Risk Of Suicidal Ideation Research Articles

Suicide and suicide attempt in users of GLP-1 receptor agonists: a nationwide case-time-control study.

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are extensively evaluated for the risk of suicidal behaviors or ideation; the influence of psychiatric history or obesity on this potential effect remains to be investigated. Therefore, we aimed to assess the association between GLP-1 RA and suicide or suicide attempt, considering these factors. Patients ≥18y who died by suicide or were hospitalized for suicide attempt (2013-2021) with at least one GLP-1 RA dispensing within the 180 preceding days were selected from the French National Health Data System (SNDS). A case-time-control design compared, for each patient, GLP-1 RA exposure in the 30 days preceding the outcome (composite of suicide or suicide attempt) to three earlier 30-day reference periods. Potential exposure trend bias was controlled using up to five time-controls matched on age, sex, psychiatric history, obesity, calendar time. Analyses were adjusted for time-varying confounders. Finally dipeptidyl peptidase-4 (DPP-4) inhibitors were studied as negative controls for potential biases. This study included 1102 cases and 5494 controls. Mean case age was 57.4 years (SD 11.4); 44.6% were male, 67.6% had a recent psychiatric history and 51.3% had obesity. GLP-1 RA use was not associated with an increased risk of suicide or suicide attempt (OR, 0.62; 95% CI, 0.51-0.75), with consistent results for DPP-4 inhibitors (0.75; 0.67-0.84). Results obtained according to recent psychiatric history and obesity were comparable. This large nationwide case-time-control study provides reassurance about the short-term psychiatric safety of GLP-1 RA, showing no specific risk for patients with psychiatric disorders or obesity. French Medicines Agency.

Interpersonal Discrimination as a Potential Source of Individual-Level Anomie and its Consequences for Suicide Ideation

ABSTRACT The relationship between interpersonal discrimination and suicidality has received increasing attention. However, research has not considered whether this relationship differs between independent forms of discrimination and how exposure to multiple forms may relate to suicidality among U.S. adults. Drawing from neo-Durkheimian paradigms of anomie, I conceptualize interpersonal discrimination as a potential source of individual-level anomie and then delineate how the attribute behind discrimination could matter to suicidal thoughts. I further consider how experiencing multiple forms of discrimination may amplify the risk of suicidality. To investigate my theoretical propositions, I use 2016–2018 data from U.S. adults ages 33–43 in the National Longitudinal Study of Adolescent to Adult Health to compare the associations between three forms of discrimination—racial/ethnic, biological sex, and body weight—and suicide ideation, and then consider how experiencing multiple forms relates to suicide ideation. Principal findings indicate that weight discrimination has a stronger positive association with suicide ideation than racial/ethnic- or sex discrimination, but individuals who experienced all three forms had an especially high risk of suicide ideation. This study underscores how the attribution behind discrimination matters to the risk of suicidal thoughts and that exposure to multiple forms increases its likelihood.

Natural disasters and suicidal behaviour: An updated systematic review.

This systematic review aims to update and extend the findings of an earlier review on the suicidogenic impact of natural disasters. A systematic search of research published in 17 bibliographic databases was conducted (PROSPERO CRD42020216722). The review following PRISMA checklist identified 64 primary studies, published between 2012 and 2022, investigating the association between natural disasters and suicidal behaviour and ideation. The majority of studies related to natural disasters in Japan, China, USA, India and Australia. Over half the studies (n = 39) investigated the impact of earthquakes. Other disasters included hurricanes, floods, tsunamis, droughts, wildfires, tornadoes and multiple disasters. Concerning suicide mortality (the most studied suicide-related outcome), there was variability in the suicidogenic impact of earthquakes depending on location, age, sex and time elapsed since the event. While suicide mortality appeared to increase following drought, investigations of hurricanes/tornadoes and floods found no evidence of a similar association. Findings relating to other suicide-related outcomes are more consistent, suggesting that exposure to droughts, hurricanes, tsunamis, floods, and other natural disasters is associated with increased risk of suicidal ideation and non-fatal suicidal behaviour. This association, however, is dependent on other factors, including the level of structural adversity in the exposed population (e.g., unemployment, poverty, food insecurity), individual vulnerabilities (e.g., physical and mental health), local resources, and availability of support. Publications in languages other than English, French, Spanish, Italian and Portuguese may have been missed. The heterogeneity and methodological weakness of primary studies limited our ability to provide definitive responses to our research questions. The considerable inconsistency in the findings reported across these studies, particularly relating to suicide mortality, is noteworthy. While this may be an artefact of methodological limitations, it is possible that there are substantive ('real') differences in the impact of natural disasters on suicidal behaviour linked to the type of disaster, the socioeconomic and sociocultural context, the type of suicidal behaviour, or other explanatory factors.

