Suicidal Intent Research Articles

A prospective examination of sleep chronotype and future suicide intent among adults in the United Kingdom: A test of the integrated motivational volitional model of suicide

Objectives/backgroundPrior research identified a connection between evening chronotype and suicidality, but the mechanism underlying that connection is not well understood. The Integrated Motivational Volitional (IMV) Model of Suicide may provide a theoretical explanation for this link. The current project includes a three-time point longitudinal survey to examine whether 1) suicide intent likelihood varies across time, 2) chronotype affects suicide intent likelihood prospectively, and 3) defeat and entrapment explain the association between chronotype and suicide intent likelihood. Patients/methodsParticipants (n = 187 UK adults) completed a baseline survey (demographics, chronotype (morning-eveningness; MEQ), defeat and entrapment, and perceived intent to make a future suicide attempt), and follow-up surveys (MEQ and suicide intent likelihood) 3 and 6 months later. ResultsResults indicated that suicidal intent at 6-month follow-up was lower than baseline or 3-month follow-up. It was also found that strong evening chronotype at baseline is associated with increased suicidal intent 6 months later, and that defeat mediates this relationship. ConclusionOur theoretically informed findings shed light on the psychological mechanisms linking chronotype (i.e., eveningness) and future suicide intent by highlighting the role of defeat and entrapment. We propose that feelings of defeat might be derived from evening types’ experiences of social jetlag (resulting from conflict between biologically driven sleep schedules and externally dictated social schedules), which consequently drives entrapment and greater future suicide intent. Within this context, defeat and entrapment may be good transdiagnostic and modifiable target variables for future intervention development.

Follow-Up Care Offers and Acceptance in Crisis Line Suicide Prevention Services.

Background: Prior work has explored the impact of follow-up calls in a crisis line context, but no research has investigated the offer and acceptance of follow-up care. Aims: To identify caller/call characteristics associated with whether a caller is offered and accepts follow-up services. Methods: This cross-sectional study included data from 55,594 callers to a member center of the 988 Suicide & Crisis Lifeline (988) between 2017 and 2019. Logistic regression analyses were conducted to examine associations between caller/call characteristics and two follow-up outcomes. Results: Black callers and those with higher suicide capability and intent had greater odds of being offered and accepting follow-up. Longer call duration was also associated with higher odds of being offered and accepting follow-up. Higher suicidal desire uniquely increased the odds of offers, whereas a higher level of buffers uniquely decreased the odds of offers. Limitations: Data were collected from a single 988-member center and cannot be generalized. Conclusions: That one-third of callers do not accept follow-up highlights the need to understand reasons for not accepting follow-up. That callers with higher risk profiles are offered and accept follow-up at higher rates is reassuring and underscores the benefit of tailoring follow-up interventions for higher-risk callers.

Role of Steroids in Paint Thinner Induced Chemical Pneumonitis

Abstract Paint thinners are organic hydrocarbons that contain a mixture of chemicals such as acetone, toluene, and xylene. Thinner poisoning is most common in children due to accidental ingestion. Acute poisoning can lead to various systemic manifestations such as chemical pneumonitis, arrhythmia, dermatitis, and metabolic acidosis. Chronic toxicity leads to encephalopathy and weakness. Usually, management of chemical pneumonitis following hydrocarbon aspiration is symptomatic and the role of steroids is controversial. We report the case of a 47-year-old female who presented with ingestion of paint thinner with suicidal intention and developed chemical pneumonitis. She was initially managed symptomatically but due to persistent symptoms, was started on intravenous steroids and antibiotic. The patient showed symptomatic and radiological resolution.

Self-poisoning with paracetamol in England: short report of characteristics of individuals and their overdoses according to source of tablets.

