Presence Of Suicidal Ideation Research Articles

Neuroinflammation, Stress-Related Suicidal Ideation, and Negative Mood in Depression

Brain translocator protein 18k Da (TSPO) binding, a putative marker of neuroinflammatory processes (eg, gliosis), is associated with stress and elevated in depressed and suicidal populations. However, it is unclear whether neuroinflammation moderates the impact of daily life stress on suicidal ideation and negative affect, thereby increasing risk for suicidal behavior. To examine the association of TSPO binding in participants with depression with real-world daily experiences of acute stress-related suicidal ideation and negative affect, as well as history of suicidal behavior and clinician-rated suicidal ideation. Data for this cross-sectional study were collected from June 2019 through July 2023. Procedures were conducted at a hospital-based research center in New York, New York. Participants were recruited via clinical referrals, the Columbia University research subject web portal, and from responses to internet advertisements. Of 148 participants who signed informed consent for study protocols, 53 adults aged 18 to 60 years who met DSM-5 diagnostic criteria for current major depressive disorder completed procedures with approved data and were enrolled. Participants were free of schizophrenia spectrum disorders, active physical illness, cognitive impairment, and substance intoxication or withdrawal at the time of scan. All participants underwent positron emission tomography imaging of TSPO binding with 11C-ER176 and concurrent arterial blood sampling. A weighted average of 11C-ER176 total distribution volume (VT) was computed across 11 a priori brain regions and made up the primary outcome measure. Clinician-rated suicidal ideation was measured via the Beck Scale for Suicidal Ideation (BSS). A subset of participants (n = 21) completed 7 days of ecological momentary assessment (EMA), reporting daily on suicidal ideation, negative affect, and stressors. In the overall sample of 53 participants (mean [SD] age, 29.5 [9.8] years; 37 [69.8%] female and 16 [30.2%] male), 11C-ER176 VT was associated at trend levels with clinician-rated suicidal ideation severity (β, 0.19; 95% CI, -0.03 to 0.39; P = .09) and did not differ by suicide attempt history (n = 15; β, 0.18; 95% CI, -0.04 to 0.37; P = .11). Exploratory analyses indicated that presence of suicidal ideation (on BSS or EMA) was associated with higher 11C-ER176 VT (β, 0.21; 95% CI, 0.01 to 0.98; P = .045). In 21 participants who completed EMA, 11C-ER176 VT was associated with greater suicidal ideation and negative affect during EMA periods with stressors compared with nonstress periods (β, 0.12; SE, 0.06; 95% CI, 0.01 to 0.23; P = .03 and β, 0.19; SE, 0.06; 95% CI, 0.08 to 0.30; P < .001, respectively). TSPO binding in individuals with depression may be a marker of vulnerability to acute stress-related increases in suicidal ideation and negative affect. Continued study is needed to determine the causal direction of TSPO binding and stress-related suicidal ideation or negative affect and whether targeting neuroinflammation may improve resilience to life stress in patients with depression.

MIGRATION RISK OF DEVELOPING PSYCHOSOMATIC DISORDERS IN SOCIALLY PROSPEROUS YOUNG PEOPLE WITH INCREASED NEUROPSYCHIC AND INTELLECTUAL LOAD

RELEVANCE: The relevance of the study is due to the lack of systematic data on the cause-and-effect relationships between the territorial remoteness of the initial and final settlements when changing place of residence with the risk of developing psychosomatic disorders in a person with increased neuropsychic and intellectual stress. AIM: To develop an integrative indicator of the risk of developing psychosomatic disorders in young people when changing their place of residence. MATERIAL AND METHODS: The study involved students of the Volgograd State Medical University, 97 men and 99 women aged 18-22 years. Nonresident respondents accounted for 44% (45 people) of the sample population of men and 60% (61 people) of the sample population of women. The cross-sectional study was carried out in June 2023, during the spring session, 9 months after the start of university studies, and, accordingly, from the moment nonresident students changed their place of residence. The level of systemic maladjustment of respondents was assessed using the I.N. Gurvich test. The indicators of the Giessen Somatic Complaints Questionnaire and indicators of anxiety-depressive disorders (HADS scale) were taken into account, and the presence of suicidal ideation was determined - according to the suicidal ideation module of the Columbia Suicidal Severity Scale (C-SSRS). The distances (km) between the initial and final settlements of the respondents’ place of residence were calculated. RESULTS: A systemic direct statistically significant relationship was identified between the severity of psychosomatic disorders and the distance of migration movement of young people from the place of previous residence to the final point of residence. Four degrees of migration risk have been identified with zero (up to 20 km) and subsequent three (up to 400, up to 800 and over 800 km) territorial ranges of somatization risk. The control critical values of the migration risk indicator for the development of psychosomatic disorders for men and women were calculated, determining that the migration risk of somatization in young people occurs when the territorial distance of the place of residence from the place of previous residence is 400 km or more. CONCLUSION: The connections between the territorial remoteness of the initial and final settlements when changing place of residence, with the risk of developing psychosomatic disorders in a person under conditions of an intense educational process, are characterized.

