Presence Of Suicidal Thoughts Research Articles

The screening accuracy of the Edinburgh Postnatal Depression Scale (EPDS) to detect perinatal depression with and without the self-harm item in pregnant and postpartum women

Background This study aims to examine whether the Edinburgh Postnatal Depression Scale (EPDS), excluding the self-harm item (EPDS-9), performs as effectively as the full EPDS in identifying depression among perinatal women. Methods A total of 3571 pregnant women and 3850 postpartum women participated in this observational study. Participants who scored ≥ 9 on the EPDS underwent further diagnostic evaluations by a clinical psychologist and/or psychiatrist. Results The EPDS-9 and full EPDS demonstrated a near-perfect correlation in both the antepartum (r = 0.996) and postpartum (r = 0.998) cohorts. EPDS-9 showed exceptional precision in identifying depression as screened by the full EPDS at cutoff points ranging 9–14, with areas under the curve ≥0.998. The sensitivity of EPDS-9 and full EPDS to detect depression that requires psychotropic medications was poor. The highest accuracy for both versions was at a cutoff score of 9: sensitivity of 0.579 for the full EPDS and 0.526 for the EPDS-9. At the cutoff point of 9, EPDS-9 performed adequately in predicting the response of the participants to the self-harm item. Conclusion The EPDS-9 represents a solid and effective replacement for the full EPDS in clinical settings. If the presence of suicidal thoughts needs to be assessed, specialized scales should be used.

Women in acute forensic psychiatric care: comparison of clinical, sociodemographic, and detention-related characteristics in pretrial detention, sentence execution, and court-ordered treatment

Compared to men inmates, women display decreased prevalence of severe mental disorder but increased occurrence of substance use disorders (SUD) and higher rates of previous contacts with mental health services. The group of women in detention is highly heterogeneous according to the status of incarceration (pre-trial detention (PTD), sentence execution (SE) and court ordered treatments (COT)). Studies focusing on the comparison of sociodemographic patterns, detention-related and clinical variables between these groups are still lacking. We explored these parameters in 136 women admitted for acute psychiatric care in the sole Geneva forensic unit during a nine year period (2014–2023). Sociodemographic and detention-related data included age, nationality, marital status, presence of children, education attainment, most frequently speaking language, social support, employment before conviction and type of offenses. Clinical variables included the main ICD-10 diagnosis, presence of concomitant SUD, type of personality disorders, presence of suicidal thoughts and attempts at admission, as well as number and mean duration of stays. PTD and SE women had at least 9 years of formal education in 38.9% and 30.3% of cases. Most women in PTD (77.7%), SE (56.6%) and COT (56.2%) groups were Swiss or European citizens. The level of French knowledge was excellent in most of the cases. 43.8% of COT women had at least one child and this percentage is even higher for PTD and SE cases. The employment rate before conviction was also quite high, mainly for PTD and SE (61.1% and 60.6%) and, in a lesser degree, for COT (43.8%) women. Significant social support was present in the vast majority of women without any significant group difference. The distribution of type of offenses did not differ between the three types of detention with a predominance of physical violence, and drug trafficking. The number of stays during the period of reference was significantly higher in COT compared to both SE and PTD women. History of previous inpatient care was also significantly more frequent in COT that SE and PTD women. Adjustment and affective disorders were more often found in SE and PTD cases, these diagnoses were absent in the COT group. In contrast, a main diagnosis of psychotic disorders was found in 62.5% of COT cases compared to only 21.2% in SE and 24.1% in PTD cases. The number of stays, history of inpatient care and diagnosis of psychosis were independent predictors of COT status. In conclusion, the present data reveal the good social integration and emotional support of women needing acute psychiatric care in prison independently of the type of detention. Clinically, women in PTD and SE display more often emotional distress whereas those in COT suffer from acute psychotic symptoms with previous history of psychiatric care and multiple inpatient stays.