Self-poisoning with paracetamol is the most frequently used overdose method in the UK. Psychosocial assessments were conducted by mental health clinicians with 127 consecutive individuals who presented with pure paracetamol overdoses to a large general hospital over 8 months, including asking about the source of the tablets and scoring the patients' acts on the Beck Suicide Intent scale (BSI). Patients were predominantly female (86%) and young (79% aged 12-24 years). Most had used paracetamol which was available in the home (77%). Those who purchased paracetamol for the act took double the number of tablets compared with those who used paracetamol available in the home (37 v. 18), had higher suicidal intent (mean BSI: 11 v. 7) and more often required treatment with N-acetyl cysteine (71% v. 43%). These results highlight the need for safer home storage of paracetamol and consideration of reducing pack size limits on paracetamol that can be purchased.

Early specialised treatment for bipolar disorder: Long-term follow-up from the early intervention in affective disorders (EIA) randomised controlled trial.

It is unclear whether treatment early after onset in bipolar disorder may improve the long-term illness course. The early intervention in affective disorders (EIA) randomised controlled trial found that 2-years treatment in a specialised mood disorder clinic combining evidence-based pharmacological treatment with group psychoeducation improved clinical outcomes compared with standard treatment in patients with bipolar disorder discharged after their 1st, 2nd, or 3rd hospital admission. We aimed to assess the 16 years long-term outcomes after randomisation of the participants in the EIA trial. Data were obtained by linking nation-wide Danish population-based registers. All 158 participants of the EIA trial (Trial Registration Number NCT00253071) were followed from time of randomisation (2005-2009) to end of study (31 December 2021). The primary outcome was risk of psychiatric readmission. Secondary outcomes were total admissions and costs, medication use, intentional self-harm or suicide attempt or suicide, and socio-economic measures. The absolute mean risk of psychiatric readmission was 49.3% in the intervention group and 59.8% in the control group, with no statistically significant difference between the groups (b = -0.10, 95% CI: -0.26 to 0.047, p = 0.18). Compared with the control group, patients in the intervention group had numerically fewer total admission days (mean (SD) 44 (77) versus 62 (109)), lower total cost of psychiatric hospital admissions and hospital-based outpatient visits (mean (SD) 22,001 (36793) euros versus 29,822 (52671) euros) and higher use of lithium and antipsychotics, but the differences were not statistically significant. Fewer patients in the intervention group had an event of intentional self-harm or suicide attempt or suicide during follow-up (OR 0.25, 95% CI: 0.15-0.40, p < 0.001) compared with the control group and more patients in the intervention group used antiepileptics (OR 2.21, 95% CI: 1.08-4.60, p = 0.031). Analyses of very long-term outcomes of the EIA trial may potentially indicate a beneficial effect of the intervention at the long term but were likely underpowered to detect a more subtle effect and for most outcomes the differences between groups were not statistically significant.

Sex differences among patients with intentional poisoning presenting to the emergency Department at a Tertiary Care Centre in Beirut, Lebanon.

Poisoning poses a worldwide public health challenge and recent data from Lebanon in 2020 revealed that over half patients presenting with acute toxicological exposure intentionally poisoned themselves, primarily with suspected suicidal intent. This study aims to assess sex disparities in intentional toxicological exposures among patients presenting to the Emergency Department, at a tertiary care centre in Lebanon. This was a secondary analysis of an existing toxicological database, including patients aged 6 years and older admitted due to acute overdose from March 2015 to August 2022. A total of 444 cases of intentional poisoning were analysed, with 302 (68.0%) women. The primary cause of intentional poisoning was suspected suicide in both sexes, significantly more common in women (85.1% versus 65.5%, P < 0.001). Specific agents exposed to patients varied by sex; sedatives/hypnotics/antipsychotics, antihistamines, and melitracen/flupentixol were significantly more prevalent in women (P < 0.001) while men showed higher prevalence for ethanol (P = 0.02), stimulants, street drugs and opioids (P < 0.001). Our study underscores substantial sex differences in intentional poisoning cases in Lebanon. Women exhibited a higher likelihood of exposures to sedatives/hypnotics/antipsychotics, antihistamines and melitracen/flupentixol, while stimulant drugs, ethanol, and opioids were prevalent in men. Developing proper and effective sex-specific measures may mitigate potential physical and psychological consequences.

