Method Of Suicide Attempt Research Articles

The MCOSUL cohort: Lethality, recurrence, and mortality in suicide attempts in the Lérida Region, Spain—Rationale, objectives, and preliminary findings

Background and objectivesSuicide is a major global health issue with profound impacts on individuals, families, and societies. Understanding the factors that influence the lethality of suicide attempts, the frequency of reattempts, ultimate causes of death, and associated immune biomarkers is crucial for developing effective prevention strategies. This article outlines the rationale, objectives, and protocol of a new cohort study, presenting preliminary descriptive results. MethodsWe designed a prospective, naturalistic cohort study involving patients from the Arnau de Vilanova and Santa Maria University Hospitals in Lleida, Spain. Participants are recruited following a suicide attempt and are monitored over time. Data on clinical assessments, suicidal methods, somatic lethality, immune biomarkers, reattempts, and causes of death are collected and analyzed. The cohort continues to recruit patients and update follow-up data. ResultsCurrently, the cohort includes 1918 patients. The majority of participants are females (62.8%) with an average age of 41.2 years. The average follow-up period is 77.6 months. Sedative poisoning is the most common method of suicide attempt (57.3%). High lethality attempts predominate (76.7%), and 43.4% of patients have reattempted suicide. During follow-up, 5.5% of patients died, with 2.1% of deaths attributed to suicide. ConclusionThe findings from this study are expected to enhance our understanding of the relationships between suicide lethality, reattempts, mortality, and immune biomarkers. This knowledge may help to personalize interventions aimed at reducing suicide rates and improving outcomes for individuals at high risk.

Suicide Attempts and Influencing Factors

Objective: The objective of this study is to evaluate the applications to the Emergency Departments in …. province between 2019 and 2023 due to suicide attempts and to provide guidance for social preventive programmes. Material and Method: This cross-sectional study was conducted with the approval of the …. University Non-Interventional Research Ethics Committee, dated 21 September 2023 and numbered 176-176-09. The study examined The archive of the …. Provincial Health Directorate was consulted to obtain records of cases of suicide attempts among individuals aged 13 years and over between the years 2019-2023. These records were examined between 1 November-31 December 2023. Results: A total of 947 patients participated in the study, 635 of whom were women. The majority of suicide attempts (43.2%) occurred between the ages of 13 and 24 years. The highest number of suicide attempts occurred between 18:00 and 23:59 (40.5%) and in summer (29.8%). The highest number of suicide attempts occurred in August (10.5%). The majority of those who attempted suicide were primary school graduates (47.0%) and unemployed (39.4%). The suicide attempt rate of farmers (42.9%) was significantly higher than other occupational groups (p=0.009). Family problems (31.3%) were the most common reason for suicide attempt. The most common method of suicide attempt was drug-toxic substance use (92.6%). Among the study participants, 21.1% had attempted suicide previously. Among those who attempted suicide, 24.2% had a previous psychiatric diagnosis. Medication (activated charcoal) was administered to 60.4% of the suicide attempters, while psychiatric consultation was requested for 11.5%. A total of 69.5% of the suicide attempts resulted in a single interview. Conclusion: Most of the suicide attempters were adolescent and young age group, female, illiterate, primary school graduate and unemployed. According to our study, the most common causes and methods of suicide attempts were familial problems and drug-toxic substance use. It is recommended that regulations should be implemented to ensure psychiatric consultation for all suicide attempters and that the follow-up and treatment of suicide attempters should be carried out by a team consisting of family physicians, psychiatrists, psychologists and social workers.

