Risk Factors For Suicidal Behavior Research Articles

Persistence of suicidal ideation within acute phase treatment of major depressive disorder: analysis of clinical predictors.

Suicidal ideation (SI) is common in major depressive disorder (MDD), and it is a risk factor for suicidal behaviour. Antidepressants are effective in reducing SI, but in some subjects, SI may persist for weeks. This study aimed to disentangle the contribution of baseline clinical characteristics in SI nonremission at week 6. Research involved 198 outpatients with MDD and SI collected within the Combining Medications to Enhance Depression Outcomes trial and treated with different antidepressant combinations. Although SI decreased from baseline to week 6 ( P < 0.0001), 78 patients (39%) failed to achieve SI remission. Insomnia [OR, 0.72; 95% confidence interval (CI), 0.52-0.99], reduced need for sleep (OR, 0.75; 95% CI, 0.58-0.99), self-confidence (OR, 0.52; 95% CI, 0.32-0.82), cheerfulness (OR, 0.57; 95% CI, 0.33-0.98), and comorbid panic disorder (OR, 0.93; 95% CI, 0.87-0.99) at baseline were associated with lack of SI remission after controlling for baseline depression and SI scores. The combination of baseline SI and insomnia was moderately effective in predicting the lack of SI remission, with a specificity of 80% (95% CI, 72-87%) and an NPV of 68% (95% CI, 63-72%). In individuals with MDD and SI, the presence of insomnia and bipolar features should prompt a search for more effective treatment solutions in order to favour SI remission and prevent suicidal behaviour.

The Role of Unemployment, Financial Hardship, and Economic Recession on Suicidal Behaviors and Interventions to Mitigate Their Impact: A Review.

Understanding the social determinants and risk factors for suicidal behaviors underlies the development of effective suicide prevention interventions. This review focused on recently published literature (2010 onwards), with the aim to determine the role of economic factors (at the individual and population level) on suicidal behaviors and ideation as well as the effectiveness of interventions addressing these factors in reducing suicidal behaviors and ideation. Where available, literature examining the economic impact of COVID-19 was highlighted. Economic recession and unemployment are associated with increased risk of suicidal behavior at the population and individual level. Additionally, personal financial problems such as debt and financial strain are associated with increased risk of suicidal behavior and ideation at the individual level. Regarding interventions, unemployment benefits, employment protection legislation, higher minimum wage and active labor market programs may reduce suicide at the population level. However, it is not clear what impact they have at the individual level, nor in relation to suicide attempts, self-harm, or suicidal ideation. There was a lack of evidence as to the effectiveness of financially focused suicide prevention interventions at either level. Current findings were contextualized within, and advance, prominent social theoretical models. Recommendations focused on future areas of research, including the unfolding economic impact of COVID-19, as well as the co-design and evaluation of tailored interventions and/or gatekeeper training for those in the financial and welfare sector, and enhanced early education aimed at increasing financial literacy in young people before onset or exacerbation of financial hardship.

Dyslipidemia as a Risk Factor for Suicidal Behavior

Dyslipidemia as a Risk Factor for Suicidal Behavior

The Influence of COVID-19 Pandemic on the Frequency of Suicides in Croatia.

Suicides are among the leading causes of death in the world and pose a major public health problem. It is not yet entirely clear to what extent the 2019 coronavirus pandemic (COVID-19) affects suicide rates, but is likely to result in an increase in risk factors for suicidal behaviors. The research objective was to compare the suicide rate in 2019 with the suicide rate in 2020 in the Republic of Croatia. A cross-sectional study was conducted for the period from January 2019 to December 2020. The necessary data on persons who committed suicide in the Republic of Croatia in that period were collected in cooperation with the Osijek-Baranja County Police Department. The number of suicides in that period was statistically processed according to demographic characteristics, suicide motives, days of the week and months by years. There was no significant difference in the total number of suicides comparing 2019 and 2020. Observed by months, significantly more suicides were committed during February 2020 compared to February 2019 (χ2-test, p=0.04). According to marital status, in 2019 compared to 2020, significantly more suicides were recorded among married persons (χ2-test, p<0.001) and among those who were unemployed (χ2-test, p<0.001). Persons with the status of veterans committed suicide significantly more often in 2019, compared to 2020 (χ2-test, p<0.001) During 2019, compared to 2020, significantly more suicides were committed by persons working in service and trade occupations (χ2-test, p=0.001). At the beginning of the pandemic in Croatia, in February 2020, there was a significant increase in suicides compared to 2019, which may indicate that the spread of the pandemic since the end of 2019, with uncertainty and cataclysmic atmosphere, had a negative effect on mental health.

