Suicidal Intent Research Articles

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.].

Suicide thoughts screening with social media using cat swarm-intelligent adaptive recurrent network

The research on detecting suicidal ideation through social media in early stages and faces several difficulties. Many persons with a propensity for suicide express their ideas and beliefs on social media. Numerous studies have found that accessible social media posts have useful criteria for rapidly identifying people thosewho are considering suicide. Finding and comprehending the risk factors and warning signals that may lead to suicide, is the most challenging aspect of suicide prevention. By automatically detecting the abrupt changes in a user behavior, this can be accomplished. Social media interactions can be used to gather textual and behavioral data using natural language processing (NLP) techniques. The framework can use this data to spot trends in social interactions that point to suicide intent. We can anticipate suicidal ideation using classification techniques based on deep learning. We can accomplish this by identifying these emotions in user postings using a combination of Cat Swarm-Intelligent Adaptive Recurrent Network (CSI-ARN) models. Adding extra training data and using an attention model to improve model performance can increase accuracy. This study examines social media comments for suicidal thoughts using a CSI-ARN model. The suggested model outperformed baseline models with 90.3% accuracy and 92.6% F1-score.

Identifying pathways from childhood adversity to suicidal thoughts and behaviors among sexual minority adults: An exploratory mediation analysis

BackgroundThe current study uses a nationally representative longitudinal dataset of sexual minority adults in the US to investigate the pathways from adverse childhood experiences (ACEs) to adulthood suicidal thoughts and behaviors. MethodsACEs were measured at year one, potential mediators at year two, and suicidal thoughts and behaviors (suicidal ideation, intent, plan, and attempt) at year three. We conducted an exploratory mediation analysis to identify potential mediating factors linking ACEs to suicidal thoughts and behaviors. Ten candidate mediators were examined: social well-being, felt stigma, experiences of everyday discrimination, social support, psychological distress, alcohol and drug use, importance of sexual identity, community connection, and internalized homophobia. ResultsParticipants were 1518 adults who identified as lesbian or gay (n = 833; 55 %), bisexual (n = 493; 33 %), or with other sexual minority identities (n = 181; 12 %) and were on average 36.48 years (SD = 14.7) of age. Psychological distress served as a common mediator between ACEs and suicidal ideation, intent, plan, and attempt. Additionally, experiences of everyday discrimination emerged as a specific mediator leading to suicidal intent, whereas social support uniquely mediated the relation between ACEs and suicide plan. LimitationsPotential recall bias due to retrospective reporting of ACEs may be a limitation. Future studies should broaden the measurement scope of ACEs and implement intersectional methods. ConclusionThe current findings underscore the urgent need for targeted interventions that address the specific mental health needs of sexual minority individuals, particularly focusing on mitigating psychological distress, combating systemic discrimination, and enhancing social support.

