Suicide Attempts Research Articles

Suicide attempt survivors’ recovery-related agency in the relational context of services: a qualitative analysis

BackgroundSuicidal persons’ contacts with services present a key opportunity for suicide prevention. However, interventions by services are not always effective. A deeper understanding of suicidal service users’ agency and its implications may facilitate the provision of meaningful responses to help-seeking during suicidal crises. This abductive study explores the recovery-related agency of suicide attempt survivors and the perceived role of interactions with services in facilitating or hindering it.MethodsFourteen Finnish suicide attempt survivors were interviewed in-depth on their experiences of interacting with services during a recent suicidal episode. An operationalization of recovery-related agency as the expressed ability to take (mental or physical) action in a direction perceived as aiding recovery from suicidality (i.e., the coupling of recovery-related intentionality and power) was used to explore transcribed interviews through directed content analysis. Data were further categorized based on whether the service context was perceived as helpful or unhelpful to recovery efforts.ResultsAll participants expressed both agency and non-agency in relation to their recovery process. The relational context provided by services was presented as highly relevant for the achievement and sustainability of recovery-related agency as well as for participants’ experience of safety in instances when agency was lacking. The results are presented as a typology of recovery-related agency in its perceived relational context, with the categories of sustained agency, strained agency, contained non-agency and uncontained non-agency.ConclusionsThe concept of agency helped capture important aspects of suicidal individuals’ recovery-related efforts and the role of services in facilitating or hindering them. The findings illuminate the value of viewing suicidal service users as agents of their own recovery process as well as the potential costs of ignoring this perspective in service delivery and design.

Neuroinflammation, Stress-Related Suicidal Ideation, and Negative Mood in Depression

Brain translocator protein 18k Da (TSPO) binding, a putative marker of neuroinflammatory processes (eg, gliosis), is associated with stress and elevated in depressed and suicidal populations. However, it is unclear whether neuroinflammation moderates the impact of daily life stress on suicidal ideation and negative affect, thereby increasing risk for suicidal behavior. To examine the association of TSPO binding in participants with depression with real-world daily experiences of acute stress-related suicidal ideation and negative affect, as well as history of suicidal behavior and clinician-rated suicidal ideation. Data for this cross-sectional study were collected from June 2019 through July 2023. Procedures were conducted at a hospital-based research center in New York, New York. Participants were recruited via clinical referrals, the Columbia University research subject web portal, and from responses to internet advertisements. Of 148 participants who signed informed consent for study protocols, 53 adults aged 18 to 60 years who met DSM-5 diagnostic criteria for current major depressive disorder completed procedures with approved data and were enrolled. Participants were free of schizophrenia spectrum disorders, active physical illness, cognitive impairment, and substance intoxication or withdrawal at the time of scan. All participants underwent positron emission tomography imaging of TSPO binding with 11C-ER176 and concurrent arterial blood sampling. A weighted average of 11C-ER176 total distribution volume (VT) was computed across 11 a priori brain regions and made up the primary outcome measure. Clinician-rated suicidal ideation was measured via the Beck Scale for Suicidal Ideation (BSS). A subset of participants (n = 21) completed 7 days of ecological momentary assessment (EMA), reporting daily on suicidal ideation, negative affect, and stressors. In the overall sample of 53 participants (mean [SD] age, 29.5 [9.8] years; 37 [69.8%] female and 16 [30.2%] male), 11C-ER176 VT was associated at trend levels with clinician-rated suicidal ideation severity (β, 0.19; 95% CI, -0.03 to 0.39; P = .09) and did not differ by suicide attempt history (n = 15; β, 0.18; 95% CI, -0.04 to 0.37; P = .11). Exploratory analyses indicated that presence of suicidal ideation (on BSS or EMA) was associated with higher 11C-ER176 VT (β, 0.21; 95% CI, 0.01 to 0.98; P = .045). In 21 participants who completed EMA, 11C-ER176 VT was associated with greater suicidal ideation and negative affect during EMA periods with stressors compared with nonstress periods (β, 0.12; SE, 0.06; 95% CI, 0.01 to 0.23; P = .03 and β, 0.19; SE, 0.06; 95% CI, 0.08 to 0.30; P < .001, respectively). TSPO binding in individuals with depression may be a marker of vulnerability to acute stress-related increases in suicidal ideation and negative affect. Continued study is needed to determine the causal direction of TSPO binding and stress-related suicidal ideation or negative affect and whether targeting neuroinflammation may improve resilience to life stress in patients with depression.