Adolescents Exposed to Cumulative Natural Disasters: A Comparison Between their Realities in Rural and Urban Areas

Introduction:Over the past years, the Outaouais region (Quebec, Canada) and their residents have had to endure no less than five natural disasters (floods, tornadoes). These disasters are likely to have a variety of consequences on the physical and mental health of adolescents, as well as on their personal, family, school and social lives. The experiences of teenagers are also likely to vary depending on whether they live in rural or urban areas.Method:Data were collected via a self-administered questionnaire in February 2022. A total of 1307 teenagers from two high schools participated in the study by completing an online survey. The questionnaire measured various aspects of the youth's mental health using validated tests, such as manifestations of post-traumatic stress, anxiety and depression, as well as the presence of suicidal thoughts and self-harm. Other aspects of the youth's experience were measured, including their level of social support, school engagement, alcohol and drug use, and coping strategies.Results:One third of young students (n=1307) were experiencing depressive symptoms and suicidal thoughts, as well as significant daily stress. More than 25% of the students had moderate or severe anxiety and thoughts of self-harm. These problems were significantly more prevalent among youths with prior exposure to a natural disaster. The study data also revealed that youths living in rural areas had a more worrying profile than those living in urban areas.Conclusion:Similar to other studies (Ran et al., 2015; Stratta et al., 2014), our research data revealed that youths living in rural areas presented a more concerning profile than those residing in urban areas. It therefore seems important, in future studies and services, to focus more specifically on these teenagers to better understand their needs and to develop adapted services more likely to meet them.

Interactions between mood and paranoid symptoms affect suicidality in first-episode affective psychoses.

Suicide prevention is a major challenge in the treatment of first-episode affective psychoses. The literature reports that combinations of manic, depressive and paranoid symptoms, which may interact, are associated with an increased risk of suicide. The present study investigated whether interactions between manic, depressive and paranoid symptoms affected suicidality in first-episode affective psychoses. We prospectively studied 380 first-episode psychosis patients enrolled in an early intervention programme and diagnosed with affective or non-affective psychoses. We compared intensity and presence of suicidal thoughts and occurrence of suicide attempts over a three-year follow-up period and investigated the impact of interactions between manic, depressive and paranoid symptoms on level of suicidality. At 12months follow-up, we observed a higher level of suicidal thoughts and higher occurrence of suicide attempts among the affective psychoses patients compared to non-affective psychoses patients. Combined presence of either depressive and paranoid symptoms, or manic and paranoid symptoms, was significantly associated with increased suicidal thoughts. However, the combination of depressive and manic symptoms showed a significant negative association with suicidal thoughts. This study suggests that paranoid symptoms combined with either manic or depressive symptoms are associated with an increased risk of suicide in first-episode affective psychoses. Detailed assessment of these dimensions is therefore warranted in first-episode affective patients and integrated treatment should be adapted to increased suicidal risk, even if patients do not display full-blown depressive or manic syndromes.

The impact of COVID-19 pandemic on the healthcare workers mental health

IntroductionThe COVID-19 pandemic represents an unprecedented in health events that has had a negative impact on the mental health of the population in general as well as on specific categories, including patients with mental and physical disorders, and healthcare professionals. In particular, COVID-19 pandemic has produced extraordinary stress in healthcare workers, especially frontline physicians, nurses and healthcare professionals.ObjectivesIn the present study we aimed to evaluate levels of burnout, a clinical condition characterized by emotional, psychological and physical exhaustion, in a sample of health workers from the Campania region, Italy, during the first phase of the COVID-19 pandemic. Secondary objectives of the study include the assessment, in the same group, of levels of anxiety-depressive symptoms, insomnia, suicidal ideation and symptoms on the post-traumatic spectrum.MethodsAn online survey was released through the official website of the University of Campania “L. Vanvitelli” and social media. The Maslach Burnout Inventory was used to assess burnout in the healthcare professionals; Depression Anxiety Stress Scale-21 Short Version to measure levels of anxiety, depression and stress; the Insomnia Severity Index was used to identify insomnia-related symptoms; the Suicidal Ideation Attributes Scale was adopted to select individuals based on the presence of suicidal thoughts while the Impact of Event Scale-Revised was administered to evaluate trauma-related dimensions.ResultsA total of 389 health workers was recruited. They were predominantly female, with an average age of 39.06 (± 11.85) years, working mainly in the second line hospitals during the COVID-19 emergency. During the pandemic, first- or second-line health workers reporting significant levels of emotional exhaustion are on average 23,89 (±4.22), those reporting feelings of depersonalization are on average 7.58 (±2.73), while those who report a good level of professional efficiency are on average 21.12 (±3.48).Predictors of increased levels of depersonalization are being a first-line worker and the presence of traumatic event avoidance symptoms. Furthermore, levels of professional fulfillment are negatively affected by age, the presence of intrusive symptoms, the presence of sleep disorders, and being a frontline worker.ConclusionsThe impact of the COVID-19 pandemic on the mental health of healthcare professionals involved in the first and/or second line COVID hospitals is indisputable. Although burnout syndrome is not a new clinical condition, the COVID-19 pandemic may further worsen the magnitude of the problem. However, our results could be a starting point to promote a change in the way we perceive the mental health of healthcare professionals.Disclosure of InterestNone Declared

