Predictors Of Suicidal Behavior Research Articles

Predictors of suicidal behaviors among school-going adolescents: a cross sectional study in Indonesia

BackgroundAdolescents are a high-risk age group for committing suicide, and the risk substantially increases from early to late adolescence. Adolescence also serves as critical time period for early detection and intervention to prevent suicidal behaviors. This study aimed to assess the prevalence of suicidality and identify significant predictors of suicidality among adolescents.MethodsA cross-sectional observational study was conducted between January-December 2023. Adolescents aged 14–18 years old (n = 2317) were consecutively recruited from 15 high schools across four provinces on Java Island in Indonesia. Self-reported validated instruments in Indonesian were used to assess sociodemographic profiles, self-esteem (RSES), hopelessness (BHS), loneliness (ULS-3), perceived social support (MSPSS), depression (PHQ-9), resilience (CD-RISC-10), suicidality (SBQ-R). With adjusted odds ratio (AOR) and 95% confidence interval (CI), binary logistic regression analysis was used to determine significant predictors of suicidality.ResultsThe prevalence of lifetime suicide ideation was 26.5%, lifetime suicide plans were 18.2%, lifetime suicide threat was 14.1%, and lifetime suicide attempt was 4.4%. The prevalence of 12-month suicide ideation was 43.1%. The following variables were identified and significantly associated with suicidality (p < 0.05): female students (AOR = 1.912; 95%CI:1.507–2.425), chronic illness (AOR = 2.886; 95%CI:1.545–5.389), low resilience (AOR = 1.347; 95%CI:1.036–1.750), low self-esteem (AOR = 2.020; 95%CI:1.578–2.585), low family support (AOR = 3.532; 95%CI:2.486–5.017), loneliness (AOR = 1.611; 95%CI:1.211–2.143), depression (AOR = 4.882; 95%CI = 3.861–6.175), and hopelessness (AOR = 1.602; 95%CI:1.154–2.224). Nagelkerke R square was 0.364 indicating the regression model explained 36.4% of variance in suicidality.ConclusionsOur study revealed several significant predictors of suicidality among adolescents which can be targeted to develop suicide prevention strategies.

A comparison of the social cognition and neurocognitive characteristics of adolescents with suicide behavior, adolescent with depression and healthy controls.

Deficits in neurocognition and social-cognition have been suggested to be an endophenotype for suicidal behavior. We aimed to compare the social-cognition and neurocognitive characteristics of adolescents diagnosed with depression with and without suicidal behavior and to investigate whether these functions predict suicide. Adolescents diagnosed with Major Depressive Disorder (MDD) with suicidal behavior (n = 42); MDD without suicidal behavior (n = 44) and age- and sex-matched controls (n = 43) were included. The University of Pennsylvania Computerized Neurobehavioral Test Battery and Autism Spectrum Screening Questionnaire (ASSQ) were used to evaluate social-cognition and neurocognitive characteristics. Several neurocognitive domain values of MDD groups, were significantly different from the control group. Neutral emotion recognition task (p = 0.025) and ASSQ scores were found to be significantly impaired in the patient groups (p < 0.001). Logistic regression analysis showed that, only the increase in the Suicide Probability Scale score was found to be significant as a risk factor predicting suicide (p = 0.007, OR: 1.246). While the neurocognitive and social-cognitive performances of adolescents with MDD were significantly lower than the control group, these performances in the two depression groups were similar. When the predictors of suicidal behavior were examined, it was found that only the increase in suicidal ideation scores predicted suicide.

A Swedish population-based study to evaluate the usefulness of resting heart rate in the prediction of suicidal behavior among males.

Resting heart rate has been distinctly related to both internalizing (high pulse) and externalizing (low pulse) disorders. We aimed to explore the associations between resting heart rate and suicidal behavior (nonfatal suicide attempt [SA] and suicide death [SD]) and evaluate if such associations exist beyond the effects of internalizing/externalizing symptomatology. We used Cox proportional hazards models to evaluate the associations between resting heart rate (age 19) and later SA/SD in 357,290 Swedish men. Models were controlled for internalizing disorders, externalizing disorders, and resilience (the ability to deal with adversity). Co-relative analysis (comparing pairs of different genetic relatedness) was used to control for unmeasured family confounders and improve causal inference. In baseline models, low resting heart rate was associated with SA (HR = 0.96; 95% CI: 0.95,0.98) and high resting heart rate with SD (HR = 1.04; 95% CI: 1.002,1.07). The association with SA remained after adjustment for all confounders (HR = 0.98). However, the association with SD did not persist after controlling for covariates. Co-relative analysis did not support causal associations. Our findings raise interesting etiological questions for the understanding of suicidal behaviors but do not support the usefulness of resting heart rate in suicide prediction.