Prevalence and Determinants of Suicidal Ideation and Suicide Attempt in People With Human Immunodeficiency Virus in Africa: a Systematic Review

People with human immunodeficiency virus (HIV) are at higher risk of suicidal ideation and suicide attempts. We reviewed the literature for the prevalence and determinants of suicidal ideation and suicide attempt in people with HIV in Africa. The PubMed, Scopus, and Google scholar were searched for original studies published in peer-reviewed journals in English language between January 2015 to July 2020, using the key words: 'suicidal behavior', 'suicidal attempt', 'suicidal ideation', 'HIV/AIDS', and/or 'Africa'. The quality of included studies was assessed using the Newcastle-Ottawa scale. 12 cross-sectional studies published in the past 5 years in African countries were included. The quality of studies was high, with score ranging from 6 to 9. The prevalence of suicidal ideation ranged from 8.8% to 39%. The prevalence of suicide attempt ranged from 2.8% to 20.1%. The most common risk factors for suicidal behaviour were mental health-related problems. Other factors included high clinical stage of HIV, being unmarried, poor medication adherence, poorer quality of life, not taking highly active antiretroviral therapy, female sex, no education, substance use, low CD4 level, and opportunistic infection. Patients with HIV/AIDS have an increased risk of suicidal ideation and suicide attempts. Early screening, treatment, and referral of suicidal patients are necessary for HIV clinics.

The Relationship Between Mental Pain, Suicide Risk, and Childhood Traumatic Experiences: Results From a Multicenter Study.

Objective: Mental pain and exposure to maltreatment are significant risk factors for suicidal behavior. This study aimed to investigate whether mental pain could be associated with a recent suicide attempt and whether it could mediate the relationship between childhood traumatic experiences and suicide risk in psychiatric patients.Methods: A multicenter observational study was organized as a joint project with representatives of numerous mixed Italian academic and clinical settings. Between December 2017 and March 2020, batteries of tests were administered to patients, assessing suicidal ideation and behavior, mental pain (usual and worst mental pain in the past 15 days), depression, and childhood maltreatment.Results: A total of 2,137 psychiatric patients (1,313 women and 824 men) were included in the final sample, and 315 reported having attempted suicide in the last 3 months. Suicide attempters (compared to nonattempters) had higher odds of reporting worse mental pain (odds ratios [ORs] between 1.02 and 1.17; P < .001) and suicidal intent with/without a specific plan (ORs between 11.57 and 11.77; P < .001). They also had higher odds of having a personality disorder (borderline personality disorder: ORs between 2.65 and 3.01; P < .001; other personality disorders: ORs between 1.96 and 2.28; P < .01) and major depression (ORs between 1.62 and 1.70; P < .05). Childhood trauma was associated with suicide risk directly (standardized effects between 0.06 and 0.07; P < .01) and indirectly through mental pain (usual mental pain: standardized indirect effect = 0.11, P < .001; worst mental pain in the past 15 days: standardized indirect effect = 0.12, P < .001).Conclusions: Mental pain constitutes a crucial framework for assessing the individual need for psychiatric help. Assessing mental pain allows identification of the main ingredient of suicide risk and puts the clinician in a strategic position to unlock some motives behind the wish to die. Further research is needed to learn if childhood adversities may interact with adult mental pain and thus foster suicide risk.

Urgent care and suicidal behavior in the child and adolescent population in a psychiatric emergency department in a Spanish province during the two COVID-19 states of alarm.