SOCIO-DEMOGRAPHIC AND PSYCHOLOGICAL CHARACTERISTICS OF PERSONS WITH SELF-DESTRUCTIVE BEHAVIOR

Self-destructive behavior is behavior associated with various forms of self-destruction: from high-risk actions aimed at seeking new sensations to self-harm and suicidal acts. This problem remains the most acute problem of modern Kazakhstan, since according to the Wisevoter report, as of February 20, 2023, our fatherland ranks 19th out of 178 countries in the world in suicide statistics (17.6 per 100 thousand population). Objective: to study the role of socio-demographic and psychological factors in persons with self-destructive and to improve preventive measures. Materials and methods: Clinical and experimental psychological methods were used to study and analyze socio-demographic and psychological factors in people who showed self-destructive forms of behavior. This research was an initiative and was carried out on the basis of the agreement on cooperation between the Department of Psychiatry and Narcology of KazakhstanRussian Medical University and the Center of Mental Health in Almaty in the period from 01.09.2022 to 01.09.2023. 120 people with various forms of self-destructive behavior who applied for psychological help were included in the study. Results: Among people with self-destructive behavior, the majority of those who applied were females 81 (67.5%%), older adolescents 15-19 years old 52 (43.3%) and young adults 20-24 years old 36 (30%), unmarried 69 (57.5%), not addicted to surfactants and gambling 77 (59.6%), not on dynamic registration and observation in the center of mental health 118 (98.3%). The leading cause of self-destructive behavior was problems in the family 58 (48,3%), undivided love 30 (25%), 16 (13,3%) were bullied in educational institutions and because of debts 7 (5,8%). In the examined persons with self-destructive behavior prevailed behavioral disorders: demonstrativeness, schizoid tendencies, rigidity, jealousy, tendency to risk, impatience, selfdestructive tendencies in alcoholism, drug addiction and negative reactions of suicidal tendencies - anxiety, pessimism, seclusion from the real world, depression. Conclusions. 1. It has been established that females, older teenagers and young people, mainly unmarried (university) students living in Almaty, are more susceptible to destructive behavior. 2. The prevalence of self-destructive behavior represented by fleeting, unobtrusive, controlled thoughts about the “meaning of life” over active suicidal intentions and actions is revealed, which corresponds to the initial stage of formation of suicidal behavior in the structure of which a high rate of this contingent of persons seeking specialized psychological, psychotherapeutic and psychiatric help is revealed. 3. It has been established that in the formation of self-destructive behavior with a suicide attempt, along with the personal characteristics of individuals (demonstrativeness, schizoid tendencies, rigidity), the clinical component in the form of affective spectrum disorders, represented by a depressive mood background, is of dominant importance.

A pilot study of repeated suicide attempts in persons hospitalized for depression: The role of immune factors

BackgroundIndividuals with major depressive disorder (MDD) hospitalized for a suicide attempt are at high risk for a repeated suicide attempt. Previous studies have identified immune alterations in MDD, but not the prospective association between immunological abnormalities and subsequent suicide behavior. MethodsWe enrolled 69 adults with MDD following hospitalization for a suicide attempt. Participants were assessed for co-occurring immunological disorders and on clinical measures. Participants had a blood sample drawn from which were measured cytokines, antibodies, and other markers of inflammation. Following hospital discharge, participants were assessed for six months. Cox proportional hazard models examined the relationships between baseline variables and a repeated suicide attempt. ResultsA total of 15 (24 %) of the 62 participants with at least one post-hospital visit had a suicide attempt in the follow-up period. These individuals had a significant alteration in a combined immune marker consisting of the cytokines, IL-1β, TNF-α, and IFN‐γ as well as IgG antibodies to Epstein Barr Virus (HR= 8.03, 95 % CI 1.73, 37.08, p=.008). A diagnosis of asthma was also associated with a repeated suicide attempt (HR= 3.10, 95 % CI 1.10, 8.79, p=.033). Suicidal intent, stressful events, and aspects of psychiatric history also predicted this outcome. LimitationsThe sample was relatively small limiting statistical power. Also, we focused on one specific high-risk group. ConclusionsPersons with MDD and immunological abnormalities have an increased rate of repeated suicide attempts. Immunological measurements combined with clinical information may identify high risk individuals who would benefit from personalized interventions.

Dealing With a Stressful Extra Duty: The Intrapersonal Conflict Experiences of Nurses Caring for Survivors of Suicide Attempts on Medical-Surgical Wards.

Nurses are the frontline professionals caring for patients who have attempted suicide. When clinical nurses learn from medical records or nursing handover, or are proactively informed by patients or family members, that the patients they are caring for have suicidal tendencies, they often experience pressure and face challenges. However, little attention has been given to the experiences of the nurses caring for patients with suicidal intent on medical and surgical wards. We aimed to address this knowledge gap. The purpose of this study was to explore medical and surgical nurses' experiences, especially the internal conflicts they might experience while caring for patients who have a history of attempted suicide. A qualitative descriptive design and semi-structured interviews were used in this study. Twenty-three nurses were recruited and interviewed individually. Data were analysed by qualitative content analysis. The focus of this paper is to examine the emergent theme of intrapersonal conflict experienced by the participants. Nurses' experiences can be clustered into two themes: (1) Pity and annoyance and (2) Hard work does not necessarily pay off. Intrapersonal conflict was identified by participants as considerable fear and anxiety about the possibility of a patient's suicide, as well as a mixture of pity for and annoyance with the patients. Nurses feel sorry for such patients, but they are also annoyed by the extra work required to prevent suicide attempts in the ward. Additionally, having limited time and ability, they see that their hard work does not necessarily pay off and may sometimes lead to punishment. Our findings raise serious concerns about the adequacy of the knowledge of the nurses, their competence and their difficulties in caring for such patients. In addition, there is a need to provide them with appropriate on-the-job education and immediate emotional support relevant to caring for survivors of suicide attempts.

