Repeated Suicide Attempts Research Articles

Toxoplasma gondii, suicidal behaviour and suicide risk factors in US Veterans enrolled in mental health treatment.

Markers of chronic infection Toxoplasma gondii (Nicolle et Manceaux, 1908) have been associated with suicidal self-directed violence (SSDV). We present the results of the first study relating T. gondii IgG serology with suicide attempts and suicidal ideation in United States Veterans, known to have higher suicide rates than members of the general population. We also related T. gondii serology to SSDV risk factors, including valid and reliable measures of trait impulsivity, aggression, self-reported depression, and sleep disturbance. We recruited 407 Veterans enrolled at three Veterans Affairs Medical Centers with mean (S.D.) age = 45.6 (11.6) years; 304 men (74.7%); 203 with a history of SSDV and 204 with no history of any self-directed violence (SDV). Seropositivity and serointensity, categorised as high (top quartile) or low (lower three quartiles), were analysed in relationship to SSDV, suicidal ideation and clinical risk factors using age and gender-adjusted linear and logistic methods, after transformations and nonparametric tests when appropriate. Associations between seropositivity and SSDV and its risk factors were not significant in all groups. High serointensity, while not associated with SSDV or repeat suicide attempts, was positively associated with suicidal ideation, depression, impulsivity, and daytime dysfunction due to sleepiness (p < 0.05), but only in Veterans with a history of SSDV. In Veterans without a history of SDV, no associations were significant. These associations remained significant after adjustment for certain socioeconomic factors (i.e., income, homelessness, military rank). Including education in the model downgraded the statistical significance of suicidal ideation and depression to statistical trends, but the significance of associations with impulsivity and daytime dysfunction due to sleepiness remained. Major limitations include the cross-sectional design, overall low seropositivity within the sample, and potentially spurious results due to multiple comparisons. Thus, the results of this report need to be replicated in larger samples, ideally longitudinally.

Suicide prevention inpatient group treatment-A treatment development and feasibility study.

One mainstay of psychiatric treatment for suicidal crises is inpatient psychiatric hospitalization. Despite the need to secure immediate safety and stabilization, inpatient treatment for acutely suicidal patients remains diagnosis-specific, which may fail to directly target and adequately manage suicidal behavior as a symptom and reason for admission or treatment. The post-discharge period is a high-risk period for repeat suicide attempts or death by suicide, but overburdened workforce and high patient turnover make it difficult to provide suicide-specific treatment. In response to this need, we developed the Suicide Prevention Inpatient Group Treatment (SPIGT), a four-module, group-based intervention, which provides evidence-supported concrete tools and psychoeducation to directly address suicidality. To assess feasibility and acceptability of implementation, the SPIGT was piloted on an inpatient psychiatric unit starting in 2016. Group participants were given optional, anonymous surveys after each module. Unit clinicians also completed optional, anonymous surveys to assess their attitudes towards the intervention. Results indicate that participants responded very favorably to each module, and that unit clinicians felt that the implementation of this intervention was feasible and acceptable. The SPIGT shows promise as a scalable suicide-specific, brief intervention, which addresses an unmet and critical need in suicide prevention.

Factors influencing repeated suicide attempts among suicide attempters who visited the emergency room due to acute drug intoxication: a retrospective study

Factors influencing repeated suicide attempts among suicide attempters who visited the emergency room due to acute drug intoxication: a retrospective study

A pilot study of repeated suicide attempts in persons hospitalized for depression: The role of immune factors

