Suicide is the 2nd leading cause of death for young adults in the United States, and rates are particularly high among psychiatric patients in the year following psychiatric hospitalization. However, the prediction of suicidal behavior continues to be a challenge. We examined hair cortisol concentrations (HCC)-reflecting HPA axis activity over the preceding months-as an objective marker of risk for suicidal behavior across the full spectrum of suicidal behavior, including death by suicide. Participants were 238 young adults across the spectrum of suicide (i.e., suicide; suicide attempt; suicidal ideation; psychiatric comparison; 57% male) and 43 individuals who died by drug overdose (56% male). Data were collected via self-report, clinical interview, medical records review, and hair sampling (i.e., 3 cm segments). Multivariate regression models were used to examine the relationship between group and HCC, controlling for covariates. HCC was significantly lower in individuals who died by suicide compared to those with a suicide attempt [Difference in EMMs (SE) = -0.64 (0.20), p = 0.010, d = 0.73], suicidal ideation [Est. Diff (SE) = -0.89 (0.20), p < 0.0001, d = 1.02], and psychiatric comparison individuals [Est. Diff (SE) = -0.74 (0.26), p = 0.022, d = 0.85]. Lower HCC may serve as an objective marker that signals risk for death by suicide among high-risk adults, which have important clinical implications for the prediction and prevention of suicide. Future studies with larger sample sizes are needed to replicate these findings and to make assaying HCC accessible for its translation into clinical practice.

Alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are frequently comorbid and are individually associated with increased risk of suicidal behavior. However, whether their comorbidity exacerbates this risk has not been adequately investigated. Using a Swedish birth cohort (born 1970-1990; N = 799,203-858,983), we employed Aalen's linear hazards models to evaluate the risk of non-fatal suicide attempt (SA) as a function of registration for AUD and/or PTSD. Models were stratified by sex and considered the temporal ordering of AUD and PTSD. We adjusted for registrations of major depression (MD) and other key covariates. The overall incidence of SA ranged from 16.52 to 19.29 per 10,000 person-years (PY). In models adjusted for MD and other covariates, PTSD accounted for an additional 12.19-22.09 SA cases per 10,000 PY; the corresponding range for AUD was 43.24-80.04, and the difference in effect size across predictors was more pronounced where AUD preceded PTSD. Comorbidity exacerbated risk: The interaction between PTSD and AUD accounted for 71.13-179.41 additional SA cases per 10,000 PY. In secondary models, interactions between AUD and MD conferred additional SA risk (40.50-127.88 additional SA cases per 10,000 PY), while interactions between PTSD and MD were very weak and, in most cases, negative (-13.26-3.29). PTSD and AUD are independently associated with SA, but risk is substantially exacerbated among comorbid individuals. While the total effect of these conditions on SA risk is overall comparable across sexes, females whose PTSD precedes AUD are particularly burdened by comorbidity.

Gender-based violence (GBV) against older women represents a critical public health problem and human rights violation. Older women experience unique vulnerabilities and invisibility regarding GBV, with severe health consequences. The aim was to examine the rates and health impacts of GBV among Spanish women aged ≥65 years and analyze its effect on health and suicidal behavior. A descriptive study analyzed data collected in 2019 from a nationwide macro-survey conducted in Spain, which included 9,568 women aged 16 years and older. A total of 2,357 older women, aged 74.2 ± 6.9 years, were selected. Sociodemographic variables were collected, as was lifetime GBV exposure by perpetrator type (intimate partner violence [IPV], non-partner, combined, and any interpersonal) and form (e.g., physical, psychological, economic, sexual, etc.), along with health outcomes (self-rated health and psychological distress) and suicidal behavior. Among participants, 23.4% reported lifetime IPV (psychological: 14.1%; physical: 6.1%; economic: 8.7%; sexual: 6.1%; controlling behaviors: 17.1%), while 9.3% experienced non-partner violence (family perpetrators: 2.9%; strangers: 2.9%). Overall, 29.0% reported any interpersonal violence exposure. IPV was significantly associated with poorer self-rated health (adjusted odds ratios, aOR = 1.64; 95% CI [1.34, 2.01]), higher psychological distress (aOR = 1.80; [1.45, 2.23]), and increased suicidal ideation (aOR = 3.89; [2.80, 5.40]). Non-partner violence showed associations with suicidal ideation (aOR = 2.44; [1.60, 3.72]). These findings show substantial GBV rates among older women and their significant health impacts, highlighting the need for age-specific screening and intervention strategies in geriatric care settings.