Virtual Mental Health Care and Suicide-Related Events

The rising suicide rates in the US emphasize the need for effective prevention. While telehealth has transformed access to mental health care, the impact of telehealth on suicide outcomes is unknown. To evaluate the association of virtual mental health services with individual-level suicide-related events (SREs). This retrospective cohort study using broadband access as an instrumental variable assessed a national sample of Veterans Health Administration patients who received mental health care between March 1, 2020, and December 31, 2021. Participants were recently separated (ie, discharged or released from active duty) veterans who completed their active duty service between March 1, 2019, and December 31, 2020, and who received at least 2 outpatient or inpatient diagnoses related to major depressive disorder, substance use disorder, or posttraumatic stress disorder within the year before their most recent separation date. Data were analyzed May 1 to October 31, 2023. Percentage of a patient's total mental health visits that were conducted virtually by psychiatrists, psychologists, or social workers within a calendar month. Binary measure indicating whether the patient had experienced an SRE (defined as a nonfatal suicide attempt, intentional self-harm, or suicide death) in a specific month and year as evaluated an instrumental variable probit model. The sample included 66 387 data points from 16 236 unique recently separated veterans. Among these entries, 44 766 were for male veterans (67.4%), the mean (SD) age across the sample was 32.9 (8.9) years, and the sample was representative of the US veteran population. There were 929 SREs (1.4%). Virtual mental health visits comprised a mean (SD) of 44.6% (46.1%) of all mental health visits. In instrumental variable probit analyses accounting for factors simultaneously associated with use of virtual mental health care and SRE risk, a 1% increase in the probability of virtual mental health visits was associated with a 2.5% decrease in SREs. Findings from this cohort study using a retrospective quasi-experimental design found that an increase in virtual mental health visits relative to total visits was associated with a statistically significant decrease in SREs, suggesting that providing virtual mental health services may reduce suicide-related outcomes.

Predicting full-thickness necrosis in adult acute corrosive ingestion injuries in a sub-Saharan African setting

BACKGROUND Corrosive ingestion remains an important global pathology with high morbidity and mortality. Data on the acute management of adult corrosive injuries from sub-Saharan Africa is scarce, with international investigative algorithms, relying heavily on computed tomography (CT), having limited availability in this setting. AIM To investigate the corrosive injury spectrum in a low-resource setting and the applicability of parameters for predicting full-thickness (FT) necrosis and mortality. METHODS A retrospective analysis of a prospective corrosive injury registry (March 1, 2017–October 31, 2023) was performed to include all adult patients with acute corrosive ingestion managed at a single, academic referral centre in Cape Town, South Africa. Patient demographics, corrosive ingestion details, initial investigations, management, and short-term outcomes were described using descriptive statistics while multivariate analysis with receiver operator characteristic area under the curve graphs (ROC AUC) were used to identify factors predictive of FT necrosis and 30-day mortality. RESULTS One-hundred patients were included, with a mean age of 32 years (SD: 11.2 years) and a male predominance (65.0%). The majority (73.0%) were intentional suicide attempts. Endoscopy on admission was the most frequent initial investigation performed (95 patients), while only 17 were assessed with CT. Seventeen patients had full thickness necrosis at surgery, of which eleven underwent emergency resection and six were palliated. Thirty-day morbidity and mortality were 27.0% and 14.0%, respectively. Patients with full thickness necrosis and those with an established perforation had a 30-day mortality of 58.8% and 91.0%, respectively. Full thickness necrosis was associated with a cumulative 2-year survival of only 17.6%. Multivariate analyses with ROC AUC showed admission endoscopy findings, CT findings, and blood gas findings (pH, base excess, lactate), to all have significant predictive value for full thickness necrosis, with endoscopy proving to have the best predictive value (AUC 0.850). CT and endoscopy findings were the only factors predictive of early mortality, with CT performing better than endoscopy (AUC 0.798 vs 0.759). CONCLUSION Intentional corrosive injuries result in devastating morbidity and mortality. Locally, early endoscopy remains the mainstay of severity assessment, but referral for CT imaging should be considered especially when blood gas findings are abnormal.