Attachment Styles as Predictors of Suicidal Behavior in School Going Adolescents

Purpose: Secondary school students face numerous challenges as they balance academic challenges, parental and peer pressures, emotional issues related to puberty changes and adolescence expectations. They also grapple about not knowing what the future holds in terms of career paths. As a result of these challenges, it is common for adolescents to have suicidal thoughts that may lead to suicide attempts.. Suicide is among the leading cause of death in young people and is prevalent worldwide. Suicidal behavior has been associated with attachment security in studies but few of these studies have been done in Kenyan adolescents. This study filled this gap by investigating whether attachment styles predicted suicidal behavior in students attending secondary schools in Nairobi, Kenya.&#x0D; Methodology: The study was correlational in design and was based on the attachment theory. Three hundred and sixty seven randomly selected students completed self-report measures consisting of the Attachment Styles Questionnaire and a Suicidal Behavior Scale.&#x0D; Findings: Results of multiple regression showed that that attachment styles significantly predicted suicidal behavior (F = 36.125, P &lt; .000) and 30% of variance in suicidal behavior was attributed to the attachment styles (R2 = .300). Preoccupied (β = .487, P &lt; .001) and dismissing (β = .122, P = .018) attachment styles predicted suicidal behaviors. &#x0D; Unique Contribution to Theory, Practice and Policy: The contribution to knowledge of this paper is that it provides a theoretical and practical contribution on the importance of attachment styles in predicting suicidal behaviours. The results of the study show that attachment security plays an important role in adolescents’ suicide behavior as insecurely attached students have a higher risk of suicide.Basically, the study contributed to a theoretical enhancement of the current level of knowledge on the existing literature on attachment styles and suicidal behaviours, achieved by testing empirically the adolescent behaviour. Therefore, suicide prevention programs should take into account adolescents’ attachment styles.

Predictors of Suicide Behavior in Adolescents with Depression

The prevalence of teenage suicide has been progressively rising in recent years, posing a significant public health concern that jeopardizes the physical and psychological well-being of adolescents, and potentially their survival. Adolescents who experience depression are at an elevated risk for suicidal behavior. The present study provides a comprehensive overview of the distinct psychological, familial, and socio-environmental factors that contribute to suicidal tendencies among adolescents diagnosed with depression. The aim of this research is to establish a sound empirical foundation for the development of effective strategies to prevent adolescent suicide behavior.

Peripheral Markers of Suicidal Behavior: Current Findings and Clinical Implications.

Biomarkers of suicidal behavior (SB), particularly peripheral biomarkers, may aid in the development of preventive and intervention strategies. The peripheral biomarkers of SB should be easily accessible, cost-effective, and minimally invasive. To identify peripheral biomarkers of SB, we summarized the current knowledge related to SB biomarkers with a focus on suicidal outcomes (suicidal ideation [SI], suicide risk [SR], suicide attempt [SA], and suicide death [SD]), measured site (center or periphery), and study design (cross-sectional or longitudinal). We also evaluated the central findings to validate the findings of peripheral biomarkers of SB. We found reduced peripheral interleukin (IL)-2 levels in individuals with a recent SA, higher cerebrospinal fluid (CSF) IL-6 levels in patients with a current SR and future SD, higher CSF tumor necrosis factor-α levels for current and future SRs, higher high-sensitivity C-reactive protein levels and lower peripheral total cholesterol levels for recent SAs, lower peripheral 5-HT levels for present SR, and a lower folate level for future SR and SA within 1 year. Previous studies have shown inconsistent associations of low peripheral leptin levels with SR and recent SA; therefore, further study is required. Given the multiple determinants of SB and weak associations with single biological markers, combinations of potential biological markers rather than single markers may improve the screening, diagnosis, and prediction of SB.

