Past-year Suicidal Ideation Research Articles

Differential associations between types of social media use and university students' non-suicidal self-injury and suicidal behavior

ObjectiveTo examine differential associations between types of social media use and non-suicidal self-injury (NSSI) and suicidal behaviors. MethodsParticipants were N = 40,065 Norwegian college and university students, age 18–25, from the 2018 Students' Health and Wellbeing (SHoT) study. Students reported on their use of social media for seven specific activities, which we categorized into active and passive non-social use, passive social use, active public social, and active private social use. We also considered students' tendency for negative social comparisons on social media. Outcomes were past-year NSSI, NSSI ideation, suicidal ideation, and suicide attempt. Covariates were age, gender, total daily screen time and financial stress. ResultsResults of multiple logistic regression revealed differential associations between types of social media use and outcomes. Notably, active social private use (e.g., messaging friends) was associated with decreased odds of all outcomes, whereas active social public use (e.g., status updates) was associated with increased odds of NSSI ideation, NSSI, and suicide attempt. Social comparison was associated with increased odds of all outcomes. ConclusionOur results suggest that specific types of social media use are differentially associated with NSSI and suicidal outcomes among university students.

Disparities in Prescription Opioid Misuse Affecting Sexual Minority Adults Are Attenuated by Depression and Suicidal Ideation.

Purpose: Heightened rates of prescription opioid misuse have been observed among sexual minority (SM) compared with heterosexual populations. In addition, depression and suicidal ideation are risk factors for misuse, and they are also elevated among SM populations. The purpose of this analysis was to examine whether depression and suicidal ideation attenuate disparities in prescription opioid misuse among SM adults. Methods: Data came from a publicly available, nationally representative data set, the National Survey on Drug Use and Health, 2015-2018. Among adults, survey-weighted logistic regression was used to assess the relationship between sexual orientation and past-year opioid misuse adjusting for demographics and either past-year major depressive episode or suicidal ideation. Probabilities of prescription opioid misuse were also assessed under counterfactual rates of depression and suicidal ideation. Analyses were stratified by sex. Results: Among participants in the analytic sample (N = 169,759; SM = 11,268), 9254 (5.5%) reported past-year prescription opioid misuse. The overall rate of opioid misuse decreased from 6.2% in 2015 to 4.6% in 2018. The association between sexual orientation and opioid misuse was attenuated downward for gay men, lesbian women, and bisexual individuals (men and women) after adjusting for either major depressive episode or suicidal ideation, but opioid misuse remained higher among most SM groups. In addition, rates of opioid misuse were found to be lower in counterfactual analyses with a nearly 2.5- and 4-fold decrease in depression and suicidal ideation among gay men and bisexual women, respectively. Conclusion: Efforts to reduce disparities in depression and suicidal ideation affecting SM individuals may reduce disparities in prescription opioid misuse affecting this population.

Prevalence and Predisposing Factors of Suicidal Ideation Among the University Students in Bangladesh: A Single-Site Survey

Recently, suicide among Bangladeshi university students has become a serious problem. However, to date, there have been no studies assessing suicidal behaviors among Bangladeshi students. Therefore, the present study investigated suicidal ideation (SI) and its risk factors among this population. A classroom-based convenience sampling method was utilized to survey 665 students of a university in Bangladesh (67.5% males; aged 21.16 years: SD ± 1.6). In addition to socio-demographic questions, the survey also included the Smartphone Application-Based Addiction Scale, Bergen Facebook Addiction Scale, and Depression Anxiety Stress Scale–21. Results showed that the prevalence of suicidal ideation was 2.3% in the past 24 h, 4.8% in the past 15 days, 6.9% in the past month, 14.7% in the past year, and 61.1% in the lifetime. The unadjusted regression model showed that being divorced (or separated) from a partner (OR = 4.486, 95% CI = 1.972–10.207, p < 0.0001), Facebook addiction (OR = 1.550, 95% CI = 1.006–2.388, p = 0.047), depression (OR = 1.657, 95% CI = 1.677–4.211, p < 0.0001), anxiety (OR = 2.649, 95% CI = 1.624–4.320, p < 0.0001), and stress (OR = 2.626, 95% CI = 1.673–4.122, p < 0.0001) were the risk factors of past-year SI. Compared with global prevalence rates, the present study reported higher levels of SI prevalence. Therefore, supportive suicide prevention programs are needed to tackle SI and alongside comorbid psychopathology.