Older Adult Self‐Harm: A Descriptive Study

ABSTRACTSelf‐harm is a public health problem and is associated with higher suicidal intent and greater suicidal risk in older adults. This retrospective cross‐sectional study examines psychosocial characteristics, service provision and outcomes in patients attending a mental health liaison service (MHLS) with self‐harm attempt in Lincolnshire. The authors also investigate demographic, psychiatric and clinical factors related to self‐harm and discharge destination.

Islamic Religiosity as a Control of Suicide Intent among Final-Year Students through Spiritual Experience

This research investigates the impact of Islamic religiosity and spiritual experiences on suicide intent among final-year students. The phenomenon of final-year students experiencing difficulties in completing their final assignments and even resorting to suicide serves as the background for this study. The research methodology employed is quantitative with a survey approach. Data analysis was conducted using path analysis techniques through Mplus version 8.0 software and its supporting tool, IBM SPSS version 24. The study's population consisted of final-year students at Sriwijaya University and Raden Fatah State Islamic University, Palembang. The sample was selected using a multistage sampling technique, with 412 respondents. This study used research instruments, including the Harkavy Asnis Suicide Scale (HASS) by Jill M. Harkavy Friedman, the Islamic Religiosity Scale by Hisham Abu Raiya et al., and the Daily Spiritual Experience Scale by Lynn G. Underwood. The research results indicate that Islamic religiosity has a significant influence on suicide intent through spiritual experiences as a mediator. Spiritual experiences are associated with a reduction in suicide intent, and both factors contribute to reducing suicide intent among students (R Square Change = 12%). Additionally, there is also a direct influence of Islamic religiosity on suicide intent without mediation. Similar findings apply to spiritual experiences. Recommendations from this research include encouraging students to engage in religious practices, strengthening spiritual experiences, and maintaining a balance between academic and religious aspects. The importance of mental health support and suicide prevention programs within the campus environment is also emphasized.

일상생활배상책임보험의 보상요건 및 설명의무에 관한 종합적 고찰 - 청주지법 2022. 12. 22. 선고 2021나55269 판결을 중심으로

Daily life liability insurance is a personal liability insurance sold in the form of a special agreement in addition to long-term insurance products. It is a very useful insurance product that covers damages due to general activities that can occur widely in everyday life with an inexpensive insurance premium of less than 1,000 won. At this time, the concept of 'daily life' means life in 'normal times', and is distinguished from 'job performance' that is for 'maintaining a living' or requires professional knowledge, experience, and skills. Of course, the scope of 'daily life' will be determined according to specific circumstances, but at least in the process of determining it, the group performance and homogeneity of the risk consisting of a large number of unspecified general policyholders should not be impaired. In the case where the insured, who usually suffered from depression and paranoid schizophrenia, jumped from a high-rise building and shocked the victim (plaintiff), who just happened to pass under it, the damage caused by the insured's actions was judged as an accidental accident in the first trial. However, in the target judgment, it was judged that the act of the insured jumping out of the building with the intention of suicide or jumping off was not the “general act that may occur in everyday life” mentioned above, but was difficult to regard as being included in the category of “daily life”. The target judgment rejected the plaintiff's claim for damages, considering that it did not meet the former requirements among the usual life and accidental accidents, which are the representative compensation requirements of the daily life liability special agreement. The insured's above actions outside the certain boundaries of daily life are very valid in that they harm the homogeneity of insurance groups. Furthermore, in this paper, an analysis is conducted to clearly distinguish the concepts of 'daily life' and 'job performance' of the special agreement for daily life liability through various lower court rulings, and the purpose and meaning of a number of reasons for indemnification are considered for each type. The results of this review are linked to the obligation to explain the terms and conditions, which are sharp disputes between the insurer and the insured in the stage of exemption and liability for compensation after an insurance accident. Most of the reasons for exemption from the Special Agreement on Daily Liability for Compensation are subject to the obligation to explain as it directly affects the interests of the policyholder and determines whether or not to conclude a contract depending on whether or not to explain it. However, 'daily life' is a concept accepted by social norms as a daily activity of the general public. Even if the insurer does not explain separately, it is reasonable to assume that the insured can fully predict or understand the contents and is not subject to the obligation to explain. This is especially true considering that the Special Agreement on Daily Liability for Compensation, which is a liability guarantee incidental to long-term non-life insurance products, guarantees various risks in daily life with an insurance premium of less than 100 million won per month.