Can morning affect protect us from suicide? The mediating role of general mental health in the relationship between chronotype and suicidal behavior among students

Although chronotype has been associated with suicidal behavior, current research suggest that this relationship may be mediated by other factors. The aim of this study was to assess whether chronotype, specifically morningness, may predict suicidal behavior and whether this relationship may be mediated by general mental health, depressive and anxiety symptoms, and/or social functioning among young adults.The study group comprised 306 students: 204 (65.8%) women, 101 (32.6%) men and one who chose not to identify with either option (0.3%). The participants completed The Composite Scale of Morningness, The General Health Questionnaire, 30-item version, Suicide Acceptance Questionnaire and The Suicidal Behaviors Questionnaire-Revised. Correlations between the continuous variables of interest revealed a weak, but significant, negative association between morning affect (CSM) and suicidal behavior (SBQ-R); a moderate positive association was found between suicidal behavior (SBQ-R) and depression/anxiety, and a weak one between suicidal behavior (SBQ-R) and interpersonal relations (GHQ-30). The models predicting suicidal behavior, and chronotype-related variables as predictors of suicidal behavior, were then tested. Although the morning affect predicted suicidal behavior, this effect became irrelevant when combined with mental health characteristics: psychopathological symptoms of depression and anxiety and the quality of interpersonal relations.Our findings imply that the role of chronotype is secondary to general mental health: mental disorder symptoms should be considered as the core risk factors for suicide and serve as the focus for suicide risk assessments.

A Suicide-Specific Diagnosis – The Case Against

A Suicide-Specific Diagnosis – The Case Against

Prevalence and predictors of suicidal behaviours among primary and secondary school going adolescents in Botswana.

There is a scarcity of studies on the prevalence and predictors of suicide behaviors among primary and secondary school going adolescents aged 10-19 years in Botswana hence, this study would fill that gap. This study used cross-sectional secondary data from Botswana Youth Risk Behavior and Biological Surveillance Survey (BYRBBSS), 2010. Multivariable binary logistic regression models were used to investigate the predictors of suicide behaviours. The study shows that 51.5% of the respondents reported having ever contemplated suicide while 40.1% of the respondents attempted suicide in the last 12 months before the survey. The study found that male learners (AOR = 0.61, 95% CI = 0.44-0.83), learners who were not attacked or threatened or injured by someone (AOR = 0.35, 95% CI = 0.17-0.72), who were not bullied (AOR = 0.22, 95% CI = 0.13-0.39), and who were confident of themselves (AOR = 0.55, 95% CI = 0.39-0.76) were less likely to contemplate suicide. Whereas learners with primary school level education were more likely to contemplate suicide (AOR = 2.12, 95% CI = 1.14-3.95). Males were less likely than their female counterparts to attempt suicide (AOR = 0.68, 95% CI = 0.47-0.97). Regarding attempt, learners who had self-confidence (AOR = 0.35, 95% CI = 0.24-0.50), not being bullied (AOR = 0.20, 95% CI = 0.11-0.35), not being attacked or threatened or injured by someone (AOR = 0.35, 95% CI = 0.18-0.69), not engaging in a physical fight that led to injury (AOR = 0.34, 95% CI = 0.19-0.61) were less likely to attempt suicide. Whereas being at primary school (AOR = 5.29, 95% CI = 2.58-10.86), and missing classes once or more in a week (AOR = 1.70, 95% CI = 1.05-2.76) were associated with increased likelihood of suicide attempt. The study shows that suicide behaviours as big challenges in Botswana among primary and secondary school going adolescents aged 10-19 years. Thus, the study recommends policy interventions aiming at including education on peer bullying or fighting or attack at primary and secondary education levels if not already in existence. There should also be interventions aiming at educating guardians and teachers on consequences of bullying or fighting so that they should consistently remind their children not to bully and for them to open up if they are being bullied. The study further recommends that schools and communities at large should have a psychosocial system for bullying or fighting reporting, follow-up, and appropriate corrective interventions for the offenders. There should also be self-confidence instilling education as well as sex/gender-specific interventions for instance girls can be given platform (private if necessary) to express peculiar problems to them that need specific help.

Prediction of Suicidal Behaviors in the Middle-aged Population: Machine Learning Analyses of UK Biobank.