Stress Factors in Multicultural Adolescents

This study aimed to identify the level of stress in teenagers from multicultural families in Korea and examine the factors influencing this stress. This cross-sectional study utilized the 15th (2019) Korea Youth Risk Bsehavior Web-based Survey. Of the 57,303 survey participants, 749 reported that their father, mother, or both parents were born outside of Korea. These 749 multicultural individuals were selected as study participants. We examined general characteristics (sex, grade, parental education level, academic performance level, foreign nationality, residence type, economic status, exposure to violence, and frequency of physical activity), health risk behaviors (sexual activity, drug use, and drinking), and mental health factors (sleep, depression, and presence of suicidal thoughts) to determine whether these factors may contribute to multicultural adolescent stress. Multicultural adolescents who reported insufficient sleep, depression, or suicidal thoughts were more likely to experience stress than those who did not report these factors. Moreover, participants with insufficient sleep were 3.73 times more likely to feel stress than those with good sleep. Among general characteristics, health risk behaviors, and mental health factors, mental health factors were observed to significantly predict an increase in multicultural adolescents’ stress levels. Considering the increase in the number of multicultural adolescents in Korea, it is important to address the difficulties they experience to provide appropriate interventional programs. Such programs should include techniques to help with the management of stress.

Can passive measurement of physiological distress help better predict suicidal thinking?

There has been growing interest in using wearable physiological monitors to passively detect the signals of distress (i.e., increases in autonomic arousal measured through increased electrodermal activity [EDA]) that may be imminently associated with suicidal thoughts. Before using these monitors in advanced applications such as creating suicide risk detection algorithms or just-in-time interventions, several preliminary questions must be answered. Specifically, we lack information about whether: (1) EDA concurrently and prospectively predicts suicidal thinking and (2) data on EDA adds to the ability to predict the presence and severity of suicidal thinking over and above self-reports of emotional distress. Participants were suicidal psychiatric inpatients (n = 25, 56% female, M age = 33.48 years) who completed six daily assessments of negative affect and suicidal thinking duration of their psychiatric inpatient stay and 28 days post-discharge, and wore on their wrist a physiological monitor (Empatica Embrace) that passively detects autonomic activity. We found that physiological data alone both concurrently and prospectively predicted periods of suicidal thinking, but models with physiological data alone had the poorest fit. Adding physiological data to self-report models improved fit when the outcome variable was severity of suicidal thinking, but worsened model fit when the outcome was presence of suicidal thinking. When predicting severity of suicidal thinking, physiological data improved model fit more for models with non-overlapping self-report data (i.e., low arousal negative affect) than for overlapping self-report data (i.e., high arousal negative affect). These findings suggest that physiological data, under certain contexts (e.g., when combined with self-report data), may be useful in better predicting—and ultimately, preventing—acute increases in suicide risk. However, some cautious optimism is warranted since physiological data do not always improve our ability to predict suicidal thinking.