BackgroundIndividuals with major depressive disorder (MDD) hospitalized for a suicide attempt are at high risk for a repeated suicide attempt. Previous studies have identified immune alterations in MDD, but not the prospective association between immunological abnormalities and subsequent suicide behavior. MethodsWe enrolled 69 adults with MDD following hospitalization for a suicide attempt. Participants were assessed for co-occurring immunological disorders and on clinical measures. Participants had a blood sample drawn from which were measured cytokines, antibodies, and other markers of inflammation. Following hospital discharge, participants were assessed for six months. Cox proportional hazard models examined the relationships between baseline variables and a repeated suicide attempt. ResultsA total of 15 (24 %) of the 62 participants with at least one post-hospital visit had a suicide attempt in the follow-up period. These individuals had a significant alteration in a combined immune marker consisting of the cytokines, IL-1β, TNF-α, and IFN‐γ as well as IgG antibodies to Epstein Barr Virus (HR= 8.03, 95 % CI 1.73, 37.08, p=.008). A diagnosis of asthma was also associated with a repeated suicide attempt (HR= 3.10, 95 % CI 1.10, 8.79, p=.033). Suicidal intent, stressful events, and aspects of psychiatric history also predicted this outcome. LimitationsThe sample was relatively small limiting statistical power. Also, we focused on one specific high-risk group. ConclusionsPersons with MDD and immunological abnormalities have an increased rate of repeated suicide attempts. Immunological measurements combined with clinical information may identify high risk individuals who would benefit from personalized interventions.

Repeated Suicide Attempts in a Patient With Stiff Person Syndrome

Repeated Suicide Attempts in a Patient With Stiff Person Syndrome

Risk Factors Associated with Suicidality in Erbil City

Background and Objectives: Suicide is an intentional attempt to end someone's life that results in death. Suicidality comprises suicidal thoughts, plans, and actions. Knowing the risk factors associated with suicide may help in its reduction. The study's aims were to ascertain the sociodemographic characteristics of suicidal patients and suicidality-associated risk factors. Methods: A retrospective case-control study recruited 60 participants aged between 18 and 53 years within eight months. Sociodemographic characteristics, risk factors associated with suicide attempts among the studied samples such as personal, maltreatment during childhood, community-associated risk factors, and suicide methods used. The data was analyzed through binary logistic regression. Results: In total, there were (26.6%) cases in the age group 18-29; the majority of the recruits were female (38.3%); most of the participants had a university degree (23.33%), and (26.6%) had never married. Regarding their occupational status, most of the patients had paid work, and populated urban areas. Among positive suicide cases, (89.3%) had experienced previous suicide attempts, mental illness; such as depression, was present in (57.1%). About )50% (of the suicidal participants experienced physical abuse and maltreatment during childhood. Binary logistic regression analysis showed that previous suicide attempts, mental illnesses such as depression, job problems or loss, and barriers to health care access P-value&lt; 0.040, 0.008, 0.023, 0.043 had a highly significant association with suicide. Conclusions: There was no association between the sociodemographic characteristics of suicidal and non-suicidal individuals. Individuals with associated characteristics, such as a history of repeated suicide attempts and generalized anxiety disorders, require special consideration. Mental illnesses, such as depression, job loss or problems, a previous suicide attempt, and barriers to health care were the highest risk factors.

The influence of psychotherapy on individuals who have attempted suicide: A systematic review and meta-analysis.

Suicide is a serious global public health issue, and a history of attempted suicide is the most critical indicator of suicide risk. There are limited studies on the effectiveness of psychotherapy in individuals who have attempted suicide, and other outcome measures related to suicide risk in suicide attempts have not been explored. This study aimed to systematically review and perform a meta-analysis of the effectiveness of psychotherapy on individuals who have attempted suicide. This study conducted a comprehensive literature search of five major databases (PubMed, EMBASE, Cochrane, Web of Science, and Ovid). The protocol for this study is registered with PROSPERO (CRD42023464401) and follows the PRISMA guidelines. This meta-analysis included a total of 34 trials from 32 literature sources. The study involved a total of 6600 participants. The results showed that psychotherapy had a positive effect on reducing the suicidal tendencies of individuals who have attempted suicide and effectively reduced the number of repeated suicide attempts as well as the levels of suicidal ideation, depression, anxiety and hopelessness. This study concludes that psychotherapy is effective in reducing the suicidal tendencies of individuals who have attempted suicide. Psychological therapy for individuals who have attempted suicide are crucial in preventing future suicidal behaviours.