Self-injury and suicidal behaviors in high-risk adolescents: Distal predictors, proximal correlates, and interactive effects of impulsivity and emotion dysregulation.

Suicide rates are rising among U.S. youth, yet our understanding of developmental mechanisms associated with increased suicide risk is limited. One high-risk pathway involves an interaction between heritable trait impulsivity and emotion dysregulation (ED). Together, these confer increased vulnerability to nonsuicidal self-injury (NSSI), suicide ideation (SI), and suicide attempts (SAs). Previous work, however, has been limited to homogeneous samples. We extend the Impulsivity × ED hypothesis to a more diverse sample of adolescents (N = 344, ages 12-15 at Baseline, 107 males and 237 females) who were treated for major depression and assessed four times over two years. In multilevel models, the impulsivity × ED interaction was associated with higher levels and worse trajectories of NSSI, SI, and SAs. As expected, stressful life events were also associated with poorer trajectories for all outcomes, and NSSI was associated with future and concurrent SI and SAs. These findings extend one developmental pathway of risk for self-harming and suicidal behaviors to more diverse adolescents, with potential implications for prevention.

Transgender and ASD identities associated with risk of suicide

Using data from students at colleges and universities, researchers has found that the combination of autism with transgender or gender‐nonconforming identities is associated with greater odds of suicide attempts. The findings point to a need to interventions for college students with autism and gender‐nonconforming identities.

Psychometric Properties of the Anxiety Measure: Stress and Anxiety to Viral Epidemics-6 (SAVE-6) for Spanish Medical Students

Backgroud and Objective: The aim of this study was to evaluate the psychometric properties of SAVE-6 in the medical student population and assess its gender invariance. Subjects and Methods: The sample consisted of 320 medical students aged 18–23 years (153 men and 167 women) who completed an anonymous online questionnaire. Data collection took place in June 2024. To assess the scale structure, a descriptive analysis of the items was carried out, followed by a confirmatory factor analysis (CFA). To analyze whether there were differences in the invariance of the measure by gender, a multigroup CFA was performed. Results: SAVE-6 showed high internal consistency, α = 0.89 and ω = 0.92, a minimum score of 12, a maximum score of 22, an unifactorial structure, and adequate convergent validity. Specifically, the following were found: the positive and significant relationship with HADS was 0.98 for the full scale, 0.76 for depression, and 0.91 for anxiety, and there was a negative and significant convergent validity with resilience (−0.82) and resilience to suicide attempts (−0.88). Regarding the gender invariance, relevant data is that the factor loadings between each item and the SAVE-6 factor were not the same, so women present a higher level of anxiety than men (Δχ 2 (6) = 42.53). Discussion: The results showed good internal reliability of SAVE-6 and good suitability. Data also revealed that they were not equal in relation to gender. Specifically, the scalar invariance revealed significant differences by items between men and women in anxiety. Conclusions: This scale can be applied to medical students as a reliable and valid instrument to assess the anxiety response to disease contagion in future health professionals.

Insights into young-onset dementia hospitalizations: An 8-year nationwide study using administrative data

ObjectiveTo characterize all Portuguese public hospitalizations of patients aged < 65 years with a primary or secondary diagnosis of dementia, based on ICD-9-CM coding. MethodsA retrospective observational study was conducted using a nationwide database encompassing all hospitalizations occurred in Portuguese mainland public hospitals with discharge from 2008 to 2015. Hospitalizations of patients aged 35–64 years with primary or secondary diagnoses of dementia were selected based on ICD-9-CM codes 290.1X-290.4X, 291.2, 292.82, 294.1X, 294.2X, 331.0, 331.1X, 331.82, 333.4 and 046.1, excluding diagnostic codes 317-319, 330.X, 343, 758.0-758.3 and 759.3. Information on age, sex, primary diagnosis, comorbidities (secondary diagnosis), type of admission, length of stay (LoS), in-hospital mortality, suicide attempts, discharge destination, readmissions and dementia etiology was collected. ResultsFrom 7971 hospitalizations, for 5682 inpatients, the median age was 57.3 years (SD±6.5) and 61.8% were of male patients. Vascular dementia was the most prevalent etiology, followed by Alzheimer's disease. Most admissions were urgent and had a primary diagnosis of ‘Delirium, dementia and other cognitive disorders’, followed by pneumonia and alcohol-related disorders. Dementia, cerebrovascular disease and diabetes were the most common comorbidities. Overall, 55.4% of admissions were first-time admissions during the study period and the median LoS was 10.0 days (Q1;Q3: 5.0;20.0). Suicide attempts were recorded in 0.6% of the episodes. The in-hospital mortality rate was 9.2% and most patients were discharged home (80.2%). ConclusionsThis study describes the complexity and strain of young-onset dementia hospitalizations providing a detailed overview and recommendations for further research and tailored interventions.