The Role of Hope and Resilience in Protecting Against Suicidal thoughts and Behaviors During the COVID-19 Pandemic

Objective The COVID-19 pandemic has impacted the mental health and wellbeing of populations across the world. This study aimed to examine: (1) which specific aspects of the COVID-19 pandemic were associated with the presence of suicidal thoughts and behaviors, and (2) the extent to which participants’ hopelessness and resilience moderated the relationship between COVID-19 related stress and suicidal thoughts and behaviors. Method We administered an online survey to 12,989 adult (16+) participants across Wales from the 9th June to the 13th July 2020. Participants completed a series of questionnaires measuring the stressors they had experienced during the COVID-19 pandemic, their levels of hopelessness over the past two weeks, their levels of resilience, and whether they had experienced suicidal thoughts or behaviors since the onset of the COVID-19 pandemic. Results Our findings revealed that: (1) food insecurity, domestic abuse, relationship problems, redundancy, social isolation and financial problems were the COVID-19 related stressors most strongly associated with suicidal thoughts and behaviors, and (2) that both hopelessness and resilience moderated the relationship between COVID-19 stress and suicidal thoughts, such that the relationship between COVID-19 stress and the presence of suicidal thoughts was much stronger for individuals with high hopelessness and low resilience. Conclusions These results highlight the aspects of the COVID-19 pandemic that are closely related to suicidal thoughts and behaviors and demonstrate the important role that hope for the future and resilience play in protecting individuals against the negative effects of the COVID-19 pandemic. Highlights Stressors caused by the pandemic are linked to increased suicidal thoughts. Hope protects individuals against the negative impact of the COVID-19 pandemic. Resilience also protects people from the negative impact of the COVID-19 pandemic.

Perceptions of Deep Brain Stimulation for Adolescents with Obsessive-Compulsive Disorder.

Objective: The present study aims to understand perceptions of deep brain stimulation (DBS) for severe obsessive-compulsive disorder (OCD) in adolescents among two groups: parents of children with a history of OCD and adults with a history of OCD. Methods: Two hundred sixty participants completed a questionnaire exploring their treatment history, relevant symptom severity, DBS knowledge, and DBS attitudes using an acceptability scale and a series of statements indicating levels of willingness or reluctance to consider DBS for adolescents with severe OCD or severe epilepsy. Results: Overall, participants found DBS to be fairly acceptable for adolescents with severe OCD, with 63% reporting at least 7/10 on a 0-10 acceptability Likert scale. Respondents were more willing to consider DBS for epilepsy than for OCD. Several factors were associated with greater willingness to consider DBS for OCD, including familiarity with DBS, the presence of suicidal thoughts, assurances of daily functioning improvements, and assurances of substantial symptom reduction. Concerns about safety, personality changes, and long-term effects on the body were associated with greatest reluctance to consider DBS for OCD. Conclusions: Our findings support the importance of increasing parents' familiarity with DBS, monitoring factors participants identified as most important to their DBS perceptions in future DBS research, and communicating benefits and risks clearly. We also highlight the need for further research on perceptions of DBS for severe and refractory OCD in adolescents.

Mental Health and the SARS-COV-2 Epidemic-Polish Research Study.

Background: The aim of this study was to assess the mental state of Poles in the first weeks of the SARS-COV-2 epidemic. Methods: In the study, the General Health Questionnaire-28 (GHQ-18), The Perceived Stress Scale (PSS-10), and Mini-Cope were used. Results: The study was conducted on a group of 443 individuals, including 348 women (78.6%) and 95 men (21.4%). There were more women (χ2 = 6.42, p = 0.02) in the group of people with high results in the GHQ-28 questionnaire and the differentiating factors between those with sten scores above 7 (significantly deteriorated mental health) and those with average or low results (sten score below 7) turned out to be: treatment for mental disorders before the pandemic (χ2 = 19.57, p < 0.001) and the use of psychotherapy during the pandemic (χ2 = 4.21, p = 0.04) and psychiatric pharmacotherapy (χ2 = 8.31, p = 0.01). The presence of suicidal thoughts since the appearance of the pandemic-related restraints and limitations significantly differentiates the compared groups (χ2 = 38.48, p < 0.001). Conclusions: Every fourth person in the examined group (over 26% of the respondents) recorded results that indicate a high probability of mental functioning disorders. Approximately 10% of the respondents signalled the occurrence of suicidal thoughts since the beginning of the pandemic. The respondents complain mainly about problems in everyday life, lack of satisfaction from one’s own activities, tension, trouble sleeping, and feelings of exhaustion. Individuals with significantly reduced mental well-being use non-adaptive coping strategies, such as denying problems, emotional discharge, taking substances, discontinuation of action, and blaming themselves for the situation. The risk factors for the deterioration of the mental state of the respondents during the pandemic include psychiatric treatment before the beginning of the pandemic, the presence of suicidal thoughts during forced isolation, and the use of non-adaptive coping strategies (denial of the existence of problems, emotional discharge, use of psychoactive substances, discontinuation of action, and blaming oneself for the situation).