The Effect of Anxiety Sensitivity on Repeated Suicide Attempts: The Serial Mediation Effects of Rumination and Hopelessness and the Moderated Mediation Effect of Gender

The Effect of Anxiety Sensitivity on Repeated Suicide Attempts: The Serial Mediation Effects of Rumination and Hopelessness and the Moderated Mediation Effect of Gender

Urinary retention induced by psychotropics: A case report

IntroductionNeurological bladder is considered a functional disability that has a significant impact on the quality of life and psychological state of patients. Psychotropic drugs, in turn, can worsen the urinary dysfunction caused by this disease.ObjectivesOur objective is to illustrate, through the case of a patient suffering from a neurological bladder decompensated by the treatment of a characterized depressive episode, the link between these two pathologies.MethodsWe report the case of Ms. M.W., aged 51, with a history of high blood pressure stabilized under nebivolol and a neurological bladder diagnosed 10 years ago with episodic pollakiuria, admitted to the psychiatric department for repeated suicide attempts. She had never used psychoactive substances and had no family psychiatric history. The patient presented depressive symptoms evolving for 5 months. The diagnosis of a characterized depressive episode with melancholic features was made and the patient was treated with sertraline. From the first intake of the drug, the patient presented acute urinary retention (UR) requiring the placement of a permanent bladder catheter. The urinary symptoms improved upon stopping the treatment. Sertraline was changed to olanzapine and escitalopram. The patient stopped the treatment after one month because of the worsening of urinary symptoms requiring the installation of a suprapubic catheter. The urinary problem, together with the cessation of treatment, were responsible for a worsening of psychiatric symptoms leading to multiple suicide attempts. Given the advanced stage of the neurological bladder demonstrated by the urodynamic tests, our patient was treated with paroxetine, quetiapine and oxazepam along with psychotherapeutic education. The evolution was characterized by improvement in psychiatric symptoms and the urinary symptoms were stable.ResultsThe lack of improvement after treatment discontinuation could be explained by an underlying neurological bladder manifesting with pollakiuria. The current literature on UR induced by psychotropic treatments is quite rare limited in case reports. This effect occurs especially when selective serotonin reuptake inhibitors (SSRIs) are prescribed in combination with other antipsychotics. Unlike first generation antipsychotics, atypical antipsychotics have muscarinic receptor antagonist properties which can induce UR. Among atypical antipsychotics, olanzapine has been shown to have the greatest antimuscarinic effects. Regarding SSRIs, they are associated with a lower risk of UR than other antidepressants and sertraline had the highest risk of UR.ConclusionsSSRIs can induce UR particularly in combination with atypical antipsychotics. Coordination of care across multiple specialties and understanding the side effects of psychotropic medications can enable faster diagnoses and adequate management.Disclosure of InterestNone Declared

The relationship between visual hallucinations, functioning, and suicidality over the course of illness: a 10-year follow-up study in first-episode psychosis

Visual hallucinations in psychosis are under-researched despite associations with increased illness severity, functional impairments, and suicidality in the few existing studies. Further, there are no long-term longitudinal studies, making it impossible to conclude if these associations are state or trait phenomena. In the current prospective longitudinal study, 184 individuals with first-episode psychosis were assessed with semi-structured clinical interviews and self-report questionnaires at baseline and 10-year follow-up. Participants were grouped based on lifetime experience of visual hallucinations: before or at baseline (VH+/+), first during follow-up (VH−/+), or never (VH−/−). Associations with functioning, suicide attempts, childhood trauma and other markers of illness severity were tested using multinomial logistic regression analysis. At baseline, the VH+/+ group (37.5%), but not VH−/+ (12.5%), had poorer functioning, higher symptom severity, a lower age at onset, and included more individuals with a history of multiple suicide attempts than the VH−/− group (50%). At follow-up, the VH−/+ group, but not VH+/+, had poorer functioning and higher symptom severity than the VH−/− group. However, the number of participants who committed multiple suicide attempts during the follow-up period was again significantly higher in the VH+/+ group. There was no association with childhood trauma. Hence, visual hallucinations are associated with impaired functioning and higher symptom severity, but only in the short-term. However, visual hallucinations that arise early in the course of illness are a risk indicator for repeated suicide attempts throughout the illness course. These findings highlight the relevance of assessing visual hallucinations and monitoring their development over time.