Suicidal ideation and suicidal behaviour constitute major public health concerns and represent key predictors of suicide, particularly in psychiatric hospital settings and during the post-discharge period. Evidence consistently indicates that suicide risk remains elevated after discharge from psychiatric hospitalisation, especially among adolescents and young adults. The objective of this systematic review was to synthesize empirical evidence on suicidal ideation in hospital contexts, with a specific focus on predictors, trajectories, and post-hospitalisation outcomes. A systematic search was conducted using the Web of Science database with the keywords “suicidal ideation” and “hospitalisation,” applying filters for open-access articles published in English over the last two decades. From an initial pool of 718 records, 50 studies met inclusion criteria based on relevance, methodological rigor, and direct focus on suicidal ideation or suicidal behaviour in inpatient or post-discharge contexts. The results indicate that suicidal ideation following hospitalisation follows heterogeneous longitudinal trajectories, with chronic and persistent patterns conferring the highest risk for suicide attempts and rehospitalisation. Key risk factors include hopelessness, emotional dysregulation, prior suicide attempts, trauma exposure, and adverse psychosocial environments, whereas family connectedness and continuity of care emerge as protective factors. The discussion underscores that psychiatric hospitalisation may temporarily stabilize acute crises while shifting vulnerability to the post-discharge phase, highlighting discharge as a critical intervention point. In conclusion, suicide risk after psychiatric hospitalisation is a dynamic and multidimensional process. Effective prevention requires sustained and temporally responsive strategies that extend beyond hospitalisation and integrate clinical, psychosocial, and emerging digital approaches.

Objective Males are at increased risk for suicide, yet less likely to seek and maintain professional help. This discrepancy suggests that current healthcare services may not be adequately tailored to males’ needs. This study explores the experiences, barriers, and needs of healthcare providers (HCPs) in supporting males with suicidal ideation and behaviors to inform gender-sensitive mental healthcare practices. Methods A mixed-method design was used, combining quantitative data from questionnaires, with qualitative data from focus groups, interviews and open-ended questionnaire responses. Results A total of 128 HCPs from diverse professions and settings in Flanders (Dutch-speaking part of Belgium) filled in the questionnaires, eight participated in interviews or focus groups. The findings revealed gender differences in various aspects of treatment. HCPs reported more difficulty discussing suicidal ideation (59.4%) and underlying emotions (77.1%) with males. Males were perceived to prefer practical, goal-oriented interventions and to require more motivational interviewing (46.9%) and psychoeducation (46.9%). Qualitative analyses provided further insight into possible mechanisms behind these gender differences, emphasizing the influence of societal stigma and traditional gender norms on males’ socialization and emotional expression. HCPs noted that males often sought care only during acute suicidal crises. Conclusions This mixed-method study provides valuable insights into the needs and experiences of HCPs in supporting males with suicidal thoughts. The findings underscore the importance of gender-responsive practices in mental healthcare to address systemic barriers faced by males with suicidal ideation. Tailored interventions, destigmatization efforts, and enhanced HCP training are essential to improve engagement and outcomes for this high-risk group.

Clinical and epidemiological profiles of suicidal behavior in psychiatric emergency users: A 13-year retrospective study of 40,306 cases in Madrid, Spain.

This study is original in that it identified the care trajectories of patients with substance-related disorders (SRDs) over a 9-year period, and associated these trajectories with the patients' sociodemographic and clinical characteristics, quality of care received, and subsequent adverse outcomes (high emergency department use, repeated hospitalizations, suicidal behaviors, death). Health administrative databases from Quebec, Canada (1996-2022) were used to investigate a cohort of 4075 patients with SRDs. Group-based multi-trajectory modeling was produced to identify profiles of care trajectories from April 1st 2012 to March 31st 2021. Multinomial regressions and survival analysis were conducted to associate profiles to patient characteristics, and adverse outcomes over the following year. Five profiles of care trajectories were identified: "Low overall but increasing care use" (Profile 1, 30% of sample); "High, increasing outpatient physical health care use" (Profile 2, 26%); "High, increasing outpatient SRD care use" (Profile 3, 15%); "High overall care use" (Profile 4, 14%); and "Increasing but moderate outpatient care use" (Profile 5, 15%). Profiles 3 and 4 used substantially more SRD outpatient care. Patients in Profiles 4 and 5 had more complex health conditions and engaged in more varied, sustained care over time, but subsequently experienced the worst adverse outcomes. In contrast, Profile 1 patients had better overall health conditions, followed by Profile 2 (older at SRD onset, less materially deprived) and 3 (more SRD issues), which both exhibited higher continuity of care than Profile 1. Profile 3 had the lowest rate of treatment dropouts. Use of care and adverse outcomes were strongly linked to the patients' clinical conditions. Tailored interventions may be recommended for each profile: outreach and motivational interventions for Profile 1; applying the chronic care model for Profile 2; high continuity of physician and SRD care for Profile 3; assertive community treatment for Profile 4; and intensive case management for Profile 5. To better address the unmet needs of patients with SRDs, overall outpatient services may be substantially consolidated and improved. Acute care providers and general practitioners may also play a key role in identifying patients with SRDs and referring them to appropriate outpatient services.