Suicidal thinking, depression, and religiosity in a freedom-deprived population.

Objective:to analyze the influence of sociodemographic variables, prison context, religiosity, and symptoms of depression on the presence of suicidal thinking in a population deprived of liberty.Method:a cross-sectional study with a quantitative approach, conducted with 228 participants, based on a sociodemographic questionnaire, on the prison context, and on the presence of suicidal thinking, from the Duke Religiosity Scale and the Depression, Anxiety and Stress Scale (DASS-21).Results:the variables that showed a statistically significant correlation were the following: female gender, not having a partner, working inside the penitentiary, being a primary defendant and using controlled medication, and females are 7.2 times more likely to present suicidal thinking, for each point more in the depression score, increases by 21% in the chances and not having a partner increases the chances of thinking about suicide by three times. Although the scores of religiosity were high, they did not present a statistically significant correlation with the presence of suicidal thinking.Conclusion:the prison context is complex and contains peculiarities that cause the involvement of mental health problems, as well as self-harming thoughts. Considering the relevance of the subject at issue, this work stands out in view of the scarce scientific production on the subject.

МЕТОДИЧНИЙ АПАРАТ ДЛЯ ОЦІНЮВАННЯ ВІЙСЬКОВОСЛУЖБОВЦІВ НАЦІОНАЛЬНОЇ ГВАРДІЇ УКРАЇНИ, СХИЛЬНИХ ДО СУЇЦИДАЛЬНОЇ ПОВЕДІНКИ

The article discusses the most common psychodiagnostic methods for identifying people are more likely to have suicidal behavior. Existing psychodiagnostic apparatus for diagnostics and possible correction of servicemen prone to suicidal behavior in different countries of the world are described. The basic personality and character traits of a person are revealed by signs of suicidal behavior, the main tasks of organization and conducting of psychodiagnostics in different countries of the world are defined. As a result of the study of scientific sources, it was found that the problem of diagnosing the propensity for suicidal behavior among military units in different countries of the world is not as wide-spread as that of civilians, but is introduced only in some leading countries of the world. The theoretical studies which were conducted have allowed to define the concept of “suicidal behavior of the personality of the serviceman of the National Guard of Ukraine” as an act of immoral activity, the purpose of which is the termination of one’s life, characterized by a conscious, volitional (controlled, desirable) character, manifested as an outcome of complex social) psycho-traumatic factors and personality traits of a soldier of such activity and entails his own death. It is proved that most of the existing techniques are not adapted to the specifics of the military organization. They do not take into account the social and environmental factors of suicidal risk, directly related to the specifics of military service, where military personnel are often unable to overcome the extreme conditions of military life on their own. They contain direct questions about the presence of suicidal thoughts and experiences and are therefore not recommended for widespread use, so as not to make ordinary people commit suicidal acts. It is described that psychodiagnostic methods for detection and diagnostics of suicidal risk evaluate only the psychological side of the individual. From the same standpoint, criteria and indicators of motives for suicidal behavior and factors of its occurrence, as well as preventive measures, are being developed. However, the diagnosis of suicidal risk involves taking into account the multifactoriality of suicide, conducting activities not only to identify psychological but also social and environmental factors.