A Cross-Sectional Study of Acute Poisoning Cases Admitted in a Tertiary Care Hospital in Mangaluru, Karnataka, India

Abstract Introduction: A poison is a substance that causes serious illness and endangers the life of a person when ingested in a relatively small quantity. Poisoning is one of the most common problems encountered in day-to-day clinical practice. Poisoning causes morbidity and mortality which can be prevented and managed if clinicians are sensitized with adequate knowledge of common poisons. Therefore, this study was conducted to know the profile of acute poisoning cases admitted in a tertiary care hospital in Mangaluru. Materials and Methods: 100 patients admitted in the intensive care units and wards of the General Medicine department, Kasturba Medical College, Mangaluru, and Government Wenlock District Hospital, Mangaluru with various poisoning were evaluated for various factors like the distribution of poisoning cases according to age, gender, intention of poisoning, nature of poisons consumed and the nature of treatment received at another hospital before getting admitted. Results: Most of the cases of poisoning occurred in the age group between 21-30 years of age (38%). The majority of the patients in the study were males (60%) and females formed 40% of the study population. The majority of patients in this study (99%) consumed poison with suicidal intention. 77% of patients received first-aid treatment in a peripheral hospital before getting admitted to our hospital. Conclusion: This study shows that the peak incidence of acute poisoning cases was seen in the age group of 21 to 30 years with male predominance. The pattern of poisoning was suicidal in the majority of the patients.

Suicide ideation and intentional self-harm as a risk factor for readmission within one year following a trauma alert: A 10 year retrospective analysis

The objective of this analysis is to study physical traumatic injury as a risk factor for suicide ideation and attempts. The analysis is retrospective, focusing on inpatient readmission with suicide ideation or intentional self-harm within one year of hospitalization as a trauma alert (TA). Injured patients were divided into TA and emergencies without activation (EMWA) of trauma services. We estimated the probability of readmission with suicide ideation or intentional self-harm using a logistic regression. Rates of readmission with intentional self-harm and suicide ideation were on average 60 and 45% higher for the TA group (p < 0.01). Over 80% of patients readmitted with intentional self-harm or suicide ideation had a preexisting mental health condition, compared to approximately 45% in the overall sample. Logistic regression results indicate these patients had an odds-ratio of near six, predicting the readmission. When patients with a preexisting mental health condition were excluded from the analysis, TA patients were significantly more likely to experience a readmission with intentional self-harm and suicide ideation. Demographic and socioeconomic characteristics (gender, age, race, insurance status, and median incomes) as well as injury type (traumatic brain injury or TBI) also help predict readmission with suicide ideation and intentional self-harm. The main risk factors for reengagement with self-harm and suicidal ideation/attempt include preexisting mental health conditions, TA status, and socioeconomic status. Targeted, sustained, and prolonged rehabilitation and trauma-informed therapy for this high-risk group of severely injured patients may yield significant health and social benefits.

Randomised controlled trial of a psychotherapeutic intervention to improve quality of life and other outcomes in people who repeatedly self-harm: FReSH START study protocol