“When you are alone you have a narrow mind, but when you are with others you think broader into the other aspects”. A qualitative study on the role of sense of belonging and mattering in attempted suicide in Uganda

ABSTRACT Introduction Suicide is globally a severe problem with an estimated 700.000 deaths annually. Six of the 10 countries with the highest suicide rates worldwide are in Africa, though, reliable statistics are scarce. Method In this qualitative interview study in Uganda, we analysed the stories of 16 people admitted to hospital following a serious suicide attempt. We focussed especially on each person’s decision process towards their resolution to attempt suicide. Findings Despite the huge heterogeneity of the narratives, we could identify problems regarding the sense of belonging and mattering in all the stories. Both the sense of belonging and mattering have been related to suicidal behaviour in earlier theories, but they were never studied together or under consideration of the influence of this specific cultural context. We found that the participants’ sense of belonging and mattering to a large degree was influenced by their traditional communalistic context with a worldview where the line between the natural and spiritual world was blurry. Conclusion This kind of knowledge could be a valuable source for health professionals in their treatment of suicidal persons; it could direct their approach to the core of each person’s relational problems and meaning-making, which is crucial for their decisions with regard to suicide.

Can large language models be sensitive to culture suicide risk assessment?

AbstractSuicide remains a pressing global public health issue. Previous studies have shown the promise of Generative Intelligent (GenAI) Large Language Models (LLMs) in assessing suicide risk in relation to professionals. But the considerations and risk factors that the models use to assess the risk remain as a black box. This study investigates if ChatGPT-3.5 and ChatGPT-4 integrate cultural factors in assessing suicide risks (probability of suicidal ideation, potential for suicide attempt, likelihood of severe suicide attempt, and risk of mortality from a suicidal act) by vignette methodology. The vignettes examined were of individuals from Greece and South Korea, representing countries with low and high suicide rates, respectively. The contribution of this research is to examine risk assessment from an international perspective, as large language models are expected to provide culturally-tailored responses. However, there is a concern regarding cultural biases and racism, making this study crucial. In the evaluation conducted via ChatGPT-4, only the risks associated with a severe suicide attempt and potential mortality from a suicidal act were rated higher for the South Korean characters than for their Greek counterparts. Furthermore, only within the ChatGPT-4 framework was male gender identified as a significant risk factor, leading to a heightened risk evaluation across all variables. ChatGPT models exhibit significant sensitivity to cultural nuances. ChatGPT-4, in particular, offers increased sensitivity and reduced bias, highlighting the importance of gender differences in suicide risk assessment. The findings suggest that, while ChatGPT-4 demonstrates an improved ability to account for cultural and gender-related factors in suicide risk assessment, there remain areas for enhancement, particularly in ensuring comprehensive and unbiased risk evaluations across diverse populations. These results underscore the potential of GenAI models to aid culturally sensitive mental health assessments, yet they also emphasize the need for ongoing refinement to mitigate inherent biases and enhance their clinical utility.