Risk factors for suicidal thoughts in informal caregivers: results from the population-based Netherlands mental health survey and incidence Study-2 (NEMESIS-2)

BackgroundPrevious research suggests that family caregivers contemplate suicide at a higher rate than the general population. Much of this research has been disease specific and in relatively small samples. This study aimed to compare suicidal thoughts between non-caregivers and informal caregivers of people with a variety of conditions, in a large representative sample, and to identify significant risk factors.MethodsThe general population study NEMESIS-2 (N at baseline = 6646) included 1582 adult caregivers at the second wave (2010–2012) who also participated at the third wave (2013–2015). Suicidal thoughts were assessed over 4 years, with the Suicidality Module of the Composite International Diagnostic Interview 3.0. The presence of suicidal thoughts was estimated and risk factors for suicidal thoughts were assessed with logistic regression analyses adjusted for age and gender.ResultsThirty-six informal caregivers (2.9%) reported suicidal thoughts during the 4 year study period. The difference between caregivers and non-caregivers (3.0%) was not significant. Among caregivers, significant risk factors for suicidal thoughts included being unemployed, living without a partner, having lower levels of social support, having a chronic physical disorder, a mood disorder or an anxiety disorder, and having impaired social, physical and emotional functioning. These risk factors were also found in non-caregivers. No caregiving-related characteristics were associated with suicidal thoughts.ConclusionThere was no elevated rate of suicidal thoughts in caregivers and risk factors for suicidal thoughts in caregivers were consistent with risk factors in non-caregivers. No association between caregiving characteristics and suicidal thoughts was found. Caregivers with limited resources and in poorer health might still benefit from prevention and intervention efforts.

SCREENING INVESTIGATION OF DISTRIBUTION OF MOOD DISORDERS IN ADOLESCENCE AND PECULIARITIES OF THEIR CURRENCY

Introduction:. The problem of mood disorders in adolescents has recently become acute due to the high frequency of encounter and social significance. The aim: To investigate the screening of anxiety and depressive disorders and their manifestations in adolescent children to determine risk factors and to develop measures for their prevention. Materials and methods: The study was attended by 189 students aged 16-17 years of the educational institutions of the Khmelnytskyi region. For study it was used: Spielberger questionnaire in adaptation A. Andreeva and questionnaire for child depression M. Kovacs, 1992. Results: A high level of personal anxiety was detected in 44 adolescents (23,3%) and situational in 76 (40,2%) adolescents. In 48 (25,4%) adolescents there were signs of depression, in 11 (5,8%) - severe depression. The level of depression in girls was significantly higher compared to boys (95% CI, 2,6-8,8) (p<0,0004), which was manifested in the form of aggressive behavior (95% CI, 3,3-9,4) (p<0,0001) and anhedonia (95% CI, 1,7-7,0) (p<0,001). Signs of depression more often were appeared in adolescents who had an incomplete family (95% CI, 0,7-8,5) (p<0,02) and manifested in the form of aggressive behavior (95% CI, 0,6 (p<0,02), anhedonia (95% CI, 0,7-7,3) (p<0,01) and negative self-esteem with the presence of suicidal thoughts (95% CI, 0,3-7,5) (p<0,03). Conclusions: Mood disorders are quite common among adolescents and require timely detection and correction in order to improve their social adaptation and prevent suicidal behavior. The main factors of mood disorders in adolescents can be an incomplete family and a female.

