Suicidal Tendencies Research Articles

Vaping Regulations and Mental Health of Teenagers

While depression and suicide rates have been on the rise in the United States, so has the use of e - cigarettes, commonly known as vaping. E-cigarettes are considered to be safer than traditional cigarettes, yet there is growing evidence that nicotine and other toxins contained in e-cigarettes may have adverse psychological effects on teenagers. For instance, e-cigarette use has been associated with mental health problems in adolescents such as symptoms of depression and suicidal tendencies. This evidence suggests that vaping could contribute to deteriorating mental health of teenagers. In contrast, the antidepressant and mood modulating properties of nicotine could cause teens with underlying conditions to turn to vaping as a way to self-medicate. Existing studies find evidence of a strong negative correlation between vaping and adolescent mental health; none examine if the relationship is causal. This study exploits exogenous changes in state policies restricting youth access to e- cigarettes and a difference-in-differences methodology to identify changes in e-cigarette use and mental health outcomes of teens. Using data from the 2005-2017 national and state Youth Risk Behavior Surveys, results suggest that MLSA laws reduce vaping but worsen the mental well-being of adolescents. For instance, between 2015-2017, MLSA laws are associated with a 3.0 and 1.8 percentage point increase in depression and suicidal attempts, respectively. These are meaningful increases relative to the overall sample averages of 29% and 8.4%, respectively. The findings are primarily consistent with the self-medication hypothesis. Adverse unintended consequences of the MLSA policy on youth mental health call for the need to address diverse concerns when formulating vaping related regulations for minors.

Impact of the 2020 lockdown on prehospital psychiatric emergencies in alarge city

The coronavirus disease 2019 (COVID-19) pandemic represented a serious challenge for healthcare systems worldwide. Special psychiatric patients represent a vulnerable group and are particularly affected by lockdown interventions. Knowledge on the possible effects for this group of patients in an emergency physician setting is low. The aim of this paper is to investigate the impact of the first lockdown during the COVID-19 pandemic in 2020 on emergency ambulance services for psychiatric patients in alarge German city. Aretrospective analysis was conducted on all prehospital psychiatric emergencies in alarge German city during the first pandemic-related lockdown from 22 March 2020 to 4 May 2020, with the same period in 2019 serving as areference. During the first lockdown there was asignificant increase in the number of emergency missions with respect to psychiatric cases. Asubstantial rise in substance-associated deployments was observed. Moreover, there was an increase in the proportion of psychiatric patients who did not meet emergency criteria. Suicidal tendencies and agitation status played aminor role during the lockdown. The lockdown had anotable impact on the frequency and profile of emergency physician calls in the metropolitan area studied. The substantial increase in substance-associated callouts can be interpreted as both adeterioration in access to the healthcare system and an expression of the increased stress faced by the general population and vulnerable groups in particular.

Study in Guiding Junior Nurse in the Care of Patients with Suicidal Tendencies: The Application of Grounded Theory Study

Study in Guiding Junior Nurse in the Care of Patients with Suicidal Tendencies: The Application of Grounded Theory Study

Predicting depression and suicidal tendencies by analyzing online activities using machine learning in android devices

Artificial Intelligence (AI) has brought about a profound transformation in the realm of technology, with Machine Learning (ML) within AI playing a crucial role in today's healthcare systems. Advanced systems with intellectual abilities resembling those of humans are being created and utilized to carry out intricate tasks. Applications like Object recognition, classification, Optical Character Recognition (OCR), Natural Language processing (NLP), among others, have started producing magnificent results with algorithms trained on humongous data readily available these days. Keeping in view the socio-economic implications of the pandemic threat posed to the world by COVID-19, this research aims at improving the quality of life of people suffering from mild depression by timely diagnosing the symptoms using AI in android devices, especially phones. In cases of severe depression, which is highly likely to lead to suicide, valuable lives can also be saved if adequate help can be dispatched to such patients within time. This can be achieved using automatic analysis of users’ data including text messages, emails, voice calls and internet search history, among other mobile phone activities, using Text mining/ text analytics which is the process of deriving meaningful information from natural language text. Machine Learning models analyse the users’ behaviour continuously from text and voice communications and data, thereby identifying if there are any negative tendencies in the behaviour over a certain period of time, and by using this information make inferences about the mental health state of the patient and instantly request appropriate healthcare before it is too late. In this research, an android application capable of performing the aforementioned tasks in real-time has been developed and tested for various performance features with an average accuracy of 95%.