Correlates of suicidal ideation and suicide attempts among bisexual+, gay/lesbian, and heterosexual young adults.

Compared to their exclusively gay/lesbian or heterosexual identifying peers, young people identifying as bisexual+ (e.g. bisexual, pansexual, asexual, queer or questioning) are at elevated risk for suicidal ideation (SI) and attempts (SA). The present study aimed to establish whether the prevalence of, and psychosocial risk factors for, SI and SA vary as a function of sexual identity. Young adults (N = 274; 18-29 years old) were recruited via online crowdsourcing. They completed questionnaires assessing adverse childhood experiences (ACEs), emotion dysregulation, impulsivity, depression symptoms and lifetime history of SI and SA. Spearman correlations, Kruskal-Wallis H-tests and binomial logistic regression models were used. No variable was associated with SI. Bisexual+ individuals reported greater SA than the heterosexual group, though statistically similar to the gay/lesbian group. A similar pattern emerged for ACEs. The bisexual+ group reported greater depression symptoms than the gay/lesbian group. Impulsivity and emotion dysregulation did not vary by sexual identity. Controlling for these psychosocial and sociodemographic variables did not alter results: bisexual+ individuals were almost three times more likely to report SA than heterosexual individuals, OR = 2.93 95% CI [1.16, 7.44]; gay/lesbian and heterosexual individuals had a statistically similar likelihood of reporting SA, OR = 1.09, 95% CI [0.27, 4.37]. This is the first study to establish that young adults identifying as bisexual+ are at greater risk for SA after controlling for well-established psychosocial correlates; this was not the case for SI. Further work is needed to establish the aetiology of this risk.

Polygenic risk scores in relation to suicidality among youth with or at risk for bipolar disorder.

The risk of suicide among individuals with bipolar disorder (BD) is among the highest of all psychiatric disorders. The etiology of suicidality is complex and multifactorial, with genetic factors playing a prominent role according to twin-, family-, and molecular genetic studies. This study examines polygenic risk scores from adult studies in relation to suicidality in youth with or at risk for BD. Primary analyses examined the association of polygenic risk scores for suicide attempt, based on adult genome-wide association study data, with suicidal ideation, self-harm, and suicide attempt in 232 youth (mean age 16.7 years), including 125 with, and 107 at high-risk for, BD. We also tested polygenic risk scores for risk tolerance, schizophrenia, major depressive disorder, BD, and attention-deficit hyperactivity disorder in secondary analyses. Polygenic risk scores for suicide attempt were not significantly associated with suicidal ideation, self-harm, or suicide attempt. Higher polygenic risk scores for major depressive disorder were nominally associated with increased risk of suicidal ideation in the overall sample (beta = 0.36, se(beta) = 0.16, p = 0.017), controlling for covariates. Our finding that polygenic risk for depression is associated with suicidal ideation converges with prior findings in youth and adults. While present findings are constrained by sample size, they underscore the importance of undertaking genome-wide association studies in youth, rather than relying solely on prior adult genome-wide association studies.

Proinflammatory gene expression is associated with prospective risk for adolescent suicidal thoughts and behaviors over twelve months.