8768 Initiation of Exogenous Sex Hormones in a Pediatric Gender Clinic

Abstract Disclosure: C.M. Roberts: None. M.M. Knoll: None. G. Robertson: None. A. Egan: None. C. Moser: None. Introduction: The demographics of patients seeking care for gender dysphoria have changed significantly since care was started in 1987. The criteria for prescribing sex hormones have also evolved to allow a greater range of patients to receive gender-affirming hormones. We examined factors associated with prescription of gender-affirming hormones to patients presenting for gender-affirming care our clinic. Methods: Secondary analysis of sex hormone initiation as a minor among 14-17-year-old adolescents diagnosed with gender dysphoria, seen in the pediatric gender clinic between 2/19/2018 and 7/20/2022. We extracted demographic variables, appointment dates, and sex hormone prescription data from our electronic medical record. We collected patient reports of gender identity and suicidal behavior, and parent and adolescent reports of general adolescent well-being, months of gender dysphoria and social transition, and parental support for the adolescent’s gender identity from electronic clinic surveys. Results: We identified 273 adolescent-parent dyads with complete data. Most of our sample were assigned female at birth (74.4%), transgender male (59.3%), and white (83.5%) adolescents who lived in urban (86.4%) and lower-middle-income (64.5%) areas. The average age was 15.9+/-1.1 years. A minority of adolescents reported recent suicidal ideation 60/273 (22%), and prior suicide attempts 20/273 (7%). Parents reported a shorter duration of gender dysphoria (-16.7 months (95%CI: -22.0, -11.5)) and social transition (-4.7: -6.5, -3.0), and higher levels of parental support than adolescents. Approximately half, 146/273 (53.5%), of adolescents started sex hormones. The average age at initiation was 16.5 years +/- 0.9. Age at presentation, length of gender dysphoria or social transition, and the presence of suicidal ideation or attempts were not associated with initiation of sex hormones. Assigned males (OR:1.82:95%CI 1.04, 3.19), adolescents with higher parent-reported parental support for the adolescent’s identity (1.03:1.01, 1.04), and adolescents with private insurance rather than Medicaid (Blue Cross- 5.39:2.73, 10.64) were more likely to start sex hormones as a minor. Conclusion: Published criteria for the initiation of sex hormones among adolescents with gender dysphoria, including age, persistence of dysphoria, and the presence of suicidality, did not predict the prescription of sex hormones to minors in our clinic. Parent-reported support for the adolescent’s gender identity played a small role in predicting the prescription of hormones, but male sex assigned at birth and having private health insurance played larger roles. Further exploration of these findings is needed to ensure equity in the treatment of gender dysphoria. Presentation: 6/3/2024

Measuring psychache as a suicide risk variable: A Mokken analysis of the Holden's Psychache Scale

BackgroundThe Psychache Scale (PAS) is a questionnaire measuring trait-level psychological pain with satisfactory internal consistency and a strong correlation with suicidal ideation severity. However, inconsistent results have been reported for the PAS dimensionality. In the present study we used a non-parametric item response theory model, called Mokken Scale Analysis (MSA), to refine an unidimensional version of the PAS. MethodsThe sample was composed of 400 Italian adults (312 females and 88 males) nonrandomly recruited from the general population. ResultsA final set of 10 items satisfied the unidimensionality, local independence, and monotonicity assumptions, although it did not satisfy the double monotonicity assumption. The internal consistency of the PAS-10 was satisfactory (ordinal alpha = 0.98, ω = 0.97, and AVE = 0.82), and ROC curves analysis indicated good discriminant validity when differentiating participants with higher suicide risk from those with lower suicide risk. LimitationsStructural invariance between nonclinical and clinical samples was not investigated, and the presence of suicide ideation and behaviors was assessed with self-report measures with potential under-reporting of the phenomenon. ConclusionThe PAS-10 resulted to be a potentially valid and unidimensional measure of psychological pain (i.e., psychache) that could be used to screen adults at higher risk for suicide. Future studies are needed to investigate psychometric properties of the PAS-10 in clinical samples and to replicate results in independent samples.