Incidence of Suicide Attempt Behaviors between 2015-2018 Among children and Adolescents in Al Najaf Al Ashraf Province

Background : Suicide is a grave public health issue that impacts people of all ages, including children and teenagers, and represents a significant global public health concern. This study concentrates on recent advancements in our comprehension of trends and risk factors related to children and adolescent suicidal behavior. While suicide is among the leading causes of mortality in many Western countries, it was, until recently, an exceedingly rare phenomenon in Eastern countries. Our study, conducted from 2015 to 2018, aims to explore on the trends in suicide attempt behaviors among children and adolescents. it was, until recently, an exceedingly rare phenomenon in Eastern countries. Methods: The research objectives were achieved through a descriptive-analytic study. Incidence in suicide attempt behaviors between 2015 and 2018 among children and adolescents in Al Najaf Al Ashraf were identified. The study was conducted in the Al-Najaf province from December 2nd, 2022, to April 16th, 2023. A non-probability purposive sample of 156 participants was included in the study. Data were collected from at Hakeem teaching hospital and from police center documentation in hospital between December 16th, 2022, and January 20th, 2023. The study instrument consisted of two parts: Part I included a socio-demographic characteristics sheet with three items, gender, age, and residence. Part II focused on the method of suicide attempt (poisoning, jumping from a high place, shooting, cutting of the artery, strangulation, hanging, and burning). Results: The highest percentage of the study sample (46%) within age group (18 years) or younger , (52%) were female. Notably, suicide attempts were highest in 2017 compared to the frequencies in 2015. A significant relationship was observed between suicide attempt behaviors and gender. Conclusions & recommendations: Poisoning was the most common method, while the percentage of attempts involving cutting of the artery was lower. Limit access to the means of suicide, such as pesticides, drugs, and weapons. Focus on treating individuals with mental disorders, especially those struggling with depression, schizophrenia, and alcoholism. In our community, poverty, deprivation, and unemployment should be addressed as political priorities, with decision-makers actively working to strengthen the community economically and ensure equal employment opportunities.

Investigating the Characteristics of Suicide And its Relationship with Family History of Suicide

Background: Several factors contribute to suicide attempts. To the best our knowledge, there is no study has been conducted to investigate the impact of a family history of suicide on suicide attempts. Objectives: This study aims to examine the characteristics of suicide and its association with a family history of suicide. Materials and Methods: This historical cohort study was carried out on individuals admitted to Shahid Beheshti Hospital in Taft and Shah Wali Hospital in Yazd for suicide attempts between 2018 and 2019. The study examined 73 individuals with a family history of suicide and 332 without such a history. It recorded demographic details, methods of suicide attempts, and family histories concerning the patients' mothers, fathers, and siblings. Data were collected and subsequently analyzed using ndependent t-tests, Mann-Whitney tests, chi-square and Fisher's exact test. A significance level of P < 0.05 was considered. Results: The average age of the subjects was 28.02 ± 10.8 years, with 295 (72.8%) of the participants being women. There were no significant differences in mean income (P = 0.99), marital status (P = 0.06), gender (P = 0.35), place of residence (P = 0.06), and education level (P = 0.37) between individuals with and without a family history of suicide. Furthermore, our results indicated that the prevalence of mental illness was significantly higher in individuals with a family history of suicide (P < 0.001). The average number of suicide attempts was 1.05 ± 1.90 for those with a family history and 1.21 ± 0.50 for those without, a difference that was statistically significant (P = 0.002). The timing, method, and reasons for suicide attempts were not associated with a family history of suicide. Conclusions: A family history of suicide was associated with an increased number of suicide attempts. There was no correlation between family history and gender, occupation, place of residence, number of children, timing of suicide, method of suicide, reason for suicide, and educational status of the patients. However, a significant relationship was found between a family history of suicide and a history of mental illness among the patients, indicating a higher prevalence of mental illness in the group with a family history compared to those without.

Determining Distinct Suicide Attempts From Recurrent Electronic Health Record Codes: Classification Study.

