Adolescent Suicide Attempters Research Articles

Self-compassion and family cohesion moderate the association between suicide ideation and suicide attempts in Chinese adolescents

BackgroundIn recent years, many studies have examined risks factors that facilitated the transition from suicide ideation to suicide attempts. Few studies, however, have examined protective factors against this transition. The current study thus assessed two protective factors, self-compassion and family cohesion, in buffering the transition from suicide ideation to suicide attempts. MethodA number of 520 Chinese adolescents (43.46% females, mean age = 12.96 years) completed questionnaires assessing self-compassion, family cohesion, suicide ideation, and suicide attempts two times with a 12-month interval. ResultsSelf-compassion significantly moderated the association between Wave 1 SI and later SA. The positive dimension of self-compassion thwarted the transition from SI and SA, and the negative dimension of self-compassion strengthened the associations. In addition, family cohesion also significantly moderated the transition from SI to SA. ConclusionIncreasing the levels of self-compassion and family cohesion may be the targets for treating adolescents with suicide ideation to prevent them from attempting suicide.

The Role of Sociodemographic, Clinical and Neuropsychological Variables in Suicide Attempts in Depressed Adolescents.

In this study, we aimed to evaluate the relationship between sociodemographic, clinical and neuropsychological variables and suicide attempts by comparing adolescents with Major Depressive Disorder (MDD) with and without suicide attempt. 30 adolescents with and without suicide attempt were included in this study. Sociodemographic and Clinical Data Form, Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime Version (K-SADS-PL), The Children Depression Inventory (CDI), Beck Hopelessness Scale (BHS), Barratt Impulsivity Scale (BIS) and neuropsychological tests (Go/NoGo test, Stroop test Wisconsin Card Sorting Test) was applied to participants. Depressed adolescents with suicide attempt compared to adolescents without suicide attempt; motor and total impulsivity scores in BIS-11, commission errors in Go/NoGo test which measure motor inhibition, completion time and errors in Stroop 5 which measure interference inhibition and scores of perseveration in Winsconsin Card Sorting Test (WCST) which measure cognitive inhibition were found to be higher. Family history of suicide attempt (OR: 5.87), commission errors (OR: 1.37), perseverative errors (OR: 1.09) ve total impulsivity (OR: 1.05) were remained in the logistic regression model. Results of this study suggested that family history of suicide attempt was the most important factor predicting suicide attempt in adolescents with depression. Other factors predicting suicide attempt were executive dysfunction and impulsivity.

Is there a relationship between thyroid hormone levels and suicide attempt in adolescents?

Is there a relationship between thyroid hormone levels and suicide attempt in adolescents?

Supplemental Material for The Association Between General Childhood Psychopathology and Adolescent Suicide Attempt and Self-Harm: A Prospective, Population-Based Twin Study

Supplemental Material for The Association Between General Childhood Psychopathology and Adolescent Suicide Attempt and Self-Harm: A Prospective, Population-Based Twin Study

Characteristics and Trends of Suicide Attempt or Non-suicidal Self-injury in Children and Adolescents Visiting Emergency Department.

BackgroundNon-suicidal self-injury (NSSI) and suicidality are common reasons for child and adolescent psychiatric emergencies. We aimed to investigate the incidence of pediatric emergency department (PED) utilization for psychiatric problems in children and adolescents and to identify demographic and clinical characteristics of youths who visited the PED for suicide attempt (SA) and/or NSSI.MethodsThe medical records of children and adolescents who visited the PED for psychiatric problems from January 2015 to November 2019 were reviewed retrospectively. Demographic and clinical variables including psychiatric disorders were collected. We compared the characteristics of youths who presented to the PED for SA and/or NSSI with those of youths without SA or NSSI. Student's t-test, χ2 test, and multivariate logistic regression were used for statistical analysis.ResultsDuring 59 months of observation, 194 youths visited the PED and the number of total PED visits was 336. Among them, 46 youths (23.7%) visited the PED for SA and/or NSSI at least once, and the number of visits was 91 (27.1% of PED visits). Youths with SA and/or NSSI were older (P = 0.001) and more likely to be a girl (P = 0.005) and to report parental absence (P = 0.023). Bipolar and related disorders (P = 0.032) and depressive disorders (P = 0.004) were more common in youths with SA and/or NSSI, while schizophrenia spectrum and other psychotic disorders (P = 0.030) and somatic symptom and related disorders (P = 0.007) were more common in those without SA and NSSI. After adjusting for age, sex, and parental marital status, bipolar and related disorders (odds ratio [OR], 6.72), depressive disorders (OR, 9.59), and somatic symptom and related disorders (OR, 0.12) were significantly associated with SA and/or NSSI. Youths with SA and/or NSSI also stayed longer in the PED (P = 0.007).ConclusionSA and NSSI are one of the main reasons for child and adolescent admittance to psychiatric services in the PED and are associated with psychiatric comorbidities. An appropriate risk assessment for suicidality and self-injury and proper management and referral to mental health services at the PED are of the utmost importance.