BackgroundSelf-harm is a major public health challenge, and repeated self-harm is common in those attending hospital following an episode. Evidence suggests psychological interventions could help people who self-harm, but few definitive studies have assessed their clinical and cost-effectiveness. Repeated self-harm is associated with poor quality of life, depression, suicide and increased health service costs which justify the development of psychotherapeutic interventions tailored for people with repeated self-harm.MethodsFReSH START is a multicentre individually 1:1 randomised controlled trial evaluating the clinical and cost-effectiveness of standard care plus psychological therapy or standard care alone for adults (≥ 18 years) presenting at an emergency department (ED) with repeated self-harm. Recruiting 630 participants, it includes an internal pilot, economic evaluation and process evaluation. The intervention will be delivered by mental health staff working in acute settings, with experience of assessing and managing risk in people presenting to emergency services with self-harm. Staff will be trained and supervised to deliver one of three specially adapted therapies: psychodynamic interpersonal therapy, cognitive behavioural therapy or acceptance and commitment therapy. Participants allocated to the intervention will receive one of the adapted therapies according to therapist allocation for up to 6 months via 12 weekly, one to one, 45–50-min sessions. The primary outcome is quality of life measured by the Clinical Outcomes in Routine Evaluation Outcome Measure at 12 months post-randomisation. Secondary outcomes include suicidal intent, depression and cost-effectiveness. Data are collected using hospital attendance records and online/postal/telephone questionnaires at 6 and 12 months post-randomisation, with resource use additionally collected at 3 and 9 months.DiscussionThis protocol outlines a randomised controlled trial to investigate whether modified therapies are cost-effective and improve quality of life for people who repeatedly self-harm. Few interventions are proven to be deliverable in the NHS for this population. This study is strengthened by the involvement of qualified mental health workers experienced in managing risk as therapists.Trial registrationRegistered on August 03, 2021.IRAS number: 297939.ISRCTN: https://doi.org/10.1186/ISRCTN73357210.REC reference: 21/EE/0145.Sponsor: University of Leeds.

Suicide Attempters Compared to Intentional Self-Harm Have a Severe Suicidal Intention and Poorer Reasons for Living Soon after Their Attempts: A Hospital-Based Cross-Sectional Study

Suicide Attempters Compared to Intentional Self-Harm Have a Severe Suicidal Intention and Poorer Reasons for Living Soon after Their Attempts: A Hospital-Based Cross-Sectional Study

An analysis of risk factors for child suicide in three centres from 2008 to 2017.

As a part of a study of suicide in children aged 17 years and under in three centers-Hennepin County in the United States (US), Auckland in New Zealand (NZ), and South Australia in Australia (AUS) from 2008 to 2017 it was decided to characterize potential risk factors and to determine whether these differed by jurisdiction. Reviewed data included a history of psychiatric illness, symptoms prior to suicide, events preceding suicide, previous suicidal ideation or suicide attempts, and communication of suicidal intent. The most common events preceding suicide were arguments with family/friends and relationship issues; in addition depression with or without expressed suicidal ideation, self-harming behavior, sadness, distress, drug/substance abuse, and anorexia were documented. Suicidal intent was on occasion communicated via technological means. In 79.5% of cases in South Australia decedents had a previously diagnosed psychiatric illness, with 62% in Hennepin County. This compared to a much lower proportion of cases in Auckland (23.8%). Whether this reflects more limited access to psychiatric services or a reluctance to seek support and therapy in Auckland is unclear. It does, however, demonstrate that risk factors for child suicide are not uniform among communities and so extrapolation of data from one area to another may not be appropriate. Disturbingly parents/carers were not aware of the decedent's suicidal intent in 84-87.2% of cases.

Assessing a Suicide Prevention Helpline’s Impact on Caller Crisis Level and Suicidality

Objective Worldwide helplines are considered an important part of suicide prevention strategies. Nevertheless, evidence regarding the impact of suicide prevention helplines on the suicidality of its users remains limited and is frequently confronted with methodological issues. This study aimed to assess the impact of crisis calls on callers’ levels of crisis and suicidality both immediately after the call and at follow-up compared to before the call. After the call, the satisfaction of the callers with the intervention was also assessed. Methods A pre-post study, generated automatically by a telephone system, was conducted in order to compare the level of crisis and suicidality (operationalized by five indicators: hopelessness, entrapment, controllability, suicidal intent, and social support) experienced by callers before and immediately after the call and at follow-up (one to two weeks after the call). Results Callers (n = 487) showed significant improvement in their level of crisis (p < .001, d = −0.31), hopelessness (p < .001, d = −0.22), entrapment (p < .001, d = −0.25), suicide intent (p < .001, d = −0.37), and social support (p < .001, d = 0.33) after the call compared to before the call. Improvements were also found at follow-up compared to pretest. The satisfaction of callers with the helpline was high. Conclusions This study adds to the growing evidence on suicide prevention helplines and addresses some important methodological issues in helpline research. Furthermore, it shows promising results regarding the potential supportive impact of helplines on callers who feel suicidal.