Suicidal behaviors, including suicide deaths and attempts, are major public health concerns. However, previous suicide models required a huge amount of input features, resulting in limited applicability in clinical practice. We aimed to construct applicable models (ie, with limited features) for short- and long-term suicidal behavior prediction. We further validated these models among individuals with different genetic risks of suicide. Based on the prospective cohort of UK Biobank, we included 223 (0.06%) eligible cases of suicide attempts or deaths, according to hospital inpatient or death register data within 1 year from baseline and randomly selected 4460 (1.18%) controls (1:20) without such records. We similarly identified 833 (0.22%) cases of suicidal behaviors 1 to 6 years from baseline and 16,660 (4.42%) corresponding controls. Based on 143 input features, mainly including sociodemographic, environmental, and psychosocial factors; medical history; and polygenic risk scores (PRS) for suicidality, we applied a bagged balanced light gradient-boosting machine (LightGBM) with stratified 10-fold cross-validation and grid-search to construct the full prediction models for suicide attempts or deaths within 1 year or between 1 and 6 years. The Shapley Additive Explanations (SHAP) approach was used to quantify the importance of input features, and the top 20 features with the highest SHAP values were selected to train the applicable models. The external validity of the established models was assessed among 50,310 individuals who participated in UK Biobank repeated assessments both overall and by the level of PRS for suicidality. Individuals with suicidal behaviors were on average 56 years old, with equal sex distribution. The application of these full models in the external validation data set demonstrated good model performance, with the area under the receiver operating characteristic (AUROC) curves of 0.919 and 0.892 within 1 year and between 1 and 6 years, respectively. Importantly, the applicable models with the top 20 most important features showed comparable external-validated performance (AUROC curves of 0.901 and 0.885) as the full models, based on which we found that individuals in the top quintile of predicted risk accounted for 91.7% (n=11) and 80.7% (n=25) of all suicidality cases within 1 year and during 1 to 6 years, respectively. We further obtained comparable prediction accuracy when applying these models to subpopulations with different genetic susceptibilities to suicidality. For example, for the 1-year risk prediction, the AUROC curves were 0.907 and 0.885 for the high (>2nd tertile of PRS) and low (<1st) genetic susceptibilities groups, respectively. We established applicable machine learning-based models for predicting both the short- and long-term risk of suicidality with high accuracy across populations of varying genetic risk for suicide, highlighting a cost-effective method of identifying individuals with a high risk of suicidality.

Antisocial traits and neuroticism as predictors of suicidal behaviour in borderline personality disorder: A retrospective study

IntroductionThe spectrum of suicidal behaviour (SB) is nuclear in the clinic and management of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB. MethodsA cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman–Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the χ2 test and the Student’s t-test. The association between variables was analysed using multivariate logistic regression. ResultsStatistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman–Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman–Kuhlman and Barrat tests does not appear to be related to SB. ConclusionsThe results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings.

Prediction of suicidal tendencies using machine learning

Suicide is nowadays a crucial public health issue. In various communities, people are much more affected by this severe tendency. Nowadays, suicide connects to mental illness. Along with depression, drug misuse is an equally important risk factor. Although anxiety, personality, and trauma-related issues, as well as genetic and mental disorders, also equally contributed to this health issue. This research work conducts to find the relation among suicidal tendencies, depression, anxiety, daily stresses, and mental health among all people, including employees, non-employee, students, old age, and all others. Step-by-step multiple linear regression, logistic regression analyses, confusion matrix, and cross-validation use for the data analysis. Suicidal illusions have a significant and positive relation with depression, anxiety, mental stress, and drug use disorder. In this research work regression technique showed that depression is the most crucial feature in the prediction of suicidal behavior, where anxiety, mental health, and daily stresses are the next, followed by respectively. Psychological problems and mental health issues with other factors such as gender problems, marital problems, and hallucinations play a role in suicidal thoughts [1]. Through this research, approximately 84 percent (%) of the data predict correctly.