Suicide attempt management among Turkish and American adolescents: A comparison of two pediatric emergency departments.

Suicide is one of the leading causes of death among adolescents. This study aimed to compare the characteristics and short-term outcomes of Turkish and American adolescents with suicide attempts and determine the differences in management and resource utilization between two pediatric emergency departments; one in Türkiye and one in the United States of America. Adolescents who presented to the emergency departments with a chief complaint of suicide attempt between October 2017 and September 2018 were eligible for including in the study. Characteristics and other information of 217 (131 American and 86 Turkish) suicide attempter adolescents were retrieved from medical records. Outcome was defined as re-admission to the emergency department for another suicide attempt within 3 months of the index visit. Overall, 78% of adolescents were female. Abuse history (physical/sexual) was more common among American adolescents (p = 0.005), whereas uncontrolled psychiatric diseases were more evident in Turkish cases (p < 0.001). Social worker assessment and hospitalization rates were significantly lower, with shorter mean duration of follow-up in the emergency department among Turkish compared to American adolescents (respectively, p < 0.001, p < 0.001 and p = 0.002). Repeated suicide attempts within three months were significantly higher in the Turkish group compared to the American one (29% vs. 8%, p < 0.001). Receiving a social worker assessment, hospitalization and longer observation in emergency department reduced the incidence of repeated suicide attempts (respectively, p < 0.001, p = 0.003 and p = 0.012). Turkish adolescents had shorter observation time in the emergency department, received fewer assessment by social workers and were less likely to be hospitalized. These may have contributed to the higher rate of repeat suicide attempts following discharge from the emergency department. Adequate resources are needed to help decrease the burden of suicide among Turkish adolescents.

Risk Factors for Suicide Reattempt among Adolescents and Young Adults: The Role of Psychiatric Disorders.

Suicidal behaviour among young people is a serious public health concern. Each suicide attempt is related to further suicide attempts and completed suicide. This study aims to explore risk factors associated with repeated suicide attempt among adolescents and young adults. The cohort included 510 patients aged 12-29 years residing in Piedmont Region in North-Western Italy, who had been admitted to hospital or emergency department with a diagnosis of suicide attempt between 2010 and 2020. Cox regression models were used to evaluate potential risk factors for repeated suicide attempt. During the 11-years follow-up, 20.6% of adolescents and young adults repeated suicide attempt, 24.8% of females and 12.3% of males. Nearly 90% of youth who attempted suicide had a diagnosis of psychiatric disorder. After adjustment, younger age of onset of suicidal behaviour, and diagnosis of schizophrenia, bipolar disorder, depressive disorder, anorexia nervosa and personality disorder were significantly associated with repeated suicide attempt. The early identification of patients at higher risk of repetition of suicidal behaviour is of crucial importance. Better understanding of risk factors and effective treatment of mental disorders could help suicide prevention to reduce the burden of the problem among young people. Special attention should be paid during the initial months following discharge from hospital or emergency department, when suicide reattempt risk is very high.