Association of ambient temperature with intentional self-harm and suicide death in Seoul: a case-crossover design with a distributed lag nonlinear model.

Previous epidemiological studies have reported a short-term association between ambient temperature and suicide risk. To gain a clearer understanding of this association, it is essential to differentiate the risk factors for intentional self-harm (ISH) from those specifically associated with suicide deaths. Therefore, this study aims to examine whether the association between daily temperature and ISH or suicide deaths differs by age and sex. Between 2014 and 2019, cases of emergency room visits related to ISH and suicide deaths in Seoul were identified. A time-stratified case-crossover design was used to adjust for temporal trends and seasonal variation. A distributed lag nonlinear model was used to analyze the nonlinear and time-delayed effect of ambient temperature on ISH and suicide deaths. Positive associations were observed between temperature and both ISH and suicide deaths. For ISH, the relative risk (RR) was high at 1.17 (95% confidence interval (CI): 1.03, 1.34) for a temperature of 25.7°C compared with 14.8°C. The RR for suicide death was higher than those for ISH, at 1.43 (95% CI: 1.03, 2.00) for a temperature of 33.7°C. These associations varied by age and sex, with males and females aged 35-64 years showing increased susceptibility to suicide deaths. This study provides detailed evidence that unusually high temperatures, both anomalous and out of season, may trigger suicidal behaviors, including both ISH and suicide deaths.

Kriminogén rizikófaktorok az önmérgező serdülők szuicid szándékának alakulásában – Hipotézisek felvetése pszichiátriai konzíliumi munka alapján

Aim: Adolescents frequently encounter normative crises that are neither deviant nor pathologically rooted, yet professionals and daily caregivers may sometimes perceive them as such. Deliberate self-poisoning, a prevalent form of suicidal behaviour in adolescents, often coexists with indicators of deviant developmental patterns and family backgrounds suggestive of potential future criminal lifestyles. This study aims to scrutinise the validity of this assumption. Methodology: Employing document analysis, they examined handwritten consultation records and subjected the extracted data to statistical chi-square tests. Findings: The study encompassed 109 cases (88 girls, 21 boys). While criminogenic risk factors were identified in the adolescents’ lives, the majority showed no direct association with suicidal intent or ideation. Exceptions included school drop-out, domestic violence, and bullying, associating with suicidal intent, and bullying alone linked to suicidal ideation. Both intent and ideation were more prevalent among girls. Value: They findings indicate that deliberate self-harm and criminogenic risk factors are largely disconnected. Thus, they emphasise that attributing deviant family backgrounds and future career prospects to adolescents’ self-poisoning is misleading. Professionals within a child’s environment must refrain from such labelling in their daily communication.

The impact of neural emotion reactivity and regulation on the association between depression and suicide ideation in high-risk adults

BackgroundDepression is closely related to suicidal ideation (SI); however, it is unclear who is most vulnerable to SI within the context of depression. Research suggests that individual differences in emotion reactivity and regulation may be potential moderators of the link between depression and SI. Therefore, the current study tested this hypothesis using objective markers of emotion reactivity and volitional cognitive regulation capacity during functional magnetic resonance imaging (fMRI). MethodsAdults (n = 91) with active SI completed validated self-report measures of current depressive symptoms and SI severity. Participants completed an fMRI task designed to probe neural response to aversive stimuli and during cognitive reappraisal – a form of volitional emotion regulation. Activation of the amygdala during aversive emotion reactivity was measured. Activation of ventrolateral, dorsolateral, and dorsomedial prefrontal cortex (vlPFC, dlPFC, and dmPFC) during cognitive reappraisal were also measured. A series of hierarchical linear regressions testing the unique and interactive effects of depression symptoms and neural activation on severity of SI were conducted. ResultsAnalyses revealed a depression x amygdala activation interaction. The positive association between depression and SI severity was more robust in the context of high amygdala reactivity than low amygdala reactivity. Analyses also indicated there was no PFC activity (neural cognitive reappraisal) by depression interaction. LimitationsPsychoactive medications were allowed and all participants endorsed suicidal intent. ConclusionStrategies aimed at targeting exaggerated emotion reactivity within the context of depression may be beneficial.