Abnormal Serum BDNF and p-mTOR in MDD in Adolescents with Childhood Trauma.

Adolescents with major depressive (MDD) episodes associated with childhood trauma have a poorer response to treatment and a higher risk of suicide. The underlying etiology is unclear. Brain-derived neurotrophic factor (BDNF) could improve depressive symptoms by down-regulating mammalian target of rapamycin (mTOR) signaling pathways, which was involved in adverse environmental stimuli during neurodevelopment. BDNF and mTOR have not been reported simultaneously in adolescents with major depressive episodes associated with childhood trauma. Childhood Trauma Questionnaire-Short Form (CTQ-SF), Children's Depression Inventory (CDI) and Children's Depression Rating Scale-Revised (CDRS-R) were used to evaluate the recruited adolescents with major depression episodes. Serum BDNF and p-mTOR levels were measured by ELISA in 31 adolescents with major depression episodes with childhood trauma and 18 matched healthy control. The serum levels of BDNF were significantly lower (p<0.001); and the serum levels of p-mTOR were high (p=0.003) in the adolescents with the first episode of major depressive episode accompanied by childhood trauma. Of the 31 adolescents with major depressive episodes, 17 had suicide or self-injury. Compared with the healthy control group, the serum levels of BDNF in patients with suicide or self-injury were lower than those without suicide or self-injury(p<0.001); the serum levels of p-mTOR were higher than those without suicide or self-injury (p=0.01). While in patients without suicide or self-injury, only serum p-mTOR was significantly higher than that in healthy group (p=0.028).BDNF was negatively correlated with CDRS-R (r=-0.427, p=0.006), p-mTOR was positively correlated with CDI (r=0.364, p=0.048). According to Receiver Operating Characteristic Curve (ROC), the combination of serum BDNF and p-mTOR levels have better diagnostic value. Neurotrophic and signaling pathways, involving BDNF and p-mTOR, may play a role in adolescent MDD with a history of childhood trauma, especially patients with suicide and self-injury tendencies.

Suicidalidade: um conceito em perspectiva

Abstract Objective In the field of psychology, there are concepts related to suicide that are not yet clear enough for application in clinical practice. The term “suicidality” is commonly used in international literature. however, the concept it encompasses remains unclear. The term “suicidality” is frequently used in international publications, but its exact definition remains ambiguous. To address this, a theoretical-reflective study was conducted, drawing from a comprehensive literature review aimed at clarifying the concept of suicidality as used in scientific literature on suicide. Method A thorough literature review was carried out, utilizing databases such as PubMed, Web of Science, Scientific Electronic Library Online, Latin American and Caribbean Center on Health Sciences Information Psychology Electronic Periodicals, and Latin American and Caribbean Health Sciences Literature. The search was based on the keywords “suicidality” and “suicide.” Results Following the application of inclusion and exclusion criteria, a total of 27 sources were included in the analytical corpus, encompassing books, review articles, research articles, theses, and dissertations. The reviewed studies approached suicidality as encompassing suicidal tendency, suicidal behavior, suicidal ideation, previous and current suicide attempts. This finding underscores the existing gaps in understanding the concept of suicidality. Conclusion Based on the findings, it is suggested that suicidality be understood as an inherent attribute that can vary in intensity, manifesting in the absence of vitality and leading individuals to consider suicide as a potential option, even in the absence of actual suicidal behavior.

Examination of suicidal thoughts in healthcare workers: Sample of a research and practice hospital

Working in a hospital is a very stressful and sometimes risky process for all healthcare professionals who have experienced this difficult process for years. This situation may increase the suicidal tendency of healthcare workers as a result of not only physical but also psychological exhaustion. The purpose of this study was to determine the examination of suicidal ideation and related factors among healthcare professionals working in a research and practice hospital. The data of this descriptive and cross-sectional study were collected prospectively by clinicians in a research and practice hospital. The sample of the research consisted of n=600 healthcare workers. The average age of healthcare workers was 32.46±7.79 years; 48% were women and 47.7% were married. 4% of healthcare workers had a past suicide attempt, and 18% had various levels of suicidal ideation. Women were more likely to attempt suicide. There was a positive, strong, and statistically significant correlation between depression, anxiety severity and suicidal ideation. Suicidal thoughts of healthcare professionals are affected by gender, depression and anxiety. The mental health of healthcare professionals should be evaluated periodically, and psychological support should be provided to healthcare professionals at risk of suicide.