Prior suicide attempts are a relatively strong risk factor for future suicide attempts. There is growing interest in using longitudinal electronic health record (EHR) data to derive statistical risk prediction models for future suicide attempts and other suicidal behavior outcomes. However, model performance may be inflated by a largely unrecognized form of "data leakage" during model training: diagnostic codes for suicide attempt outcomes may refer to prior attempts that are also included in the model as predictors. We aimed to develop an automated rule for determining when documented suicide attempt diagnostic codes identify distinct suicide attempt events. From a large health care system's EHR, we randomly sampled suicide attempt codes for 300 patients with at least one pair of suicide attempt codes documented at least one but no more than 90 days apart. Supervised chart reviewers assigned the clinical settings (ie, emergency department [ED] versus non-ED), methods of suicide attempt, and intercode interval (number of days). The probability (or positive predictive value) that the second suicide attempt code in a given pair of codes referred to a distinct suicide attempt event from its preceding suicide attempt code was calculated by clinical setting, method, and intercode interval. Of 1015 code pairs reviewed, 835 (82.3%) were nonindependent (ie, the 2 codes referred to the same suicide attempt event). When the second code in a pair was documented in a clinical setting other than the ED, it represented a distinct suicide attempt 3.3% of the time. The more time elapsed between codes, the more likely the second code in a pair referred to a distinct suicide attempt event from its preceding code. Code pairs in which the second suicide attempt code was assigned in an ED at least 5 days after its preceding suicide attempt code had a positive predictive value of 0.90. EHR-based suicide risk prediction models that include International Classification of Diseases codes for prior suicide attempts as a predictor may be highly susceptible to bias due to data leakage in model training. We derived a simple rule to distinguish codes that reflect new, independent suicide attempts: suicide attempt codes documented in an ED setting at least 5 days after a preceding suicide attempt code can be confidently treated as new events in EHR-based suicide risk prediction models. This rule has the potential to minimize upward bias in model performance when prior suicide attempts are included as predictors in EHR-based suicide risk prediction models.

Characteristics of suicide attempts in Northwestern Iran: a five-year population-based survey.

Suicide is a serious public health problem in the world. This study aims to describe the characteristics of suicide attempters in North-Western Iran and identify latent classes of suicide attempts. This cross-sectional study was conducted in Ardabil Province (Northwest Iran) during 2017-2021 based on a registration system for suicide attempts. We performed latent class analysis (LCA) using a procedure for LCA (PROC LCA) in SAS to investigate the subgroups of suicide attempters based on their characteristics and method, history, and outcome of suicide. Three latent classes were identified for males and females; the first class (non-lethal attempters with lower educational levels) comprised 41.3% of males and 55.4% of females. The second class (non-lethal attempters with higher educational levels) described 52.4% of males and 42.7% of females. Finally, the third class (lethal attempters) included 6.4% of males and 1.9% of females. The main method of suicide attempts was poisoning with medications (87.3%). The results show that only 2.8% of people have a history of suicide attempts. Also, the suicide rate reached 8.26 per 100,000 population in 2021. The present study showed an increasing trend of suicide attempt incidence rate in Ardabil Province from 2017 (99.49 per 100,000 population) to 2021 (247.41 per 100,000 population). This means that the rate of change was 147.92 per 100,000 population during the study period. The findings of LCA, stress the necessity of identification and prioritization of unmet needs of people who had an incomplete suicide in Ardabil.

Sex differences in the factors that affect medical lethality in elderly suicide attempters

ObjectivesThis study aimed to identify sex differences in the factors that affect medical lethality in elderly suicide attempters.MethodsA total of 253 elderly suicide attempters and 351 middle-aged attempters (comparison group) who visited the emergency room at a general hospital were included. The sociodemographic and clinical characteristics of the patients were investigated. The Chi-squared test and logistic regression analysis were performed. And Spearman’s correlation coefficient was calculated.ResultsIn older males, the risk of high lethality was lower when attempting suicide due to the loss of family members [adjusted odds ratio (AOR): 0.08]. The risk increased as the intent to die became more certain (some AOR: 11.31, certain AOR: 28.75), and this association became more pronounced with age (rho middle-aged: 0.329; young-old: 0.387; old-old: 0.415). In older females, the risk was lower when employed (AOR: 0.28). The method of suicide attempt also affected lethality (agricultural chemicals AOR: 3.71; psychiatric medication AOR: 0.31).ConclusionSex differences in the factors that affect medical lethality were identified among elderly suicide attempters. In particular, medical lethality can be predicted by the degree of suicide intention in older males. These findings will help to establish more efficient preventive strategies with specific targets.

Factors affecting patients who attempted suicide in the emergency department due to the prolonged pandemic of COVID-19.