Demographic and Clinical Profile of Persons with Substance Abuse Disorder Attending Happy Life Psychological Services Islamabad, Pakistan

Substance Abuse Disorder is a treatable mental health disorder that influences persons’ brains and behavior. It leads to an inability to control drug use, resulting in moderate to severe addiction. The research aims to study the demographic and clinical profile of persons with substance abuse disorders attending Happy Life Psychological Services (HLPS). A sample of 156 persons with substance abuse disorder was selected who were admitted to HLPS in the past two years. The study showed that 78.8% of persons with substance abuse disorder were males admitted at HLPS. In the reported cases, smoking, tobacco, opioids, cannabis, amphetamines, sedatives, hallucinogens, alcohol, and cocaine use was significantly higher in males, but inhalant use was higher in females. Middle adults were the age group where drug addiction was higher and mental health problems were most evident. Even medical comorbidities and suicidal intentions seem higher in this specific age group. In addition, married persons experienced more personality, anxiety, depression, and psychotic disorders than unmarried persons. The study outcomes can be used at the broader level to control the use of drugs in developing countries like Pakistan. Everyone is responsible for controlling the easy accessibility of drugs within the country especially, the Anti-Narcotics Agency should perform a pivotal role in this regard.

Life narratives in the context of war trauma

The article is devoted to the analysis of life narratives in the context of war trauma. One of the most important tasks of social cognition is to predict the intentions of others towards us and people we care about, this information is best conveyed by a person's moral character, not sociability, and it is also important to predict the probability that a person will do what he is going to do, especially as it relates to the trauma of war and suicidal intentions common in our time. However, we assume that sociability and memories of the self before the war or before the traumatic event determine how effectively a person uses his skills to support his moral or immoral intentions, in fact this information is important from the point of view of adaptation. The purpose of the research is to study the peculiarities of life narratives, in particular those determined by morality, positive or negative attitude towards oneself in the context of war trauma. The objectives of the study are to define the concept of moral trauma, its connection with positive or negative self-attitude, PTSD, autobiographical memories of the events preceding the trauma, including the war in general. Research results: A positive attitude towards morality promotes the emergence of such phenomena as mutual altruism, encouraging cooperation for the common good. A negative attitude toward immorality promotes phenomena such as punishment, discouraging destructive behavior such as cheating, stealing, and free-riding. Therefore, it is critical to determine whether the influence of moral traits on liking and positive attitudes toward self and others is dominant and how it is related to positive autobiographical memories and life narratives, particularly in wartime, when immoral and moral actions are often closely related. and moral trauma has become a common phenomenon not only for the military, but also for civilians in Ukraine.

Progress in Studying Theoretical Models of NSSI Behavior in Adolescents

Non-suicidal self-injury, NSSI refers to the individual in subjective without suicide intention, a series of not for the purpose of death, directly, intentionally, repeatedly hurt their organs and tissues, and objectively will not cause death, but cause mild or moderate damage, such as the skin cutting, friction, needles, scratch, this behavior can not be accepted by recognition or society. NSSI has become a serious impact on adolescent psychosomatic health worldwide public health problems, NSSI behavior is an important factor predicting suicide, the incidence of adolescent NSSI in China, the physical and mental health is closely related to its personal future development, about the family, social and national harmony and stability, should cause the attention of the whole society. NSSI may be related to many factors, such as psychological problems, family environment, campus atmosphere, and social relations. This paper summarizes the shortcomings of NSSI behavior theory model and analyzes the good understanding of the mechanism of adolescent NSSI behavior, provides the theoretical basis for adolescent NSSI research, provide the theoretical basis for NSSIR prevention, intervention program and policy formulation for health departments, education system and schools in China.