IntroductionThe COVID-19 outbreak and lockdown may have an impact in mental health among youth, but reports of psychiatry emergency department encounters in young Spanish population are scarce. The aim of this study is to characterize the reasons for psychiatric urgent care of youth during COVID-19 pandemic in our hospital.Material and methodsThis cross-sectional study compare visits to the psychiatry emergency department and their characteristics in young patients in the province of Lleida before and after the pandemic with special attention to the two states of alarm and suicidal behavior. Information regarding sociodemographic status, chief complaints, diagnosis, characteristics of suicidal behavior, and other data were obtained from the electronic medical records.ResultsWithin the total psychiatric emergency attendances, youth patients increased a 83.5% in the second state of alarm (p = 0.001). In this period patients were younger (p = 0.006), had less psychiatric history (p = 0.017) and their living conditions changed with an increase of those living with relatives (p = 0.004). Suicidal ideation care increased without statistical significance (p = 0.073). Multiple logistic regression identifies independent risk factors for suicidal behavior being female (OR: 2.88 [1.39–5.98]), living with relatives (OR: 3.49 [1.43–8.54]), and having a diagnosis of depression (OR: 6.34 [3.58–11.24]).ConclusionsThe number of young people seen in psychiatric emergencies during the chronic stage of the pandemic increased, and these were getting younger and without previous psychiatric contact. The trend to higher rates of suicidal ideation indicates that youth experienced elevated distress during these periods, especially women, living with relatives and presenting depression.

Epidemiological Risk Factors of Suicidal Behavior and Effects of the Components of Coping Strategies on Suicidal Behavior in Medical Students: A North-Indian Institution-Based Cross-Sectional Study.

Background Mental stresses and adoption of poor coping strategies can be a cause of suicidal behavior in medical students. Objective The aim of this study is to evaluate the prevalence and risk factors of suicidal behavior, and effects of the components of coping strategies on suicidal behavior among medical students Methodology An institution-based cross-sectional study was conducted among medical students of a college located in North India for a period of 2 months from February to March 2021. A total of 531 study participants (calculated sample size) were selected, and then allocated proportionally to each academic year, both through stratified random sampling technique. Then, the participants were asked to complete a self-administered questionnaire consisting of sociodemographic characteristics, Patient Health Questionnaire-9, Suicidal Behaviors Questionnaire-Revised (SBQ-R), and coping inventory. A pretest was done to modify the coping inventory and then exploratory factor analysis was performed on it to classify the components of coping strategies. Chi-square test and multiple logistic regression analysis were used to determine the risk factors and their association with suicidal behavior. Results A total of 104 (19.6%) respondents had reported SBQ-R cutoff score > 7 and had suicidal behavior. The rate of lifetime suicidal ideation, plan, and attempt was 20.3, 10.3, and 2.3%, respectively, among medical students, with 1-year prevalence of suicidal ideation at 33%. The mean age of the participants was 21.26 years (standard deviation = 1.99). The identified risk factors significantly associated with higher suicidal behavior were depression (odds ratio [OR] = 9.6), dissatisfaction with academic performances (OR = 4.9), and coping with mental disengagement (OR = 4.6), while coping with supportive strategies (OR = 0.57) was investigated as a preventive factor for the suicidal behavior. Conclusion The prevalence of suicidal behavior is found to be highly alarming, revealing that depression and poor coping strategies are risk factors among medical students. The analysis recommends that quantification of the problems, treatment at an early stage, and proactive student counseling to help them embrace the appropriate coping strategies, should be the first steps in prevention of suicidal behavior.

Antisuicidal (protective) factors in recovery from schizophrenia

IntroductionDetermination of antisuicidal factors (AF) in balance with risk factors for suicidal behavior (SB) is essential for treatment and prophylactic measures.ObjectivesStudy AF in a sample of schizophrenic recovered patients (F.20, ICD-10) according to operational criteria R.P. Liberman et al. (2002).MethodsThe content analysis of published self-reports of a sample (n = 13) of Russian and foreign psychiatrists and clinical psychologists with psychotic experience was used as a part of a more extensive qualitative analysis of «wounded healers».ResultsIn the history of &gt; ½ (i.e., 7) ex-patients, repeated SPs (aborted suicides), as well as non-suicidal self-harm (e.g., self-cutting), were noted during the active period of the disease, and in four of them – during untreated psychosis. Following AFs can be distinguished in recovery state: clinical (absence of potentially suicidogenic residual depression or/and anxiety, according to criteria N.C. Andreasen et al. (2005) social (professional goals, coping with stigmatization), and existential (e.g., hope, gaining a whole Self ).ConclusionsAF is an important integral component of recovery in schizophrenia as a process of personality development despite a burden of severe mental disorders.DisclosureNo significant relationships.