This study examined the characteristics of patients who attempted suicide in the emergency department before and during the COVID-19 pandemic. We compared data from patients in the emergency department following suicide attempts between January 2018 and December 2021. The patients were categorized into two groups: "pre-COVID-19" and "during COVID-19" pandemic. The findings revealed an increasing trend of suicide attempts during the study period. Suicide attempts were reported at 1,107 before the COVID-19 pandemic and 1,356 during the COVID-19 pandemic. Patients who attempted suicide during the COVID-19 pandemic were younger (38.0±18.5 years vs. 40.7±18.4 years, P<0.01), had a smaller proportion of men (36% vs. 44%, P<0.01), and had fewer medical comorbidities (20.2% vs. 23.6%, P<0.05). The group during the COVID-19 pandemic reported better hygiene conditions (50.5% vs. 40.8%, P<0.01) and lower alcohol consumption (27.7% vs. 37.6%, P<0.01). Patients who attempted suicide during the COVID-19 pandemic had higher rates of use of psychiatric medications and previous suicide attempts. The most common reasons for the suicide attempt were unstable psychiatric disorders (38.8%), poor interpersonal relationships (20.5%), and economic difficulties (14.0%). Drug poisoning (44.1%) was the most common method of suicide attempts. Subgroup analysis with patients who attributed their suicide attempts to COVID-19 revealed a higher level of education (30.8%) and employment status (69.2%), with economic difficulties (61.6%) being the primary cause of suicide attempts. These findings suggest that the prolonged duration of the COVID-19 pandemic and its effects on social and economic factors have influenced suicide attempts.

Uncovering the role of substance use in suicide attempts using a mixed-methods approach.

Substance use is an established risk factor for suicide attempt. Clarifying the role of substance use in suicide attempts may identify modifiable treatment targets. This study used mixed methods to associate substance use with suicide attempt history and identify pathways through which substance use contributes to attempts. Study 1 included 213 adult inpatients (n = 127 with substance use disorder [SUD]), who completed assessments of suicide attempt history as well as demographic and clinical suicide risk factors. Study 2 was a narrative analysis of suicide attempt stories described by 20 inpatients diagnosed with SUD. In Study 1, patients with co-occurring alcohol and drug use disorders reported more actual lifetime suicide attempts than did those without SUD. In addition, alcohol and drug use disorders were independently associated with lifetime suicide attempts after controlling for demographic and clinical confounders. In Study 2, substance use played a role in all suicide attempts through at least one pathway before, during, or after a triggering stressor, or as suicide attempt method. Substances play a role in suicide attempt baseline risk, acute risk and as means. It is important to target chronic and acute substance use in suicide prevention treatment plans.

Impact of child sexual abuse on suicidal behavior in a population of Moroccan women with severe psychiatric disorders: Impact des abus sexuels à l'enfance sur les comportements suicidaires chez une population de femmes marocaines atteintes de troubles psychiatriques sévères

BackgroundChild sexual abuse (CSA) was associated with an increased risk of suicidal behavior. AimsEvaluate the impact of child sexual abuse on suicidal behavior in a population of Moroccan women with severe psychiatric disorders. MethodA cross-sectional study was carried out at the psychiatry department of Mohammed VI University Hospital Center in Oujda (Morocco). Results400 women with psychiatric disorders were included. 5% of the patients in our sample had a history of CSA, and the average age at the time of sexual abuse was 12.5 ± 3.4 years old, ranging from 4 to 18. 25.5% of the patients had a history of a lifetime suicide attempts. The prevalence (7.8% vs. 4%, p = 0.078), and the number of the lifetime suicide attempts (6.25 ± 4.68 Vs 2.59 ± 2.69, p = 0.0008), were significantly higher in sexually abused patients. Jumping from heights was the most common method of suicide attempts among sexually abused patients (p = 0.0055). In addition CSA is significantly more frequent among patients with borderline personality disorder (p = 0.0034), and those who use tobacco (28% vs. 8.5%, p = 0.00007), cannabis (38.5% vs. 4%, p = 0.00018), and alcohol (45.5% vs. 4%, p = 0.00007). LimitationsThe cross-sectional design, as well as the non-performance of logistic regression, were the main limitations of our study. ConclusionCSA significantly influences suicidal behavior in women with severe psychiatric disorders. CSA screening and evaluation could prevent suicidal behavior and improve patients' overall quality of life.