The #BlueWhaleChallenge and presence of suicidal ideations on Polish-language Twitter

ABSTRACT Objective The Blue Whale Challenge (BWCh), widely reported as a media hoax in 2017, was allegedly an online game encouraging teenagers to commit suicide. Method Google Trends identified the peak interest in the BWCh in March 2017. Tweets containing ‘suicide’ were analyzed, with each tweet reviewed for personal suicidal content. Data on suicide attempts and deaths were sourced from the National Police Headquarters, while hospital admissions data (ICD-10 codes F00-F99 and T36-T65) was collected from the Hospital Morbidity Survey. Crisis helpline data for children and adolescents (116 111) was also gathered. Results Between January 24 and April 10, 2017, 17,063 tweets containing ‘suicide’ were posted, with 240 identified as personal suicidal content: 65.7% expressed suicidal thoughts, 11.7% plans, and 1.3% encouragement. In April 2017, suicide deaths were higher among 19–24-year-olds compared to April 2018, while suicide attempts were lower among 13–18-year-olds compared to April 2019. No significant increase in suicide attempts was found during the BWCh period for individuals aged 0-18. Hospital admissions for T36-T65 codes peaked in 2017 for the 5–14 age group. Crisis helpline data showed decreasing phone calls and increasing chat messages from 2015 to 2020. Discussion There is no definitive link between BWCh popularity and a rise in suicidal behaviour nationwide. Despite widespread media coverage, there was no noticeable surge in suicide statistics. This study highlights the prevalence of harmful suicidal content on Twitter, emphasising the importance of mental health promotion, prevention, and support for social media users.

Representación del riesgo suicida y su exploración en una simulación realizada por estudiantes de Medicina

IntroductionExploring suicide risk is a fundamental skill for medical professionals. However, university medical education typically does not include enough formal training in this area. Simulation has been used as a method for learning this skill, although most studies using this pedagogic tool focus on analysing changes in self-perceived capabilities and attitudes after receiving specific training on suicide. MethodsA formative assessment task was carried out, consisting of recording a video in which groups of final-year medical students conducted a general psychiatric assessment with a simulated patient. The patient's diagnosis, suicide risk assessment, and exploratory questions were chosen by the students. Videos recorded over one term were studied. The chosen suicide risk assessment and exploratory questions regarding suicide risk were analysed independently and in relation to the chosen diagnosis. ResultsOut of 34 videos recorded, in 70% of those where suicide risk was explored, there was no suicidal ideation, and none had active suicidal ideation. Suicide risk was explored in 88% of the videos, but only 23.5% directly asked about the presence of suicidal ideation. ConclusionsThe task helped students integrate the importance of exploring suicide risk. The proportion of suicidal risk represented, and the exploratory questions, highlight the need to implement additional training interventions that focus on knowledge and stigma towards suicide.

Analysis of factors related to the use of Korean medicine treatment in adult patients with depressed mood: Based on the Korea Health Panel Annual Data 2019

Objectives: This study analyzed the factors related to outpatient service to Western medicine (WM) and Korean medicine (KM) of Korean adults with depressed mood using data from the 2019 Korea Health Panel Study.Methods: The general characteristics according to group of 827 individuals, and the factors influencing the use of integrative medicine (IM) medical service were identified using the Chi-square test and binary logistic regression results. The factors were classified based on the Andersen healthcare utilization model. The results of regression analysis were presented as odds ratio (OR) and 95% confidence interval (CI).Results: Among the individuals of the study, 658 (79.6%) were in the WM group and 169 (20.4%) were in the IM group. In the WM group and the IM group, the presence of suicidal ideation was common at 37.7% and 43.2%, respectively. As a result of regression analysis, the living in Busan/Daegu/Ulsan/Gyeongsang compared to living in Seoul/Gyeonggi/Incheon [OR = 0.522 (95% CI = 0.328 to 0.830)], and presence of musculoskeletal [OR = 1.686 (95% CI = 1.071 to 2.653)] and mood disorders [OR = 1.737 (95% CI = 1.106 to 2.726)] were the most influential factors on the use of IM medical service.Conclusions: This study is the first in Korea to analyze the patterns of medical institution use and factors used in KM treatment among adults with depressed mood. The results of this study provide preliminary evidence for the contribution of KM to national mental health in the context of depression.