ДЕЯКІ ОСОБЛИВОСТІ СУЇЦИДАЛЬНОЇ ПОВЕДІНКИ ХВОРИХ НА ПАРАНОЇДНУ ШИЗОФРЕНІЮ

Suicidal behavior is one of the most pressing social and medical problems. At the same time, a number of important issues related to the suicidal behavior of schizophrenic patients, in particular gender features, remain insufficiently studied.The aim of the study – to learn the peculiarities of suicidal behavior of patients with paranoid schizophrenia taking into account the gender factor on the basis of a comparative analysis of medical records and direct clinical research.Materials and Methods. To study the peculiarities of suicidal behavior of patients with paranoid schizophrenia, taking into account the gender factor, a study of suicidal behavior was conducted by studying medical records of 407 men and 409 women and a clinical examination of 53 men and 49 women with paranoid schizophrenia.Results and Discussion. A relatively low prevalence of suicidal phenomena before the onset of schizophrenia: a suicidal ideation was found in 1.0 % of men and 1.5 % of women according to medical records and 5.7 % of men and 4.1 % of women according to the clinical examination, suicidal actions – in 1.5 % of women according to medical records. Installed that after the debut of schizophrenia, the suicidal activity of patients sharply increases: according to the analysis of medical documentation suicidal thoughts were found in 17.2 % of men and 18.8 % of women, according to the clinical survey – in 47.2 % of men and 20.4 % of women, suicide attempts were in 9.3% and 15.6%, respectively, and 26.4 %, respectively, versus 10.2 %. The significant severity of psychopathological symptoms of schizophrenia in patients with suicidal tendencies is established. The most closely associated with the presence of suicidal thoughts are negative symptoms and behavioral disorders (97.3 % among all patients, 95.7 % among men, 98.7 % among women according to the documentation analysis, 100.0 % according to the clinical survey). Suicidal actions are characterized by close association with negative symptoms.Conclusions. Patients with paranoid schizophrenia are characterized by high suicidal activity, both at the level of suicidal thoughts and at the level of suicidal actions.

Predictors of suicide in the patient population admitted to a locked-door psychiatric acute ward

ObjectiveNo prior study appears to have focused on predictors of suicide in the general patient population admitted to psychiatric acute wards. We used a case-control design to investigate the association between suicide risk factors assessed systematically at admission to a locked-door psychiatric acute ward in Norway and subsequent death by suicide.MethodFrom 2008 to 2013, patients were routinely assessed for suicide risk upon admission to the acute ward with a 17-item check list based on recommendations from the Norwegian Directorate of Health and Social Affairs. Among 1976 patients admitted to the ward, 40 patients, 22 men and 18 women, completed suicide within December 2014.ResultsCompared to a matched control group (n = 120), after correction for multiple tests, suicide completers scored significantly higher on two items on the check list: presence of suicidal thoughts and wishing to be dead. An additional four items were significant in non-corrected tests: previous suicide attempts, continuity of suicidal thoughts, having a suicide plan, and feelings of hopelessness, indifference, and/or aggression. A brief scale based on these six items was the only variable associated with suicide in multivariate regression analysis, but its predictive value was poor.ConclusionSuicide specific ideations may be the most central risk markers for suicide in the general patient population admitted to psychiatric acute wards. However, a low predictive value may question the utility of assessing suicide risk.

Insomnia is associated with suicide attempt in middle-aged and older adults with depression.

Insomnia increases in prevalence with age, is strongly associated with depression, and has been identified as a risk factor for suicide in several studies. The aim of this study was to determine whether insomnia severity varies between those who have attempted suicide (n = 72), those who only contemplate suicide (n = 28), and those who are depressed but have no suicidal ideation or attempt history (n = 35). Participants were middle-aged and older adults (age 44-87, M = 66 years) with depression. Insomnia severity was measured as the sum of the early, middle, and late insomnia items from the Hamilton Rating Scale for Depression. General linear models examined relations between group status as the independent variable and insomnia severity as the dependent variable. The suicide attempt group suffered from more severe insomnia than the suicidal ideation and non-suicidal depressed groups (p < 0.05). Differences remained after adjusting for potential confounders including demographics, cognitive ability, alcohol dependence in the past month, severity of depressed mood, anxiety, and physical health burden. Moreover, greater insomnia severity in the suicide attempt group could not be explained by interpersonal difficulties, executive functioning, benzodiazepine use, or by the presence of post-traumatic stress disorder. Our results suggest that insomnia may be more strongly associated with suicidal behavior than with the presence of suicidal thoughts alone. Accordingly, insomnia is a potential treatment target for reducing suicide risk in middle-aged and older adults.