Recent theories have implicated inflammatory biology in the development of psychopathology and maladaptive behaviors in adolescence, including suicidal thoughts and behaviors (STB). Examining specific biological markers related to inflammation is thus warranted to better understand risk for STB in adolescents, for whom suicide is a leading cause of death. Participants were 211 adolescent females (ages 9-14 years; Mage = 11.8 years, SD = 1.8 years) at increased risk for STB. This study examined the prospective association between basal levels of inflammatory gene expression (average of 15 proinflammatory mRNA transcripts) and subsequent risk for suicidal ideation and suicidal behavior over a 12-month follow-up period. Controlling for past levels of STB, greater proinflammatory gene expression was associated with prospective risk for STB in these youth. Similar effects were observed for CD14 mRNA level, a marker of monocyte abundance within the blood sample. Sensitivity analyses controlling for other relevant covariates, including history of trauma, depressive symptoms, and STB prior to data collection, yielded similar patterns of results. Upregulated inflammatory signaling in the immune system is prospectively associated with STB among at-risk adolescent females, even after controlling for history of trauma, depressive symptoms, and STB prior to data collection. Additional research is needed to identify the sources of inflammatory up-regulation in adolescents (e.g., stress psychobiology, physiological development, microbial exposures) and strategies for mitigating such effects to reduce STB.

Exploring the association between hearing status and suicidal ideation among U.S. adults: An observational study.

Suicidal ideation is a critical public health concern, and its relationship with hearing status has garnered increasing attention. This study aimed to investigate the association between hearing status and suicidal ideation in a nationally representative sample of U.S. adults. Data were analyzed from 8095 participants in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression models, along with restricted cubic spline (RCS) analyses, explored the relationship between hearing status and suicidal ideation, adjusting for potential confounders. Subgroup analyses by sex, race, education level, marital status, family monthly poverty level, vision trouble, mobility trouble, smoking, hypertension, diabetes, coronary heart disease, stroke, and cancer were conducted. A Zero-Inflated Poisson (ZIP) regression model was applied to explore the association between hearing status and the level of suicidal ideation. Participants with more difficulty hearing showed a higher likelihood of experiencing suicidal ideation (P<0.05 for all). Further analysis using RCS regression confirmed a linear relationship between hearing status and suicidal ideation risk (Pnonlinear>0.05). Subgroup analyses revealed no significant interactions across different stratifications (P>0.05 for all). The ZIP analysis revealed that individuals with moderate hearing trouble or those identified as deaf or hard of hearing exhibited higher frequencies of suicidal ideation. This study identifies an association between hearing status and suicidal ideation among U.S. adults. Factors such as discrimination, social isolation, environmental inaccessibility, and communication barriers may underlie this relationship. Interventions aimed at reducing suicidal ideation should focus on addressing these underlying factors, improving access to supportive resources, and promoting inclusive and accommodating environments for individuals with hearing difficulties.

Pengaruh Stigma Seksual Terhadap Ideasi Bunuh Diri pada Individu Lesbian Gay Bisexual Transgender (LGBT) Dewasa Awal

This study aims to examine the influence of sexual stigma on suicidal ideation in early adult lesbian, gay, bisexual, and transgender (LGBT) individuals aged 18-29 in Indonesia. Suicidal ideation is a global mental health issue frequently experienced by LGBT individuals due to discrimination and stigma. The study employed a quantitative survey design, involving 120 LGBT early adult participants selected through purposive sampling. The research instruments included an adapted version of the Sexual Stigma Scale to measure sexual stigma and the Adult Suicidal Ideation Questionnaire (ASIQ) to measure suicidal ideation. Data analysis utilized linear regression to assess the influence of sexual stigma on suicidal ideation. The results revealed a significant positive relationship between sexual stigma and suicidal ideation, with a Pearson correlation coefficient of 0.414 (moderate category) and a significance value of 0.000 (p &lt; 0.01). Sexual stigma contributed 17.1% to suicidal ideation, indicating a significant influence while acknowledging the presence of other influencing factors. These findings emphasize that higher sexual stigma is associated with an increased risk of suicidal ideation in LGBT individuals..