P68: Early psychiatric referral after attempted suicide helps prevent suicide reattempts: A longitudinal national cohort study in South Korea

Introduction:Although people who attempted suicide tend to repeat suicide attempts, there is a lack of evidence on the association between psychiatric service factors and suicide reattempt among them.Methods:We used a nationwide, population-based medical record database of South Korea to investigate the use of psychiatric services before and after the index suicide attempt and the association between psychiatric service factors after the index suicide attempt with the risk of suicide reattempt.Results:Among 5,874 people who had attempted suicide, the all-cause mortality within 3 months after the suicide attempt was 11.6%. Among all subjects who attempted suicide, 30.6% of them had used psychiatric services within 6 months before the suicide attempt; 43.7% of them had used psychiatric services within 3 months after the suicide attempt. Among individuals who had visited clinics following attempted suicide, the cumulative incidence of suicide reattempt over a mean follow-up period of 5.1 years was 3.4%. About half of suicide reattempts occurred within 1 year after the index suicide attempt. Referral to psychiatric services within 7 days was associated with a decreased risk of suicide reattempt (adjusted hazard ratio, 0.51; 95% confidence intervals, 0.29-0.89).Conclusion:An early psychiatric referral within 1 week after a suicide attempt was associated with a decreased risk of suicide reattempt.

Cognitive and behavioral factors in the chronification of suicidal behavior

Relevance. Suicide is one of the leading causes of death worldwide. Suicidal behavior is a complex phenomenon that includes suicidal thoughts, intentions and actions; and those actions do not always lead to death, but often turn into chronic suicidal behavior. The study of the factors in chronification of suicidal behavior is necessary for the development of evidence-based programs for the prevention of repeated suicide attempts.Aim of study. is to compare cognitive and behavioral strategies for coping with stress in patients with single suicide attempts and chronic suicidal behavior.The hypothesis of the study is that in patients with repeated suicide attempts, destructive cognitive and behavioral strategies for coping with stress are more pronounced.Materials and methods. The study included 119 patients treated at the somatopsychiatric and toxicology departments, 60 patients after the primary suicide attempt, 59 – after repeated ones. Patients were asked to complete the following procedures: Beck Depression Inventory (Beck, 1961; N.V. Tarabrina, 2001), Beck Anxiety Inventory (Beck, 1961; Tarabrina, 2001), Rumination Scale (Treynor W. et al., 2003; adaptation by O.D. Pugovkina et al., 2021), Alexithymia Scale (Toronto Alexithymia Scale G.J. Taylor et al., 1985; adaptation by Starostina E.G. et al. 2009), COPE Inventory (Ch.S. Carver et al., 1989; adaptation by P.A. Ivanov and N.G. Garanyan, 2013).Results. Patients after repeated suicide attempts, compared with patients who made the first attempt, are more likely to be diagnosed with borderline personality disorder, have more pronounced symptoms of depression and suicidal readiness, higher rates of ruminative thinking and alexithymia — reflecting a deceptive cognitive style, — as well as indicators of the use of destructive behavioral strategies for coping with stress in the form of various types of avoidance behavior.

Association of hospitalization for suicide attempts in adolescent girls with subsequent hospitalization for eating disorders.

To determine the association between adolescent hospitalization for suicide attempts and the subsequent risk of eating disorder hospitalization. This was a cohort study of 162,398 adolescent girls in Quebec, Canada, including 7741 with suicide attempts before 20 years of age, matched to 154,657 adolescents with no attempt between 1989 and 2019. The main exposure measure was suicide attempt hospitalization. The main outcome measure was hospitalization for an eating disorder up to 31 years later, including anorexia nervosa, bulimia nervosa, and other eating disorders. We used adjusted Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between adolescent suicide attempts and eating disorder hospitalization. Adolescent girls admitted for a suicide attempt had 5.55 times the risk of eating disorder hospitalization over time (95% CI 3.74-8.23), compared with matched controls. Suicide attempt was associated with anorexia nervosa (HR 3.57, 95% CI 1.78-7.17) and bulimia nervosa and other eating disorders (HR 8.55, 95% CI 5.48-13.32). Associations were pronounced in girls with repeated suicide attempts. Girls who attempted suicide through self-poisoning had an elevated risk of anorexia nervosa, whereas girls who used violent methods such as cutting or piercing had a greater risk of bulimia nervosa and other eating disorders. Suicide attempt was strongly associated with eating disorder hospitalization in the year following the attempt, but associations persisted throughout follow-up. Suicide attempt admission is associated with the long-term risk of eating disorder hospitalization in adolescent girls. This study of adolescent girls suggests that suicide attempt admission is associated with the long-term risk of hospitalization for eating disorders. The risk is greatest in the year after the attempt, but persists over time. Adolescents who present with a suicide attempt may benefit from screening for eating disorders and long-term follow-up to help prevent the exacerbation or development of eating disorders.