Suicide-related interpersonal needs of young Iranian people: A preliminary validation of thwarted belongingness and perceived burdensomeness constructs.

The aim of the current study was to validate the Interpersonal Needs Questionnaire (INQ-15) and to test its reliability in Persian-speaking Iranian undergraduate students. In this cross-sectional study, 485 undergraduate students (age: 20.66 ± 1.42, 60% female) were assessed on the two subscales of perceived burdensomeness (PB) and thwarted belongingness (TB) and the Suicide Behavior Questionnaire-Revised (SBQ-R). Exploratory structural equation modelling (ESEM) confirmed the construct validity of INQ-14, excluding INQ#9. In addition, INQ#8, articulated in an equivalent Persian phrasing, loaded well on TB. The measurement model tested by confirmatory factor analysis (CFA) suggested INQ#11 to be eliminated, resulting in INQ-13-P to consist of PB and TB-7. The internal consistency and convergent/discriminant validity were established. The concurrent validity of PB was solidly established in terms of past year suicidal ideation (PY-SI) above and beyond anxiety, depression, prior suicidality, and TB-7. The effect of PB on PY-SI was stronger, where prior suicidality had already occurred or the perceived likelihood of future suicide (PLFS) was high. Moreover, TB-7 could only indicate PY-SI, where prior suicidality had already occurred or PLFS was high, albeit when PB was omitted. The interaction term was significant; however, beyond anxiety and depression, the effect of TB-7 on PY-SI was significant where PB was very high (n = 40, 8.25%). Therefore, future studies can utilize INQ-13-P as a valid and reliable instrument in Persian-speaking populations. However, further studies should examine the construct validity of TB and its relationship with suicide ideation in different populations.

The roles of gender affirmation and discrimination in the resilience of transgender individuals

Abstract Background Transgender individuals face severe stigma-driven health inequities structurally, institutionally and interpersonally, yielding poor individual-level outcomes. Gender affirmation, or being recognized based on one's gender identity, expression and/or role, may be considered a manifestation of resilience. Methods To provide intervention and policy guidelines, we examined latent constructs representative of gender affirmation (legal documentation changes, transition-related medical procedures, familial support) and discrimination (unequal treatment, harassment, and attacks), and tested their impact on mental, physical, and behavioral health outcomes among 17,188 binary-identified transgender participants in the 2015 US Transgender Survey. Results Confirmatory factor analyses revealed high standardized factor loadings for both latent variables, on which we regressed outcomes using structural equation modeling. Fit indices suggested good model fit. Affirmation was associated with lower odds of suicidal ideation (p &amp;lt; .001) and psychological distress (p &amp;lt; .001), and higher odds of substance use (p &amp;lt; .001), and past-year healthcare use and HIV-testing (p &amp;lt; .001). Discrimination was associated with higher odds of suicidal ideation (p &amp;lt; .001), psychological distress (p &amp;lt; .001), substance use (p &amp;lt; .001), and past-year HIV-testing (p &amp;lt; .001). Affirmation and discrimination interaction analyses showed lower odds of past-year suicidal ideation (p &amp;lt; .01), with affirmation having a significant moderating protective effect against discrimination. Conclusions Gender affirmation is paramount in upholding transgender health, and these findings carry global significance, beyond the US. Clarification of affirmation procedures, and increases in its accessibility, equitably across racial/ethnic groups, should become a priority, from policy to the family unit. The impact of discrimination demands continued advocacy via education and policy.

Suicidal ideation among Nepali widows: an exploratory study of risk factors and comorbid psychosocial problems.