Suicide attempt among adolescent in Tamil Nadu: A case-control study

Introduction: Suicide is a complex social issue and a serious global health problem. Its incidence among adolescents is increasing. Understanding of risk factors helps early detection and prompt treatment of high-risk youngsters. Materials and Methods: It was a hospital-based case-control study carried out among 60 adolescent suicide attempters and 60 of their normal counterparts for the period of one year. Pretested structured questionnaire was used to collect information. Ethical principles were followed throughout the study. SPSS version 24 was used to do the analysis. Odd's ratio (OR) and its 95% confidence interval (CI) were calculated as a measure of the strength of association between risk factors and suicide attempts. Results: Among the study participants, 70% were in the age group of 16 – 18 years and 45% were males. The identified risk factors for suicide attempt were, presence of psychiatric illness (OR-7.8; 95% CI: 3.3-19), substance abuse among family members (OR-4.3; 95% CI: 2-9.3), family history of attempted suicide (OR-7.2; 95% CI: 1.5-3.3), family history of completed suicide (OR-3.6; 95% CI: 1.2-1.1) and residence at rural areas (OR-2.8; 95% CI: 1.2 – 6.3). Suicide intent score was significantly correlated with various standard scoring tools for stress and depression among cases. Conclusion: The established risk factors should be considered in creating an effective intervention program and strategies with intersectoral collaboration and coordination to prevent suicide among high-risk adolescents. Keywords: Adolescent, Attempted suicide, Case-control study, Risk factors.

Adolescence and Gender Equality in Health

Adolescence and Gender Equality in Health

Prospective prediction of suicide attempts in community adolescents and young adults, using regression methods and machine learning

BackgroundThe use of machine learning (ML) algorithms to study suicidality has recently been recommended. Our aim was to explore whether ML approaches have the potential to improve the prediction of suicide attempt (SA) risk. Using the epidemiological multiwave prospective-longitudinal Early Developmental Stages of Psychopathology (EDSP) data set, we compared four algorithms—logistic regression, lasso, ridge, and random forest—in predicting a future SA in a community sample of adolescents and young adults. MethodsThe EDSP Study prospectively assessed, over the course of 10 years, adolescents and young adults aged 14–24 years at baseline. Of 3021 subjects, 2797 were eligible for prospective analyses because they participated in at least one of the three follow-up assessments. Sixteen baseline predictors, all selected a priori from the literature, were used to predict follow-up SAs. Model performance was assessed using repeated nested 10-fold cross-validation. As the main measure of predictive performance we used the area under the curve (AUC). ResultsThe mean AUCs of the four predictive models, logistic regression, lasso, ridge, and random forest, were 0.828, 0.826, 0.829, and 0.824, respectively. ConclusionsBased on our comparison, each algorithm performed equally well in distinguishing between a future SA case and a non-SA case in community adolescents and young adults. When choosing an algorithm, different considerations, however, such as ease of implementation, might in some instances lead to one algorithm being prioritized over another. Further research and replication studies are required in this regard.

Effectiveness of a school-based mental health education program in an impoverished urban area of Peru.

This study aimed to evaluate the effectiveness of a school-based mental health education program in preventing adolescent suicide attempts in an impoverished urban area in Peru, as part of an Official Development Assistance project by the Korea International Cooperation Agency. The PRECEDE-PROCEED model informed the effectiveness study. In this intervention, the participants were first to fifth grade students in public secondary schools. The pre-post intervention survey was conducted with a stratified random sampling method. A sample of 768 and 738 students in experimental and control groups was analyzed comparatively, using chi-squared tests and logistic regression. This study found that the program had a positive effect on adolescent mental health-related risk behaviors and suicide attempts in the experimental group compared to the control group. Thus, the intervention may have helped prevent the increase in mental health-related risk behaviors and suicide attempts. Further, parental affection, when included in the intervention, had a significant effect on suicide attempts. As such, the involvement of parental affection in the intervention might be effective in preventing suicide attempts. To enhance the effectiveness of interventions aiming to prevent adolescent suicide, the participation and attention of parents, as well as adolescents, must be encouraged. Further, to maintain the effectiveness of the intervention and expand coverage to other schools in the neighborhood, a strategy for project sustainability is needed, particularly with regards to capacity-building in schools and communities.