The Influence of Negative Emotion and Self-Acceptance on Suicidal Ideation of Disabled College Students: The Mediating Effect of Hopelessness

Background: Disabled college students are facing special life pressures and social challenges due to physical and psychological obstacles. Given such difficulties, they may experience a high level of negative emotion (NE) that aggravates their risk of suicidal ideation. As a positive psychological trait, self-acceptance is very important to promote the mental health of disabled college students and reduce their risk of committing suicide. A state of high-intensity hopelessness easily mediates the influence of the NE and self-acceptance of disabled college students. Methods: A group questionnaire survey was conducted among 663 college students with disabilities across 16 universities from Zhejiang Province. These surveys involved the use of a self-acceptance questionnaire, NE questionnaire, suicidal ideation questionnaire, and the Beck hopelessness scale, and the mediating role of hopelessness in the influence of NE and self-acceptance on the suicidal ideation of disabled college students was tested. Results: Self-acceptance had a significantly negative influence on suicidal ideation (P&lt;0.01), while NE exerted a significantly positive influence (P&lt;0.01). Hopelessness partially mediated the influence of NE on the suicidal ideation of disabled college students and exerted a masking effect on the influence of self-acceptance on suicidal ideation. Hopelessness was a key psychological mechanism that bonds NE and self-acceptance with suicidal ideation. Conclusion: The mental health intervention measures for disabled college students should include self-acceptance strategies and skills for reducing these students’ NE to relieve their hopelessness and further reduce their risk of committing suicide.

Academic performance and suicidal ideation in young maladaptive daydreamers, a cross-sectional descriptive study.

To find the relationship between maladaptive daydreaming with academic performance and suicidal ideation in young adults. The cross-sectional, descriptive study was conducted from August 1 to November 30, 2022, after approval from the ethics review committee of the Islamic International Medical College, Rawalpindi, Pakistan, and comprised individuals who were part of an online community of maladaptive daydreamers. Screening was done using the Maladaptive Daydreaming Scale and the Suicidal Ideation Attributes Scale. Data was analysed using SPSS 22. Of the 485 subjects, 344(71%) were females and 141(2%) were males. The overall mean age was 21.65±4.9 years. Of the total, 441(90.9%) subjects were screened as maladaptive daydreamers; 323(73.2%) females and 118(26.7%) males. Maladaptive daydreamers had a significant association with both declining academic scores and suicide ideation (p<0.001). Maladaptive daydreamers were more likely to have an adverse effect on academic grades and were at a higher risk of suicide ideation than non-maladaptive daydreamers.

Social-Ecological Determinants of Suicidal Ideation Among Sexual and Gender Minority Adults: A Cross-Sectional Study in the United States.

Background/Objectives: Sexual and gender minority (SGM) adults are at an increased risk for suicide and suicidal ideation compared with cisgender/heterosexual adults. Due to the complexity of suicidal ideation, individual, social, and systemic factors must be considered. The purpose of this study was to identify determinants of suicidal ideation among SGM adults using constructs from the Social-Ecological Model (SEM). Methods: This was a cross-sectional study of data collected from 1034 SGM adults between 27 January and 7 February 2022, and variables reflected the four constructs of the SEM, including individual, family, community, and societal levels. Hierarchical multiple linear regression was used to enter the variables in blocks. Results: The final model explained 55% of the variance in suicidal ideation, and determinants of suicidal ideation were identified at all four levels. At the individual level, factors were depression (p < 0.001, β = 0.231), anxiety (p < 0.001, β = 0.279), vigilance distress (p = 0.036, β = 0.157), not being out/open (p = 0.046, β = 1.136), having some college education (p = 0.002, β = -1.875), and personal strength (p = 0.012, β = -0.131). Family of origin discrimination distress was significant at the family level (p = 0.016, β = 0.174). Social resources (p < 0.001, β = -0.113), victimization distress (p < 0.001, β = 0.795), and harassment/discrimination distress (p = 0.035, β = 0.179) were significant at the community level. At the social level, SGM protective state law score (p = 0.43, β = -0.35) and having a proposed or enacted transgender sports ban (p = 0.027, β = 1.480) were significant. Conclusions: Understanding the factors across the various levels of the SEM that influence suicidal ideation allows for the development of multi-level, social-ecological suicide prevention programs. Such programs can address the unique needs of SGM individuals and help mitigate suicidal ideation.