Emerging Problem Evaluation of Hypocalcemia in Super Vasmol Hair Dye Poisoning Patients: Clinical Study in RIMS, Kadapa

Introduction: One of the most frequent method of suicide attempt in India is intentional super vasmol poisoning. If it is untreated, it leads to many complications such as, rhabdomyolysis, angioedema, acute kidney injury, and hypocalcemia. Of all above mentioned; hypocalcemia can cause pathologies of the neuromuscular, cardiovascular, and respiratory systems. Early detection and treatment of the issue can reduce the diseases and fatalities that are related to it.&#x0D; Aim: This study aims to assess the incidence, clinical manifestations, and management of hypocalcemia in super vasmol poisoning patients.&#x0D; Methods: A prospective observational study was undertaken on 50 super vasmol poisoning patients for about six months at the government general hospital, RIMS, Kadapa from November 2021 to April 2022. Only subjects who are willing to give their consent were included in the study. All trial participants were observed for the duration of their hospital stay to evaluate hypocalcemia.&#x0D; Results: Out of the 50 subjects, 22 (44%) were male, 28 (56%) were female, and the majority (40%) were in between the age group of 21 to 30 years. 15 patients (30%) out of the 50 subjects were developed with hypocalcemia, particularly those who consumed more than 50 ml of super vasmol. We observed that 66.5% of subjects received parenteral calcium gluconate while 33.5% subjects received oral calcium carbonate.&#x0D; Conclusion: Hypocalcemia is a hidden complication of super vasmol poisoning, and there is a need to raise awareness among the among medical professionals about the necessity of routinely checking serum calcium levels as well as public regarding the dangers of super vasmol.&#x0D; Keywords: Super vasmol, Toxicity, Hypocalcemia, Hospitalization, Counselling.

Factores relacionados con la reincidencia de intento de suicidio en adolescentes y adultos jóvenes atendidos en una empresa social del estado en Cali del 2016 al 2019

IntroductionAccording to data from the World Health Organization, about 700,000 deaths by suicide per year are estimated by June 2021, being the fourth leading cause of death among young people aged 15 to 19 in the world. Faced with this problem, there is a need to seek strategies to achieve a reduction in suicide cases. For this, it is relevant to know that the recurrence of suicide attempts is the main predictor for this outcome. Given the above, it is crucial to determine those risk factors for recurrent suicide attempts, and thus ensure timely follow-up and intervention. Materials and methodsA cross-sectional study was carried out, based on a secondary analysis of data from the report of the epidemiological notification files of suicide attempts in the Red de Salud del Centro in Cali during the period between 2016 and 2019. Results54.4% presented recurrence of attempted suicide, 75.1% corresponds to women, with a median age of 18 years (IQR 15-21). From the multivariate analysis, it was found that the history of family suicide (OR = 3.34; CI 95% 1 004-11.14; P < .05), the problem of Consumption of Psychoactive Substances (SPA) (OR = 2.88; CI 95% 1.42-5.8; P < .01), severe mental disorder (OR = 2.11; CI 95% 1.13-3.9; P < .05) and the use of a sharp weapon as a method of suicide attempt (OR = 2.75; CI 95% 1.32-5.74; P < .01) were associated with recidivism of suicide attempts. ConclusionHealth strategies to reduce cases of recurrence of suicide attempts in young people and adolescents must have a multidisciplinary scope, encompassing sociodemographic, clinical, and psychosocial characteristics. This study allows us to glimpse some risk factors for recurrence of suicide attempts, such as a history of family suicide, the problem of consumption of psychoactive substances, the presence of a serious mental disorder and the use of a sharp weapon as a method for the suicide attempt; however, there are other variables reported in the literature that could become the subject of future research, which cannot be described due to the methodology of this research.