Risk Factors of Suicidal Behaviour in old age

Several observational studies investigated risk factors for suicide attempts/completed suicides in older age with contrasting evidence from ongoing population-based research. The risk factors most associated to suicide attempts than other variables were: depressive disorders, methods employed to self-harm (particularly poisoning), and psychotropic drug utilization followed by psychological factors and disability. Moreover, male sex, violent methods to self-harm, any psychiatric disorder (depression, anxiety and bipolar disorders), a poor medical condition, stressors/bereavement, and living alone appeared to be more significant for predicting completed suicides in late life. There is growing evidence of a role of environmental exposures in the pathogenesis and epigenetics of suicidal behavior in older age. Little is known about the possible relationship between suicidal ideation in older age and its biopsychosocial predictors, although psychiatric disorders (among which late-life depression, LLD), play a fundamental role. LLD, distinguished as late-onset depression (LOD) and early-onset depression (EOD). Suicidal ideators accounted for 2.32% of subjects, were female, smokers and obese affected by multimorbidity. After adjusting for age, gender, education and social dysfunction, suicidal ideation was associated to LLD (EOD&gt;LOD:OR:21.71, 95% CI:9.22-51.14). In the full random forest model, asthma was the most important contributor to suicidal ideation. Among biomarkers, interleukin (IL)-6 followed by tumor necrosis factor (TNF)-a, Apolipoprotein E e4 allele-carriers, C-reactive protein contributed most to suicidal ideation. Although EOD is a strong determinant of suicidal ideation, other non-psychiatric factors, i.e., serum inflammation biomarkers, APOE e4 allele, and multimorbidity, should be taken into account when evaluating a suicidal ideation phenotype in older age.DisclosureNo significant relationships.

Suicide and Ageism

Suicide in old age is frequently considered the result of a rational decision. Accumulation of physical illnesses, frailty, dependence on others, loss of partner and loneliness are often seen as reasons that might justify suicidal acts. Depression is an important risk factor for suicidal behaviour even at very advanced age. However, ageistic views tend to consider depression as a normal feature of the aging process; it is possible that its presence can be overestimated or perhaps generalized more than necessary by making it the scapegoat of any situation related to suicide. In fact, adopting an attitude that involves excessive simplification of problems, where everything is attributable to ‘depression’, can induce a rigid prescriptive approach, often limited to the indication of an antidepressant drug. In this way, the appreciation of the multifactorial nature of an individual’s crisis becomes too narrow and the chances of counteracting the complexities of a dangerous suicide progression too modest. From a prospect of suicide prevention, approaching a patient carefully and prudently is always to be preferred to the disposition that considers life events as inevitable as well as all reactions related to them, including the most extreme, such as suicide. This attitude can lead to a poor involvement of the treating physicians, who might become too acceptant of the ‘unavoidability’ of the unfavourable progression of their patient. Such a passive approach may especially characterise the relationship with patients of very advanced age, where stressors of physical and non-physical nature easily aggregate, multiplying their impacting power.DisclosureNo significant relationships.