Exposure to, and searching for, information about suicide and self-harm on the Internet: Prevalence and predictors in a population based cohort of young adults

BackgroundThere is concern over the potential impact of the Internet on self-harm and suicidal behaviour, particularly in young people. However, little is known about the prevalence and patterns of suicide/self-harm related Internet use in the general population. MethodsCross sectional study of 3946 of the 8525 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) who were sent a self-report questionnaire including questions on suicide/self-harm related Internet use and self-harm history at age 21 years. ResultsSuicide/self-harm related Internet use was reported by 22.5% (886/3946) of participants; 11.9% (470/3946) had come across sites/chatrooms discussing self-harm or suicide, 8.2% (323/3946) had searched for information about self-harm, 7.5% (296/3946) had searched for information about suicide and 9.1% (357/3946) had used the Internet to discuss self-harm or suicidal feelings. Suicide/self-harm related Internet use was particularly prevalent amongst those who had harmed with suicidal intent (70%, 174/248), and was strongly associated with the presence of suicidal thoughts, suicidal plans, and history of self-harm. Sites offering help, advice, or support were accessed by a larger proportion of the sample (8.2%, 323/3946) than sites offering information on how to hurt or kill yourself (3.1%, 123/3946). Most individuals (81%) who had accessed these potentially harmful sites had also accessed help sites. Limitations(i) There were differences between questionnaire responders and non-responders which could lead to selection bias and (ii) the data were cross-sectional, and we cannot conclude that associations are causal. ConclusionsSuicide/self-harm related Internet use is common amongst young adults, particularly amongst those with suicidal thoughts and behaviour. Both harmful and helpful sites were accessed, highlighting that the Internet presents potential risks but also offers opportunities for suicide prevention.

SUICIDAL THOUGHTS AND BEHAVIORS IN CHILDREN AND ADOLESCENTS WITH CHRONIC TIC DISORDERS.

Despite evidence of elevated risk factors for suicidal thoughts and behavior in youth with Tourette syndrome and chronic tic disorders (CTD), few studies have actually examined that relationship. This study documented the frequency and clinical correlates of suicidal thoughts and behaviors in a sample of children and adolescents with CTD (N = 196, range 6-18 years old). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Centers for Disease Control. Youth and parents completed a battery of measures that assessed co-occurring psychiatric diagnoses, child emotional and behavioral symptoms, and impairment due to tics or co-occurring conditions. A structured diagnostic interview identified that 19 youths with CTD (9.7%) experienced suicidal thoughts and/or behaviors, which was elevated compared to 3 youths (3%) who experienced these thoughts in a community control sample (N = 100, range 6-18 years old, P = .03). For youth with CTD, suicidal thoughts and behaviors were frequently endorsed in the context of anger and frustration. The Child Behavior Checklist (CBCL) anxious/depressed, withdrawn, social problems, thought problems, and aggressive behavior subscales, as well as the total internalizing problems scale, were associated with the presence of suicidal thoughts and/or behaviors. Suicidal thoughts and/or behaviors were significantly associated with tic symptom severity; tic-related impairment; and obsessive-compulsive, depressive, anxiety, and attention-deficit/hyperactivity disorders' symptom severity. CBCL anxiety/depression scores mediated the relationship between tic severity and suicidal thoughts and behaviors. Findings suggest that about 1 in 10 youth with CTD experience suicidal thoughts and/or behaviors, which are associated with a more complex clinical presentation and often occur in the presence of anger and frustration.

Precarious employment and the risk of suicidal ideation and suicide attempts

ObjectiveAlthough the effect of occupation or employment status on suicide risk is notable, there are few studies on the effect of precarious employment on suicide. We compared suicidal ideation and suicide attempts in precarious workers and their non-precarious counterparts using a representative sample from South Korea. MethodThe 2008 Korean Community Health Survey data were used for this study. Information was obtained on 52,161 participants (41,063 employees with non-precarious work and 11,098 employees with precarious work). The outcome of the logistic regression model was the presence of suicidal thoughts and attempts, and the independent variables were the demographics, socioeconomic status, and health status. ResultsEmployees with precarious work were more likely to exhibit suicidal ideation (OR=1.41; 95% CI, 1.28–1.55) and suicide attempts (OR=1.52; 95% CI, 1.02–2.27) than employees with non-precarious work. After controlling for income and education (Model 2) depressive feelings (Model 6), compared with unadjusted model, remained significant but the odds ratio was largely attenuated, indicating a strong association between suicidal risk and socioeconomic and feelings of depression. ConclusionPrecarious workers had a higher risk of suicidal ideation and suicide attempts than non-precarious workers. Our study suggests that precarious employment is an important risk for suicide.