Association and interaction between overweight/obesity and suicide attempts in young first-episode and drug-naïve patients with major depressive disorder

AimsThis research's objective was to explore the correlation of overweight/obesity and suicide attempts in young patients with major depressive disorder (MDD) and the related factors of suicide attempts in patients with/without overweight/obesity. MethodsThis study included 520 young patients with MDD who were first-episode and drug-naïve (FEDN), with an average age of 20.50±2.36 years. Height and weight of each subject were measured, and overweight was classified as 24≤BMI<28, and obesity as BMI≥28.Biochemical indicators were detected including blood glucose, lipid, and thyroid function indicators. Depressive symptoms, anxiety symptoms, and psychotic symptoms were evaluated using Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Positive and Negative Syndrome Scale (PANSS) positive subscale, respectively. ResultsOverweight/obesity was a separate factor influencing suicide attempts in subjects(p<0.05, OR=0.57, 95%CI: 0.34-0.95). Higher HAMD, HAMA scores, levels of total cholesterol (TC), thyroid stimulating hormone (TSH), and prevalence of thyroid peroxidase antibody abnormalities were seen in overweight/obese individuals who attempted suicide(all p values < 0.01).While in patients without overweight/obesity, those who attempted suicide had higher HAMD, HAMA, PANSS positive subscale scores, levels of TSH, fasting blood glucose, TC, blood pressure, prevalence of TSH abnormalities, and lower levels of high-density lipoprotein cholesterol(all p values < 0.01). ConclusionsIn young FEDN patients with MDD, overweight/obesity might influence the incidence of suicide attempts and related influences.

Suicide attempts in Martinique and Reunion Island and appointments no-show

ObjectivesStudies on suicidal behaviors in the French overseas territories remain rare. Although mental health resources are limited, some patients identified as being at risk of suicide do not attend the specialist consultations scheduled after identification or screening. Thus, the objective of our study was, firstly to provide a descriptive profile of patients followed up for a suicide attempt in Martinique and Reunion Island, and secondly to explore the risk factors associated with appointments no-show during follow-up. MethodsWe conducted an ancillary retrospective cross-sectional study using data from the APSOM study. Data were collected on 255 patients aged at least 16, admitted to hospital emergency departments after a suicide attempt and followed up in ambulatory care, including 137 in Martinique and 118 in Reunion Island. The characteristics of the sample were described by means [min, max] and proportions [95% confidence intervals]. Differences according to the presence of appointments no-show or not were analyzed using comparison tests of means and percentages (Chi2, Fisher and Wilcoxon). Factors associated with appointments no-show were analyzed using a bootstrapped multivariate logistic regression model. ResultsThe mean age of patients was 35 years [16–84 years]. Women were predominant with a sex ratio of 2.4:1 (71% women). Unemployment affected 37% [28%, 46%] of patients in Martinique and 49% [40%, 59%] in Reunion Island. Psychoactive substances consumption at the time of the suicidal act was observed in 36% [27%, 45%] of patients in Martinique and 34% [26%, 44%] in Reunion Island. The average number of suicide attempts was two per patient [1–20]. Finally, we found no significant association with appointments no-show except for center. Patients from Reunion Island were associated with better compliance than patients from Martinique (OR: 0.20 [0.05–0.65], P<0.012). ConclusionOur study provides a description of suicide attempts admitted to hospital and followed up in ambulatory care in two French overseas territories and suggests interesting approaches for adapting prevention strategies to the socioeconomic context and cultural realities of these territories, particularly outreach interventions for the most vulnerable patients.

Reciprocal relations between acute interpersonal negative life events and acute alcohol use: An examination of the 24 h preceding suicide attempts among hospitalized patients

ObjectiveTo examine the within-person relations between acute alcohol use and interpersonal negative life events (INLEs) in the 24 h preceding suicide attempts. MethodParticipants were 151 adult patients (67.55 % female; M age = 36.00) who were hospitalized within 24 h of a suicide attempt. Participants completed the Timeline Follow-back for Suicide Attempts interview to gather information about hourly events for the 24 h preceding their suicide attempt. Hierarchical logistic models were estimated to examine the influence of acute INLEs on next-hour alcohol use and acute alcohol use on next-hour INLEs. Biological sex and chronic alcohol use (past year) were evaluated as potential moderators. ResultsOverall, acute alcohol use was associated with increased odds of next-hour INLEs and acute INLEs were associated with increased odds of next-hour alcohol use. Moderator analyses indicated that the influence of alcohol use on INLEs increased as participants' level of chronic alcohol use decreased, and relations did not vary by biological sex. ConclusionsThere is a bidirectional relation between INLEs and alcohol use in the hours preceding suicide attempts. Understanding that these within-person interrelations may differ in strength depending on one's level of chronic alcohol use has practical utility for providers tasked with clinical decision making.