Low level of perfectionism as a possible risk factor for suicide in adolescents with attention-deficit/hyperactivity disorder

IntroductionPrevious research highlighted that adolescents with attention-deficit/hyperactivity disorder (ADHD) are four times as vulnerable to suicidal behavior as the healthy population. Maladaptive perfectionism is also viewed as an important risk factor for suicide. Yet, there are no studies which focused on the relationship between perfectionism and suicide among adolescents with ADHD.ObjectivesThe objective of the present study was to explore if perfectionism may be a risk factor for suicidal behavior in adolescents with ADHD.MethodsThe clinical group was recruited from outpatient clinics, while the non-clinical group was recruited from high schools around Hungary. The clinical group’s inclusion criterion was ADHD diagnoses, while the non-clinical group required the absence of any current or past psychiatric treatment or diagnoses.ResultsIn the ADHD group 88 adolescents participated, and 96 adolescents participated in the non-clinical group. There was no difference regarding the level of perfectionism in the groups, except one dimension of perfectionism, which is ‘Organization’. The ADHD group had significantly higher level of suicidal behavior than the control group ((χ2 (1) = 11.222, p &lt; .001, V = 0.25). Among the ADHD group adaptive perfectionism was significantly negatively correlated with suicidal behaviour.ConclusionsAdolescents with ADHD did not have a different level of perfectionism than the healthy control group only in ‘Organization’ trait. This result could add to the therapeutic work with adolescents diagnosed with ADHD with underlining the importance to focus on organizational skills. The result highlights that adaptive perfectionism appears to be a protective factor against suicidality.DisclosureNo significant relationships.

Risk Factors for Suicide Attempt During Outpatient Care in Adolescents With Severe and Complex Depression.

Background: Young people receiving tertiary mental health care are at elevated risk for suicidal behavior, and understanding which individuals are at increased risk during care is important for treatment and suicide prevention. Aim: We aimed to retrospectively identify risk factors for attempted suicide during outpatient care and predict which young people did or did not attempt during care. Method: Penalized logistic regression analysis was performed in a small high-risk sample of 84 young people receiving care at Orygen's Youth Mood Clinic (age: 14-25 years, 51% female) to predict suicide attempt during care (N = 16). Results: Prediction of suicide attempt during care was only moderately accurate (Area Under the Receiver Operating Curve range 0.71; sensitivity 0.57) using a combination of sociodemographic, psychosocial, and clinical variables. The features that best discriminated both groups included suicidal ideation during care, history of suicide attempt prior to care, changes in appetite reported on the PHQ-9, history of parental separation, and parental mental illness. Limitation: Replication of findings in an independent validation sample is needed. Conclusion: While prediction of suicide attempt during care was only moderately successful, we were able to identify individual risk factors for suicidal behavior during care in a high-risk sample.

The Role of Transdiagnostic Variables Within Gender Differences in Adolescents' Self Reports of Suicidal Ideation and Suicide Attempts.

The incidence of suicide attempts peaks during adolescence, with adolescent girls having a higher rate of attempts than boys. Depression is one of the main risk factors of suicidal behaviour and yet not all adolescents with suicidal ideation or attempting suicide have a diagnosable depressive disorder. The present study examined the unique contributions to suicidal ideation and attempting suicide of cognitive processes known to be associated with depression and anxiety, but which are also transdiagnostic: anomalous perception of reality, intolerance of uncertainty, and rumination. 605 adolescents (M= 13.22, SD= 1.03, 47% girls) were evaluated in a cross-sectional study. Multiple linear regression showed that the anomalous perception of reality and intolerance of uncertainty were uniquely associated with the severity of suicidal ideation, even when accounting for symptoms of depression and anxiety, but only amongst girls. In a logistic regression, self-reported depression symptoms, and not underlying cognitive processes, predicted the likelihood of a person having attempted suicide versus not having done so. In adolescent girls, less frequently evaluated transdiagnostic variables may have an important impact on suicidal ideation. However, depression symptoms, and not these transdiagnostic variables, seem to be the greatest contributor to attempting suicide.