Recent advances in understanding and managing self-harm in adolescents.

Adolescent suicide is a serious public health problem, and non-suicidal self-injury (NSSI) is both highly comorbid with suicidality among adolescents and a significant predictor of suicide attempts (SAs) in adolescents. We will clarify extant definitions related to suicidality and NSSI and the important similarities and differences between these constructs. We will also review several significant risk factors for suicidality, evidence-based and evidence-informed safety management strategies, and evidence-based treatment for adolescent self-harming behaviors. Currently, dialectical behavior therapy (DBT) for adolescents is the first and only treatment meeting the threshold of a well-established treatment for self-harming adolescents at high risk for suicide. Areas in need of future study include processes underlying the association between NSSI and SAs, clarification of warning signs and risk factors that are both sensitive and specific enough to accurately predict who is at imminent risk for suicide, and further efforts to sustain the effects of DBT post-treatment. DBT is a time- and labor-intensive treatment that requires extensive training for therapists and a significant time commitment for families (generally 6 months). It will therefore be helpful to assess whether other less-intensive treatment options can be established as evidence-based treatment for suicidal adolescents.

4.31 TRENDS OVER 2 DECADES IN ADOLESCENT SUICIDAL AND RECREATIONAL INGESTIONS OF OVER-THE-COUNTER DEXTROMETHORPHAN PREPARATIONS

We sought to identify trends in overdoses with over-the-counter (OTC) dextromethorphan (DXM) cough preparations among adolescents from a national poison center surveillance database. Our objective was to identify both severity of outcomes and trends in adolescent suicide attempts with OTC DXM cough preparations.

35.4 BORDERLINE PERSONALITY FEATURES AND HISTORY OF PRIOR SUICIDE ATTEMPTS DEFINE A SEVERITY GRADIENT IN ADOLESCENT SUICIDE ATTEMPTERS: EVIDENCE FROM A LARGE CROSS-SECTIONAL STUDY OF ADOLESCENT INPATIENTS

Adolescent suicide is a significant public health concern. Borderline personality disorder (BPD) and history of suicidal behaviors have been shown to be high predictors for subsequent suicide attempts (SA). However, no previous study examined how both factors interact to modify clinical and suicidal severity in adolescents. This study presents a comprehensive assessment of adolescent inpatient suicide attempters, allowing testing clinical interactions between BPD features and number of prior suicide attempts.

Adolescent self-harm and suicidal behavior and young adult outcomes in indigenous and non-indigenous people.

The aim of this study was to examine the associations between self-harm and suicidal behavior in indigenous Sami and non-Sami adolescents and mental health and social outcomes in young adulthood. Data were obtained by linking the Norwegian Patient Registry (2008-2012), the National Insurance Registry (2003-2013), and the Norwegian Arctic Adolescent Health Study, a school-based survey inviting all 10th grade students in North Norway (2003-2005). In total, 3987 (68%) of all 5877 invited participants consented to the registry linkage, of whom 9.2% were indigenous Sami. Multivariable logistic regression was used to explore the associations between self-harm only, suicidal ideation with and without self-harm, and suicide attempts in adolescence (≤16-year-old), and later mental health disorders, long-term medical, social welfare benefit receipt, or long-term unemployment in young adulthood. Self-harm and suicidal behavior in Sami and non-Sami adolescents were associated with increased risk of later mental health disorders, long-term welfare benefit receipt, and long-term unemployment. These associations were attenuated by adolescent psychosocial problems. No major differences between the indigenous Sami participants and their non-Sami peers were found. Young suicide attempters experienced the highest risk, with adolescent suicide attempts being significantly associated with all four adult outcomes after adjustment. Self-harm and suicidal behavior in adolescence are markers of mental health disorders and unfavorablesocial outcomes in young adulthood, mostly accounted for by adolescent psychosocial problems. In contrast to other indigenous peoples, no indigenous health disparities were found, indicating that the indigenous Sami adolescents were not worse off.