Clinical features and factors related to suicidal ideation in adult patients with benzodiazepine use disorder

IntroductionBenzodiazepine use disorder (BUD) has been associated with the presence of suicidal ideation (SI) in general population. It seems there is an overall increase in the risk of attempting suicide due to the increase of impulsivity, rebound and withdrawal of those who use benzodiazepines(1). However, this association has been scarcely studied.ObjectivesTo explore the prevalence, clinical features and factors related to lifetime SI in adults with BUD.MethodsA cross-sectional study was conducted in an outpatient center for addiction treatment between 01/01/2010 and 12/31/2021. Adult patients who met criteria for active BUD were included. Patients with language barriers, cognitive impairments and those who were participating in any clinical trial were excluded. All patients were evaluated with an ad-hoc questionnaire, EuropASI (European Addiction Severity Index), BDI (Beck Depression Inventory) and HRQoL SF-36 (Health-related quality of life according to SF-36). Univariate and bivariate analyses were performed comparing BUD patients with or without SI.Results554 patients were included (65.2% males; M age 42.6±12.6 years). SI was reported in 57.2% of the patients. Regarding the sociodemographic variables, any type of lifetime abuse was correlated with SI (67.8%, 73.5% and 77.8% of the patients with emotional, physical and sexual abuse respectively). Considering the different psychiatric features studied, having any psychiatric diagnosis increased SI up to 64%. Depressive and cluster B personality disorders were the ones with a higher presence of SI (67.1% and 68.1% respectively). Anxiety and cluster A personality disorders had also higher proportions of SI (56.1% and 58,7% respectively). Regarding the different assessment instruments used, a higher punctuation on BDI score was seen in the group of patients with SI (23.73±12.86). The scores also showed a worse perception of the mental quality of life of those people with SI, measured by HRQoL (13.76 and 36.82±31.93 in patients with SI and no SI respectively). Considering the EuropASI, there was an increased proportion of SI in those patients with a worse familiar situation (0.44±0.30), a higher alcohol consumption (0.26±0.28) and a worse psychological condition (0.48±0.24).ConclusionsThe prevalence of SI in patients with BUD is significative and is related to several clinical factors. Those factors should be taken into account in daily clinical practice, research, and any health policies on suicide. Further research should be developed.1. Dodds, T.J. ‘Prescribed benzodiazepines and suicide risk’, The Primary Care Companion For CNS Disorders 2017; 19(2).Disclosure of InterestNone Declared

The relationship between sleep problems and suicidality in Bipolar Disorder: a Systematic Review and a Meta-analysis

IntroductionBipolar disorder (BD) is a multifaceted illness encompassing mood, energy, cognitive and biorhythms alterations. Sleep disturbances are common in prodromic, acute and inter-episodic phases of BD. Suicidality presents a known association with sleep disturbances. However, their interplay in BD remains intricate and not fully elucidated.ObjectivesThe aim of the present systematic review (SR) and meta-analysis (MA) is to summarise the available evidence and to provide an estimate of the association between sleep disturbances and suicidality, defined as presence of suicide ideation, behaviour and suicide attempts, in patients with BD.MethodsWe conducted a comprehensive literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across PubMed, PsycINFO, and SCOPUS databases. We included all studies reporting an association between sleep problems and suicidal behaviour in BD patients. No language restriction was imposed. Effect sizes were calculated as odds ratio (OR) for dichotomic variables, standard mean difference (SMD) for continuous outcomes, and Spearman’s coefficient (r) for correlations. Heterogeneity was assessed using the I2 statistic. Global inconsistency was evaluated using the Q statistics with the corresponding p-value.ResultsThe initial search yielded 911 unique abstracts, of which 62 underwent full-text screening. Fourteen publications were included, comprising twelve cross-sectional and two longitudinal studies. The total sample consisted of 19,601 subjects diagnosed with BD, of which 51.76% were females and 69.52% had a diagnosis of BD type 1. We found that people with BD and sleep disturbances tend to have higher suicidality, both current (SMD=0.79, 95%CI=0.53, 1.05) and lifetime (OR=1.8; 95%CI=1.41, 2.55), when compared with people with BD and no sleep disturbances. Additionally, patients with BD and a history of suicide attempts tend to have more sleep problems (OR=1.37, 95%CI=1.21, 1.55). Moreover, a positive correlation exists between suicidality and poor sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) (r= 0.24, 95%CI=0.10, 0.36). No heterogeneity was found, except in the subanalysis of correlation (I2=66.67%, Q p-value=0.01).ConclusionsOur SRMA outlines a positive relation between sleep disturbances and suicidality in patients with BD. The small number of included studies and the scarcity of longitudinal studies, preventing the inference of a causal relationship, represent the major limitations of this study. Also, studies with objective measures of sleep alterations are currently lacking. The prompt recognition, objective measurement, and treatment of sleep alterations could be crucial in averting or reducing suicidal attempts in BD.Disclosure of InterestC. Possidente: None Declared, M. Bort: None Declared, M. De Prisco: None Declared, V. Oliva: None Declared, G. Fico Grant / Research support from: Fellowship from “La Caixa” Foundation (ID 100010434 - fellowship code LCF/BQ/DR21/11880019), L. Bracco: None Declared, C. Sommerhoff: None Declared, L. Montejo: None Declared, A. Murru Grant / Research support from: Spanish Ministry of Science and Innovation (PI19/00672, PI22/00840) integrated into the Plan Nacional de I+D+I and co-financed by the ISCIII-Subdireccion General de Evaluacio ́n and the Fondo Europeo de Desarrollo Regional (FEDER), E. Vieta Grant / Research support from: Spanish Ministry of Science and Innovation (PI18/ 00805, PI21/00787) integrated into the Plan Nacional de I+D+I and cofinanced by the ISCIII-Subdireccio ́n General de Evaluacio ́n and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357; the European Union Horizon 2020 research and innovation program (EU.3.1.1. Understanding health, wellbeing and disease: Grant No 754907 and EU.3.1.3. Treating and managing disease: Grant No 945151).