Frontal Pole Neuromodulation for Impulsivity and Suicidality in Veterans With Mild Traumatic Brain Injury and Common Co-Occurring Mental Health Conditions: Protocol for a Pilot Randomized Controlled Trial.

Suicide remains a leading cause of death among veterans in the United States, and mild traumatic brain injury (mTBI) increases the risk of suicidal ideation (SI) and suicide attempts (SAs). mTBI worsens impulsivity and contributes to poor social and occupational functioning, which further increases the risk of SI and SAs. Repetitive transcranial magnetic stimulation is a neuromodulatory treatment approach that induces neuroplasticity, potentially repairing neurodamage. Intermittent theta burst stimulation (iTBS) is a second-generation form of transcranial magnetic stimulation that is safe, shorter in duration, displays a minimal side effect profile and is a promising treatment approach for impulsivity in mTBI. Our novel proposed treatment protocol uses frontal pole iTBS to target the ventromedial prefrontal cortex, which may reduce impulsivity by strengthening functional connectivity between the limbic system and frontal cortex, allowing for improved top-down control of impulsive reactions, including SI and SAs. The objectives of this study are to (1) develop an iTBS intervention for veterans with mTBI, impulsivity, and SI; (2) assess the feasibility and tolerability of the intervention; and (3) gather preliminary clinical outcome data on SI, impulsivity, and functions that will guide future studies. This is a pilot, double-blinded, randomized controlled trial. In developing this protocol, we referenced the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) guidelines. We will enroll 56 participants (28 active iTBS and 28 sham iTBS). The iTBS intervention will be performed daily, 5 days a week, for 2 weeks. We will collect 10 validated, psychometric, quantitative outcome measures before, during, and after the intervention. Measures included will assess functioning, impulsivity, suicidality, posttraumatic stress disorder, and depressive symptoms. We will collect qualitative data through semistructured interviews to elicit feedback on the participants' experiences and symptoms. We will perform quantitative and qualitative analyses to (1) assess the feasibility, tolerability, and acceptability of the treatment; (2) gather advanced neuroimaging data to assess neural changes elicited by treatment; and (3) assess improvements in outcome measures of impulsivity and suicidality in veterans with mTBI. This study protocol was approved by the Edward Hines, Jr. VA Hospital Institutional Review Board (Hines IRB number 14-003). This novel treatment is a 5-year research project (April 1, 2023, to March 31, 2028) funded by the Veterans Administration Rehabilitation Research and Development service (CDA2 award IK2 RX002938). Study results will be disseminated at or before the project's end date in March 2028. We will provide preliminary evidence of the safety, feasibility, and acceptability of a novel frontal pole iTBS treatment for mTBI, impulsivity, SI and SAs, and functional deficits. ClinicalTrials.gov NCT05647044; https://clinicaltrials.gov/study/NCT05647044. PRR1-10.2196/58206.

Breakfast consumption was associated with suicidal ideation, plan, and attempt: a population-based cross-sectional study