Psychiatric and legal considerations for ketamine treatment within prison settings.

The fundamental right to equivalence of health care in prison settings encompasses the provision of medication to address mental health conditions. Considering the increased risk for self-harm among individuals dealing with depression, the limited effectiveness of conservative antidepressants is a major challenge in psychiatry. The high prevalence of suicidal tendencies within prison populations underscores the imperative for state-of-the-art pharmacological treatment to uphold adequate health care standards. Notably, the denial of access to effective medication could be deemed a violation of human rights of people living in prison according to international treaties, domestic law, and United Nations normative standards of detention. This article presents the authors' perspective on the accessibility of ketamine treatment in prison settings, discussing psychiatric and legal considerations as well as current challenges in this context. Implementing novel psychopharmacological interventions may alleviate the distress experienced by individuals struggling with depressive symptoms and suicidality. At the same time, unprecedented treatment alternatives bring along potential issues, including limited understanding of long-term effects and the risk of abuse. Given the scarce data-availability, a pressing need exists for further research on the benefits and risks of ketamine treatment within prison populations.

Recent clinical and pharmacological advancements of incretin-based therapy and the effects of incretin on physiology

Abstract A novel therapeutic target for diabetes mellitus is incretin-based therapies, glucagon-like peptide-1, and glucose-dependent insulinotropic polypeptides are released from the gastrointestinal (GI) tract and act on beta cells of pancreatic islets by increasing the secretion of insulin. The management and prevention of diabetes require habitual and pharmacological therapies along with quality and healthy lifestyle. This includes maintaining the body weight, blood glucose level, cardiovascular risk, complexity, and co-morbidities. The utilization of glucagon-like peptide-1 (GLP-1) agonists is an object of research with favorable hemoglobin A1C levels and weight loss in type 1 diabetic patients. However, cost-effectiveness and tolerability, remain significant barriers for patients to using these medications. The risk of suicidal tendencies and thoughts of self-harm have been increased in patients receiving GLP-1 receptor agonists. Tirzepatide treatment showed a potent glucose-lowering effect and promoted weight loss with minimum GI adverse effects in animal studies as well as phase I and II human trials, in comparison with established GLP-1 receptor agonists. The glucose-dependent insulinotropic polypeptide receptor (GIPR) peptide-antagonist effectively blocks the action of gastric-inhibitory-polypeptide (GIP) in vitro and ex vivo in human pancreas and in vivo in rodent models. However, incretin-based therapies have received enormous attention in the last few decades for the treatment of diabetes, obesity, and other repurposing including central nervous system disorders. Therefore, in this article, we demonstrate the overview, physiological, and pharmacological advances of incretin-based pharmacotherapies and their physiological roles. Furthermore, the recent updates of glucagon-like peptide-1 receptor agonist, Glucagon-like peptide-2 receptor agonist, GLP-1/GIP co-agonists, GIP/GLP-1/glucagon triple agonist and GIP-antagonist are also discussed.

An Epidemiological Study of Poisoning: A Follow-up Study from a Tertiary Care Hospital