Social Support Reduces the Risk of Unfavorable Parenting Styles for Suicidal Behaviors in Early Adolescents

Objective Depression and perceived stress are important risk factors for suicidal behaviors among adolescents. The current study examined the joint effects of parenting styles on suicidal ideation (SI) and attempt (SA) in early adolescents while considering relevant individual factors, and evaluated whether social support can offset the risk. Methods The present study was part of a large cohort study aiming at tracing the mental health and risk behaviors in adolescents, and we utilized baseline data collected from 645 4th grade students with complete assessment of suicidal behaviors, social support, parental bonding, depression, and perceived stress. Participants’ mean age was 9.97 years (SD = 0.38) with 53.02% boys. Logistic regression was performed to analyze the associations between independent variables and youth suicidal behaviors. Results 16.28% students reported to have SI and 4.96% had SA. Depression (SI: OR = 3.66-3.89; SA: OR = 3.98–4.50), father’s low care and high authoritarian (LCHA) (SI: OR = 3.04; SA: OR = 2.43), and low acceptance and high authoritarian (LAHA) (SI: OR = 3.58; SA: OR = 4.77) parenting styles were strong risk factors, while overall social support (SI: OR = 0.98; SA: OR = 0.97) was a protective factor of SI and SA for early adolescents. Perceived stress (OR = 1.07–1.08) and mother’s LCHA parenting style (OR = 2.03) were risk factors of SI. Overall, a family with LCHA parenting (OR = 2.82) or LAHA parenting (OR = 3.35–3.72) regardless parental gender had increased risk for SI and SA. Conclusion Family and social factors are important to consider in suicidal prevention and interventions among early adolescents, in addition to assessing individual risk factors. Highlights Suicidal ideations (16.28%) and attempts (4.96%) were prevalent in early adolescents at elementary schools. Depression status remains a significant risk factor for both SI and SA in early adolescents. Unfavorable parenting styles (LCHA or LAHA) increased the risk of SI and SA, especially received from father. Overall social support had independent protective effect on suicidal behaviors, when taking aforementioned individual and family risk factors into account.

Suicide in cancer patients undergoing palliative care: A report of two cases

Introduction. Suicide represents a major public health problem worldwide, and cancer patients might have vulnerability factors which increase suicide risk. There are multiple factors associated with this tragic outcome, including those stemming from the disease itself, mental illness and social, personal and spiritual factors. Although previous reports have identified a suicide rate which ranges from .03-7% among cancer patients undergoing palliative care, this has not been studied in Mexico. Objective. This study sought to report the cases of suicide in patients with cancer undergoing palliative care at a large cancer reference center. Method. A retrospective review of records was performed between 2018-2019 for patients treated at the Palliative Care Service of the Instituto Nacional de Cancerología in Mexico City. Records for patients who committed suicide were reviewed to describe factors associated with this outcome. Results. Among all deaths identified during the record review, two were due to suicide (.09%). The patients were one female and one male, 60 and 42 years of age, diagnosed with breast cancer and gastroesophageal junction cancer, respectively, associated with tobacco and alcohol consumption, as well as several economic, social, and familial stress factors. One of the patients was identified as likely having major depressive disorder. Discussion and conclusion. Deaths might be underreported in our population. A systematic evaluation is required in order to establish and detect suicidal behavior risk factors, and a follow-up plan for all these patients.

The concurrence of sexual violence and physical fighting among adolescent suicide ideators and the risk of attempted suicide

Sexual violence and physical fighting are independent risk factors for suicidal behaviors among adolescents. However, whether the concurrence of these two risk factors increases the risk of suicidal behaviors among ideators, and by how much that risk increases are unknown. This study analyzed data from the 2019 National Youth Risk Behavior Surveys. Students who reported having seriously considered attempting suicide in the past year were included (n = 1755). The associations between physical fighting/sexual violence status and the risk of suicide attempt/plan/attempt requiring medical intervention were estimated. The concurrence of physical fighting and sexual violence substantially increased the relative risk of attempted suicide (adjusted relative risk, adRR = 1.99, 95% CI 1.72, 2.29) and attempted suicide requiring medical intervention (adRR = 4.07, 95% CI 2.84, 5.85; subgroup analyses: among women, adRR = 3.33, 95% CI 2.14, 5.17; among men, adRR = 6.25, 95% CI 3.32, 12.28). Among students who had experienced concurrent physical fighting and sexual violence, more suicide-attempt-associated health-risk behaviors were reported by men (median = 14) than women (median = 12) (p = 0.0023). The concurrence of physical fighting and sexual violence among adolescent suicide ideators was shown to be significantly associated with an increased risk of attempted suicide. A wide variety of health-risk behaviors were shown to cluster with the concurrence of physical fighting and sexual violence. This was especially the case among men, consistent with their higher rate of attempted suicide requiring medical intervention.