Risk factors associated with suicide attempts in patients with schizophrenia: an observational study from South India

BackgroundAs a suicide attempt is an important predictor of suicide in patients with schizophrenia, it is essential to assess risk factors to prevent suicides. This study aimed to assess the clinical factors and reasons associated with suicide attempts in patients with schizophrenia. A chart review of the patients diagnosed with schizophrenia from January 2014 to December 2019 was conducted at a tertiary hospital in South India. Socio-demographic and clinical details were extracted using a pro-forma. Details of suicide attempts were collected for all the patients.ResultsOut of 300 patients, 54 patients (18%) had at least one suicide attempt. Comorbid depression (p < 0.001,φ = 0.32) and substance abuse (p = 0.043,φ = 0.1) were significantly more in patients with suicide attempts. The group with suicide attempts had a significantly higher record of poor treatment compliance (p = 0.001, φ = 0.19). The most common methods of suicide attempts were drug overdose and consumption of poison (20.3% each). The most common reasons were the presence of depressive symptoms (24.1%) and delusions (24.1%). Hallucinations contributed to 22.2% of the suicide attempts.ConclusionsSuicide attempts were common among schizophrenia patients in up to 18%. Evaluation and early treatment of depressive symptoms and substance abuse and improvement of treatment adherence may help prevent suicide in patients with schizophrenia.

Suicide attempts among children and adolescents admitted to a Polish Emergency Department: Analysis of epidemiology, circumstances and methods of 154 cases.

Suicide attempts among pediatric patients are currently one of the most critical issues in modern psychiatry and emergency medicine, and constitute a serious public health problem that affects people of almost every age group. It is often emphasized that attempted suicide is a cry for help, and according to international studies, the pandemic year of 2020 massively impacted the frequency of suicide attempts among children. However, such studies have yet to appear in Poland. To characterize the frequency, circumstances and methods of suicide attempts among children and adolescents, and investigate their relationship with coronavirus disease 2019 (COVID-19). The study retrospectively analyzed the medical records of 154 children admitted to the Emergency Department due to suicide attempts between January 2020 and June 2021. No statistical relationship was found between the direct impact of the pandemic and suicide attempts among children and adolescents. However, age and gender influenced the methods used and the frequency of suicide attempts. Females are more likely to attempt suicide than males, and patients as young as 8 tried to take their own lives. Due to the increasing frequency of suicide attempts in children and adolescents, people at particular risk of such behaviors should be identified and provided with effective care. Unfortunately, although the vast majority of pediatric patients who attempted suicide had psychiatric consultations in the past, it did not prevent them from actively trying to end their lives. Furthermore, even children of a very young age are at risk of suicide events.

Is lethality different between males and females? Clinical and gender differences in inpatients suicide attempters

IntroductionAccording to the gender paradox,in suicidology an important sex difference has been reported with a preponderance of females in nonfatal suicidal behavior and a preponderance of males in completed suicide.The lethality of suicidal behavior in females is lower most likely because males choose more violent suicide methods.Furthermore,women more frequently present traditional risk factors for suicide than do men,including depression,childhood sexual abuse, and prior suicidal ideation and attempts.ObjectivesThe purpose of this study was to explore possible clinical differences between male and female psychiatric inpatients who had recently attempted suicide.We hypothesized that clinical characteristics such as psychiatric diagnosis,the methods and lethality of the suicide attempt,the history of suicide attempts,age at onset of psychiatric illness,the presence of substance or alcohol use and the length of stay differ between male and female suicide attempters.MethodsThe study included 177 adult inpatients at the University Psychiatric Clinic, Sant’Andrea Hospital, Sapienza University of Rome hospitalized following a suicide attempt, between January 2018 and May 2022.Clinical features assessed included psychiatric diagnosis, method and lethality of suicide attempts using the Risk-Rescue Rating Scale, the history of suicide attempts, age at onset of psychiatric illness, the presence of substance or alcohol use, and the length of stay.All statistical analyses were performed with the Statistical Package for Social Sciences(SPSS 27.0).ResultsMales and females differed according to the method used for suicide attempt(x23=10.96,p&lt;0.05),the scores for risk and rescue(t175=2.55,p&lt;0.05;t146.6=-1.99,p&lt;0.05,respectively),and the length of stay(U= 3084.5,p&lt;0.05).Females were more likely to use drug/poisoning ingestion as method for suicide attempt than were males(72.8% vs.51.4%),whereas males were more likely to use hanging than were females(20.3% vs. 6.8%).The risk score was higher for males(3.76±0.68)than for females(3.49±0.72),and the rescue score was higher for females than for males(2.79±1.09 vs. 2.43±1.22).Finally,the length of stay was longer for males than for females(10.66±8.09 vs. 8.25±6.48).These results confirm the role of difference in suicide methods used by males and females for explaining the “gender paradox.”ConclusionsThe present study illustrates the usefulness of the Risk-Rescue Rating Scale which is a descriptive and quantitative method of assessing the lethality of suicide attempts.Identifying sex related characteristics of suicide risk in patients is important for implementing specific suicide prevention strategies to reduce suicidal intent, psychological pain and rehospitalization in patients with psychiatric disorders.Men and women may need different strategies for the prevention of future suicidal behavior.Disclosure of InterestNone Declared