Background: As per systematic review and meta analysis, 63% of poisoning in India were due to pesticides from 2010 to 2020. Poisoning can be suicidal, homicidal, or accidental. The morbidity or complications caused by poisoning is still a major public health problem in India. Aim: Therefore, this study aimed to assess the epidemiological profile of different types of poison consumed, factors associated, and outcomes of poisoning among the victims. Subjects and Methods: It was a follow-up study conducted for 6 months (September 2022 to February 2023) among 315 victims reported to tertiary care hospital in Jabalpur. Data collection was done by interview technique using a pretested self-structured questionnaire consisting of sociodemographic profile of the victim, information regarding poison and poisoning, duration of stay in the hospital, and outcome. Data entered in MS-Excel, descriptive and inferential statistical analysis was performed by IBM-SPSS 23.0. Results: In this study, it was observed that among 315 victims, the maximum belonged to the age group of 21–45 years (66.67%), with male predominance (65.71%) with the majority of poisoning was due to pesticides (48.57%), followed by tablets overdose (17.78%), then by Insecticides (12.06%) and Rodenticides (10.16%). It was noted that a maximum of the victims had a suicidal (74.29%) mode of poisoning, followed by accidental (13.97%), then homicidal (7.30%), followed by stupefaction (4.44%). Conclusion: In this study, it was observed that the majority of victims had a suicidal tendency to poison with pesticides, with the majority staying within 3–5 days in the hospital with maximum recovery.

Prospective observational study on quality of life in painful neuropathic pain conditions

Background: Neuropathic pain is the most complicated, disabling condition due to varied etiologies and clinical presentations, and with substantial global problem on the individual suffering with pain as well as the society he thrives in. The consequences of long effects of pain are so huge that it has an impact on one’s social, physical, psychological, behavioral domains, etc., and mainly leads to substance abuse, mood disorders, sleep disturbances, and increased suicidal tendencies which have an enormous and detrimental effect on patient’s quality of life (QOL). Aims and Objectives: The aim of this study was to assess the effect of neuropathic pain on the QOL and to determine the extent of socioeconomic burden on subjects with neuropathic pain conditions. Materials and Methods: This prospective, observational study was done on 100 successive subjects including both the gender aged 18–65 years, diagnosed with neuropathic pain conditions, who attended pain clinic (Outpatient Department) at Kempegowda Institute of Medical Sciences, Hospital and Research Centre, Bangalore, and subjects assessed for the impact of neuropathic pain conditions on the QoL and its influence on overall health using short-form (SF) 12 QoL. Results: The assessment of health-related QoL in the study subjects, regarding age group, gender, and duration of pain, concluded that scores with physical health (PH) and mental health (MH) were low in the age group of 31–50 years (54%) in both sexes. Lower scores in PH and MH dimensions were noted more in women (31%) than men. It was also noted that the scores were low in PH and MH components with increasing duration of illness. Conclusion: The health-related QoL in subjects with NP was assessed by SF-12 QoL questionnaire that evaluated the eight domains of Health, that is, PH and MH scores that summed up to PH composite scale-12 and MH composite scale-12 scores with respect to age group, gender, duration of pain, etc. and ongoing drug therapy, the results of which were statistically significant.

Are Medical Records Truly Prepared for Malpractice Liability in Cases of Suicide?

The most common reason for a malpractice claim is suicide or attempted suicide. It is argued that suicide can be prevented if the danger is recognized and proper and timely treatment is provided. Failure to make an informed decision as to whether to admit an individual to a psychiatric unit generally constitutes the initial breach in a claim of negligence. The present study was designed to identify exactly what essential data was missing from files of completed suicides, using 39 medical case records of the risk-management files of the state-owned malpractice insurance company between 2004 and 2022 in Israel. We found that a great deal of important information was missing from those files (e.g., records of previous suicide attempts, documentation of disagreement between the emergency department and the patient as to whether the individual should be hospitalized, and information regarding a history or lack thereof of suicidal tendencies in the individuals immediate family). Our study demonstrates that lacking the proper documentation of vital patient history, allegations of negligence would be very difficult to disprove.

Conditions for the provision of psychiatric care under compulsion: civil law aspect

The article is devoted to the issues of compulsory psychiatric care and ensuring the legitimate rights and interests of a person suffering from mental disorders and subjected to compulsory medical measures. It is noted that the level of a person’s mental health is determined by the influence of many factors – social, biological and psychological. The analysis of current legislation and specialised literature are allowed the author to argue that the issue of mental health of people, the population as a whole, is relevant today also because humanity is faced with various stress factors which can negatively affect human health, and in particular, mental health, worsen the moral and psychological climate in the family due to illness or death of loved ones, devastating natural disasters with a huge number of victims, military conflicts, military operations, including in Ukraine, which entail huge human losses and cause suffering for many.&#x0D; The author is substantiated the conclusion that compulsory psychiatric care is possible and necessary on the following grounds: the presence (assumption) of an acute mental illness or exacerbation of a chronic mental illness requiring inpatient treatment; danger of a mentally ill person to others or to himself/herself (psychomotor agitation with a tendency to aggressive actions, systematic delusional syndromes if they determine the patient’s socially dangerous behaviour, depressive states with suicidal tendencies, epileptic status, manic and hypomanic states that cause violations of public order or aggressive behaviour towards others, etc. etc.); inpatient examination (labour, military, forensic psychiatric).