Estudio descriptivo de conducta suicida en adolescentes hospitalizados en la Unidad de Psiquiatría de un hospital de Madrid durante 2023.

The suicidal behavior among adolescents has shown a significant increase in the last decade, according to a study by the ANAR Foundation. Subsequently, there is a highlighted increase of 128% in the post-COVID-19 period. This study aims to analyze the reasons for admission and sociodemographic characteristics of adolescents hospitalized in 2023. An observational descriptive study was conducted at the Puerta de Hierro University Hospital. Out of the 229 recorded admissions, 78.6% were females and 21.4% males, with a mean age of 15.07 years. Suicidal ideation and suicide attempts were the main reasons for admission, with drug overdose being the most common method. The main diagnoses at discharge were mixed emotions and behavior disorder onset in childhood and adolescence, and adaptive disorder. The majority had a history of mental health problems. These findings reinforce the importance of prevention and early intervention programs to address suicide as an urgent public health issue.

Religiosity, Spirituality, Meaning-Making, and Suicidality in Psychiatric Patients and Suicide Attempters: A Systematic Review and Meta-Analysis

Abstract Learning Objective After participating in this CME activity, the psychiatrist should be better able to: • Explain current understanding of how religiosity, spirituality, and meaning-making (R/S/M) affect patients with psychiatric diagnoses. Introduction R/S/M generally protect against suicidality and suicide. Thus far, reviews on the topic have largely been descriptive, and there are no meta-analyses focused on psychiatric patients. This study systematically evaluates all empirical evidence on R/S/M’s potential influences on suicidality for psychiatric patients and recent suicide attempters. Methods A systematic PROSPERO preregistered search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was performed in MEDLINE and PsycInfo. Quantitative studies until 31 December 2022 on R/S/M and suicidality in psychiatric populations and recent suicide attempters were selected; psychological autopsy studies were excluded. Results The search identified 4,374 studies for screening. This resulted in 108 eligible studies for the systematic review and 75 studies for the meta-analysis, including 231 effect sizes (ES) and 17,561 subjects. Research focused mainly on the emotional, moral, and ritual aspects of R/S/M. Most research was cross-sectional; repeated R/S/M assessments were rarely reported. A combined significant and negative ES (Fisher Z = -0.13, p = .006, equivalent to Cohen's d = -0.26) was found for all good- and fair-quality studies. Conclusion Overall, R/S/M was associated with lowering suicidality. Maladaptive-distressing dimensions of R/S/M correlated with higher rates of suicidality (e.g., religious struggles). The explanatory value was limited by the predominantly cross-sectional nature of ESs. Registration and funding PROSPERO registration 2023 CRD42023398692; there was no funding involved.

No association between acne treatment with retinoids and suicide attempts in adolescents: A case-control study

No association between acne treatment with retinoids and suicide attempts in adolescents: A case-control study

Riesgo autolítico en población adolescente.

Suicidal behavior in adolescents has increased in recent years and consequently the psychiatric hospitalization due to the suicidal risk.In this article, a study is carried out on adolescents who are psychiatric inpatients in the Hospital 12 de Octubre in Madrid. The reasons for admission to a psychiatric hospital are analyzed and they show that the most common reason is risk of self-injury, whether suicidal ideation or frustrated suicide attempt. The methods used in suicide attempts are also studied. The results obtained are discussed and the importance of establishing adequate measures for the prevention and intervention of suicidal behavior is emphasized.