Suicides and ambient temperature in Switzerland: A nationwide time-series analysis.

Previous literature suggests that ambient temperature may play a role in increasing the risk of suicide. Although in Switzerland suicides are an important cause of death, limited research exists on risk factors for suicidal behaviour, including ambient temperature. We aimed to assess the short-term association between ambient temperature and suicide risk in Switzerland between 1995 and 2016, and the differences by region, individual characteristics and method of suicide. We collected daily data on suicides and mean temperatures in each canton of Switzerland. We used a two-stage approach, consisting of a case time series analysis using conditional quasi-Poisson and distributed lag non-linear models followed by a multivariate meta-regression analysis. We conducted subgroup analyses by sex, age (<35, 35-65 and >65 years) and method of suicide (violent or nonviolent). Between 1995 and 2016, there were a total of 24,067 suicides in Switzerland. Overall, we found a positive and non-linear temperature-suicide association in all regions. On average, the risk of suicide increased by 34% (1.34 relative risk [95% confidence interval: 1.19-1.52]) from the 10th to the 99th temperature percentile in Switzerland (lag period of 0-2 days). Indications of larger risks were mostly found in females, younger individuals (<35 years) and with nonviolent methods. Regional risks ranged from 24% (East region) to 55% (North-West region). Our findings suggest that increasing temperatures could be considered a risk factor for suicidal behaviour in Switzerland. Knowledge of the profile of people committing suicide could help us to understand the mechanisms behind this association and thus support policymakers in suicide prevention.

A controlled examination of acute warning signs for suicide attempts among hospitalized patients.

Near-term risk factors for suicidal behavior, referred to as 'warning signs' (WS), distinguish periods of acute heightened risk from periods of lower risk within an individual. No prior published study has examined, using a controlled study design, a broad set of hypothesized WS for suicide attempt. This study addressed this gap through examination of hypothesized behavioral/experiential, cognitive, and affective WS among patients recently hospitalized following a suicide attempt. Participants were recruited during hospitalization from five medical centers across the USA including two civilian hospitals and three Veterans Health Administration facilities (n = 349). A within-person case-crossover study design was used, where each patient served as her/his own control. WS were measured by the Timeline Follow-back for Suicide Attempts Interview and were operationalized as factors that were present (v. absent) or that increased in frequency/intensity within an individual during the 6 h preceding the suicide attempt (case period) compared to the corresponding 6 h on the day before (control period). Select WS were associated with near-term risk for suicide attempt including suicide-related communications, preparing personal affairs, drinking alcohol, experiencing a negative interpersonal event, and increases in key affective (e.g. emptiness) and cognitive (e.g. burdensomeness) responses. The identification of WS for suicidal behavior can enhance risk recognition efforts by medical providers, patients, their families, and other stakeholders that can serve to inform acute risk management decisions.

Risk factors for suicidal behaviour in late-life depression: A systematic review.

BACKGROUNDSuicide is a leading cause of preventable death worldwide, with its peak of maximum incidence in later life. Depression often puts an individual at higher risk for suicidal behaviour. In turn, depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing. AIMTo gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults, and to examine the effects of depression treatment to tackle suicide behaviour in this population. METHODSA systematic review of empirical studies, published from 2000 onwards, was conducted. Suicidal behaviour was addressed considering its varying forms (i.e., wish to die, ideation, attempt, and completed suicide).RESULTSThirty-five papers were selected for review, comprising both clinical and epidemiological studies. Most of studies focused on suicidal ideation (60%). The studies consistently pointed out that the risk was related to depressive episode severity, psychiatric comorbidity (anxiety or substance use disorders), poorer health status, and loss of functionality. Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults. Finally, the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response. Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms.CONCLUSIONTo sum up, common and age-specific risk factors seem to be involved in suicide development in depressive older adults. A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well.