Sleep disturbance and suicidal ideation among youth with depression

BackgroundSleep disturbance may exacerbate the risk of suicide among youth with depression, but whether this association is independent of psychopathology requires further study. MethodsThis cross-sectional study included 576 youths (13–25 years old) recruited from January 2022 to May 2023. The patients were first divided into two groups by the presence of suicidal ideation according to the Columbia-Suicide Severity Scale (C-SSRS). Sleep quality was assessed by the Athens Insomnia Scale (AIS) and mental health with the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA). Logistic regression was conducted to analyze the association between sleep disturbance and suicidal ideation, adjusted for depressive symptoms severity. ResultsThe suicidal ideation group exhibited more severe sleep disturbances, anxiety symptoms, and depressive symptoms than the non-suicidal ideation group. Pearson correlation showed that sleep disturbance (AIS) was significantly correlated with the severity of anxiety symptoms, depressive symptoms, and suicidal ideation. Logistic regression analysis revealed that the AIS factor “daytime dysfunction” (β = 0.145; OR = 1.156, 95 % CI: 1.02, 1.309; p = 0.023) was significantly associated with suicidal ideation after adjusting for demographic characteristics and depressive symptoms severity. LimitationsDue to the cross-sectional nature of the data, no causal inference can be made regarding the observed associations between sleep disturbance and suicidal ideation. ConclusionSleep disturbance, particularly in the realm of daytime dysfunction, is associated with increased suicidal ideation among depressed youth. Clinicians need to assess and manage sleep disturbance in the context of suicidal ideation for young depression patients.

Exploring Narcissism in Suicidal Ideation Using the Italian Version of the Guilt and Shame Proneness Scale.

Several theoretical and clinical observations lead to the hypothesis that pathological narcissism could be associated with suicide ideation due to the difficulty in regulating shame in a functional way. The present study investigated the roles of guilt, shame and rivalry in the relationship between pathological narcissism and suicidal ideation. A set of self-report questionnaires was completed by a sample of 936 Italian adults. These included the Italian version of the Guilt and Shame Proneness (GASP) scale, the Pathological Narcissism Inventory, the Beck Scale for Suicidal Ideation, and the Narcissism Admiration and Rivalry Questionnaire. A structural equation model that tested the factorial structure of the GASP and its invariance produced satisfactory results. Moreover, shame was a significant factor in the relationship between narcissism grandiosity and suicidal ideation. However, beta regression coefficients were low. These findings suggest that despite clinicians should consider the presence of suicidal ideation in patients with pathological narcissism and their maladaptive regulation of shame, the relationship between these variables is complex and deserve further investigation.