Acceptability of a Chinese version of volitional help sheet to prevent self-harm repetition: qualitative study.

Individuals who self-harm have increased suicide rates. Brief interventions are associated with reduced repeated suicide attempts. However, very few previous studies investigated the acceptability of brief interventions before implementing new trials. We aimed to explore the perceptions of individuals who self-harm toward a brief intervention, the Chinese version of the volitional help sheet (VHS-C), which encourages people to link a critical situation with an appropriate response. Fourteen participants who presented to hospitals with self-harm were interviewed about their perspectives regarding the acceptability of the paper- and web-based VHS-C. Data were analysed with the framework method. The participants could understand the intended goal of the VHS-C by reading the written instructions, but indicated that having verbal instructions would also help. They shared the reasons why they felt the VHS-C was helpful (e.g. relatable contents, useful coping strategies and appropriate instructions that made them feel understood) or unhelpful (e.g., being not specific enough, not useful during the crisis and triggering negative emotional responses). Some indicated that the VHS-C might not be applicable to people experiencing ongoing distress in emergency departments. Most participants preferred the web-based to the paper-based VHS-C, and suggested that the format and frequency of follow-up reminders could leave the patient to decide. The contents of the VHS-C were acceptable for people who presented to hospitals with self-harm. The VHS-C may be more helpful before individuals encounter suicidal thoughts than when they have an ongoing crisis.

Predictors of suicide coping self-efficacy among youth presenting to a psychiatric emergency department.

Low levels of youth-reported self-efficacy to cope with suicidal urges have been shown to prospectively predict repeat emergency department (ED) visits and suicide attempts, yet little is known about how self-efficacy may change following receipt of crisis services or about factors that may strengthen self-efficacy. Protective factors (e.g., parent-reported youth competence, parent-family connectedness, and receipt of mental health services) were examined in relation to self-efficacy at the time of a psychiatric ED visit and 2 weeks later. Participants were 205 youth (ages 10-17), presenting to a psychiatric ED due to a suicide-related concern. Youth primarily identified as biological female (63%) and White (87%). Multivariate hierarchical linear regressions were used to examine candidate protective factors in relation to initial and follow-up suicide coping self-efficacy. Self-efficacy significantly improved in the 2 weeks following the ED visit. Parent-family connectedness was positively related to suicide coping self-efficacy at the time of the ED visit. Parent-family connectedness and receipt of inpatient psychiatric care following the ED visit were associated with higher follow-up suicide coping self-efficacy. During the adolescent developmental period when suicidal thoughts and behaviors notably increase, study findings highlight potential malleable intervention targets, including parent-family connectedness, that may strengthen suicide coping self-efficacy.

Prevalence of and Factors Influencing Suicide Ideation, Attempt, and Completion in Heroin Users: A Systematic Review and Meta-Analysis.

Suicide is considered a fundamental problem in discussions on public and global health. Thus, the current study aimed to review the prevalence of and reasons for successful suicide attempts in heroin users. This study was conducted by systematically searching the electronic databases of PubMed, Scopus, Web of Science, and PsycINFO from 1960/1/1 to 2021/11/1 based on the PRISMA checklist and using MeSH keywords with no temporal or linguistic limitations. The primary and secondary impacts of suicide were identified, and all studies following an observational design (cohort, case-control, and cross-sectional studies) were included in the research. Data analysis was performed using Stata version 13. Finally, 17 studies were included in the work process for systematic review and meta-analysis. The results showed the most frequent reasons for suicide among the studied individuals were gender (being female), youngness, heroin overdose, multi-drug abuse, history of repeated suicide attempts, history of psychiatric disorder (especially depression), joblessness, homelessness, distorted family relationships, etc. Moreover, the results of synthesizing the studies revealed the prevalence of suicide attempts equaled the effect size (95% CI=0.3 [0.23-0.37]) among these individuals, and the prevalence of successful suicides approached the effect size (95% CI=0.03 [0.01-0.05]). The results of the present study showed the high prevalence of suicidal thoughts and suicide attempts among the heroin-abusing population. Furthermore, according to the findings, the prevalence of unsuccessful suicide attempts was ten times more than that of successful ones in the target population.