Self-harm as a predisposition for suicide attempts: A study of adolescents' deliberate self-harm, suicidal ideation, and suicide attempts

The aim of this study was to analyze the predictive risk factors for self-harm in adolescents with and without suicidal ideation. 600 adolescents answered a questionnaire about self-harm and suicidal behaviors. A logistic regression analysis was conducted. Over half of the individuals with deliberate self-harm (DSH) presented significant suicide risk. There was a direct association between DSH and suicide attempts, with almost the totality of the adolescents with suicide attempts also reporting DSH. According to the prediction model, suicidal ideation and diversity of DSH behaviors are significant predictors of suicide attempts, with an augmentation in the diversity of DSH behaviors and suicidal ideation predicting suicide attempts. Depression and anxiety appeared also as significant predictors of suicide attempts in adolescent self-harmers. Considering that the majority of the sample was not from a clinical setting, an alarming finding was that one third of the total sample was at suicide risk. These results place DSH as a key variable for early intervention.

Association between Attention Deficit Hyperactivity Disorder and Suicide Attempts in Patients with Bipolar Disorder

Objective: The present study aimed to examine the association between ADHD and suicide attempts among adolescents with bipolar disorder. Method : Participants were 168 adolescents who fulfilled DSM-IV-TR criteria for bipolar disorder. They were divided into 2 groups: The first group of patients with bipolar disorder with a history of suicide attempts (n = 84) and the second group without a history of suicide attempts (n = 84). ADHD and other variables were analyzed using a chi-squared test and logistic regression model. Results: No significant difference was observed between the 2 groups in comorbidity of ADHD and other psychiatric disorders (P > 0/05). In the logistic regression model, and after controlling for other factors, gender (OR = 3.9, CI 95%: 1.5-9.6) and history of sexual abuse (OR = 3.4; CI 95%: 1.06-11.3) were the only 2 factors associated with a history of suicide attempts. Conclusion: No significant association was found between ADHD and suicide attempts in adolescents with bipolar disorder.

Association of emotional and behavioral problems with single and multiple suicide attempts among Chinese adolescents: Modulated by academic performance

BackgroundThere were differences in the characteristics and prevalence rates between individuals with a history of one suicide attempt and those with multiple suicide attempts. This large-scale study was conducted to test, among Chinese adolescents, the associations of emotional and behavioral problems with single and multiple suicide attempts and whether these associations vary with adolescents’ academic performance. MethodsData were drawn from the 2019 School-based Chinese Adolescents Health Survey (n = 20,702). Information about emotional and behavioral problems, suicide attempts, suicidal ideation, academic performance, and sleep duration was gathered. Multinomial logistic regression models using Firth penalized likelihood approach and appropriate sampling weights were performed. ResultsCompared with no suicide attempt, peer problems, emotional problems, conduct problems, and hyperactivity were associated with an elevated risk of both a single suicide attempt and multiple suicide attempts, respectively (P < 0.05); the magnitudes of these associations in multiple suicide attempters were higher than those in single suicide attempters. Further stratification analyses by academic performance showed a greater association of the four difficulties with multiple suicide attempts in adolescents reporting poor academic performance than in those with good or average academic performance. LimitationsThe school-based study sample only included students, and causal inference could not be delineated due to the cross-sectional design. ConclusionsEmotional and behavioral problems are associated with an elevated risk of single and multiple suicide attempts with differences between multiple suicide attempters and single suicide attempters. Adolescent academic performance plays a modulating role in these associations for multiple suicide attempts.

Characteristics of adolescents who visit the emergency department following suicide attempts: comparison study between adolescents and adults

BackgroundThe purpose of this study was to identify the demographic and clinical characteristics of suicide attempts in adolescents who visit the emergency department compared to those of adults.MethodsThis study included 149 children under the age of 18, and 1427 people in the age of 19–65 who came to the emergency department with suicide attempt from 2009 to 2015. We compare sociodemographic, clinical, and suicide attempt-related characteristics through Chi-square test and logistic regression analysis to evaluate the difference between two groups.ResultsIn adolescents, suicide attempters had more number of previous suicide attempt history than adults. Adolescents used more non-lethal method such as poisoning of over the counter drugs and had about 5 times higher odds ratio in suicide attempts with analgesics. The motivation of suicide attempt among adolescents was more related with interpersonal problems but less with financial or illness-related problems. The intention of suicide attempt in adolescents was less serious and lethal compared to adults.ConclusionSuicide attempts among adolescents had showed different from adults in method, motivation and intention. Considering the characteristics of suicide attempt among adolescent, it is necessary to keep close attention to adolescent’s suicide attempters and develop the customized intervention program to prevent the suicide attempt in this groups.