BackgroundAlthough several studies have explored the association between breakfast consumption and suicidal behaviors among children and adolescents, such associations have been less frequently reported among adults and seniors.MethodThis population-based cross-sectional study was conducted in Hebei Province, China. A total of 21, 376 community residents aged 18 years and older were interviewed. This study evaluated the breakfast frequency per week (BFF), full breakfast frequency (FBF), suicidal ideation, suicide plans, and suicide attempts of the participants. Sociodemographic variables, living alone, and sleep quality were also measured.ResultsThe prevalence of suicidal ideation, plans, and attempts were 1.4, 0.3, and 0.2%, respectively. Compared to ≥6 days/week BFF, 2–3 days/week BFF was positively associated with suicidal ideation (OR = 1.93, p &amp;lt; 0.01), suicide plan (OR = 2.73, p &amp;lt; 0.05), and suicide attempts (OR = 3.46, p &amp;lt; 0.05). In addition, participants with 2–3 days/week FBF was also at higher risk of suicidal ideation (OR = 2.06, p &amp;lt; 0.001), comparing with never FBF.ConclusionThe reported prevalence of suicidal ideation, plans, and attempts were lower compared to other countries. Lower breakfast frequency was positively associated with suicidal behaviors, and participants with 2–3 days/week of full breakfast consumption were also at a higher risk of suicidal ideation.

Prevalence and Clinical Correlates of Suicidal Ideation and Attempts in Individuals at Clinical High Risk for Psychosis.

Individuals with psychosis symptoms are at high risk for suicidal ideation and attempts. The prevalence and correlates of suicidal ideation and attempts in clinical high risk for psychosis (CHR-P) have yet to be clarified. This study reports on the prevalence and clinical correlates of suicidal ideation and attempts in a clinical CHR-P sample. Participants (n = 135) included CHR-P clients at a CHR-P community specialty clinic, who participated in a clinical assessment between 2017 and 2022. Assessments measured attenuated psychosis symptoms, suicidal ideation and attempts, clinical covariates, and functioning. Frequency analyses assessed the prevalence of lifetime suicidal ideation and attempts and t-test and Chi-square identified clinical correlates. Logistic regression assessed the relationship between significant clinical correlates and lifetime suicide attempts. Sixty-five percent of participants at CHR-P endorsed lifetime suicidal ideation, while 22.2% reported at least one lifetime attempt. Correlates for lifetime suicidal ideation included self-reported gender expansive identity, hopelessness, depression, trauma, obsessive compulsive symptoms, insight: reflectiveness, trauma diagnoses, mood disorder diagnoses, and perceptual abnormalities/hallucinations. Significant correlates for lifetime suicide attempts included self-reported hopelessness, depression, trauma diagnosis and mood disorder diagnosis. CHR-P clients are at a higher risk for suicidal ideation and attempts compared to the general population. Correlates of suicidal ideation and attempts may be diagnostically heterogeneous and therefore interventions should be tailored to specific clinical needs. Clients with trauma-disorder diagnoses may be at highest risk for suicidal ideation and attempts. Continued intervention and longitudinal research is needed to clarify causal risk factors and establish evidence-based treatments for suicidal ideation and attempts in CHR-P.

No Way Out? Cognitive Rigidity and Depressive Symptoms Associated with Suicidal Thoughts and Behaviors in Autistic Youth.

Research has found increased premature mortality among autistic individuals, with suicide being one of the most common causes of premature death in autistic youth. This study aimed to fill literature gaps related to suicidal thoughts and behaviors (STB) in autistic youth by exploring the clinical predictors of suicidal ideation (SI) and suicidal and/or self-injurious behavior (SSIB) in 404 autistic youth from a clinic database. Consistent with prior literature, STB were elevated in autistic youth compared to general population rates. Self-reported suicidal ideation and behaviors were increased in autistic youth assigned female at birth. Caregivers reported greater SI in older autistic youth as compared to younger youth. Logistic regression analyses showed that elevated depressive symptoms and greater cognitive rigidity significantly increased the likelihood of SI in autistic youth. Results have important implications for understanding factors that increase the risk for suicidal ideation and behaviors in autistic youth and informing the development of responsive interventions.

Dementia subtypes and suicidality: A systematic review and meta-analysis.