TASR in suicide risk evaluation in patients in crisis

Introduction and objective: To determine the value of the Tool for Assessment of Suicide Risk (TASR) for assessing suicide risk in the psychiatry admission room in patients in suicide crisis. Materials and methods: A case-control study was planned. The case group consisted of patients hospitalised after suicide attempt in suicide crisis (with diagnosed or suspected adjustment disorder). The control group comprised those with no previous suicide attempts. The TASR was performed in the admission room after psychiatric examination. Sociological data were also taken and included in the analysis. Results: In total, 82 patients hospitalised in psychiatric wards/acute poisons ward (aged 18–79 years) were recruited, of these 79 were included in the analysis (54 women, 25 men). No significant demographic nor socioeconomic differences were found between the case and control groups. Intergroup differences, at least at trend level, were observed for age over 65, harmful substance use, a history of physical or sexual abuse, anhedonia, anxiety and impulsive behaviour. No significant differences were noted in suicidal ideation, intention and plan. The proposed optimal total TASR score cut-off points between low, medium and high risk are 14 and 22 points. Conclusions: The TASR can be used in suicidal risk assessment in patients in crisis, but a holistic assessment is more important than one focused on individual risk factors, even suicidal thoughts or tendencies. However, the tool demonstrates low discriminatory power.

Fusing multi-scale fMRI features using a brain-inspired multi-channel graph neural network for major depressive disorder diagnosis

Depression stands as one of the most pernicious mental disorders in contemporary society, characterized by a highly intricate pathological mechanism. Specifically, individuals suffering from Major Depressive Disorder (MDD) exhibit heightened vulnerability to suicidal tendencies. Currently, healthcare practitioners often encounter challenges related to the misdiagnosis and underdiagnosis of depression during clinical assessments. Consequently, it is of paramount importance to develop highly accurate auxiliary diagnostic tools for depression. Unfortunately, traditional machine learning and deep learning methodologies frequently neglect the integration of multi-source data and disregard the intricate topological structure and high-order attributes of brain networks. In this study, a multi-scale feature fusion classification framework is proposed to distinguish between MDD patients and healthy controls. Within the proposed model, a novel method, the Cross-Level High-Order Interaction (CLHOI), is introduced and implemented on a low-order functional connectivity (LOFC) matrix to derive two distinct high-order functional connectivity (HOFC) matrices. Subsequently, a Multi-Channel Fusion Graph Convolutional Network (MFGCN) is trained by integrating high-order and low-order brain graph features along with phenotypic information. The results of 10-fold cross-validation experiments conducted on the publicly available REST-meta-MDD dataset indicate that the fusion of multi-scale features improves the average accuracy by approximately 3%, resulting in an accuracy rate of 77.6%. Simultaneously, the hypothesis asserting the existence of intricate information interactions at various levels within brain connectivity networks is validated. Moreover, our model exhibits strong explanatory capabilities, effectively identifying brain regions closely associated with MDD, including the Precentral gyrus, Superior frontal gyrus, Cuneus, Lingual gyrus, and Fusiform gyrus. In comparison to numerous advanced studies within the same domain, our approach has produced competitive results. Furthermore, our proposed method can be readily extended to facilitate the diagnosis of various neurological diseases.