Trends in Drug Overdose Deaths by Intent and Drug Categories, United States, 1999‒2022.

Objectives. To examine trends in overdose deaths by intent and drug category to better understand the recent decrease in overdose suicides amid the overdose epidemic. Methods. We examined trends in rates of overdose deaths by intent (unintentional, suicide, or undetermined) across 9 drug categories from 1999 to 2022 using US National Vital Statistics System mortality data. Results. Unintentional overdoses involving synthetic opioids, polydrug toxicity involving synthetic opioids, psychostimulants, and cocaine increased exponentially with annual percentage changes ranging from 15.0% to 104.9% during 2010 to 2022. The death rates also increased for suicides involving these drugs, especially for psychostimulants (annual percentage change = 12.9% for 2010-2022; P < .001). However, these drugs accounted for relatively small percentages of overdose suicides. The leading drug categories among suicides were antidepressants, prescription opioids, and benzodiazepines, though these deaths have decreased or leveled off in recent years. Conclusions. Different drugs commonly involved in suicides and unintentional overdoses may contribute to their divergent trends. Public Health Implications. Amid the overdose epidemic, safe storage of medications remains a crucial strategy to prevent overdose suicides. The large increases in suicides involving psychostimulants warrant monitoring. (Am J Public Health. Published online ahead of print August 8, 2024:e1-e5. https://doi.org/10.2105/AJPH.2024.307745).

Insomnia and circadian rhythms dysregulation in people who have attempted suicide: correlations with markers of inflammation and suicidal lethality

Introduction Suicide is a widespread problem, with risk factors still a challenge. The aim was to assess correlations among insomnia, circadian rhythm, and inflammatory markers in individuals who attempted suicide. Materials and Methods Consecutive patients hospitalised following an attempted suicide, were assessed. Psychiatric diagnosis (DSM-5-TR Criteria), lethality of the suicide attempt (Suicide Intent Scale-SIS), and inflammatory parameters NLR (neutrophil-lymphocyte ratio) PLR (platelet-lymphocyte ratio), and SII (systemic inflammation index/neutrophil-to-platelet ratio on lymphocytes), were computed. Depressive and manic symptoms (Beck Depression Inventory-BDI-II, Young Mania Rating Scale- YMRS), circadian rhythms disturbances (Biological Rhythms Interview of Assessment in Neuropsychiatry-BRIAN), insomnia symptoms (Insomnia Severity Index-ISI) were assessed together with socio-demographic, clinical and pharmacological data. Results The final sample included 52 individuals. Patients who experienced insomnia during the preceding two weeks utilised high lethality methods, reported heightened dysregulation of chronobiological rhythms, heightened severity of depression, and elevated levels of inflammatory markers. High lethality was best predicted by insomnia symptoms (OR = 20.1, CI-95% 4.66-87.25, p = 0.001), by disturbances of circadian rhythms (OR = 6.97, CI-95% 1.82-26.66, p = 0.005), and by NLR indices (OR 4.00, CI-95% 1.14-13.99, p = 0.030). Conclusions Sleep disturbances may be a risk factor for suicidal lethality, along with markers of inflammation. It is plausible that insomnia and circadian sleep dysregulation may contribute to inflammation, thereby promoting suicidal risk.

A suicide attentional bias as implicit cognitive marker of suicide vulnerability in a high-risk sample.