Suicide is a leading cause of death among Nepali women of reproductive age. Suicidal ideation has known associations with stressful life events, which Nepali widows disproportionately experience. We aimed to identify risk and protective factors that could lead to effective interventions for this population. To study suicidal ideation in Nepali widows, we collected data from 204 women in urban, semi-urban, and rural areas whose husbands died at least one year prior. The questionnaire included sociodemographic information, the Hopkins Symptom Checklist-25, PTSD Checklist-Civilian Version, Somatic Symptom Scale-8, and the Multidimensional Scale of Perceived Social Support. Overall severity of prolonged grief was assessed by a counselor after completing a structured clinical interview. Using multivariate regression models, we assessed associations of sociodemographic and psychosocial indicators with past-year suicidal ideation. Latent profile analysis was also performed to estimate profiles of comorbidities. Past-year suicidality was high, with 16.2% (N = 33). Each year increase since husband's death was protective and reduced odds of ideation 8% (95% CI 0.85-0.98) and being educated and of older age also reduced the odds of ideation by 0.21 (95% CI 0.06-0.70), and 0.09 (95% CI 0.01-0.64), respectively. Depression (OR = 6.37, 95% CI 2.78-14.59), PTSD (OR = 3.84, 95% CI 2.15-6.86), prolonged grief (OR = 6.04, 95% CI 3.04-12.00) and anxiety (OR = 6.52, 95% CI 2.96-14.38) were highly associated with suicidality, and mapped onto the three profiles of increasing mental distress severity. Suicide remains a major issue among Nepali widows, showing high comorbidity with other mental disorders. Screening for depression, anxiety, and prolonged grief, may aid in identifying widows at increased risk of suicidal ideation.

The Roles of Gender Affirmation and Discrimination in the Resilience of Transgender Individuals in the US

Transgender individuals face severe stigma-driven health inequities structurally, institutionally, and interpersonally, yielding poor individual-level outcomes. Gender affirmation, or being recognized based on one’s gender identity, expression, and/or role, may be considered a manifestation of resilience. To provide intervention and policy guidelines, we examined latent constructs representative of gender affirmation (legal documentation changes, transition-related medical procedures, familial support) and discrimination (unequal treatment, harassment, and attacks), and tested their impact on mental, physical, and behavioral health outcomes among 17,188 binary-identified transgender participants in the 2015 US Transgender Survey. Confirmatory factor analyses revealed high standardized factor loadings for both latent variables, on which we regressed outcomes using structural equation modeling. Fit indices suggested good model fit. Affirmation was associated with lower odds of suicidal ideation and psychological distress, and higher odds of substance use, and past-year healthcare use and HIV-testing. Discrimination was associated with higher odds of suicidal ideation, psychological distress, substance use, and past-year HIV-testing. Affirmation and discrimination interaction analyses showed lower odds of past-year suicidal ideation, with affirmation having a significant moderating protective effect against discrimination. Gender affirmation is paramount in upholding transgender health. Clarification of affirmation procedures, and increases in its accessibility, equitably across racial/ethnic groups, should become a priority, from policy to the family unit. The impact of discrimination demands continued advocacy via education and policy.

Suicidal thoughts and behaviors in preadolescents: Findings and replication in two population-based samples.

Given increasing concern in suicide in preadolescent children, this study aimed to characterize and identify potential indicators of risk for suicidal ideation (SI) and suicide attempts (SAs) in this population. Data were drawn from two population-based samples of preadolescents: the 2007 and 2010 Minnesota Student Survey and analyses were restricted to 11- and 12-year-olds. Sociodemographic characteristics, childhood maltreatment, parental relations, peer relations, and school climate were examined in relation to past-year SI and SA. To examine correlates of SI, unconfounded by risk for SA, individuals with a history of SA were excluded from SI analyses. Correlates of SA were examined among individuals with past-year SI. Logistic regression analyses were conducted with past-year SI and SA as criterion variables. Results from the 2007 and 2010 data sets were highly consistent. The prevalence of past-year SI was 9.28% and 9.25% in 2007 and 2010, respectively. Of the total sample, 1.90% and 1.87% reported a past-year SA (17.00% and 16.78% of those with past-year SI). Overall, effect sizes were generally modest to medium. The strongest effects were observed for sexual and physical abuse, parental support, and perceived safety at school (ps < .001). In multivariate analyses of SI and SA, sexual and physical abuse had the largest effect sizes (ORSI = 2.18 [95% CI = 1.90-2.51] to 2.96 [95% CI = 2.69-3.26]; ORSA = 1.55 [95% CI = 1.29-1.86] to 2.26 [95% CI = 1.82-2.80]). SI and SA occur at a concerning rate among preadolescent children. Screening for childhood sexual and physical abuse may be important for identifying those at risk for these clinical outcomes.