Electroacupuncture ameliorates chronic unpredictable mild stress-induced depression-like behavior and cognitive impairment through suppressing oxidative stress and neuroinflammation in rats

BackgroundDepression is associated with lowered mood, anxiety, anhedonia, cognitive impairments, and even suicidal tendencies in severe cases. Yet few studies have directed acupuncture's mechanism toward enhancing axonal repair correlated with synaptic plasticity and anti-inflammatory effects related to oxidative stress in the hippocampus. MethodsMale Sprague-Dawley (SD) rats were randomly divided into control group (CON), chronic unpredictable mild stress (CUMS) group, CUMS + electroacupuncture group (EA), and CUMS + fluoxetine group (FLX) (n = 10/group). Rats were given a 28-day treatment at the Shangxing (GV23) and Fengfu (GV16) acupoints with electroacupuncture or fluoxetine (2.1 mg/kg). ResultsRats exposed to CUMS induced depression-like behaviors and spatial learning-memory impairment, changed the ionized calcium binding adaptor molecule 1 (IBA-1), Vglut1, myelin basic protein (MBP), and postsynaptic density protein 95 (PSD95) level of hippocampal, increased the Nod-like receptor protein 3 (NLRP3), atypical squamous cell (ASC), Caspase level and hippocampal reactive oxygen species (ROS), and prompted the activation of Epha4-mediated signaling and an inflammatory response. Conversely, electroacupuncture administration reduced these changes and prevented depression-like behaviors and cognitive impairment. Electroacupuncture also promoted hippocampal expression of Sirtuin1(SIRT1), Nuclear factor erythroid 2-like (Nrf2), Heme oxygenase-1 (HO-1); reduced the expression of interleukin-1β (IL-1β), interleukin-18 (IL-18), and tumor necrosis factor-alpha (TNF-α); and prevented neural damage, particularly the synaptic myelin sheath, and neuroinflammation by regulating Eph receptor A4 (EphA4) in the hippocampal. ConclusionThese results indicate that electroacupuncture prevents depression-like behaviors with cognitive impairment and synaptic and neuronal damage, probably by reducing EphA4, which mediates ROS hyperfunction and the inflammatory response.

Safety of Large Language Models in Addressing Depression.

Background Generative artificial intelligence (AI) models, exemplified by systems such as ChatGPT, Bard, and Anthropic, are currently under intense investigation for their potential to address existing gaps in mental health support. One implementation of these large language models involves the development of mental health-focused conversational agents, which utilize pre-structured prompts to facilitate user interaction without requiring specialized knowledge in prompt engineering. However, uncertainties persist regarding the safety and efficacy of these agents in recognizing severe depression and suicidal tendencies. Given the well-established correlation between the severity of depression and the risk of suicide, improperly calibrated conversational agents may inadequately identify and respond to crises. Consequently, it is crucial to investigate whether publicly accessible repositories of mental health-focused conversational agents can consistently and safely address crisis scenarios before considering their adoption in clinical settings. This study assesses the safety of publicly available ChatGPT-3.5 conversational agents by evaluating their responses to a patient simulation indicating worsening depression and suicidality. Methodology This study evaluated ChatGPT-3.5 conversational agents on a publicly available repository specifically designed for mental health counseling. Each conversational agent was evaluated twice by a highly structured patient simulation. First, the simulation indicated escalating suicide risk based on the Patient Health Questionnaire (PHQ-9). For the second patient simulation, the escalating risk was presented in a more generalized manner not associated with an existing risk scale to assess the more generalized ability of the conversational agent to recognize suicidality. Each simulation recorded the exact point at which the conversational agent recommended human support. Then, the simulation continued until the conversational agent stopped entirely and shut down completely, insisting on human intervention. Results All 25 agents available on the public repository FlowGPT.com were evaluated. The point at which the conversational agents referred to a human occurred around the mid-point of the simulation, and definitive shutdown predominantly only happened at the highest risk levels. For the PHQ-9 simulation, the average initial referral and shutdown aligned with PHQ-9 scores of 12 (moderate depression) and 25 (severe depression). Few agents included crisis resources - only two referenced suicide hotlines. Despite the conversational agents insisting on human intervention, 22 out of 25 agents would eventually resume the dialogue if the simulation reverted to a lower risk level. Conclusions Current generative AI-based conversational agents are slow to escalate mental health risk scenarios, postponing referral to a human to potentially dangerous levels. More rigorous testing and oversight of conversational agents are needed before deployment in mental healthcare settings. Additionally, further investigation should explore if sustained engagement worsens outcomes and whether enhanced accessibility outweighs the risks of improper escalation. Advancing AI safety in mental health remains imperative as these technologies continue rapidly advancing.

