-injury among female veterans: Prevalence, timing, and onset

BackgroundSuicide rates among female veterans have continued to increase, particularly among those not using Veterans Health Administration (VHA) care. Nonetheless, suicide research has rarely focused on female veterans, particularly non-VHA users. The present study examined the prevalence and onset of suicidal ideation (SI), suicide attempt (SA), and non-suicidal self-injury (NSSI) in relation to military service among female veterans. Additionally, current, past, and never VHA users were compared in regard to SI, SA, and NSSI prevalence. MethodsFemale veterans (n = 439) participated in a national, cross-sectional survey. ResultsLifetime prevalence of SI (47.9%), SA (17.7%), and NSSI (13.2%) were high. Participants were more likely to report experiencing SI and SA following separation, compared to preceding (SI, SA) or during (SI only) military service, controlling for time at risk. However, onset was more likely to occur prior to military service, compared to after separation, for SI, SA, and NSSI. In age-adjusted analyses, current and past users of VHA care were more likely to report experiencing lifetime SI, compared to those who never used VHA care. However, when adjusting for service era, past and never VHA users did not significantly differ. LimitationsCross-sectional design, retrospective recall, and convenience sample. ConclusionsFor female veterans, onset of SI, SA, and NSSI appears to most commonly occur before military service. However, SI and SA prevalence are highest following separation, suggesting a period warranting additional support and intervention. Results underscore the need for continued suicide surveillance, prevention, and intervention efforts for female veterans, especially current VHA users.

LONELINESS AND SUICIDE IDEATION IN OLDER ADULTS: A LONGITUDINAL INVESTIGATION

Older adults have the highest rates of suicide globally, necessitating theory and research investigating suicide and its prevention in later-life. The experience of loneliness is significantly associated with depression, hopelessness, negative health outcomes, and mortality among older adults. Yet, relatively little research has focused on the role of loneliness in conferring suicide risk in later life. The purpose of the present study was thus to investigate the potential associations between loneliness and suicide ideation and behavior in a sample of community-residing older adults recruited into a larger two-year longitudinal study of psychological risk and resiliency to later-life suicide ideation. We specifically recruited 173 adults, 65 years or older, from community locations in a medium-sized Canadian city, for a study on “healthy aging.” Participants completed measures of positive and negative psychological variables, including depression, loneliness, and suicide ideation at a baseline assessment, and again at 2-4 week, 6-12 month, and 1-2 year follow-up points. Findings indicated that loneliness (UCLA Loneliness Scale) was significantly positively associated with concurrent depression and suicide ideation, negatively associated with psychological well-being and perceived social support, and differentiated between participants who endorsed or denied having ever engaged in suicide behavior. Baseline loneliness also explained significant variability in the onset of suicide ideation over a 1-2 year period of follow-up, controlling for age, sex, and baseline depression and suicide ideation. These findings will be discussed in the context of the need for increased focus on psychosocial factors when assessing and intervening to reduce suicide risk in older adults.

Nicotine Dependence and Pre-Enlistment Suicidal Behavior Among U.S. Army Soldiers

Identification of modifiable risk factors for suicidal behaviors is a priority for the U.S. Army. This study investigated associations of nicotine dependence with suicidal behaviors among incoming soldiers. Lifetime DSM-IV nicotine dependence, mental disorders, suicidal behaviors, and their ages of onset were retrospectively assessed in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) New Soldier Study. Discrete-time survival analysis of person-year data from 30,436 soldiers was performed to evaluate associations of nicotine dependence with subsequent suicidal ideation, plans, and attempts. Among respondents with lifetime ideation (n=4,060), models tested associations of nicotine dependence with progression from ideation to first onset of plan, from plan to first attempt, and, among ideators without plans, from ideation to first unplanned attempt. A hierarchy of models incorporated increasing controls for other risk factors. Data were collected in 2011-2012 and analyzed in 2017-2018. In models controlling for sociodemographic characteristics, nicotine dependence was associated with onset of all suicidal behaviors (AORs, 2.07-4.08, p<0.001) and with each type of progression of suicidal behavior (AORs, 1.48-2.44, p<0.005). After adjusting for childhood adversities and mental disorders, nicotine dependence remained associated with onset of ideation (AOR=1.27, 95% CI=1.10, 1.46, p=0.001) and attempt (AOR=1.83, 95% CI=1.41, 2.37, p<0.001); and with progression from ideation to unplanned attempt (AOR=2.03, 95% CI=1.17, 1.74, p<0.001). Nicotine dependence exhibited associations with onset of suicidal ideation and suicide attempt-and with progression from ideation to unplanned attempt-that were independent of other measured risk factors. Awareness of associations of nicotine dependence with suicidal behaviors may inform risk assessment, facilitate targeting of prevention efforts, and provide further impetus for reducing nicotine dependence.