Past-Year Suicidal Ideation Among Transgender Individuals in the United States

This study assessed potential correlates to past-year suicide ideation among a national sample of transgender adults in the United States. A secondary analysis of the 2015 Transgender Survey was conducted. The 2015 Transgender Survey is the first and largest survey assessing health behaviors among transgender individuals living in the United States. Participants were recruited by several methods (e.g., social media, random sampling, photobooth campaigns. Weighted logistic regression analyses adjusting for covariates were conducted to investigate potential associations to whether or not an individual thought about suicide. A total of 27,795 individuals who self-identified as transgender participated in the study. Of the sample, 34.0% identified as a man, 29.8% identified as a woman, 20.6% identified as non-binary, and 15.5% identified as part time one gender/part time another. Nearly half of participants (48.5%) reported past year suicide ideation. Significant predictors included gender identity, age, income, race, low family support, and self-reported physical and sexual assault. This is one of the first studies that we are aware of examining past-year suicidal ideation among a large, nationally representative sample of transgender individuals. Interventions (e.g., acceptance therapy, evaluation, focus groups) are desperately needed to address this burgeoning problem among transgender individuals.

Pathways from parenting practices to adolescent suicidality: Evidence on the role of emotional and behavioral symptoms from a prospective cohort of Canadian children.

To investigate longitudinal relationships between parenting practices in childhood and adolescent suicidality, and assess the mediating role of emotional and behavioral symptoms. Data were drawn from the National Longitudinal Survey of Children and Youth, a Canadian population-based longitudinal cohort study. The sample included 9,490 children aged 10-11 who were followed up biennially to ages 14-15. Parents reported their positive and punitive parenting practices when children were 10-11. Adolescents self-reported symptoms of depression/anxiety, hyperactivity, conduct disorder, and social aggression at 12-13, and past-year suicidal ideation and suicide attempts at 14-15. The inverse associations between positive parenting at 10-11 and suicidal behaviors at 14-15 were significantly mediated by symptoms of hyperactivity, conduct disorder, and social aggression at 12-13. Direct relationships between punitive parenting and suicidal behaviors were observed. These associations were significantly mediated by hyperactivity and, among boys only, by conduct disorder and social aggression. The association between punitive parenting and suicide attempt was additionally mediated by depression/anxiety. Parenting in childhood may be associated with adolescent suicidality both directly and indirectly through emotional and behavioral symptoms. Interventions aimed at reducing the use of harsh disciplinary strategies and promoting positive parent-child interactions may reduce the burden of adolescent suicidality.

The link between LGBTQ-supportive communities, progressive political climate, and suicidality among sexual minority adolescents in Canada

Despite supportive structural changes to reduce stigma towards lesbian, gay, and bisexual, transgender, queer, and questioning (LGBTQ) Canadian residents, sexual minority youth still face disparities compared to heterosexual peers. We aimed to characterize LGBTQ-supportive environments and political climates, and examine their links to suicidal behavior among sexual minority adolescents in western Canada. Data were from the 2013 British Columbia Adolescent Health Survey, a cluster-stratified random cross-sectional survey of public school students in BC, Canada; We sampled 2678 self-identified LGB and mostly heterosexual students (69% girls) from 274 schools, representing an estimated provincial population of 24,624 sexual minority students in weighted models. Student reports of past-year suicidal ideation, suicidal attempts, and self-harm behaviors were merged with community-level data assessing diverse aspects of LGBTQ-supportive resources and progressive political climates in communities surrounding the schools. Adjusted multilevel models showed that for sexual minority adolescent girls, higher community LGBTQ-supportiveness predicted marginally significant lower suicidal ideation (aOR = 0.94, 95% CI [0.88, 1.01]) and suicidal attempts (aOR = 0.91, 95% CI [0.83, 1.00]) and significantly lower self-harm behaviors (aOR = 0.91, 95% CI [0.85, 0.98]). Further, progressive political climates predicted marginally significant lower suicidal ideation (aOR = 0.89, 95% CI [0.78, 1.02]) and significantly lower self-harm behaviors (aOR = 0.87, 95% CI [0.77, 0.99]). For sexual minority adolescent boys, no community-level variables were associated with suicidal behavior in adjusted models. Thus, LGBTQ-supportive communities and progressive political climates appear to be protective against suicidal behavior among sexual minority adolescent girls, but not sexual minority adolescent boys.