보드게임을 활용한 집단상담프로그램이 자살경향성이 있는 청소년의 자기효능감, 또래관계 및 우울에 미치는 영향

Objectives The purpose of this study is to verify the effects of the board games group counseling program on self-efficacy, peer relationships and depression of Adolescent with suicidal tendency.&#x0D; Methods The subjects of the study were 16 students in the first grade of O Middle School in U City who scored a sum of 2 or more on the suicide crisis questions (AMPQ-III Q53, Q57) in the 2019 Student Emotional and Behavioral Characteristics Test, and 8 students were randomly assigned to the experimental group and the control group, and the homogeneity test confirmed that they were the same group. Both the experimental and control groups were given a pretest on self-efficacy, peer relationships, and depression, and the experimental group was given a group counseling program using board games for a total of 12 sessions of 50 minutes twice a week. Afterwards, the two groups were given a post-test, and normality and an analysis of covariance (ANCOVA) were conducted to verify the effectiveness.&#x0D; Results First, suicidal adolescents who participated in the group counseling program using board games showed significant positive changes in self-efficacy and peer relationships. Second, suicidal adolescents who participated in the group counseling program using board games showed significant positive changes in depression. This means that the experimental group who participated in the program had less depression and improved self-effi-cacy and peer relationships than the control group.&#x0D; Conclusions This study confirmed that the group counseling program using board games is an effective program for improving self-efficacy and peer relationships and reducing depression in suicidal adolescents, and suggested the need to develop programs for suicidal adolescents that reflect their needs and characteristics.

A descriptive cross-sectional study on eating disorders, suicidal thoughts, and behaviors among adolescents in the Valencian community (Spain). The pivotal role of school nurses

PurposeThe aims of this study were: 1) to describe the rates of risk of having an Eating Disorder (ED) and the rates of suicidal thoughts and behaviors, and 2) to examine the relationship between the risk of having an ED with suicidal thoughts and behaviors in adolescents enrolled in educational centers in the Community of Valencia (Spain). Design and methodsA cross-sectional study was conducted with 718 adolescents between September 2019 and July 2020 in five schools in the Community of Valencia (Spain). ResultsThe adolescents studied, mostly females, are at risk of having an ED (18.6% to 30.8%) and experiencing suicidal thoughts (23% to 30.7%) and behaviors (2.2% to 6.2%). A strong association was found between EDs and suicidal thoughts and behaviors in both sexes. This association was higher in females with positive EAT-26 scores (OR: 2.09; 95% CI: 1.35–3.24) and in males with positive SCOFF scores (OR: 4.66; 95% CI: 2.40–9.02). Suicidal behaviors were positively associated with both EAT-26 (OR: 2.58; 95% CI: 1.17–5.67) and SCOFF (OR: 1.89; 95% CI: 1.21–2.26) scores in females. ConclusionsA considerable number of adolescents, females in particular, are at risk of having an ED and of experiencing suicidal thoughts and behaviors, establishing a strong link between EDs and suicidal tendencies. Practical implicationsThe study highlights the importance of establishing national and regional regulations to ensure the availability of school nurses in the Community of Valencia (Spain). Collaboration between school nurses, educators, and policy makers is critical to the early detection of problems and the provision of support to both adolescents and families.

Short-term ketamine use in bipolar depression: a review of the evidence for short-term treatment management.

Bipolar depression constitutes a major problem in psychiatry. It correlates with high suicidality, treatment resistance, chronicity, and poor quality of life. Registered treatment for bipolar depression is limited and insufficient. There is an urgent need for implementing new therapeutic strategies. Intranasal ketamine's enantiomer-esketamine is a novel rapid-acting antidepressant with proven efficacy in treatment-resistant depression. Research on bipolar depression, although not as comprehensive, indicates that it may be a viable and safe substitute with minimal risk for mood polarity changes. Reports suggest that ketamine treatment in bipolar depression may reduce suicidal tendencies, decrease anhedonia, and alleviate anxiety. Ketamine's mood-stabilizing properties are also hypothesized. In this narrative review, we focus on ketamine use as an add-on to standard medication for the acute treatment of bipolar depression.