Emotionally Unstable Personality Disorder and Severity of Suicide Attempt are related to Epigenetic Hypermethylation of Brain-Derived Neurotrophic Factor in Women

IntroductionBrain-derived neurotrophic factor (BDNF) has been associated with both emotionally unstable personality disorder (EUPD) and suicidal behavior. No study has yet investigated BDNF-associated epigenetic alterations in severely impaired EUPD and suicidal patients.ObjectivesThe main goal of the present study was to investigate whether epigenetic dysregulation in BDNF, CRP, IL-1, IL-2 and IL-6 were associated with EUPD and severity of suicidal behavior.MethodsThe discovery cohort consisted of 97 women with emotionally unstable personality disorder (EUPD) with at least two serious suicide attempts (SA) and 32 healthy women. The genome-wide methylation pattern was measured by the Illumina EPIC BeadChip and analyzed by robust linear regression models to investigate mean BDNF methylation levels in a targeted analysis conditioned upon severity of suicide attempt. The validation cohort consisted of 60 female suicide attempters, stratified into low- (n=45)and high-risk groups (n=15) based on degree of intent-to-die and lethality of suicide attempt method, and occurrence of death-by-suicide at follow-up.ResultsMean BDNF methylation levels exhibited hypermethylation in relation to EUPD(p=0.0343, percentage mean group difference ~3.8%). Similarly, this locus was confirmed as hypermethylated in an independent cohort of women with severe suicidal behavior (p=0.0469). Results were independent of age and BMI.ConclusionsThis study elicits emerging evidence of epigenetic dysregulation of BDNF in relation to phenotypes known to increase risk of suicide (lethality of suicide-attempt method and presence of EUPD diagnosis with history of recent SA). Further studies investigating epigenetic and genetic effects of BDNF on severe suicidal behavior and EUPD are needed to elucidate the role of epigenetic regulatory mechanisms and neurotrophic factors in relation to suicide risk.Disclosure of InterestNone Declared

İntihar Girişimi ile Acil Servise Başvuran Hastaların Analizi

Aim: Suicide is an important public health problem worldwide. This study aims to investigate the general characteristics of patients presenting to the emergency department with a suicide attempt. Material and Methods: Patients who presented to the emergency department with a suicide attempt between 01.12.2019 and 31.05.2020 were investigated prospectively. Age, gender, vital signs, method of suicide attempt, past medical history, additional diseases, and regularly used medications were recorded. Results: The study included 247 patients. The median age of the patients was 32 (IQR 25-75: 25-41). 157 (63.6%) of the patients were female. While 222 (89.9%) of the patients attempted suicide by medication overdose, 78 (31.6%) of the patients were receiving psychiatric treatment. There was no statistically significant correlation between the suicide attempt method and the psychiatric treatment status of the patients (p&amp;gt;0.05). Similarly, no statistically significant correlation was found between the outcome of the patients and patients’ psychiatric treatment receiving status. (p&amp;gt;0.05). Conclusion: The most frequent method used for suicide in patients who presented to the emergency services with a suicide attempt is medication overuse. There is no relationship between the method of suicide attempt and the psychiatric treatment status of the patients.