Differentiating Adolescent Suicide Attempters and Ideators: A Classification Tree Analysis of Risk Behaviors

PurposeAlthough many youth consider suicide, only a subset act on suicidal thoughts and attempt suicide. The objective of this study was to identify patterns of risk factors that differentiate adolescents who experienced suicidal thoughts from those who attempted suicide. MethodsThis study analyzed data from the 2013, 2015, and 2017 National Youth Risk Behavior Surveys. Classification tree analysis was used to identify combinations of health risk behaviors and demographic factors that improved the identification of past-year suicide attempts among adolescents with past-year suicide ideation or planning (overall n = 7,493). ResultsForty percent of the past-year ideators attempted suicide in the same period. The best-performing tree included three variables and defined four subgroups. Youth characterized by heroin use and past-year physical fights were at a strikingly high risk of being attempters (78%). Youth who had experienced rape were also likely to be attempters (58%), whereas those who had endorsed none of these three variables were relatively less likely to be attempters (29%). Overall, the tree’s classification accuracy was modest (area under the curve = .65). ConclusionsThis study advances previous research by identifying notable constellations of risk behaviors that accounted for adolescents’ transition from suicidal ideation to behavior. However, even with many health risk behavior variables, a large sample, and a multidimensional analytic approach, the overall classification of suicide attempters among ideators was limited. Implications for future research are discussed.

Suicidal Behaviors Among Nurses in Canada.

Nurses are regularly exposed to potentially psychologically traumatic events, experience high rates of burnout, and may be at an elevated risk of death by suicide. Few studies have assessed for suicidal behaviors among Canadian nurses, and factors that may increase risk for suicidal behaviors are unknown. The current study was designed to assess past-year and lifetime suicidal behavior (i.e., ideation, plans, and attempts) using a large sample of Canadian nurses. Participants (n = 3969; 94.3% women) completed an online survey including measures of suicidal behavior and symptoms of mental disorders. Considerable proportions of participants reported past-year and/or lifetime suicidal ideation (10.5%, 33.0%), plans (4.6%, 17.0%), and attempts (0.7%, 8.0%), considerably higher than general population estimates. Significant differences were identified across age groups, years of service, marital status, regional location, and nursing type (e.g., registered psychiatric nurses, licensed practical nurses, registered nurses). Participants who screened positive for almost all measured mental disorders had significantly higher rates of suicidal behavior. The results necessitate further research to evaluate risk factors contributing to suicidal behavior in Canadian nurses and methods to decrease the risk (e.g., developing effective monitoring and prevention measures).

Perceived overweight and suicidality among US adolescents from 1999 to 2017.

Identifying oneself as overweight is a risk factor for poor mental health and suicidality independent from objective weight status. The stigma associated with heavier body weight has risen in recent decades and this may have exacerbated the detrimental mental health effects of perceived overweight. In this study, we examined the association between perceived overweight and suicidality in a nationally representative sample (N = 115,180) of US adolescents assessed from 1999 to 2017. We drew on data from the Youth Risk Behavior survey, a biennial population-based survey of students in grades 9-12. Suicidality was gauged by participant reports of past-year suicidal ideation, suicide plans, or suicide attempts. Across all waves, perceived overweight (vs. perceived "normal" weight) predicted a 7.7 percentage point (p < 0.001) increased risk of suicidality after adjustment for age, sex, ethnicity, and BMI. The risk of suicidality associated with perceived overweight increased from 5.7 percentage points in 1999-2001 to 10.1 points in 2015-2017, a difference of 4.4 points (p = 0.001). This growth was most evident after 2009 and was apparent across suicidality measures. Among US adolescents, perceiving one's body as overweight increases risk of suicidality and this risk appears to have grown substantially from 2009 to 2017.