Mental pain as a predictive risk factor for committing suicide. Mentalization of mental pain

The article examines the concept of mental pain and its potential influence on the decision to commit suicide, as well as the role of the mentalization method in working with patients who are at risk of suicidal behavior. The relationship between the experience of mental pain and the risk of suicide attempts in the short term is described.&#x0D; A brief review of theories and research describing mental pain and the causal relationships between mental pain and suicidal behavior is provided. Mental pain is considered as a prognostic factor of high readiness to commit suicide and as one of the main risk factors, which is taken into account equally with depression, anxiety and feelings of hopelessness.&#x0D; The article briefly reviews additional influencing factors that can be predictors of suicidal behavior, they should be taken into account when assessing the psychological state and can complement the general psychological picture of suicidal risk. But the emphasis is on the key factor of suicidal risk - mental pain.&#x0D; The process of mentalizing is defined and the significance of object relations for the development of the ability to mentalize is considered; emphasis is placed on the impact of a violation of this process on the formation of the ability to monitor, analyze, endure, symbolize experiences and the negative impact on the development of the communication ability to convey messages about one's suffering.&#x0D; The hierarchy of mentalization in terms of the degree of mental processing, the function of mentalization and its various dimensions, as well as possible imbalances that may occur in one or more of its dimensions are described.

Association between childhood physical abuse and suicidal behaviors among Chinese adolescents: The mediation of aggression

BackgroundAlthough previous studies have examined many predictors of suicidal behaviors. However, little is known for childhood physical abuse (CPA) and aggression, which are prevalent among adolescents. This study aimed to explore association between CPA and suicidal behaviors, and the potential mediating role of aggression. MethodA total of 16,111 students graded 7 to 12 were recruited using a stratified cluster sampling across five representative provinces in China. Conflict Tactics Scale-Parents to Child (CTS-PC) and Buss and Warren's Aggression Questionnaire (BWAQ) were used to measure CPA and aggression, respectively. ResultsDuring the last year, 16.0 % of adolescents reported suicidal behaviors. Specifically, 7.9 % were suicide ideators, 4.6 % were planners, and 3.5 % were attempters. The prevalence of CPA in mild, moderate, and severe was 15.7 %, 26.9 %, and 4.4 %, respectively. Multinomial logistic regression indicated that moderate and severe CPA and overall aggression were associated with suicide ideators, planners, and attempters. In five sub-types of aggression, only hostility was significantly associated with all three suicidal behaviors. Structural equation modelling showed that aggression partially mediate the relationship between CPA and suicidal behaviors. The mediation proportion of overall aggression, physical aggression, verbal aggression, anger, hostility, and indirect aggression were 27.2 %, 22.4 %, 5.2 %, 14.2 %, 23.5 %, and 12.1 %, respectively. LimitationsCross-sectional design, self-reported questionnaire, and no other forms of childhood maltreatment. ConclusionsCPA is a critical risk factor of suicidal behaviors among Chinese adolescents and aggression is a mediator between CPA and suicidal behaviors. Targeted suicide prevention should focus on those adolescents who report CPA and aggression, especially for hostility.

Suicidality and Alcohol Use as Predictors of Future Suicidal Behavior in College Students.

There has been a marked increase in suicide fatalities among college-age students in recent years. Moreover, heavy alcohol use, a well-known risk factor for suicide, is present on most campuses. Yet, no prospective studies have examined alcohol use patterns among college students as predictors of suicidal behaviors. Online of 40,335 students at four universities took place at the beginning of four academic years, 2015-2018. Of these, 2296 met criteria for an increased risk of suicidal behavior and completed 1- and/or 6-month follow-up evaluation(s). Baseline assessments included the Alcohol Use Disorders Identification Test to quantify alcohol consumption and resulting problems, and measures of depression, suicidal ideation and suicidal behavior. Suicide attempts during follow-up were reported by 35 (1.5%) of high-risk students. Regression analyses indicated that baseline severity of alcohol use consequences, but not amount of alcohol consumption, was associated with greater odds of a follow-up suicide attempt after controlling for baseline suicidal ideation, functional impairment and history of suicide attempts. Among college students at elevated risk for suicide, the severity of alcohol-related consequences was a significant predictor of future suicide attempts. Alcohol consumption was not a significant predictor, suggesting that the amount students drink is less of a concern for suicidal behavior than are the problems (e.g. failing to meet expectations, experiencing blackouts) associated with drinking.