Клинико-психологические и социодемографические факторы суицидального поведения и риска его хронификации: обзор исследований

&lt;p&gt;&lt;strong&gt;Relevance.&lt;/strong&gt; The article presents an overview of studies on clinical, psychological and socio&amp;ndash;demographic factors of suicidal behavior and the risk of its chronicity. According to the WHO, 800,000 people die each year by suicide, and many others seek help from medical centers after a suicide attempt. Suicide and suicide attempts are a medical, social and psychological problem. &lt;strong&gt;Purpose of the study&lt;/strong&gt;. Evaluation of the role of various factors in the chronification of suicidal behavior and an increase in its risk. &lt;strong&gt;Results.&lt;/strong&gt; According to numerous studies, most often repeated suicide attempts are made by people with borderline personality disorder and other personality disorders, often in combination with depressive and anxiety symptoms. The motives for suicide in this group of patients may be emotional regulation, coping with dissociation, stress, and more often do not contain the desire to die. This group of patients tend to self-cut in the limbs or attempt self-poisoning. A distinctive feature of suicide attempts in individuals with schizophrenia, severe depression and bipolar disorder is the intention to die, combined with more severe methods of self-harm, in contrast to patients with personality disorders. The risk of chronification of suicidal behavior is higher in people of working age who have experience in the use of psychoactive substances, low social status and wealth, and the unemployed. This group of patients needs to be provided with medical, psycho-social assistance, since without treatment and psychological support, the risk of chronification of suicidal behavior, an increase in symptoms of depression and the completion of suicide increases. &lt;strong&gt;Conclusions.&lt;/strong&gt; Chronic suicidal behavior requires active interdisciplinary team work with patients based on a biopsychosocial model already at the stage of the first hospital admission after a suicide attempt. It is important to take into account the specifics and characteristics of suicidal behavior, work styles may differ depending on the diagnoses, age and motives of suicidal behavior.&lt;/p&gt;

Risk of suicide after a diagnosis of sleep apnea: A nationwide longitudinal study

Previous studies have presented evidence on the association between sleep apnea and suicidal ideation and planning, but the relationship between a clinical diagnosis of sleep apnea and suicide attempts remains unknown. We investigated the risk of suicide after a diagnosis with sleep apnea using data from a nationwide community-based population database, i.e., the Taiwan National Health Insurance Research Database. We recruited 7,095 adults with sleep apnea and 28,380 age-, sex-, and comorbidity-matched controls between 1998 and 2010 and followed them up until the end of 2011. Individuals who exhibited any (once or repeated) suicide attempts were identified during the follow-up period. The E value was calculated for unmeasured bias. Sensitivity analysis was conducted. Patients with sleep apnea were more likely to carry out any suicide attempt (hazard ratio: 4.53; 95% confidence interval: 3.48–5.88) during the follow-up period than the controls after adjusting for demographic data, mental disorders, and physical comorbidities. The hazard ratio remained significant after excluding individuals with mental disorders (4.23; 3.03–5.92). The hazard ratio was 4.82 (3.55–6.56) for male patients and 3.86 (2.33–6.38) for female patients. Consistent findings of increased risk of repeated suicide attempt were found among patients with sleep apnea. No association was found between continuous positive airway pressure treatment and suicide risk. The calculated E values support suicide risk after the diagnosis of sleep apnea. The risk of suicide was 4.53-fold higher in patients diagnosed with sleep apnea than in their counterparts without sleep apnea.