Migration-Related Stressors and Suicidal Ideation in North Korean Refugee Women: The Moderating Effects of Network Composition.

Alarmingly high rates of suicidal ideation have been reported in North Korean (NK) refugee women living in South Korea. This population often endures traumatic experiences and violence in North Korea as well as human trafficking and sexual exploitation in intermediary countries. Following resettlement in South Korea, NK refugee women continue facing multiple hardships, such as discrimination, that can negatively affect their mental health and contribute to suicidality. Support from social networks can buffer the harmful impacts of pre- and postmigration stressors on mental health in NK refugee women. Using the stress-buffering hypothesis, the present study examined the moderating effects of network composition (i.e., network diversity and church-based ties) on the associations among premigration trauma, postmigration discrimination, and suicidal ideation in NK refugee women living in South Korea. Participants (N = 273) were NK refugee women living in South Korea who were 19 years of age or older; 34.4% of the participants reported past-year suicidal ideation. The study results indicated that network diversity significantly moderated the association between postmigration discrimination and suicidal ideation, p = .031, whereas networks with church-based ties significantly moderated the association between premigration trauma and suicidal ideation, p = .026. The present findings support the hypothesis that social ties can buffer the appraisal of migration-related stressors on suicidality. These findings have implications for practitioners serving vulnerable populations that experience multiple traumatic events.

Proportion of Individuals With Past-Year Suicidal Ideation Who Attempted Suicide Over the Past 10Years in the United States, and the Influence of Age and Sex.

Background: In recent years, the rate of death by suicide has been increasing disproportionately among females and young adults in the United States. Presumably this trend has been mirrored by the proportion of individuals with suicidal ideation who attempted suicide. Aim: We aimed to investigate whether the proportion of individuals in the United States with suicidal ideation who attempted suicide differed by age and/or sex, and whether this proportion has increased over time. Method: Individual-level data from the National Survey on Drug Use and Health (NSDUH), 2008-2017, were used to estimate the year-, age category-, and sex-specific proportion of individuals with past-year suicidal ideation who attempted suicide. We then determined whether this proportion differed by age category, sex, and across years using random-effects meta-regression. Overall, age category- and sex-specific proportions across survey years were estimated using random-effects meta-analyses. Results: Although the proportion was found to be significantly higher among females and those aged 18-25 years, it had not significantly increased over the past 10 years. Limitations: Data were self-reported and restricted to past-year suicidal ideation and suicide attempts. Conclusion: The increase in the death by suicide rate in the United States over the past 10 years was not mirrored by the proportion of individuals with past-year suicidal ideation who attempted suicide during this period.

Gender and Racial-Ethnic Differences in Treatment Barriers among College Students with Suicidal Ideation

ABSTRACT Understanding barriers to treatment-seeking among college students with suicidal ideation (SI) is critical to campus suicide prevention efforts. We used data from the Healthy Minds Study to test for gender and racial/ethnic differences in self-reported barriers to professional help-seeking among college students with past-year SI. Students (n = 1,817) with SI who reported no past-year care indicated their reasons from a list of 25 attitudes, experiences, and structural factors. We examined differences in reported barriers to mental health services between men and women and between Asian, Black, Latino, and White students. There were significant gender differences for seven of the barriers, including that men were more likely to report a preference to deal with issues on their own. There were significant racial-ethnic group differences for 14 barriers. Implications for suicide prevention practices and policies are provided, including targeted group outreach tailored to the most salient barriers to treatment.

Prescription opioid misuse motive latent classes: outcomes from a nationally representative US sample.