Recent research has highlighted a link between dementia and increased risk of suicidal ideation, suicide attempts and suicide deaths. Understanding the relative risk of suicide between subtypes of dementia is important for services to offer appropriate intervention. We searched five databases from inception to July 2023 for peer-reviewed publications reporting suicidal ideation, suicide attempt or death by suicide for at least two dementia subtypes. Meta-analyses compared suicidality between subtypes of dementia with Alzheimer's Disease (AD). From 4983 studies identified, 12 met inclusion criteria. Pooling data, people with Vascular Dementia were significantly more likely to experience suicidal ideation (OR= 2.02 [95 % CI= 1.06;3.8]) and attempt suicide (OR=1.94 [95 % CI= 1.28;2.94]) than people with AD, but not die by suicide (OR= 1.05 [95 % CI= 0.69;1.59]). People with Dementia with Lewy Bodies were significantly more likely to report suicidal ideation (OR= 1.56 [95 % CI= 1.09;2.23]) than AD but not attempt suicide (OR= 1.12 [95 % CI= 0.83;1.50]). People with Frontotemporal Dementia were significantly more likely to attempt suicide (OR= 2.42 [95 % CI= 1.02;5.72]) than people with AD but not report suicidal ideation (OR= 1.67 [95 % CI= 0.34;8.33]). People with Mixed Dementia were significantly more likely to attempt suicide (OR= 2.83 [95 % CI= 1.52;5.27]) than people with AD but not report suicidal ideation (OR = 1.65 [95 % CI= 0.5;5.46]). Further research is needed to understand what underlies the increased risks of suicidal ideation and suicide attempts for rarer subtypes.

Suicide-related risk among patients using branded and generic fluoxetine: a propensity score-matched, new‐user design in Taiwan

BackgroundTo date, the clinical equivalence between branded and generic medications remains debate and may sometimes be a reason why psychiatrists are hesitant to prescribe generic medications. Depression is recognized to exacerbate suicide risk globally and selective serotonin reuptake inhibitors, such as fluoxetine are common treatment options. Therefore, this study aimed to explores differences in suicidal risks between users of branded and generic fluoxetine in Taiwan.MethodsThis cohort study used Taiwan Longitudinal Health Insurance Database, encompassing 2 million individuals covered by National Health Insurance (NHI) program. The full cohort consisted of 32,298 fluoxetine new users. Then, 7,380 branded and 7,380 propensity score matched (PSM) generic fluoxetine new users were identified. The study further utilized Cox proportional hazards models to assess risk of 5-year suicidal ideation, suicide mortality, and all-cause mortality.ResultsThe study revealed that the adjusted hazard ratios (HRs) for suicidal ideation, suicide mortality and all-cause mortality in branded users were 0.766 (95% CI, 0.497 − 1.181), 0.660 (95% CI, 0.447 − 0.975), and 0.942 (95% CI, 0.849 − 1.045), respectively, when compared with matched generic fluoxetine users. Stratified and sensitivity analyses showed the lower risk of suicide mortality in specific subgroups, such as male (adjusted HRs = 0.536, 95% CI = 0.306–0.939) and young branded users (adjusted HRs = 0.549, 95% CI = 0.334–0.904).ConclusionThis study observed trends in the prevention effects of suicide-related risks. However, only suicide mortality was statistically significant, especially in males and those aged < 40 years. These insights may assist clinicians and policymakers in decision-making.Clinical trial numberNA (This study is a cohort study utilizing the national health insurance database, not a clinical trial).

Suicidal ideation among Canadian adults during the third year of the COVID-19 pandemic compared to pre- and early pandemic periods

PurposeThis study examined the prevalence of suicidal ideation among adults in Canada during the third year of the COVID-19 pandemic comparing to the pre- and early pandemic periods, and assessed sociodemographic and pandemic-related factors. MethodsWe estimated prevalence of suicidal ideation from the Survey on COVID-19 and Mental Health (SCMH) conducted between February and May, 2023 (11,526 respondents, response rate 46.5 %), and compared with the prevalence in the 2019 Canadian Community Health Survey (57,034 respondents, response rate 54.9 %) and the 2021 SCMH (5,742 respondents, response rate 51.2 %). We used logistic regressions to assess the likelihood of reporting suicidal ideation. ResultsIn 2023, 3.8 % of adults reported suicidal ideation in the past 12 months, which was not significantly different from the 4.2 % in 2021, but higher than the 2.7 % in 2019. Adults aged 35-64 years and females 65 years or older had significantly higher prevalence in 2023 compared to 2019. Higher prevalence compared to the pre-pandemic baseline was also observed in other subpopulations, but none of them significantly differed from the prevalence in 2021. Adults who were aged 65 years or younger, White, Indigenous, born in Canada, with low income, without a spouse or child, LGBTQ2, with disability, or had experienced pandemic-related impacts had higher risk of suicidal ideation than their peers. ConclusionPrevalence of suicidal ideation remained elevated compared to the pre-pandemic baseline among most adults in Canada during the late pandemic period. Continued surveillance to evaluate middle and long-term impacts of the pandemic on mental health is needed.