Suicide risk assessment based on self-report questionnaires is considered as problematic because risk states are dynamic and at-risk individuals may conceal suicidal intentions for several reasons. Therefore, recent research efforts increasingly focus on implicit risk markers such as the suicide attentional bias (SAB) measured with the Suicide Stroop Task (SST). However, most SST studies failed to demonstrate a SAB in individuals with suicide risk and repeatedly demonstrated insufficient psychometrics of the SST. This study aimed to investigate a SAB using a modified SST (M-SST) and to test its psychometric properties. We compared n = 61 healthy controls and a high-risk inpatient sample of n = 40 suicide ideators and n = 40 suicide attempters regarding interference scores of positive, negative and suicide-related words. Interference scores were calculated by subtracting the mean reaction time (mean RT) of the neutral words from the mean RT of the suicide-related words (mean RT Suicide -mean RT Neutral), resulting in a suicide-specific interference score. Similarly, interference scores were calculated for the positive and negative words by subtracting the mean RT of neutral words from the mean RT of positive and negative words. A Group × Interference ANOVA showed a significant interaction effect (p <.001, ηp2 = .09), indicating that group effects significantly vary across interference type. Post hoc comparisons revealed that both ideators and attempters demonstrated greater interferences only for suicide-related words compared to healthy controls, indicating a SAB in patients, while a difference between ideators and attempters was lacking. The suicide interference score classified with an AUC = 0.73, 95% CI [0.65 - 0.82], p <.001, between controls and patients with STBs. The M-SST demonstrated good internal consistency and convergent validity. The study adds evidence to the assumptions of the Cognitive Model of Suicide, viewing a SAB as a cognitive marker of suicide vulnerability independently of the engagement in suicidal behavior. The results' clinical implications are discussed in the context of recommended intervention strategies during an acute suicidal state. Future studies with the M-SST should include non-suicidal patient controls to investigate whether a SAB is uniquely related to suicidality.

DepressionEmo: A novel dataset for multilabel classification of depression emotions

Emotions are integral to human social interactions, with diverse responses elicited by various situational contexts. Particularly, the prevalence of negative emotional states has been correlated with negative outcomes for mental health, necessitating a comprehensive analysis of their occurrence and impact on individuals. In this paper, we introduce a novel dataset named DepressionEmo designed to detect 8 emotions associated with depression by 6037 examples of long Reddit user posts. This dataset was created through a majority vote over inputs by zero-shot classifications from pre-trained models and validating the quality by annotators and ChatGPT, exhibiting an acceptable level of inter-rater reliability between annotators. The correlation between emotions, and linguistic analysis are conducted on DepressionEmo. Besides, we provide several text classification methods classified into two groups: machine learning methods such as SVM, XGBoost, and LightGBM; and deep learning methods such as BERT, BART, GAN-BERT, and T5. Despite achieving the same F1 Macro score of 0.76 as BART, the pretrained BERT model, bert-base-uncased, stands out as the most efficient model in our experiments due to its lower number of parameters. Across all emotions, the highest F1 Macro value is achieved by suicide intent, indicating a certain value of our dataset in identifying emotions in individuals with depression symptoms through text analysis. The curated dataset is publicly available at: https://github.com/abuBakarSiddiqurRahman/DepressionEmo.

Fundamentals of Nonsuicidal Self-Injury in Pediatric Patients.

Nonsuicidal self-injury (NSSI) is deliberate self-inflicted injury to one's own body without suicidal intent. There is a high prevalence of NSSI among adolescents, especially in adolescents with history of adverse childhood events and intense reactive emotions. Pediatricians are commonly the first point of contact for adolescents and preadolescents with mental health concerns, and knowledge of how to elicit and respond to reports of NSSI are critical in identifying, supporting, and making appropriate referrals to behavioral health providers. Appropriate referrals include a psychiatric assessment by a child and adolescent psychiatrist and licensed therapist. Therapy targets NSSI by identifying the function of the behavior for the patient and finding ways to obtain that function safely using coping skills. Pediatricians should consider their role in setting the tone for families to engage in productive mental health treatment, with the goal of having the adolescent and caregiver work collaboratively to use healthy coping skills. [Pediatr Ann. 2024;53(8):e280-e282.].