Toxicological risk profiles in suicide: The forensic value of hair-based substance detection.

ABSTRACT Suicide is a leading cause of death worldwide, and is one of the most devastating, complex, and perplexing of all human behaviors. Unfortunately, despite centuries of scientific and scholarly inquiry, suicidal thoughts and behaviors remain exceedingly difficult to understand, predict, and prevent. Fortunately, recent advances in mathematical, computational, and digital methods are providing new opportunities to capture and model the immense complexity of suicidal thoughts and behaviors. In this paper, we first provide a brief review of existing literature and then identify four priorities for future research, including: 1) rigorous conceptual and descriptive research, 2) formal theory development and refinement, 3) measurement in context and over time, and 4) prediction of group- and individual-level suicide risk. Finally, we discuss cross-cutting considerations related to ethical dilemmas, enhancing diversity, and training the next generation of scientists. Together, these future directions offer an actionable agenda to guide the future of suicide research and make meaningful progress toward reducing its global burden.

Cerebellum-cerebrum functional connectivity mediates the association between Adverse Childhood Experiences and suicidal behaviors in depressed adolescents.

Childhood maltreatment and suicidal behaviors among heterosexual and sexual minority youth in China.

Association between tirzepatide use and risk of mortality, hospitalization, and suicidal behavior in patients with schizophrenia spectrum disorders: A one-year retrospective cohort study of 3618 patients.

Aboriginal and Torres Strait Islander Peoples share rich cultural traditions unrivalled across the world; however, the continued impact of colonisation led to sustained, profound trauma that has spanned generations. With Aboriginal and Torres Strait Islander people presenting to hospital emergency departments (ED) for self-harm and suicidal behaviours at a rate 2.9 times higher than non-Indigenous people, there is a need to develop culturally appropriate interventions to address this growing problem. This paper sought to describe the co-design process of culturally adapting a brief therapeutic intervention for Aboriginal and Torres Strait Islander young people who display self-harm and/or suicidal behaviours. The adaptation focus was Therapeutic Assessment (TA), a brief intervention provided to young people who present to the ED with self-harm. The process was split into two phases located in Geraldton and Meekatharra, two communities in the Mid-west of Western Australia. In phase one, three male Aboriginal young people (aged between 16 and 19 years old) and eight Aboriginal Elders participated in two yarning circles run on one day. In phase two, 26 Aboriginal young people (aged between 12 and 25 years old), five Aboriginal senior members of the community and one Aboriginal carer participated in a combination of small yarning circles and/or single interviews. This paper describes the elements of the culturally safe process of adapting a brief intervention for Aboriginal and Torres Strait Islander young people experiencing self-harm and/or suicidal behaviours. Two points are important to note. The first is that implementing a culturally safe process can be an outcome in itself, and second, that the principles supporting cultural safety can assist in evaluating how non-Indigenous researchers implement this process.

Suicidal behaviour is a leading cause of morbidity and mortality for women during the perinatal period, yet a synthesis of evidence on interventions is lacking. This review sets out to answer two questions: (i) what interventions have been conducted to reduce suicidal behaviour in women during the perinatal period? (ii) what interventions for perinatal suicidal behaviour are perceived as effective, acceptable and feasible by perinatal women? This systematic review followed the Preferred Standards for Systematic Reviews and Meta-Analysis (PRISMA), and the review protocol was prospectively registered with PROSPERO (CRD42024524681). Six databases were searched from their respective inception dates until April 2, 2024. The search string comprised keywords relating to the perinatal period, intervention approaches and suicide. The searches yielded five eligible studies. The eligible studies used a variety of designs, including one non-randomised controlled trial, two cross-sectional studies and one cohort study and one case series. The results of this systematic review indicate that research is urgently needed using more robust approaches and consistent, validated measures of suicidal behaviour, both at baseline and follow-up. This review has scope for informing future interventions with women at risk of or experiencing suicidal behaviour and highlights the importance of a whole family, trauma-informed, integrated model of care approach to perinatal suicidal behaviour interventions.

An assessment of mental health challenges and occupational stressors among public safety personnel senior leadership.

The influence of interpersonal relationships on self-harm, suicidal ideation and suicide attempts in adolescents: A cross-sectional study in Eastern China.

Suicidal thoughts and behaviours among construction workers: Identifying risks and protective factors.

Differences in personality traits among individuals with suicidal thoughts and behaviors and non-clinical populations: A systematic review and meta-analysis.

Effectiveness of psychoeducation for family members of suicide attempters in preventing recurrent suicidal behaviour: A secondary analysis of the ACTION-J Study.

Intimate partner violence in United States military veterans: Results from the National Health and Resilience in Veterans Study.