Correlations between problematic internet use and suicidal behavior among Chinese adolescents: a systematic review and meta-analysis.

Problematic Internet Use (PIU) has been increasingly linked to suicidal behavior among adolescents, raising significant public health concerns, particularly in Chinese youth. This study aimed to systematically review and meta-analyze the correlation between PIU and suicidal behavior in Chinese adolescents to provide a clearer understanding of this association. A comprehensive search was conducted across seven databases up to July 1, 2024. Studies investigating the relationship between PIU and suicidal behavior among Chinese adolescents were included. A random-effects meta-analysis was employed to assess pooled effect sizes, with subgroup analyses conducted to explore potential moderators, such as geographic region, age, gender, assessment tools for PIU and suicidal ideation, and the presence of depression. Data analysis was performed using STATA software (version 16). This meta-analysis, comprising 23 studies with 353,904 participants, identified significant associations between PIU and suicidal behavior among Chinese adolescents. PIU was associated with increased risks of suicidal ideation (OR = 1.72, 95% CI: 1.45, 2.03), suicidal plans (OR = 1.50, 95% CI: 1.02, 2.20), and suicidal attempts (OR = 1.48, 95% CI: 1.16, 1.89). Subgroup analyses indicated higher risks in specific groups: adolescents from Central China (OR = 1.84, 95% CI: 1.46, 2.32), college students (OR = 2.09, 95% CI: 1.66, 2.62). The risk of suicidal ideation was particularly elevated when depression was not controlled (OR = 1.86, 95% CI: 1.53, 2.25). These findings underscore the need for targeted interventions in vulnerable populations. This meta-analysis demonstrated significant associations between PIU and suicidal behaviors among Chinese adolescents. The findings emphasize the need for targeted interventions, particularly for adolescents from Central and Western China, college students, and those with untreated depression. Focused strategies are required to mitigate the risks associated with PIU and to effectively address suicidal behaviors in these high-risk populations. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024577593, identifier CRD42024577593.

Revealing the potential causality of suicidal ideation and psychopathic symptoms among survivors 10 years after the Wenchuan earthquake using network analysis.

Little is known about the interactions and causal inference between psychopathic symptoms and suicidal ideation (SI) among earthquake survivors. Using a 10-year large cohort of Chinese adolescents exposed to the Wenchuan earthquake, this study aimed to structure networks of suicidal ideation and some specific symptoms of posttraumatic symptoms and depression among survivors of the Wenchuan earthquake to clarify the interactions and causality between these symptoms. A total of 684 survivors who completed surveys at 6 months and 10 years postearthquake and had one or above psychopathic symptoms were included in the analyses. Sociodemographic, posttraumatic stress symptoms, depressive symptoms, and suicidal ideation were measured at 6 months and/or 10 years postearthquake. Network analyses were performed based on R Version 4.1.3. The Gaussian graphical model network revealed that "depressed mood" had the highest expected influence value. In addition, the directed acyclic graph network revealed that anhedonia could affect "depressed mood," which further leads to "suicidal ideation." The pathway of "anhedonia → depressed mood → suicidal ideation" was a crucial psychopathic mechanism of suicidal ideation. It informs that intervening in anhedonia and depressed mood among earthquake-exposed survivors is necessary to potentially decrease the risk of future suicidal ideation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).