Adolescent Suicide Attempt Prevention: Predictors of Response to a Cognitive-Behavioral Family and Youth Centered Intervention.

Suicide is a leading cause of adolescent death. Recent data support the efficacy of cognitive-behavioral treatments with strong family components for reducing suicide risk; however, not all youth benefit from current interventions. Identifying predictors of treatment response can inform treatment selection and optimize benefits. This study examines predictors of response to a DBT-informed cognitive-behavioral family treatment (SAFETY), among 50 youth with recent suicide attempts/self-harm. Youth and parents were assessed at baseline and post-treatment. Results indicated medium-to-large effect sizes for SAFETY on youth suicidal behavior (SB; defined as suicide attempts, aborted attempts, and planning), depression, hopelessness, social adjustment, and parental depression. Classification tree analysis, with a correct classification rate of 93.3%, and follow-up logistic analyses indicated that 35% of youths reporting active SB at baseline reported active SB at post-treatment, whereas post-treatment SB was rare among youths whose active suicidality had resolved by the baseline assessment (5%). Among youths reporting baseline SB, those endorsing sleep problems were more likely to report post-treatment SB (53%) versus those without sleep problems (0%). These findings highlight the potential value of personalized treatment approaches based on pretreatment characteristics and the significance of baseline SB and sleep problems for predicting treatment response.

Characteristics associated with depression and post-traumatic stress disorder among childhood sexual abuse women

A significant proportion of childhood sexual abuse victims suffer from psychological sequelae in adulthood. Factors that provide a better understanding for the reasons why some victims develop these sequelae remain under-explored. In this context, the main objective is to examine the specific contribution of the contextual characteristics of childhood sexual abuse, multitype childhood maltreatment and adolescent suicide attempts on the development of depression and post-traumatic stress disorder in adulthood among sexually abused women as children. A secondary objective aimed to establish the prevalence of various forms of childhood maltreatment, adult onset post-traumatic stress disorder and depression among those women. The sample included 479 women victims of childhood sexual abuse who participated in two separate surveys taken by women in the province of Quebec. More than half of these women reported at least one other form of childhood maltreatment, 30% of them presented post-traumatic disorder and 40% suffered from depression in adulthood. Regression analysis indicates that post-traumatic stress disorder was associated with early onset childhood sexual abuse and intergenerational continuity of sexual victimization, as well as childhood physical maltreatment and negligence. Depression was associated with childhood psychological maltreatment and negligence, a non-supportive response following child sexual abuse related disclosure and suicide attempt in adolescence. These results confirm the need to consider the cumulative effects of various childhood adversity factors in the psychosocial assessment of sexually abused women in early life, thus helping to better understand and treat their psychological sequelae.

Social media, internet use and suicide attempts in adolescents.

Purpose of reviewSuicide is the second leading cause of death in youth aged 10–24 years old globally, but detecting those at risk is challenging. Novel preventive strategies with wide influence across populations are required. Interest in the potential for both detrimental and supportive influences of social media/internet use on suicidal behaviour has been growing; however, the relationship remains unclear.Recent findingsA systematic search of articles from database inception up to 25 January 2019 across five databases: Medline, PsycINFO, EMBASE, HMIC and CINAHL revealed nine independent studies investigating social media/internet use and suicide attempts in young people less than 19 years old (n = 346 416). An independent direct association was found between heavy social media/internet use and increased suicide attempts in seven studies (adjusted ORs ranged from 1.03 to 5.10), although adjusting for cyberbullying victimization and sleep disturbance reduced the strength of this association. Two studies found that some social media/internet use, versus no use, may be associated with fewer suicide attempts. There were no studies investigating the relationship between social media/internet use and completed suicide.SummaryThere is an independent association between problematic use of social media/internet and suicide attempts in young people. However, the direction of causality, if any, remains unclear. Further evaluation through longitudinal studies is needed.