Brain and blood transcriptome profiles delineate common genetic pathways across suicidal ideation and suicide

Human genetic studies indicate that suicidal ideation and behavior are both heritable. Most studies have examined associations between aberrant gene expression and suicide behavior, but behavior risk is linked to the severity of suicidal ideation. Through a gene network approach, this study investigates how gene co-expression patterns are associated with suicidal ideation and severity using RNA-seq data in peripheral blood from 46 live participants with elevated suicidal ideation and 46 with no ideation. Associations with the presence of suicidal ideation were found within 18 co-expressed modules (p < 0.05), as well as in 3 co-expressed modules associated with suicidal ideation severity (p < 0.05, not explained by severity of depression). Suicidal ideation presence and severity-related gene modules with enrichment of genes involved in defense against microbial infection, inflammation, and adaptive immune response were identified and investigated using RNA-seq data from postmortem brain that revealed gene expression differences with moderate effect sizes in suicide decedents vs. non-suicides in white matter, but not gray matter. Findings support a role of brain and peripheral blood inflammation in suicide risk, showing that suicidal ideation presence and severity are associated with an inflammatory signature detectable in blood and brain, indicating a biological continuity between ideation and suicidal behavior that may underlie a common heritability.

Teacher Experience of Guidance and Counseling in Treating Youth with Cyberbullying Case

Background: Cyberbullying in adolescents may cause depression, decreased academic achievement, withdrawal from the environment, family and the presence of suicidal ideation. The success of teachers in dealing with cyberbullying is unknown.Objective: To explore the Guidance and Counseling Teachers experience in dealing with adolescents with cyberbullying incidents.Methods: This study used a qualitative descriptive approach with a phenomenological approach and data were collected through in-depth interviews with 8 Guidance and Counseling Teachers who deal with adolescents with cyberbullying incidents. Data analysis in this study used the Colaizzi method.Results: In this study, there were five essential themes in this research including cyberbullying is not a serious problem, various problems faced in dealing with cyberbullying, emotional responses to cyberbullying victims, cyberbullying victims are weak emotional mentality students and lack of coordination between parents, teachers subjects and Guidance and Counseling teachers.Conclusion: The problem of cyberbullying has considered as unserious problem and there is a lack of coordination between parents, subject teachers and guidance and counseling teachers. So that special training is needed to deal with cyberbullying, there are guidelines, clear cyberbullying prevention strategies and the existence of government agencies that specifically handle cyberbullying case.

Prevalence and correlates of suicidal ideation in the general public during the fifth wave of COVID-19 pandemic in Hong Kong.

Literature reveals increased suicidal ideation in the general population during pandemic. However, few COVID-19 studies comprehensively assessed factors associated with suicidal ideation, and mixed findings were observed. We aimed to examine prevalence and correlates of suicidal ideation in general public during the peak of fifth COVID-19 wave in Hong Kong based on a broad array of relevant measures. This survey assessed 14,709 community-dwelling adults during March 15-April 3, 2022. Comprehensive assessment was administered including socio-demographics, pre-existing mental/physical morbidity, mental-health symptoms, resilience, loneliness, coping strategies, and pandemic-related factors. Presence of suicidal ideation was evaluated by ratings of item 9 on Patient-Health-Questionnaire-9. A total of 2,249 (15.3%) participants exhibited suicidal ideation. Multivariable-regression analysis found that being single and unemployed, pre-existing mental disorder, more severe depressive and anxiety symptoms, higher levels of loneliness and engagement in avoidant coping were significantly associated with suicidal ideation. Conversely, attaining tertiary educational level or above, greater resilience and adopting problem-focused coping were associated with lower likelihood of suicidal ideation. Although univariate-analyses revealed that a number of pandemic-related factors were linked to suicidal ideation, none remained significant in the multivariable model. A significant proportion of people experienced suicidal ideation during the peak of fifth COVID-19 wave. Risk and protective factors identified would facilitate early identification of high-risk individuals and provision of targeted interventions to minimize suicidal ideation and risk of self-harm. Caution should be exercised due to study limitations of a cross-sectional design which precluded establishing causality among variables, and reliance on self-reported data.