Bullying and other risk factors related to adolescent suicidal behaviours in the Philippines: a look into the 2011 GSHS Survey

BackgroundsThe present study retrospectively examined gender differences in bullying and suicidal behaviour (ideation, plan, and attempts) as well as associations between selected risk factors and suicidal behaviour among secondary school Filipino students.MethodsThe study used a secondary data set from the GSHS developed by the World Health Organization, which was conducted in the Philippines in 2011. Participants included 5290 Filipino students (male N = 2279, female N = 2986). A two-tailed Chi-square of independence was used to test for gender differences and a multivariate logistic regression model explored statistical associations between risk factors and outcome variables.ResultsChi-square results suggested that gender differences were statistically significant for being bullied χ2 (1, N = 2384) = 10.6, p = .001, experiencing suicidal ideation χ2 (1, N = 857) = 61.7, p = .000, making suicide plans χ2 (1, N = 590) = 10.2, p = .001, and suicide attempts χ2 (1, N = 674) = 8.4, p = .004, with females showing higher vulnerability to examined risk factors. The logistic regression model also suggested that adolescents claiming to have no close friends were three to four times more likely to attempt suicide. Other strong predictors of suicidal behaviours were loneliness and getting in trouble due to alcohol consumption.ConclusionsBullying is an independent yet, not the strongest predictor associated with adolescents’ suicidal behaviour in the present study. The strongest predictors of Filipino adolescents’ suicidal behaviours in the 2011 cohort included having no close friends, loneliness, anxiety and getting in trouble due to alcohol use among both genders. Peer and mental health support programmes need to be made available and accessible for adolescents in the Philippines. Considering the increase in suicide rates in 2020/2021 among Filipino young adults due to the Coronavirus pandemic, it is suggested that preventing suicidal vulnerability in adolescence can hinder this occurrence later on in the lifetime.

Suicide risk management in clinical practice. Current challenges and future perspectives

There is still little reliable information about the psychological processes underlying suicidal behaviour, and suicide risk assessment scales also have only limited predictive value. However, the recently described suicide-specific syndromes such as acute suicidal affective disorder (ASAD) and suicide crisis syndrome (SCS) open up new possibilities for a complex interpretation and prediction of suicidal behaviour. We briefly summarize modern theoretical approaches explaining the development of suicidal behaviour, the possibilities of predicting suicide risk, and contemporary methods of assessing pre-suicidal psychopathological symptoms, highlighting the suicide-specific syndromes and their screening tools. The results of the systematic review of the suicide-specific syndrome literature indicate that both the ASAD construct and the SCS may be helpful in predicting suicidal behaviour and they correlate with other similar questionnaires. Suicide-specific syndromes and the measurement tools are proven to be effective in theoretical research as well as in the field of clinical applicability in the prediction of suicidal behaviour, so their adaptation and application in Hungary may be recommended.

Non suicidal self injury and suicidal behavior among adolescents: co-occurrence and associated risk factors

BackgroundNon-suicidal self-injury (NSSI) and suicidal behavior (SB) are the major public health problems in adolescents. Despite the increased focus on these phenomena, there exist no reliable data in Nepal. This study aimed to determine the prevalence of NSSI and SB among adolescents. Furthermore the study identified the relationship between these two behaviors and assessed demographic, behavioral, and psychological risk factors of NSSI and SB in Nepalese adolescents in a representative sample of the general population.MethodsThe study was conducted among 730 adolescents studying in grade 9 to 12 of public and private schools of Pokhara Metropolitan city, Nepal. Data were collected through self administered standard tools- Functional Assessment of Self Mutilation (FASM) tool, Suicidal Behaviors Questionnaire-Revised (SBQ-R), Rosenberg self-esteem scale (RSES) and Beck Depression Inventory (BDI). Descriptive statistical measures such as frequency, percentage, mean, standard deviation, range were used to assess demographic characteristics and adolescent’s behavior regarding NSSI and suicide. For inferential analysis chi-square and one way ANOVA test was used. Furthermore, to determine the predictors of NSSI and SB, multiple logistic regression analysis was used.ResultsRegarding behavioral characteristics, nearly half of the sample 327 (44.8%) reported a history of NSSI in past 1 year. Furthermore, 25.8% (n = 188) of the overall sample engaged in minor NSSI only and 3.42% (n = 25) engaged in at least one act of moderate/severe NSSI. The mean number of type of NSSI performed was 2.63 ± 1.71. The most common type of NSSI method used were picking at wound (27.3%), biting self (20.3%), pulling hair out (11.8%), cutting self (11.1%). Boys (52.6%) were more likely to be engaged in NSSI than girls (47.4%) (χ2 = 10.298, p = 0.002). Furthermore, among 730 adolescents who completed the SBQ-R questionnaire, 131 (17.9%) had suicidal behaviors (SB) (as defined by SBQ-R a total score ≥ 7). Regarding sex differences female were significantly higher in life time prevalence of suicidal behavior than male (χ2 = 30.26, p = 0.001). Simple Chi-square tests indicated that NSSI was significantly associated with SB (χ2 = 58.16, P < .001). Logistic regressions identified the four significant predictors of NSSI behavior: male, low-level of self-esteem (SE), moderate to severe form of depression and SB. Similarly, significant predictors of SB were: female, low-level of SE, moderate to severe form of depression and NSSI behavior.ConclusionThe prevalence of both NSSI and SB is high in adolescents. Despite the differences between NSSI and SB a significant number of adolescents reported a history of both behaviors. Lower level of SE and moderate to severe depression were the significant predictors of both NSSI and SB. Furthermore, male and adolescents with the history of SB were at risk of NSSI behavior whereas female sex and adolescents with the history of NSSI were at risk of SB.