Risk factors for subsequent suicidal acts among 12–25-year-old high-risk callers to a suicide prevention hotline in China: a longitudinal study

BackgroundA few previous cross-sectional studies investigated correlated factors of suicidal ideation or suicide attempts among suicide prevention hotline callers; however, scarcely any evidence was from a longitudinal study. In addition, it is still unclear whether improvements in some suicide risk factors could reduce the occurrence of subsequent suicidal acts. This longitudinal study focusing on the risk factors for subsequent suicidal acts among adolescent and young adult callers with high suicide risk aims to fill this gap.MethodsThis study recruited 12–25-year-old high-risk callers to a China nationwide suicide prevention hotline. Potential risk factors, including hopefulness, psychological distress, depression, history of suicide attempts, alcohol or substance misuse, and acute life events, were examined during the index calls, and improvements in hopefulness, psychological distress, and suicide intent were assessed before ending the index calls. The recruited callers were followed up 12 months after their index calls. The primary outcome was the occurrence of suicidal acts (suicide attempts or suicide death) during follow-up. Kaplan–Meier survival curves, log-rank tests, and Cox proportional hazards model were used.ResultsDuring the follow-up period, 271 of 1656 high-risk adolescent and young adult callers attempted suicide, and seven callers died by suicide. After adjusting for demographic variables, low hopefulness (Hazard Ratio [HR] = 2.03, 95% Confidence Interval [CI]=[1.47, 2.80]) at the beginning of the index call was associated with a higher risk for subsequent suicidal acts, whereas improvements in psychological distress (HR = 0.61, 95%CI [0.41, 0.89]) and suicidal intent (HR = 0.56, 95%CI [0.38, 0.84]) during the index call reduced the risk of subsequent suicidal acts. In addition, alcohol or substance misuse (Model 2, HR = 1.65, 95%CI [1.11, 2.46]) and suicide attempt history(Model 1: one episode, HR = 1.96, 95%CI=[1.05, 3.66]; two or more episodes, HR = 2.81, 95%CI [1.59, 4.96]. Model 2: one episode, HR = 2.26, 95%CI [1.06, 4.82]; two or more episodes: HR = 3.28, 95%CI [1.63, 6.60]) were risk factors for subsequent suicidal acts.ConclusionsWhile suicide prevention hotline operators deliver brief psychological interventions to high-risk adolescent and young adult callers, priority should be given to callers with low hopefulness and to the alleviation of callers’ high psychological distress and suicide intent.

Suicidal thoughts and self-destructive tendencies among adolescents

One must not ignore or underestimate it when adolescents say that they feel like a burden to those around them or that their life has no meaning. Suicidal thoughts in young people can be a signal of a threat to health or life or of a weakened mental condition. Increasing awareness of the frequent thoughts of giving up and the experience of a lack of meaning in life, characteristic of adolescents, helps to develop standards and preventive strategies in the field of mental health care. The article is an attempt to define terms related to suicide, data regarding the magnitude of the phenomenon among young people and discuss the causes of self-harm and suicide. It is also a reference to the approach of dialectical behaviour therapy (DBT), which considers, for example, emotional dysregulation and suicidal tendencies as a transdiagnostic problem. The characteristics of the transactional model in DBT emphasise that what is most important for a favourable prognosis is the provision of adequate support from the close environment, especially parents and professionals. Suicide prevention among children and adolescents is possible through scientific conferences, suicidological research and preventive programmes. Multidisciplinary cooperation to prevent suicidal intentions during childhood and adolescence is essential. In conclusion, as far as working with patients with emotional dysregulation and suicidal tendencies is concerned, the guiding motto of DBT should be stressed, which is to shape “a life worth living”.