The mediating effect of dysmorphic concern in the association between avoidant restrictive food intake disorder and suicidal ideation in adults

BackgroundReflecting on the existing literature on suicidal ideation and Avoidant/Restrictive Food Intake Disorder (ARFID), this article investigates the complex relationship between them, hypothesizing about the possibility of dysmorphic concerns, being a mediator linking ARFID to suicidal ideation.MethodsUsing a snowball sampling approach, a survey was created on Google Forms and circulated across messaging applications and social media networks (WhatsApp, Instagram, Messenger). The sample involved 515 participants recruited between February and March 2023. The questionnaire included the following scales: Nine-items Avoidant/Restrictive Food Intake Disorder screen (NIAS), Dysmorphic Concern Questionnaire (DCQ), and Columbia-Suicide Severity Rating Scale (C-SSRS). When filling the questionnaire, respondents were warned that they can experience distress when answering certain questions and received information about mental health services. Five hundred fifteen adults participated in this study, with a mean age of 27.55 ± 10.92 years and 60.1% females.ResultsAfter adjusting over potential confounders (i.e., age, education, marital status, and household crowding index), analyses showed that dysmorphic concerns fully mediated the association between avoidant restrictive eating and suicidal ideation. Higher avoidant restrictive eating was significantly associated with more dysmorphic concerns, and higher dysmorphic concerns were significantly associated with the presence of suicidal ideation. Finally, avoidant restrictive eating was not significantly associated with suicidal ideation.ConclusionThis study highlights the potential indirect link between ARFID and suicidal ideation mediated by dysmorphic concerns. While no direct connection was observed between ARFID and suicidal ideation, the presence of dysmorphic concerns appeared to be a crucial factor in amplifying the risk of suicidal ideation in individuals with ARFID. This emphasizes the importance of addressing dysmorphic concerns alongside ARFID treatment to enhance mental health interventions and outcomes.

Characterization of Psychiatric Inpatients: The Role of Gender Differences in Clinical and Pharmacological Patterns.

Severe mental disorders that require hospitalization are disabling conditions that contribute to the burden of mental diseases. They pose increased clinical challenges and highlight the need to thoroughly explore variables emerging from daily clinical practice. In this study, we assessed to what extent gender differences may characterize a large population of psychiatric inpatients. We conducted a cross-sectional study in 2 Italian teaching medical centers, which included 2358 patients who were consecutively admitted to the psychiatric emergency units. We explored and characterized gender differences for variables such as prevalence of psychiatric diagnosis, presence of suicidal ideation, suicide attempts, age at onset of psychiatric illness, presence of substance or alcohol abuse, length of stay, number of hospitalizations, presence of involuntary admission, type of discharge from the hospital, and pharmacological treatment at discharge. Female patients were primarily diagnosed with bipolar disorder or personality disorders. Female patients had a significantly higher prevalence of lifetime suicide attempts (23.1% vs. 16.5%, P<0.001) and a longer length of hospitalization (11.43±10.73d vs. 10.52±10.37d, t=-2.099, gl=2356, P=0.036) compared with male patients. Male patients had more involuntary admissions (25.1% vs. 19.7%, χ2=9.616, gl=1, P=0.002), more use of illicit substances (34.1% vs. 20.9%, χ2=51.084, gl=1, P<0.001), and higher rates of alcohol abuse (21.3% vs. 14.7%, χ2=17.182, gl=1, P<0.001) compared with female patients. Finally, antidepressants and lithium were prescribed more frequently to the female patients, whereas other mood stabilizers were more often prescribed to the male patients. Our real-world results highlighted gender differences among patients with severe mental disorders admitted to psychiatric units, and suggest further investigations that may help in understanding trajectories accompanying disabling clinical conditions.

FC43: Particularities of late-life psychosis: from epidemiology to treatment option

Objective:Psychotic disorders are not infrequent in late life and involve massive costs to society, affecting individuals and their caregivers. The epidemiology of late-life psychosis remains imprecise and despite its high prevalence, it remains a diagnostic and treatment dilemma. The aim of this article is to review the current literature regarding late-onset psychosis and whether it is recognized as a clinical entity on itself, differing from early-onset psychosis.Methods:Review of the most recent literature regarding late-onset psychosis its clinical and epidemiological particularities. The research was carried out through the PubMed and UptoDate databases, using the terms “late-onset psychosis”, “late-life psychosis”, “dementia” and “elderly”.Results:Late-life psychotic disorders may originate in an intricate interaction between several biological, psychological, social, and environmental factors. These may include functional status, other physical diseases, hospitalizations, physical activity, and stability of care. Some authors refer that older age, and the presence of suicidal ideation were associated with incident late-life psychosis. Assuming the significant load associated with psychotic disorders in late life, their assessment should identify the potential causes and distinguish predictive factors. Treatment should include a combination of nonpharmacological approaches and psychotropic medications, used cautiously.Conclusion:Late-life psychosis differs from early-onset psychosis on several characteristics. The treatment must be directed towards the cause and adapted to each individual. Non-pharmacologic interventions are frequently used as first line treatment, and pharmacotherapy must be used carefully. The crescent number of senior population must alert to this entity and the specificity of its approach.