Assessing suicidality in adult ADHD patients: prevalence and related factors

BackgroundThe association between Attention-deficit hyperactivity disorder (ADHD) and suicidality has been subject of growing interest for research in the latest years. Suicidality was generally assessed categorically and without the use of validated instruments, leading to heterogeneous or even conflicting evidence. The prevalence of both suicidal ideation and attempts varies considerably, and the associated risk factors remain unclear. Our study investigated suicidality in ADHD using a dimensional approach and a validated and internationally recognized instrument. Our primary aim was to evaluate the prevalence of suicidal ideation (SI), severe suicidal ideation (SSI), suicidal behavior (SB) and non suicidal self-injury behavior (NSSIB) in a sample of adult patients with ADHD. The second objective was to identify sociodemographic and clinical features associated with increased risk of suicidality in these patients.MethodsThe sample included 74 adult patients with clinical diagnosis of ADHD. Suicidality was assessed by administering the Columbia-Suicide Severity Rating Scale. Logistic regressions were used to examine predictors of SI, SSI, SB and NSSIB.ResultsThe lifetime prevalence of SI and SSI were 59.5% and 16.2%, respectively. The 9.5% of patients showed lifetime SB, while NSSIB was found in 10.8% of the subjects. Lifetime SI was associated with severity of inattentive symptoms during adulthood, low self-esteem and impairment in social functioning. Lifetime SSI appeared related to severity of inattentive symptoms during childhood, attentional impulsiveness and number of hospitalizations, while physical activity appeared to be protective. The prevalence of lifetime SB and NSSIB did not appear significantly related to any socio-demographic or clinical feature.ConclusionsAdults with ADHD should be considered at risk of suicide and it is important to determine which patients are at higher risk, in order to guide preventive interventions. The association between ADHD and suicidal ideation did not appear to be influenced by psychiatric comorbidities, but rather by inattention itself, which represents the core symptom of ADHD.

Communication dynamics and media interactions of young adults who have attempted suicide: a qualitative thematic analysis

ObjectiveThe study examines the potential effects of communication processes and media consumption habits on suicide ideation among male and female young adults aged 18–29 who have attempted suicide at least once.MethodsIn-depth interviews were analyzed using MAXQDA Analytics Pro 2024, and thematic analysis was applied according to Braun and Clarke’s model.ResultsFour themes emerged: (1) Family-related factors, (2) sociopsychological factors, (3) sociocultural factors, and (4) media-related factors. Regarding family-related factors, most participants come from broken family structures and commonly report issues with family communication and experiences of violence. Regarding sociopsychological factors, anger issues, despair, and addictions among participants were observed to increase suicide tendencies. Regarding sociocultural factors, most participants expressed difficulties in conforming to society and feeling pressures from cultural or religious expectations. Regarding media-related factors, it was noted that a vast majority of participants spend long hours consuming media daily and frequently interact with content that leads them into adverse emotional states, primarily for time passing on social media platforms.DiscussionThis research not only reinforces information in the literature but also presents unique findings compared to similar studies, particularly in cultural and geographical contexts. The results uniquely highlight the diversity in perceptions of the relationship between religion and suicide. While literature generally notes religion as a deterrent to suicide, this study reveals that intense religious pressure could increase suicidal tendencies through effects like rejection and hatred of religious values. Media also plays a reinforcing role in this context.ConclusionIn conclusion, this study elucidates the complex interactions underlying suicide attempts among young adults and provides a solid foundation for policies and interventions aimed at better managing media interactions, which play a critical role in suicide prevention efforts.

Correlation between lithium concentrations in drinking water and suicide attempt in the southeast of Iran.

Suicide, as an avoidable cause of death in public health systems, currently lacks effective global strategies to prevent it. However, several epidemiological studies found a correlation between the concentration of lithium (Li) in drinking water and lower suicide rates in the general population. Our ecologicalstudy investigated this hypothesis in the Rafsanjan districtof Iran. Samples from the public water supply in 16 areas in the district were analyzed using the graphite furnace atomic absorption. The resulting data were examined in relation to the suicide attempt from March 2019 to March 2020 obtained from Iran's Ministry of Health's registration system. During that period, 239 suicide attempts were recorded, resulting in an average of 69 individuals (85 women and 54 men) per 100,000 residents of the area. The average Li concentration in the drinking water was 47.30 µg/L (ranging from 9.4 to 141 µg/L). A negative significantcorrelation (r = -0.551, p = 0.027) between Li concentration in water and the rate of suicide attempt were observed in the studied population. Notably, these findings indicate an inverse significantrelationship between Li levels and suicide attempt rate in women (r = -0.725, p = 0.001). This is the first study in Iran that examines the relationship between Li levels in drinking water and suicide attempt rate. The findings of this study support an inverse relationship between the level of Li in public drinking water and the rate of womensuicide attempt.