Suicide and Intentional Self-harm Among Older Men Treated With 5-Alpha Reductase Inhibitor or Alpha-blockers for Benign Prostatic Hyperplasia

ObjectiveTo compare the risk of intentional self-harm (ISH) and suicide in older men using 5-α reductase inhibitors (5-ARIs) and alpha-blockers for benign prostatic hyperplasia (BPH). Observational research of older men with BPH suggested an increase in ISH with 5-ARI use compared with nonuse; we aimed to address potential confounding by indication with an active comparator reference group. MethodsUsing Medicare data linked to the National Death Index (NDI) from 2007-2016, we implemented a retrospective cohort design in males aged ≥65 years who initiated 5-ARI or alpha-blocker use for BPH. ISH was identified using ICD-9-CM and ICD-10-CM diagnosis codes. Suicides were identified through cause-of-death information from the NDI. We used inverse probability of treatment weighted Cox proportional hazards regression to compare time-to-event between treatment groups, with robust variance estimation. ResultsThe event rates for ISH and suicide, respectively, were 0.314 and 0.308 per 1000 person-years (PY) among 5-ARI users (n=181,675), and 0.364 and 0.382 per 1000PY among alpha-blocker users (n=850,476). For 5-ARI use relative to alpha-blocker use, hazard ratios (HRs) for ISH and suicide, respectively, were 0.88 (95% CI:0.62–1.25) and 0.82 (95% CI:0.54–1.24); for the composite outcome (non-fatal ISH or suicide), the HR was 0.88 (95% CI:0.66–1.16). Subgroup and sensitivity analyses supported these results. Conclusion5-ARI use was not associated with an increased risk for ISH or suicide compared to alpha-blocker use in older men with BPH. Study limitations included low event rates and potentially low sensitivity for ISH events.

Suicide-specific rumination as a predictor of suicide planning and intent

BackgroundSuicide-specific rumination (SSR), that is repetitive negative thinking about suicide, has been proposed as a risk factor for suicidal behavior. Yet, few studies have investigated associations between SSR and suicide intent and planning in a longitudinal study design. The purpose of the present study was to investigate the association between SSR, suicide intent, suicide planning and suicide attempts in a sample of adult outpatients undergoing psychotherapy. MethodData from N = 637 patients (58.4% female, 41.6% male; Mage = 35.81, SDage = 13.50, range: 18–79 years) who started therapy at an outpatient clinic were collected. A subsample of n = 335 patients (n = 335; 56,4% female, 43,6% male; Mage = 35.4, SDage = 13.1, range: 18–73 years) also took part in a post-treatment assessment after twelve therapy sessions. ResultsSSR differentiated lifetime suicide attempters from suicide ideators. Furthermore, SSR was associated with lifetime suicide attempt status above age, sex, suicide ideation, depression, anxiety, and stress. Finally, SSR served as a prospective predictor of both suicide planning and suicide intent. ConclusionThe results emphasize the key role of SSR in understanding the suicidal process.

Psychosocial Factors Related to Attempted Suicide During COVID-19 Pandemic

Background: The likelihood of more suicide attempts and fatal suicides remains high due to the significant changes in lifestyle and pressures brought on by to COVID-19 pandemic. Public health initiatives during the COVID epidemic, including social exclusion, lockdown, and travel restrictions, have harmed mental health and increased the risk factors for suicide. The current study is done to pinpoint the socio-demographic and psychosocial risk factors for suicide and evaluate whether they significantly influenced the suicide attempts made during the COVID-19 epidemic. Methodology: The present cross-sectional analytical study was conducted for the duration of 18 months among those who survived the suicide attempts. Socio-demographic and psychosocial factors were discussed to evaluate the suicide risk. The Beck’s suicide intent scale was used to assess the level of intent. Result: Out of 90 patients, the majority had medium intent for suicide (60, 67%) and 18 (20%) had high intent for suicide. Suicide intent was equally present in both genders. Out of 27 study participants with loneliness, 37% had high intent for suicide and there was a significant association found between suicide intent and feeling of loneliness perceived by study participants. There was no association found for suicide intent and feelings of panic or fear of the COVID-19 pandemic. Conclusion: In our study, participants who were unemployed were going through financial problems due to loss of wages during the lockdown period was significantly associated with suicide intent severity among study participants. Similarly, during the COVID-19 pandemic, people were suffering from loneliness, which was significantly associated with high intent on suicide scale in our study. Moreover, participants who had a history of past psychiatric illness during the pandemic were significantly associated with high intent for suicide on an intent scale in our study.