Investigation of the Relationship of Suicidal Ideation and Suicide Attempt History with Early Maladaptive Schemas in Individuals with Major Depressive Disorder

Objective: We aimed to examine the relationship between the presence of suicidal ideation and attempt history and maladaptive schemas in individuals with major depressive disorder.&#x0D; Materials and methods: The experimental group consisted of 28 individuals were diagnosed with major depressive disorder, had a history of suicide attempt and active suicidal ideation. 26 individuals who did not have active suicidal ideation and any history of suicide attempt constitute the control group. Sociodemographic data form, Beck Anxiety Scale, Beck Depression Scale, Beck Suicidal Ideation Scale and Young Schema Scale-Short Form-3 were administered to the participants.&#x0D; Results: The groups differed in terms of all scale scores (p

Suicidal ideation in female individuals with fibromyalgia and comorbid obesity: prevalence and association with clinical, pain-related, and psychological factors.

Individuals with fibromyalgia report alarming levels of suicidal ideation, and comorbidity with other chronic health conditions such as obesity-a risk factor for suicidal ideation per se-could further complicate the clinical picture. The aim of this study is to determine, in a sample of women with fibromyalgia and comorbid obesity, the prevalence of suicidal ideation and to evaluate clinical, pain-related and psychological factors associated with suicidal ideation. In total, 156 female individuals with fibromyalgia and obesity were recruited and completed a series of self-report measures that assessed (i) the level of pain intensity, (ii) depressive symptomatology, (iii) sleep quality, and (iv) pain catastrophizing. Suicidal ideation was evaluated by item #9 of the Beck Depression Inventory. In addition, information regarding previous suicide attempts and current opioid use was collected. 3n sum, 7.8% of participants reported presence of suicidal ideation. According to the results of the multiple logistic regression, depressive symptomatology, sleep quality, and pain catastrophizing were associated with the presence of suicidal ideation. The presence of suicidal ideation in our sample was significantly associated with depressive symptomatology, sleep quality, and pain catastrophizing. Our findings are the first to suggest a unique (ie, independent of depressive symptomatology, and sleep quality) association between pain catastrophizing and suicidal ideation in the context of fibromyalgia and comorbid obesity. In order to prevent and reduce suicidal ideation, these factors should be assessed and targeted in interventions for pain management. Future research should investigate the extent to which addressing depressive symptoms, sleep quality, and pain catastrophizing reduces suicidal ideation.

Association of interleukin-6 with suicidal ideation in veterans: a longitudinal perspective.

Studies showing associations between inflammation in suicide are typically cross-sectional. Present study investigated how cytokine levels track with suicidal ideation and severity longitudinally. Veterans with a diagnosis of major depressive disorder (MDD) with or without suicide attempt history (MDD/SA n = 38, MDD/NS n = 41) and non-psychiatric non-attempter controls (HC n = 33) were recruited, MDD/SA and HC groups were followed longitudinally at 3 months and 6 months. Blood plasma was collected and processed using Luminex Immunology Multiplex technology. Significant differences in depression severity (BDI) and suicidal ideation severity (SSI) were observed across all groups at study entry, wherein MDD/SA group had the highest scores followed by MDD/NS and HC, respectively. Cytokines IL-1β, IL-4, TNF-α, IFN-γ, and IL-6 were examined at study entry and longitudinally, with IL6 levels differing significantly across the groups (p = 0.0123) at study entry. Significant differences in changes in cytokine levels between depressed attempters and the control group were detected for IL-6 (interaction F1,91.77 = 5.58, p = 0.0203) and TNF-α (F1,101.73 = 4.69, p = 0.0327). However, only depressed attempters showed a significant change, in IL-6 and TNF-α levels, decreasing over time [IL-6: b = -0.04, 95% CI = (-0.08, -0.01), p = 0.0245 and TNF-α: b = -0.02, 95% CI = (-0.04, -0.01), p = 0.0196]. Although IL-6 levels were not predictive of suicidal ideation presence [OR = 1.34, 95% CI = (0.77, 2.33), p = 0.3067], IL-6 levels were significantly associated with suicidal ideation severity (b = 0.19, p = 0.0422). IL-6 was not associated with presence of suicidal ideation. IL-6 however, was associated with severity of ideation, suggesting that IL-6 may be useful in clinical practice, as an objective marker of heightened suicide risk.