Significantly elevated phosphatidylethanol levels in recent suicide attempters, but not in depressed controls and healthy volunteers

IntroductionSuicide is a complex transdiagnostic phenomenon. It is strongly associated with, but not exclusive to major depressive disorder (MDD). Hazardous alcohol drinking has also been linked to an increased risk of suicidal behaviours, however, it is often underreported. The study aimed to evaluate whether an objective measure of chronic alcohol use, phosphatidylethanol (PEth) could be useful as a biomarker in clinical practice. Methodology. The present case-control multi-centric study recruited 156 participants into three study groups: 52 patients treated for major depressive disorder (MDD), 51 individuals immediately following a suicide attempt (SA), and 53 volunteers. Sociodemographic data, medical history, and laboratory data, including PEth concentrations and C-reactive protein levels, were collected from study participants. ResultsPEth concentrations were the highest in suicide attempters (232,54 ± 394,01 ng/ml), followed by patients with MDD (58,39 ± 135,82 ng/ml), and the control group (24,45 ± 70,83 ng/ml) (Kruskall Wallis χ2 = 12.23, df = 2, p = .002). In a multinomial logistic regression model with adjustments, PEth concentration was able to predict belonging to suicide attempters’ group, but not to depression group (p = .01). Suicide attempters were also more likely to underreport their recent alcohol consumption. LimitationsWe did not analyze SA methods, psychiatric comorbidity and several other factors that might be associated with PEth levels, such as body mass index, race, and haemoglobin levels. Sample recruited in hospital settings may not be representative of the whole population. The results of this adult-only study cannot be generalized to adolescents. ConclusionsPEth levels in recent suicide attempters significantly exceeded those of patients with MDD and controls. Suicide attempters also were more likely to underreport their alcohol consumption when questioned about their consuption. PEth might be an interesting biomarker to evaluate individuals at risk of SA.

High hs-CRP levels after an attempted suicide: A matched case-control study

• Plasma levels of hs-CRP are higher in subjects who had recently attempted suicide compared to age- and sex-matched healthy subjects. • The lack of correlations between hs-CRP levels measured shortly after the attempted suicide vs. depression severity and other psychological symptoms suggests that inflammation may be specifically related to suicidal behavior. We found significantly higher levels of hs-CRP in 27 subjects who had recently attempted suicide compared to 27 age- and sex-matched healthy subjects. Moreover, the levels of hs-CRP in suicide attempters were not related to background or psychopathological characteristics, nor to the methods of suicide attempt. Our matched case-control study confirms previous observations of high levels of the inflammation marker hs-CRP in patients who have attempted suicide, irrespective of their underlying type and levels of psychopathology.

Is Lethality Different between Males and Females? Clinical and Gender Differences in Inpatient Suicide Attempters.

According to the gender paradox in suicidology, an important sex difference has been reported with a preponderance of females in nonfatal suicidal behavior and a preponderance of males in completed suicide. Furthermore, females and males present different risk factors for suicide. The present study explored possible clinical differences between male and female psychiatric inpatients who had recently attempted suicide. The study included 177 adult inpatients hospitalized following a suicide attempt at the University Psychiatric Clinic, Sant’Andrea Hospital, Sapienza University of Rome. Clinical features assessed included psychiatric diagnosis, method and lethality of suicide attempts using the Risk/Rescue Rating Scale, the history of suicide attempts, age at onset of psychiatric illness, the presence of substance or alcohol use, and the length of stay. The results found that males and females differed in the method used for the suicide attempt, the scores for risk and rescue, and the length of hospitalization post-suicide attempt. In conclusion, identifying gender characteristics of patients at higher risk of suicide is important for implementing specific suicide prevention strategies and reducing the risk of future suicidal behavior in psychiatric inpatients.