Prediction of suicidal behavior using self-reported suicidal ideation among patients with bipolar disorder

BackgroundPeople with bipolar disorder have elevated suicide risk. We estimated the ability of the Patient Health Questionnaire (PHQ9) to predict suicide outcomes for outpatients with bipolar disorder. MethodsVisits by adults with bipolar disorder who completed a PHQ9 were identified using electronic health record (EHR) data. Bipolar diagnoses and suicide attempts were ascertained from EHR and claims data, and suicide deaths from state and federal records. Depression severity was assessed via the first eight items of the PHQ9, while suicidal ideation was assessed by the ninth item. Results37,243 patients made 126,483 visits. Patients reported at least moderate symptoms of depression in 49% and suicidal ideation in 30% of visits. Risk of suicide attempt was 4.21% in the subsequent 90 days for those reporting nearly daily suicidal ideation compared to 0.74% in those reporting none. Patients with nearly daily suicidal ideation were 3.85 (95% CI 3.32–4.47) times more likely to attempt suicide and 13.78 (95% CI 6.56–28.94) times more likely to die by suicide in the subsequent 90 days than patients reporting none. Patients with self-harm in the last year were 8.86 (95% 7.84–10.02) times more likely to attempt suicide in the subsequent 90 days than those without. LimitationsOur sample was limited to patients completing the PHQ9 and did not include data on some important social risk or protective factors. ConclusionsThe PHQ9 was a robust predictor of suicide. Suicidal ideation reported on the PHQ9 should be considered a strong indicator of suicide risk and prompt further evaluation.

A longitudinal study of suicide and suicide attempt in northwest of Iran: incidence, predictors, and socioeconomic status and the role of sociocultural status

BackgroundA detailed community-level understanding of socioeconomic status (SES) and sociocultural status (SCS) of suicides and suicide attempters (SAs) in a prospective design could have significant implications for policymakers at the local prevention and treatment levels. The effect of SCS and SES on SAs is poorly understood and investigated in Iran. The present study aimed to investigate the incidence, trend, and role of SES and SCS on suicide and SAs.MethodsA longitudinal study was conducted based on the registry for SAs in Malekan County, Iran, from 2015 to 2018. Demographic characteristics, SES, SCS, incidence rates, and predictors of suicidal behaviors were measured via structured instruments. Simple and multiple logistic regressions were used to estimate crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs).ResultsA total of 853 SAs (32 suicides and 821 attempts) were identified during the study. Trend analysis revealed that the suicide rate significantly decreased from 2014 (10.28) to 2018 (1.75) per 100,000. In the final multiple variable models, age (26–40), male sex, unemployment, antisocial activities, history of SA, hanging method, and season (spring) increased the suicide risk while religious commitment had protective effects on suicide.ConclusionsOur findings indicated that demographic characteristics, low SES, and SCS are associated with suicide. In this county, trend of suicide and SA were decreased from 2014 to 2018. This study findings highlight the need to consider a wide range of contextual variables, socio-demographic, SES, and SCS in suicide prevention strategies. Improving inter-sectoral collaborations and policymakers’ attitudes are imperative for SA reduction.