Prescription opioid misuse (POM) contributes to a larger opioid crisis in the US and Canada, with over 17 000 US POM-related overdose deaths in 2017. Our aims were to (1) identify specific profiles of respondents based on POM motives using the US National Survey on Drug Use and Health (NSDUH) and (2) compare profile respondents on sociodemographics, substance use and mental and physical health outcomes. Analyses included 2017-18 NSDUH respondents with data on POM motives (n = 4810). POM was defined as prescription opioid use in a way not intended by the prescriber, including use without a prescription, in larger amounts or more frequently. Nine POM motives for the most recent episode were assessed, including 'to relieve physical pain' and 'to get high'. Latent classes, based on POM motives, were estimated. Classes were compared on sociodemographics, substance use and physical and mental health outcomes. Eight latent classes were identified (in order of prevalence): pain relief only, relax-pain relief, sleep-pain relief, multi-motive, high, experimenter, emotional coping and dependent/hooked. Compared to the pain relief only group, the high and multi-motive classes had higher odds of all substance use outcomes, with the dependent/hooked class having higher odds on all but one outcome. Six of the eight classes had higher odds of past-year mental health treatment and suicidal ideation than the pain relief only class. Screening for pain, pain conditions, problematic substance use and psychopathology are recommended in those with any POM. While those in the dependent/hooked, multi-motive and emotional coping classes are most likely to have prescription opioid use disorder (OUD), screening for OUD symptoms in all individuals with POM is also warranted.

Longitudinal associations between adolescents' trajectory membership of depressive symptoms and suicidality in young adulthood: a 10-year cohort of Chinese Wenchuan earthquake survivors.

Previous studies regarding associations between depressive symptoms and suicidality (suicidal ideation, plans and attempts) have usually employed a variable-centred approach, without considering the individual variance in time-varying changes of depressive symptoms. Through 10-year follow-up of a large cohort of Chinese adolescents exposed to the 2008 Wenchuan earthquake, this study examined whether individual variance in depressive symptoms during the early phases post-earthquake could generate different suicidality outcomes in young adulthood. A total of 1357 Chinese adolescents exposed to the Wenchuan earthquake were surveyed on depressive symptoms and other variables at 6, 18 and 30 months post-earthquake. In total, 799 participants responded to the 10-year follow-up and completed an online survey covering suicidality and other variables. The analytic sample was 744 participants who had valid data on depressive symptoms and suicidality. Data were analysed using logistic regressions. Prevalence estimates of past-year suicidal ideation, suicide plans and suicide attempts measured at 10 years post-earthquake were found to be 10.8%, 7.3% and 3.0%, respectively. Five trajectories of depressive symptoms were classified: resistance (54.4%), chronicity (13.3%), recovery (10.4%), delayed dysfunction (12.0%) and relapsing/remitting (10.0%). After controlling for covariates, whole-sample regressions revealed only the relapsing/remitting depressive trajectory remained significantly predictive of suicidality. Moreover, males not females in the chronic group were more likely to have suicide plans. The findings highlight the importance of detecting disaster survivors with different trajectories of mental status and providing with them individualised and effective mental health services, to decrease their risk of suicidality in the future.

Prevalence and correlates of suicidal ideation in Korean firefighters: a nationwide study

BackgroundIt is generally known that firefighters are at increased risk of suicide. However, the prevalence and correlates of suicidal ideation in firefighters have not been thoroughly described to date. The aim of this study was to measure the 1-year prevalence of suicidal ideation in firefighters and to investigate the correlates of past-year suicidal ideation among the demographic, occupational and clinical characteristics.MethodA web-based survey was conducted using a self-reported questionnaire. A total of 45,698 Korean firefighters were included for analysis. The prevalence of suicidal ideation in the past year was calculated and its correlates were elucidated using a multivariable logistic regression analysis.ResultsThe 1-year prevalence of suicidal ideation was 10.66% in Korean firefighters. Recent traumatic experience, high levels of occupational stress from physical work environment and emotional labor, as well as current duty of officer were significant correlates of suicidal ideation in the previous year, even after controlling for the effects of PTSD and depressive symptoms. With respect to demographic factors, female gender and marital status of divorced/separated/widowed were identified to be associated with suicidal ideation in the previous year among firefighters.ConclusionsThe 1-year prevalence of suicidal ideation was high in Korean firefighters and was associated with various occupational factors as well as psychiatric symptoms. Early detection and management of these risk factors could reduce the risk of suicidal ideation in firefighters.